1. Malaria Programmes and Implication on Strengthening the overall Health System
Presentation by Dr Maryse Dugué RBM Partnership Secretariat, Malaria Medicines & Supplies Services
Copenhagen – 31 January 2006 3

2. Drug resistance
Drug policy issues
Procurement systems
Drug management, distribution, monitoring
Pharmacovigilance

3. Malaria: a heavy burden on the health system
A major challenge in most sub-Saharan African countries: leading cause of morbidity, second highest cause of mortality, children and women most affected (10% of pregnancy-related morbidity and mortality).
Drug resistance to commonly used drugs has reached unacceptable levels: needs to introduce new treatments, more expensive and for which local experience does not exist.

4. Issues for scaling up Scaling up requires: System issues
Appropriate strategic planning
Strong program management
Adequate procurement planning and monitoring
Efficient logistics
System issues
Attention focused on inputs (drugs and other commodities)
Issue of health system : staffing and health facilities (evidence from cost effectiveness analysis)

5. Challenges in program planning and implementation
Gap between current performance and targets (Abuja, MDGs)
HR attrition
Monitoring: lack of reliable indicators at all levels
Involvement of private sector
Prioritization/other infectious diseases
Coverage of community-based malaria control programs
Vertical approach

6. Opportunities Political commitment/support
Strengthening health system through SWAp
High resources mobilization

7. Objectives of the procurement/drug management system
Availability
Of the right drugs and commodities
At the right place
With the right quantities
with the right quality
On the right time
Without stock out or wastage
At all level of the health system

8. Challenges in procurement
Risk rating
Resources for the activities
Procurement plan
Tender evaluation
Commodity selection
Quantification

9. Challenges in changing clinical practice
In-service training
Provision of job aids
Update treatment and case management recommendations in all the manuals

10. Logistics challenges Storage Cold/cool chain (RDTs) Transport systems
Inventory
Monitoring at all levels

11. How to contact us… Malaria Medicines & Supply Services (MMSS)
Roll Back Malaria Partnership Secretariat
Website:
Dr Maryse Dugue
Manager
Tel: +41 (0)