1. WHO STRATEGY FOR WORKING WITH COUNTRIES:REGIONAL AND COUNTRY PERSPECTIVE TECHNICAL BRIEFING SEMINAR,Geneva,19-23 September 2005 Dr. Jean-Marie TRAPSIDA Essential Drugs and Medicines Policy (EDM) WHO REGIONAL OFFICE FOR AFRICA

2. 2 MISSION STATEMENT FOR WORKING WITH COUNTRIES Provide appropriate support to countries to build sustainable environment, capacity and develop relevant policies and programmes in order to ensure that quality, safe and effective essential medicines are available, affordable to the population and are used appropriately.

3. 3 WORKING WITH COUNTRIES The WHO Medicines Strategy represents a framework for WHO support to countries in order to improve the situation; Planning: o Country level o Regional Office level o HQ level Implementation o Regular budget (RB) o Extra budgetary funds or voluntary funds Monitoring and evaluation: o Semi annual monitoring (SAM) o Mid Term Review (MTR) o Biennium evaluation

4. 4 ENHANCED EXPERTISE IN COUNTRY OFFICES 14 National Medicine Advisors in AFRO: Cameroon, Chad, Congo, DRC,Ethiopia,Ghana,Kenya,Mali, Nigeria,Senegal,Rwanda, Tanzania, Uganda and Zambia; Assist in planning, implementation and monitoring of medicines policies; Assist in coordination of partners involved in pharmaceuticals

5. 5 NATIONAL MEDICINES POLICY Implementation and monitoring of national medicines policies Cape Verde, Burundi, Ghana, Nigeria and Tanzania were supported in the review of NDP and implementation plans Chad, Niger and Mali were also supported to assess specific aspects of the NDP

6. 6 ACCESS Training in medicines supply management in The Gambia, Ethiopia, Niger, Tanzania and Uganda Capacity building of NPO and their MOH counterparts in TRIPS (Ghana, Ethiopia, Kenya, Nigeria & Uganda Direct support in pricing surveys to Cameroon, Ethiopia, Ghana, Kenya, Mali, Nigeria, Tanzania & Uganda

7. 7 ACCESS Cont'd.. National and local drug supply systems ä Enhanced drug supply management capacity ä Efficient drug supply management within health sector reform ä Good pharmaceutical procurement practices ä Good drug donation practices ä Local production supported

8. 8 QUALITY AND SAFETY Implementation of instruments on effective drug regulation and quality assurance systems: Sub regional harmonization(SADC,UEMOA,EAC,CEAC) Assessment of National Drug Regulatory Authorities in Ghana, Mali, Nigeria and Senegal. Quality control of Anti-TB medicines undertaken in Cameroon, Chad, Ethiopia, Ghana, Nigeria, Rwanda, Senegal, Tanzania and Uganda revealed need for routine monitoring.

9. 9 Quality and safety Onging assessment of ARV quality in 7 countries (joint HQ/AFRO project) Drug registration in Cape Verde, Mali, Niger, Burkina Faso, Cameroon, Kenya. Training of Laboratory personnel from Cameroon, Mali, Niger, Nigeria and Uganda in WHO Collaborating centres in Algeria and South Africa

10. 10 RATIONAL USE OF MEDICINES Review of EML & STG completed in Ghana Cameroon and Nigeria reviewed the STG for ART Tanzania reviewed the STG Support was provided to Ethiopia, Senegal and Uganda for creation of Drugs and Therapeutics committee in targeted hospitals.

11. 11 TRADITIONAL MEDICINE Institutionalization of TRM in Health Systems: Development of tools such as Policy framework, Strategic Master Plan, Code of Ethics, Protocols for validating the safety, efficacy and quality of TMs, Guidelines for registration of TMs, etc… Assessment of local production of traditional medicines identified products with marketing authorization in Madagascar and Nigeria

12. 12 FUNDING FOR ACTIVITIES DFID: Improving access to medicines; EUROPEAN COMMISSION: Implementation of WMS 2004-2007; WORLD BANK: Support to the Pharmacy Direction of CHAD; SIDA: Support to Medicines supply systems and strengthening regulatory systems; CIDA: Traditional Medicine ADB: Implementation of Sierra Leone Pharmaceutical Project.

13. 13 ENABLING FACTORS Good collaboration between technical Units AFRO, TCM/PSM/HQ and Member States; Better involvement of EDM/NPOs in EDM AoW; Good collaboration and availability of the WHO Regional Expert Committee on TRM and consultants; Availability of extra budgetary funds from EC, DFID, SIDA and CIDA.

14. 14 CONSTRAINTS Role of WHO misunderstood in some countries; Limited relevant human resource capacity at some WCOs and countries to respond to increasing demand. Most activities dependent on limited funds in the regular budget.

15. WHO THANK YOU