who medicines strategy - libdoc.who.int - World Health Organization

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WHO MEDICINES STRATEGY 2004-2007 | 70Efforts by WHO and other partners to scale upaccess to essential medicines for priority diseaseshave refocused attention on the need to ensurethe effectiveness of medicine supply systems.Reliable supply systems are vital 33 in order toensure that health commodities and medicaland pharmaceutical services are delivered topatients in accordance with acceptable qualitystandards, and to guarantee uninterrupted servicesand supply. A well-coordinated supply systemwill ensure that public funds available for drugpurchases are used effectively to maximizeaccess, obtain good value for money, and avoidwaste. This in turn will increase confidencein health services and promote attendance bypatients. However, good coordination betweenthese central elements of the supply system iscritical. Failures at any point in the medicinessupply system can lead to life-threateningshortages and to waste of limited resources.Therefore monitoring and evaluation of medicaland pharmaceutical services are essential toensure that any major weaknesses are identifiedand addressed.Many developing countries continue to strugglewith inefficient public supply systems unableto meet the demands of their health caredelivery objectives or the expectations of healthworkers and the general public. In response,governments have tried to introduce market forcesinto public medicine supply systems/centralmedical stores (CMS). The aim was to improveboth the efficiency and quality of services byintroducing private sector management featuresin the public medicines supply structure. Inmany countries, public sector managementperformance is characterized by low wagesunrelated to performance, limited motivation,inflexible personnel policies and inefficientadministrative and financial procedures. Bycontrast, private sector management is morelikely to be characterized by performance-basedwages, more flexible personnel policies, andstreamlined administrative procedures. The roleof governments is to ensure that both public andprivate pharmaceutical sectors are able to supplysufficient quantities of safe, effective drugs, whichare of good quality and affordable. The challengeis to find a balance between public healthobjectives and economic realities.The supply of medicines in emergency situationsposes an additional challenge. The worldcommunity is usually quick to send largeand often unsolicited donations of drugs andmedical supplies — some of which can be ofgreat help and save lives, but others which can
COMPONENTS OF THE STRATEGY | 71Figure 19:Reliable health and supply sytems – successful examples exist in all regions***Regional bulk purchasing – centralized, multi-countryDirect delivery system – privatized, centralized*Primary distributor system – privatized, centralizedAutonomous medical stores – partly private,do more harm than good. In response, in 1998WHO worked together with a large group ofinternational humanitarian aid agencies todevelop a standard kit of essential medicines,supplies, and basic equipment, ready for dispatchwithin 24 hours, for use in the first phase of anacute emergency involving large populationmovements or a sudden influx of refugees.In addition, interagency guidelines for drugdonations have been developed (1999) to helpguide donors and recipients 34 . In 2003, WHOalso published interagency guidelines for pricediscounts of single-source pharmaceuticals 35 .ProgressGovernments have developed strategies toincrease private sector involvement in theCMS system to improve their efficiency andperformance, such as divestiture, introductionof private management features, and contractingout of services. In doing so, governments hadto take into account the country’s capacitiesand economic realities as well as the possibleinvolvement of the private sector. Stronggovernment commitment and appropriate actionsappears to be essential for successful reformimplementation 36 . Examples of country progresscan be found in EO 4.1.WHO will support countries torun efficient and secure systemsfor medicines supply managementin both the public and privatesectors to ensure continuousavailability and delivery ofmedicines at all levels of thedistribution chain.
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REFERENCES | 1471Annual report 2000
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