Optimizing medicines use to improve patient outcomes Guidelines on pharmaceutical donations; The case of KNH

The need for guidelines Medicine donations though well intended can cause problems Major disasters elicit emotional appeal for medical supplies without regard to the need. WHO in collaboration with other stakeholders issued guidelines in 1996 which were reviewed in 1999.The aim was to reduce problems associated with donations Guidelines are applicable to both emergency and long term donations.

Problems with donations may not be relevant to the emergency, disease patterns or level of care may not be known to the local health professionals may not comply with policies and treatment guidelines arrive unsorted and labeled in foreign language with unknown brand names quality may not comply with standards in the donor country

Problems with donations may be medicines or free samples returned to pharmacies with short expiry may have high declared value based on market value in donor country leading to high import taxes arrive with short shelf life leading to expiry and need for disposal create extra workload in sorting, documenting and distribution

Examples of donations to KNH 1998 Bomb blast (lessons learnt) Sachang’wan fire tragedy of 2009(after KNH guidelines) Sinai fire tragedy of 2011

Core principles for donations Maximum benefit Respect for the wishes and authority of the recipient No double standards in quality Effective communication between donor and recipient

Implementation of policy on pharmaceutical donations Decide who is responsible for defining the needs and who will prioritize them Decide who coordinates all medicine donations Which documents are needed when a donation is planned and who should receive them Which procedure should be used when donation do not follow guidelines

Implementation of policy on pharmaceutical donations What are the criteria for accepting or rejecting donations and who makes the final decision Decide who coordinates reception, storage, and distribution of donated medicine How are donations valued and entered into the budget/ expenditure records How will inappropriate donations be disposed of

Challenges Pharmaceutical donation guidelines developed and disseminated yet dumping and inappropriate donations still occur Donations delivered directly to the clinics/wards No record or proper documentation of donations interference of clinical activities by medical representatives

Conclusion Adhering to pharmaceutical donation guidelines will optimize use of donated medicines for improved patient outcomes