Last Mile, Last Patient: The Challenges of Supplying Antimalarial Medicines in Low-incidence Settings

By Edgar Barillas, Portfolio Manager; and Claire Dunn, Senior Project Associate Many countries in Central and South America have made significant progress toward eliminating malaria. Between 2000 and 2012, 13 countries in the Americas saw malaria incidence rates drop by more than 75%.[1] Argentina, Belize, Costa Rica, Ecuador, El Salvador, Mexico, and Paraguay have all … Read more

Better Treatment Outcomes through Patient-Centered Pharmaceutical Care

“USAID/SIAPS did a great job in helping us to establish a pharmaceutical care unit for patients suffering from chronic illnesses.” –Mr. Tariku Belachew, CEO of Debre Marcos Hospital Debre Markos Referral Hospital, like most referral hospitals in Ethiopia, faced major challenges in medication adherence for patients who were suffering from chronic non communicable diseases such … Read more

Nairobi pharmacovigilance conference highlighted in FDA video

Pharmacovigilance Conference Featured by FDA

The May PV conference in Nairobi, hosted by USAID’s SIAPS Program and the Food and Drug Administration, has generated continued interest in patient safety and associated issues in Africa.

Please follow the link below to see Dr. Gerald Dal Pan, acting director for the Office of Surveillance and Epidemiology in FDA’s Center for Drug Evaluation and Research, highlight a recent example of FDA’s efforts to transform from a domestic to a truly global agency. He describes a meeting in Nairobi, Kenya, with the U.S. Agency for International Development (USAID) to share tools and best practices with African regulators on drug safety.

Pharmaceutical Leadership Development Program Piloted in South African Provinces

Facilitators Tumi Molongoana and Sue Putter engage the Bona Bona Team in Workshop 2 of the Free State – Northern Cape Group October 2011 (Photo credit: Ian Thiessen/MSH)

Pharmacy managers in South Africa are often overwhelmed trying to address several daunting workplace challenges at once, such as making sure there is an adequate supply of pharmaceuticals managing efficient quantification of needs and ensuring the optimal use of medicines. Through the Pharmaceutical Leadership Development Program (PLDP) developed by the USAID-funded Strengthening Pharmaceutical Systems (SPS) Program, led by Management Sciences for Health (MSH), however, they now have the opportunity to apply leadership and management principles to better develop actionable and measurable results.

Launched last year by the SPS Program, the PLDP presents a novel approach by combining pharmaceutical management knowledge and sound leadership practices to better equip pharmacy managers to respond to challenges in their workplace.

PLDP is structured into five workshops which are held at monthly intervals. Working in teams, participants tackle one of their own workplace issues by applying the challenge model – previously developed by MSH – and other supporting tools where one challenge at a time is tackled. In working through the model, participants:

  • create a shared vision and define one measurable result;
  • assess the current situation and identify opportunities;
  • define their challenge and select priority actions;
  • develop an action plan;
  • implement their plan; and
  • monitor and evaluate their progress towards achieving their desired result.

The SPS Program adapted the LDP specifically for pharmacists and added sections on legislation, ethics, governance, financial management and human resources.

At the end of the course participants present their results to senior managers and other key stakeholders.

The PLDP pilot was conducted in South Africa’s Gauteng province from March to August 2011 with a group of 17 pharmacists from the Gauteng Provincial and Tshwane Metro Departments of Health. A further group from two more provinces namely Free State and Northern Cape completed the course in April 2012, with a third group in the Eastern Cape commencing in January 2012.

The Free State and Northern Cape groups addressed several challenges they face daily including the readiness of clinics to supply antiretrovirals (ARVs), compliance with Standard Treatment Guidelines and correct administration of antibiotics, improving adverse drug reaction reporting and improved medicine supply management in a rural clinic.

Expansion of PLDP to other provinces in South Africa is being organized under the SIAPS Program, while opportunities to to find a more permanent home for the program at a South African training institution are being explored.

SIAPS Launched in Cameroon

Left to right: SIAPS Country Program Director Dr. Buke, US Ambassador Jackson, and Minister of Health Fouda

A ceremony to formally launch the SIAPS Program in Cameroon was held last Thursday in Yaounde at the Djeuga Palace Hotel in which the Minister of Public Health, André Mama Fouda and the US Ambassador to Cameroon, Robert P. Jackson both attended.

Dr. Kaze Gege Buki, SIAPS Country Project Director, presented on results from a pharmaceutical management analysis previously performed in Cameroon. Low access to quality medicines in the public sector due to poor staffing, coordination, management of HIV commodities, sexually transmitted diseases, and family planning all contribute to frequent stock-outs at health care sites. Due to such poor access, over 500,000 people in Cameroon are living with HIV and AIDS and new infections continue annually.

SIAPS will be working with the Cameroon Ministry of Public Health through the Directorate of Pharmacy, the National Centre for Essential Drugs Procurement and Medical Disposables, the regional departments for stocking drugs and the National AIDS Control Committee to build the capacity of pharmaceutical services at all levels to strengthen the pharmaceutical system over a three year period.

In Cameroon, SIAPS interventions will be designed to provide immediate response to urgent day-to-day pharmaceutical problems, while developing the policy framework and human capacity to strengthen the system in the medium and long terms.

Read about the launch on


Africa 2012 Pharmacovigilance Meeting

While access to new essential medicines in Africa continues to increase, a lack of proper monitoring and promotion of safe, good quality, and effective medication is also on the rise. With such weak pharmacovigilance systems, adverse drug reactions, poor product quality and medication errors become a hazard to health care systems.

During three days in April, the 2012 Pharmacovigilance Meeting, which was hosted by the Ministry of Health, Kenya; the Pharmacy and Poisons Board; SIAPS Program; and the USAID-funded Health Commodities and Services Management (HCSM) Program brought together partners from the African Regulatory Authorities, WHO, BMGF, EMA, CDC, FDA, USAID, and other key stakeholders to disseminate study findings of pharmacovigilance systems and performance in sub-Saharan Africa and facilitate a dialogue around common needs and opportunities.

The meeting was held in Nairobi, Kenya from April 18-20 and included a one-day launch of the study publication, Safety of Medicines in Sub-Saharan Africa: Assessment of Pharmacovigilance Systems and their Performance, followed by a two-day intensive workshop where countries shared their current practices and collectively identified operational tools and guidelines needed to implement pharmacovigilance activities with a systems perspective.

The full agenda and presentations can be found here.

Learn more about what SIAPS is doing in pharmacovigilance.



SIAPS Assists UN Commission Inquiry on Lifesaving Medicines for Mothers and Children

Globally, pregnant women still continue to suffer and die from postpartum hemorrhage and pre-eclampsia/eclampsia – when a women has dangerously high blood pressure levels (pre-eclampsia) which can lead to fatal seizures (eclampsia) – even though there are proven therapies that can prevent and treat these conditions.

In 2010, the United Nations (UN) first launched the Every Woman, Every Child initiative to help save the lives of 16 million women and children by 2015 – in accordance with the Millennium Development Goals (MDGs). As a part of this initiative, the UN will soon commence a special Commission focused on overlooked life-saving commodities for women’s and children’s health.

SIAPS took part in planning meetings convened by UNICEF, WHO and UNFPA to prepare for the UN Commission inquiry. Ad hoc working groups were formed to prepare background documentation to analyze existing information on potential barriers to access of maternal and child health medicines including policy and regulatory frameworks, manufacturing issues, procurement, supply chain management and use.

At the request of USAID, SIAPS reviewed documentation submitted by other members of the group and synthesized findings. The documents reviewed included assessments from several countries, journal articles, and reports from various USAID-funded projects. Through this review, several problems in health systems worldwide were identified.

Although prevention and treatment policies for postpartum hemorrhage and pre-eclampsia/eclampsia existed, these policies were often not put into practice appropriately or at all. National medicine regulatory authorities who are supposed to ensure the quality of medicines often lack the capacity to monitor and evaluate maternal health commodities sufficiently. Inadequate storage conditions of medicines lead to severely degraded products that cannot be used to help pregnant women in physical distress. Even data needed to quantify the true supply needs of these medicines are absent.

These findings have been synthesized by the maternal health working group in a report to be presented to a soon-to-be launched UN Commission – a diverse group of leaders and experts invited to catalyze changes in the way overlooked commodities are made, distributed and used in order to prevent the leading causes of death among women. The Commission will advocate at the highest levels to build consensus around priority actions for increasing the availability, affordability, accessibility and rational use of selected commodities for maternal health.