Access to medicines track
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Access to medicines track. Track team Maryam Bigdeli * - AHSPR/WHO - Switzerland Brenda Colatrella – Merck - USA Brian Gunn – MoH – Sultanate of Oman Joel Lexchin – York University - Canada Vera Lucia Luiza* - NSPH - Brazil Zafar Mirza – WHO - Switzerland

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Access to medicines track

Access to medicines track

Track team

Maryam Bigdeli* - AHSPR/WHO - Switzerland

Brenda Colatrella – Merck - USA

Brian Gunn – MoH – Sultanate of Oman

Joel Lexchin – York University - Canada

Vera Lucia Luiza* - NSPH - Brazil

ZafarMirza – WHO - Switzerland

Mohamed Bin Shahna*- WHO - Egypt

Key lessons learned multi stakeholder approach
Key lessons learnedMulti-stakeholder approach

  • There may be benefits in the pooling of ideas, innovations, data and funds but there are still many challenges to be addressed.

  • Value chain on access to medicines is only effective if all links work but processes are not linear: reflective, adaptive system.

  • Private sector is an important player but it is important to ensure equal balance of power among stake holders.

  • There are also multiple stakeholders at health care delivery level, and mechanisms exist to include them and improve performance (e.g. DTC, ADDO, etc.)

Policy recommendations multi stakeholder approach
Policy recommendationsMulti-stakeholder approach

  • In using pooling mechanisms it is important to identify how to incorporate expertise from the LMIC.

  • Assure a good balance of relevant stakeholders in round tables on access to medicines, empowering them all.

  • An independent body should be established at government level covering all Ministries to sort out inappropriate incentives on medicines use.

  • DTC and pharmacotherapy training were pointed out as important mechanisms to improve medicines use.

  • Partnership between academic teaching institutions and services delivery is crucial.

Research gaps multi stakeholder approach
Research gapsMulti-stakeholder approach

  • How does the private sector perform related to rational use of medicines and what are the main determinants?.

  • Research is needed on developing effective pooling approaches.

  • There is a need for more research on effectiveness of DTC in low resource countries.

  • Explore the use of traditional medicines resources for access and better information on efficacy and safety.

Key lessons learned gender and inequities
Key lessons learnedGender and inequities

  • Multiple determinants of poor access include social, demographic, institutional etc.

  • Problem on access to medicines is exacerbated for chronic diseases and private sector.

  • Population based information is important for policy and WHO proposed indicators are useful tools.

  • There are gender inequities in outcomes but evidence in inequities in prescribing does not exist.

  • Gender inequities have more complex determinants.

Policy recommendations gender and inequities
Policy recommendationsGender and inequities

  • Improving access to medicines needs looking as issues over and beyond financial access, such as structural factors, social issues, safety etc..

  • It is critical to address demand side issues such as: health seeking behavior, self medication, self exclusion etc., especially for chronic illness.

  • Governments should institutionalize initiatives on rational use of medicines.

  • Gender based programs need to take into account the complexity of determinants of gender inequity.

Research gaps gender and inequities
Research gapsGender and inequities

  • National household surveys, e.g. DHS, should consider incorporating access to medicines issues.

  • Joint facility and household surveys are required to be able to link the issues.

  • Future studies on access to medicines should consider social determinants and behavioral issues such as adherence, patients preferences, etc..

  • There is a need for validation of analytical methods used to do country comparisons on medicines use.

Key lessons learned innovation and information technology
Key lessons learnedInnovation and Information technology

  • Availability of selected drugs improved after introduction of innovative interventions (e.g., SMS, internet, mapping services, etc.)

  • Success factors for innovative technology interventions are missing to be determined.

Policy recommendations innovation and information technology
Policy recommendationsInnovation and Information technology

  • New information technologies for access to medicines need to be developed but contextualized to resource poor settings.

  • Innovative education to providers and users - individuals and communities - need to be designed and implemented.

Research gaps innovation and information technology
Research gapsInnovation and Information technology

  • Need to examine the cost-effectiveness of introducing new technologies in public health system (independent assessment).

  • Can new technologies be scaled up and how?

  • There is a need for innovating in routine monitoring and use of data in a sustainable way.

Thank you

Thank you !!!

Acknowledgements to moderators and rapporteurs