1. Pharmaceutical Services Unit Essential Medicines Management
Zambia: Towards Sustainable Access to Essential
Medicines
Presented by Chikuta Mbewe
Pharmaceutical Services Unit

2. Pharmaceutical Services Unit Essential Medicines Management
Outline:
Objectives
Introduction
Why Worry about Medicines
Public Health Objectives and the EMs Concept
Defining & Improving Access to EMs
Zambia Medicines Policy Goals and elements
Challenges in Pharmaceutical Management
Key Lessons for Zambia in P’ceutical Management
Zambia’s position on TRIPS
Pharmaceutical Services Unit

3. Pharmaceutical Services Unit Essential Medicines Management
Objective:
To describe current issues and opportunities in access to EMs
Pharmaceutical Services Unit

4. Pharmaceutical Services Unit Essential Medicines Management
Introduction
Interest in human health is as old as humanity
In developed countries modern pharmaceuticals has eliminated or radically reduced mortality from most infections, extended lives of millions
In developing countries it is estimated that % lack regular access to EMs
Lack of access is directly proportional to income
Pharmaceutical Services Unit

5. Pharmaceutical Services Unit Essential Medicines Management
Why Worry so much about medicines
Medicines save lives and improve health
Medicines promote trust and participation in Health services
Medicines cost money
Medicines are different from other consumer products
Substantive improvements in the supply and use of medicines are possible
Pharmaceutical Services Unit

6. Pharmaceutical Services Unit Essential Medicines Management
Public Health Objectives and the EMs Concept
Public Health Programes are concerned with using available resources to achieve maximum health improvements
In 1975 WHO defined EMs indispensable and necessary for the health needs of the population that need to be available all times in proper dosage forms
Guiding principle is good selection (ZEML) and use (DTCs)
Procurement and distribution economically and efficiently done with the few medicines
Pharmaceutical Services Unit

7. Pharmaceutical Services Unit Essential Medicines Management
Defining Access to EMs
Isn’t access to health care including EMs a fundamental human right
4 dimensions of Access include availability (type and quantity needed Vs provided);
-affordability (Pricing Vs ability to pay)
-Accessibility (location of product Vs location of user
-acceptability (satisfaction Vs expectations)
Pharmaceutical Services Unit

8. Pharmaceutical Services Unit Essential Medicines Management
Access to Medicines Policy Environment
Zambia has a National Medicines Policy that was 1st promulgated in 1996
Zambia has a generic policy on procurement of EMs
Has health related goals of increasing availability and accessibility to quality EMs
Has economic goals that include lower cost of EMs, sustainable financing, job creation
Has national development goals that include skills in pharmacy management
Pharmaceutical Services Unit

9. Pharmaceutical Services Unit Essential Medicines Management
Access to Medicines Policy Environment
Selection
Zambia has a NEML regularly updated
Zambia National Formulary Committee is appointed body to oversee formulary activities
Planning & Procurement
Steady increase in the medicines budget
Pharmaceutical Services Unit

10. Pharmaceutical Services Unit Essential Medicines Management
Planning & Procurement
National Essential Medicines Budget
2013 Budget Key Strengths
112% ↑ increase of drug budget from ZMK 270 Billion (2012) to ZMK 594 billion
248% ↑ for ARVs & 20% increase for EMs, TB, Laboratory, RHCs, vaccines, Cancer, Blood Products and 540% ↑ for medical supplies .
ZMK 120 Billion for ACTs (latest budget-line for GRZ
Pharmaceutical Services Unit

12. Pharmaceutical Services Unit Essential Medicines Management
Distribution
MoH strengthening equitable distribution systems for EMs through decentralization of MSL services
6 distribution hubs will be operationalization by end of 2015
Pharmaceutical Services Unit

13. Pharmaceutical Services Unit Essential Medicines Management
Use
has developed key essential medicines documents to improve use of medicines
New editions (2013) available of ZNF, STGs, NEML, Guidelines of Medicines and Therapeutic Committees
Pharmaceutical Services Unit

14. Pharmaceutical Services Unit Essential Medicines Management
Regulation
Reform of Pharmaceutical regulation completed in 2013 by repealing old Pharmaceutical Act and replacing it with the new Medicines & Allied Substances Act
New act will increase access through regulated health shops to the Zambian Population
Zambia very active on issues of regional harmonisation of pharmaceutical regulation
Pharmaceutical Services Unit

15. Pharmaceutical Services Unit Essential Medicines Management
National Challenges in Pharmaceutical Management
Financing and sustainability (Public Health diseases including HIV/AIDS, TB, Malaria medicines is a high cost treatment category)
Improving efficiencies in public supply system (weak distribution systems)
Changing behaviours of providers and patients (irrational use of medicines)
Regulating quality
Pharmaceutical Services Unit

16. Pharmaceutical Services Unit Essential Medicines Management
Key Lessons for Zambia in P’ceutical Management
National Medicine Policy provides a sound foundation for managing pharmaceutical supply
Wise selection of EMs underpins all other improvements
Effective management and good governance saves resources
Rational medicines is a practice issue
Systematic assessment & monitoring are very essential
Pharmaceutical Services Unit

17. Pharmaceutical Services Unit Essential Medicines Management
TRIPS Vs Access in Zambia (Our Stand)
Medicines are sacred commodities as they improve the quality of life and human development
We have a right to better and dignified health
We need PERMANENT exemptions from TRIPS
Pharmaceutical Services Unit

18. Pharmaceutical Services Unit Essential Medicines Management
Thank you for listening
Pharmaceutical Services Unit