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Annual Report 2002 - Essential Drugs and Medicines Policy: Supporting Countries to Close the Access Gap
(2003; 20 pages) [French] [Spanish] View the PDF document
Table of Contents
View the documentDeveloping a monitoring culture to improve impact
View the documentTraditional and complementary medicine: putting policy into action
View the documentKey country support in Africa and Eastern Mediterranean
View the documentWHO Collaborating Centres: supplying active support for medicines work
View the documentHow is TRIPS affecting access to medicines?
View the documentDevelopment of the essential drugs concept over the past 25 years
View the documentMeasuring access to antimalarials
View the documentStrengthening regional and national bulk procurement
View the documentLearning from successful supply systems
View the documentWorking out the cost of medicines
View the documentSupporting MDG target on access to essential medicines
View the documentCommon guideline for evaluating new medicines in Baltic countries
View the documentNGO toolkit for improving access to HIV/AIDS treatment
View the documentHarmonizing medicines regulation in the Americas
View the documentGood manufacturing practice in China: rapid progress
View the documentPharmacovigilance: detecting and reporting adverse drug reactions
View the documentVariations in prescribing information in 26 countries
View the document10th ICDRA: an international basis for medicines regulation
View the documentFighting poor-quality drugs
View the documentImproving medicines use in hospitals in Cambodia and Lao PDR
View the documentWHO-India Essential Drugs Programme: multiplying impact
View the documentOman: improving antibiotic use in primary health care

Measuring access to antimalarials

In 2000, the Abuja Declaration issued by the African Summit on Roll Back Malaria, called on African countries to "Make appropriate treatment [of malaria] available and accessible to the poorest groups in the community." With increasing problems of resistance, this means ensuring access not only to 1st-, 2nd-, and 3rd-line antimalarial treatments, but also to the new, and hence more expensive, artemisinin-derived antimalarials.

But in order to devise effective strategies to improve access to anti-malarials, a clear picture must first be drawn of their current availability, funding for procurement, capacity for medicines regulation and control, and mechanisms for ensuring rational selection and use. While some of the related data are available within the ministries of health of malaria-endemic countries, they are often not disaggregated, which means that they cannot be used optimally in planning, budgeting or reporting.

To tackle this problem, a survey tool was developed and pilot-tested in Kenya. The tool incorporated elements of a drug pricing methodology already developed by Health Action International and WHO (see Working Out the Cost of Medicines on page 14). Survey results showed that:

• resources for procuring antimalarials are limited

• shortcomings exist in the quality of prescribing, but dispensing of antimalarials is often appropriate

• antimalarials are widely available

• antimalarial prices in private health facilities vary considerably

• post-marketing surveillance for quality assessment of antimalarials is sporadic

• patients who suspect that they have malaria mainly consult public health facilities

• 83% of those seeking medical care for malaria were diagnosed as having malaria

• 86% of patients diagnosed with malaria obtained the medicines they were prescribed

• 77% of those who obtained medicines took them as prescribed.

A similar survey will be carried out in 2003 in Ghana, Tanzania, Uganda and Zambia.

Price (US$) of 8 artemisinin antimalarial products varied widely in the private sector in Kenya in 2002


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