How can we save women and children without access to medicines? A country-level analysis of pharmaceutical systems and policies

Session: Commodities and Medicines: Improving Access and Availability

Presenter: Jane Briggs, Management Sciences for Health
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Background: As the deadline nears, many countries are still struggling to scale-up interventions in pursuit of Millennium Development Goals (MDGs) 4 and 5. While we know which essential RMNCH medicines and commodities are required for these interventions, a critical component is ensuring that women and children have access to them and that they are used appropriately. Progress toward the MDGs is being tracked; however, this analysis documents the status of pharmaceutical management policies and systems related to specific RMNCH medicines and supplies needed to achieve the MDGs and stresses areas to strengthen if priority RMNCH countries are to improve access.

Methodology: We developed a set of key indicators related to national level pharmaceutical policy, regulations, procurement, financing, supply chain management, and logistics management information systems and analyzed data from two World Health Organization surveys: the first looked at RMNCH policies and systems issues across the 75 countdown countries, and the second focused on pharmaceutical regulatory and procurement issues from a subset of countries.

Results: Across a subset of priority RMNCH countries, we found incoherent policy guidelines, weak regulatory systems, such as products not being registered, weak systems for monitoring quality of medicines, stock outs at central level, weaknesses in distribution, and lack of decision-making data. These challenges can lead to the availability of poor quality medicines or no medicines being available at all.

Conclusion: Access to quality RMNCH commodities is put at risk without, for example, harmonized guidelines, solid quality assurance measures and supply planning. Strengthening national pharmaceutical systems is essential in order to avoid this risk.