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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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Supporting drug and therapeutics committees in Sierra Leone to promote safe, appropriate medicine use

Irrational medicine use and poor pharmaceutical management at all levels are widespread problems in many developing countries, including Sierra Leone. Misuse, underuse, and overuse of medicines; weak systems that compromise medicine safety; the waste of scarce resources due to expiry; and the rise of antimicrobial resistance (AMR) are particularly worrying because they directly affect health outcomes. Because of a lack of sound data for decision making, health workers may need to select products for medicines lists, supply, and prescribing based on observation and preferences. SIAPS is facilitating the selection of appropriate, safe products to be procured and used at different levels of the public health system. Promoting rational medicine use cuts down on waste, improves health outcomes, and helps prevent the spread of AMR.

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Supportive Supervision and Mentorship Site Visit for Pharmacy Services in the Shiselweni Region, Swaziland

With support from SIAPS and in collaboration with other development partners, the Central Medical Stores (CMS) conducts supportive supervision and mentorship (SSM) visits to health facilities. Through these visits, the capacity of health personnel is built to effectively manage pharmaceuticals and services, improve the rational use of pharmaceuticals, and strengthen supply chain management at all levels of health care delivery.

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Mozambique Drug and Therapeutics Committee Workshop: Technical Report

Inefficient and irrational use of medicines is a well-documented problem in both developed and developing countries. It leads to cost increases and adverse clinical effects for patients. The inappropriate use of medicine can be reduced if health care professionals involved in the different aspects of medicine use promote good practices for medicine management and use. An appropriate forum for the development and implementation of medicine policies is the Drug and Therapeutics Committee (DTC).

In Mozambique, the establishment of hospital DTCs was officially requested by the Ministério da Saúde (MISAU) (Ministry of Health) in the document The Departamento de Farmacia Hospitalar (DFH) (Department of Hospital Pharmacy) in the Direcção Nacional de Assistência Médica (National Directorate of Medical Assistance) of MISAU also took on the establishment of hospital DTCs as a priority intervention to improve the appropriate use of medicines at the hospital level. SIAPS has provided technical assistance to assist hospitals in establishing DTCs to improve medicine use, and in the collection and analysis of medicine use information for decision making as part of its support to counterparts in the pharmaceutical sector.

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Technical Brief: Building Pharmaceutical Management Capacity in South Sudan

South Sudan’s health system is struggling to overcome a myriad of challenges, including poor pharmaceutical supply management practices, weak infrastructure, and inadequate skilled manpower. The outbreak of civil unrest in the nascent nation in December 2013 further exacerbated the already dire situation. South Sudan has one of the highest maternal mortality rates in the world, estimated at 789/100,000 live births. The country’s HIV prevalence rate increased from about 2% in 2000 to 2.6% in 2015 among adults, according to the South Sudan HIV/AIDS Commission and Ministry of Health. As of 2014, only 6% of 15 million people living with HIV were on antiretroviral therapy (ART).

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Technical Brief: Strengthening Drug and Therapeutics Committees to Promote Rational Medicine Use in Mozambique

Mozambique is one of the poorest countries in the world, with approximately 70% of the population living below the poverty line. Many women and children are unable to access essential health services and medicine due to inadequate geographic coverage, financing, and available health professionals. Neonatal mortality is 30 deaths per 1,000, and under-five mortality is 90/1,000. Malaria accounts for approximately 26% of hospital deaths. Dual infections of tuberculosis (TB) and HIV and the threat of increasing multidrug-resistant TB complicate the national TB program response. To support priority programs such as HIV prevention and treatment and maternal and child health, Mozambique’s Ministry of Health and SIAPS are establishing Drug and Therapeutics Committees (DTCs) and training committee members to improve medicine management and use, thereby helping to achieve good health outcomes.

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Methodology for the Rapid Review and Updating of Lists of Medicines in the Dominican Republic

The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program proposed a methodology for reviewing lists of essential medicines (LEM) and formularies, with the potential to achieve optimum results in short periods of time and with a minimal investment of resources. The methodology consisted of identifying an expert international pharmacologist with experience in the LEM process and the following procedural steps: Design of an instrument for drafting the proposal, drafting and review of proposal by the expert, and national workshop to review and validate the proposal.

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Technical Brief: Strengthening the Leadership and Management of Pharmaceutical Services in South Africa

South Africa’s health system is under enormous strain. There is a sizeable and increasing number of people with chronic diseases, both communicable and noncommunicable. The country has the largest population living with HIV, estimated at 7 million; an HIV prevalence rate of 19.2%; and 180,000 HIV-related deaths in 2015. South Africa has the highest number of people on HIV treatment—nearly 2.6 million—and has committed to nearly doubling that number in the next few years. It also has a significant burden of tuberculosis (TB), including multi- and extensively-drug resistant TB.

According to the World Health Organization, South Africa ranks third in terms of TB burden, after India and China.3 There is also high maternal, neonatal, and child mortality. In partnership with civil society and development organizations, the country has made significant strides in reducing the tide of HIV, AIDS, and TB, thereby contributing to an increase in life expectancy. Nevertheless, the effectiveness and efficiency of the country’s health system remain a huge challenge. The burden of communicable and non-communicable diseases and the rapidly growing patient population have considerable implications for the delivery of pharmaceutical services.

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The Role of PTCs in Using Financial Resources Efficiently in South Africa

Using the pharmaceutical systems strengthening approach, SIAPS supported the GPPTC in three critical systems-strengthening areas. First, SIAPS facilitated the development and approval of provincial guidelines to establish pharmaceutical and therapeutics committees (PTCs) at all health facilities in Gauteng Province. The guidelines reinforce the governance mechanisms supporting the PTCs, outlining expected compliance to procurement practices and assessing pharmaceutical expenditures. Second, SIAPS strengthened human resources capacity through the implementation of a workshop on financial management for pharmacists, carried out in tertiary hospitals and at the district level. Third, SIAPS strengthened information systems through the implementation of financial reporting software at the depot level.

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RxSolution: An Electronic Inventory and Patient Management Tool Improves Access To and Rational Use of Medicines

Over the past three years, SIAPS has expanded the use of RxSolution to a total of 350 sites across South Africa. SIAPS is also developing numerous customized modules and modifications to meet the specialized needs of different clinical settings including expanded functionality for barcode tracking, biometric monitoring, and mobile phone applications.

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