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Lucky Specials Brings Focus to TB Awareness Week in Namibia

Theresia Cloete was diagnosed with tuberculosis (TB) in 2002. She was put on treatment but after four months stopped taking her TB medication. Last year, she was diagnosed with drug-resistant TB. Like Cloete, many TB patients stop taking their life-saving medication before they are cured. She is now one of eight in-patients waiting for stabilization […]

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SIAPS Voices Q&A: No time to waste in preventing AMR

As part of World Antibiotic Awareness Week 2017, we present a Q&A with Mohan P. Joshi, MBBS, MSc, MD, SIAPS principal technical advisor. Dr. Joshi is responsible for providing technical guidance and support in the planning and implementation of rational medicine use and antimicrobial resistance (AMR)-related activities.  Are there new AMR threats that are particularly worrying? […]

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The Antimicrobial Resistance Challenge: No Room for Complacency

A presentation by Mohan P. Joshi, Principal Technical Advisor and Lead for Pharmaceutical Services, SIAPS, at USAID in Arlington, VA on November 9 2017.

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HIV/TB Pharmaceutical Management Training in Swaziland to Improve Medicine Availability and Rational Use

An off-site training was held for 104 pharmacy personnel (32 males, 72 females) responsible for managing HIV and TB medicines in 88 health facilities in the 4 regions around the country. SIAPS supported the training, which included pharmacists, pharmacy technicians, and nurses. The trainings took place over August 7–17, 2017, and each region was trained […]

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Pediatric Antiretroviral Treatment Uptake, Treatment Adherence, Regimen Switches, and Retention in Care in Namibia

In Namibia, a preliminary review of EDT records suggests that children form a small proportion of the patients accessing ART in any given setting, nationally composing 8% of the patients on ART in the MoHSS facilities. Over the years, managing children has been complicated with formulations that have not been friendly for children, complicated regimens, and occasional stock-outs of pediatric ARVs. These challenges may increase the number of children that might receive suboptimal care, including delayed or no interventions in face of poor adherence, ultimately leading to suboptimal response to treatment. This can then increase the risk of HIV drug resistance and leads to short survival of HIV-infected children. Findings from this assessment will provide much needed evidence on trends in pediatric HIV treatment uptake, levels of adherence, and retention among those on treatment. Ultimately, the evidence generated will support MoHSS policy makers and leaders in modifying and strengthening interventions aimed at enhancing treatment uptake, adherence, retention, and viral load suppression among HIV-infected children in Namibia.

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The Economic Cost of Non-Adherence to TB Medicines Resulting from Stock-Outs and Loss to Follow-Up in the Philippines

A key element of successful tuberculosis (TB) control programs is adherence to treatment. Non-adherence results in increased length and severity of illness, death, disease transmission, and drug resistance. The purpose of this study was to estimate the morbidity and mortality impact and economic costs of non-adherence to TB medicines resulting from treatment interruption due to stock-outs or loss to follow-up (LTFU).

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The Economic Cost of Non-adherence to TB Medicines Resulting from Stock-outs and Loss to Follow-up in Kenya – Research Summary

One of the key elements of successful tuberculosis (TB) control programs is adherence to treatment, which is a cornerstone of most international and national policies and guidelines. Non-adherence results in increased length and severity of illness, death, disease transmission, and drug resistance. Treatment interruption is often due to patient-related factors—classed as loss to follow-up (LTFU)—but can also be a result of provider issues, such as stock-outs of medicines. The purpose of this study was to estimate the morbidity, mortality, and economic impact of TB treatment interruption due to stock-outs and LTFU. The results are expected to help promote the benefits of ensuring the availability of good quality medicines and of undertaking interventions to reduce LTFU.

For the full report, please follow this link.

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The Economic Cost of Non-adherence to TB Medicines Resulting from Stock-outs and Loss to Follow-up in Kenya

One of the key elements of successful tuberculosis (TB) control programs is adherence to treatment, which is a cornerstone of most international and national policies and guidelines. Non-adherence results in increased length and severity of illness, death, disease transmission, and drug resistance. Treatment interruption is often due to patient-related factors—classed as loss to follow-up (LTFU)—but can also be a result of provider issues, such as stock-outs of medicines. The purpose of this study was to estimate the morbidity, mortality, and economic impact of TB treatment interruption due to stock-outs and LTFU. The results are expected to help promote the benefits of ensuring the availability of good quality medicines and of undertaking interventions to reduce LTFU.

For the research summary, please follow this link.

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Every Breath Counts: Strengthening Pharmaceutical Systems for Better Health Outcomes with Pneumonia

By Jane Briggs, Principal Technical Advisor More than 900,000 children die of pneumonia each year (more than malaria, measles, and HIV/AIDS combined), according to the World Health Organization. Many of these cases go undiagnosed and untreated. How can this be when we know what works? A five-day, twice-daily amoxicillin regimen—in either dispersible tablet (DT) or oral […]

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Systems-based Approaches to Improving Medication Adherence

With the shift from a disease landscape that focuses on the treatment of acute and short-term illnesses to one that faces an increasing burden of chronic diseases that may require life-long medicine use, the role of medicines in ensuring a healthy population is more important than ever.

However,even when medicines are available, patients may not take them as directed. In other words, they may not adhere to the treatment prescribed to them. This problem is surprisingly widespread. Several studies have estimated that in developed countries, only approximately 50% of patients who suffer from chronic diseases take their medicines as directed.

This document suggests a health systems strengthening (HSS) approach to addressing
medication adherence issues, with a particular emphasis on its application in low- and middle-income settings. Chapter 2 reviews the importance of considering health systems in improving medication adherence and introduces a system-based framework, while Chapters 3–5 discuss approaches, interventions, and activities that span the health system as described at the
macro, meso, and micro levels and provide implementation examples.

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