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

WHO MEDICINES STRATEGY 2004-2007 | 72EO 4.1Supply systems assessed andsuccessful strategies promoted toidentify strengths and weaknessesin the supply systems and improvethe performance and functioning ofnational medicines supply systemsRationaleMany countries have to contend with a twintrackmedicines supply system — comprising anoften inefficient public medicine supply systemintended to serve the entire country and a varietyof private supply systems serving mostly urbanareas. Recent experience indicates that medicinesupply systems are most effective when they arebased on an appropriate mix of public, private,and NGO procurement, storage, and distributionservices.Public medicines supplysystems are not meeting eitherthe demands or the needs ofcountriesProblems include:> organizational structure and financialmechanism are rigid and inadequate> capital and budget allocations areinsufficient for a well-functioningsystem> number and/or capacity of supply staffare not sufficient to fulfil the tasks> no career development or incentivestructure> procurement procedures are nottransparent and efficient> government interference.The CMS strategy has been successful only wherepublic funding is substantial and sustainable, andwhere the economy has been stable. This is notthe case in most developing countries. As a resultof health sector reforms, a number of differenttypes of supply strategies have evolved out of thehighly centralized public sector supply system.These vary considerably in relation to the role ofthe government, the role of the private sector, andthe use of incentives to boost efficiency.ProgressInnovative approaches to public and privatesupply systems have been adopted in countriessuch as Benin and other West African countries,Colombia, Guatemala, the Newly IndependentStates (NIS) of East and Central Europe, SouthAfrica, and Thailand. 37 These reflect differentcombinations of public and private, centralized,and decentralized approaches. The potential toimprove access through private sector channelshas also been demonstrated in countries asdiverse as Indonesia, Kenya, and Nepal. WHOhas supported developments in supply systemsin the NIS countries and the Balkan Region andprovided training to improve the effectiveness ofsupply systems in Peru and Colombia.Elsewhere, alternative supply mechanisms suchas regional and sub-regional bulk purchasingschemes have been successfully adopted bythe Gulf Cooperation Council and by theOrganization of Eastern Caribbean StatesPharmaceutical Procurement Service whichoperate pooled procurement systems for six andeight countries respectively.