by Gabriel Daniel, SIAPS Principal Technical Advisor
Onchocerciasis, lymphatic filariasis and schisotomiasis are among a group of illnesses known as neglected tropical diseases (NTDs) that are not commonly heard of which affect over millions of people globally who live in poverty and have poor access to basic needs such as clean water. They can cause blindness, contribute to mother and child illnesses, and cause disfigurement, damage physical and cognitive development, rendering their victims unable to participate in everyday life – even limiting a child from attending school.
Seven of the most common NTDs can be treated and controlled by using preventive chemotherapy, largely donated by philanthropic pharmaceutical companies, which involves the use of mass drug administration (MDA). Access to such medicines, however, is not always smooth process due to weaknesses in supply chain management and logistics information systems. In other words, the timely distribution, proper storage, handling, recording and reporting of the medicines is a challenge leading to less than optimal operation of the logistics system.
The Pharmaceutical Supply Management System
In order to safeguard those infected with NTDs who need preventive chemotherapy have access to treatment, robust drug management and supply chains are required to make certain high quality NTD medicines are available when and where they are needed. Efficient and cost-effective donation management and MDA efforts call for a specific set of pharmaceutical management interventions known as supply chain management.
The pharmaceutical supply management system itself consists of forecasting, procurement, storage, distribution, use, inventory control and quality assurance activities that ensures access to effective and safe products to the patient. This approach can effectively be applied to and enhance the uninterrupted availability and proper use of NTD medicines by integrating it into the national medicines supply system.
Distribution and Storage
The supply chain and logistics information system aspects are largely connected to central medical stores (CMS) within countries. In some instances, NTD medicines distribution is managed by the CMS who distribute them along with essential medicines. However, it is difficult to respond to time-sensitive MDA requirements if they are distributed on the same schedule as other essential medicines.
Additionally, storage conditions at various levels including district stores and health facilities often do not meet medicines and supply storage standards, meaning the stability and safety of drugs can be compromised. At the same time, undistributed or unused medicines are not returned back to the center medical stores or are not redistributed to other areas in the country where there could be a shortage.
Strengthening the NTD Pharmaceutical Supply Chain
Building an integrated NTD pharmaceutical supply chain and rational use approach will require strengthening the capacity of the pharmaceutical supply sector to ensure better understanding of the unique demands of the NTD program so that the central medical store system can comprehensively manage NTD products and respond effectively to NTD program needs.
Full integration can be achieved by more active engagement of the national supply chain pharmaceutical sector in the management of NTD products to enhance efficient use of resources, bring professional expertise to the forefront and added value to the global and national NTD effort. This win-win situation can give the NTD program management the time and energy to focus on its core NTD programmatic matters leaving the supply chain task to the pharmaceutical service unit where such expertise resides.
SIAPS works to build capacity in holistic medicines management system, harmonize the integration of medicines supply chain with the national supply chain system, strengthen pharmacovigilance to ensure patient safety and promote treatment acceptance, ensure uninterrupted supply and operationalize a functional management information system for better forecasting of needs and inventory control.
SIAPS is striving to assure access to quality pharmaceutical products and effective pharmaceutical services at all levels in developing countries to achieve positive and sustainable health outcomes.
