Assessment of the TB Pharmaceutical Management System in Namibia: February 13–March 4, 2011
(2011; 63 pages)

Owunna, C., R. Chana Chapchet, C. Ntege, and N. Nashilongo. 2011. Assessment of the TB Pharmaceutical Management System in Namibia. Submitted to the US Agency for International Development by the Strengthening Pharmaceutical Systems (SPS) Program. Arlington, VA: Management Sciences for Health.


Namibia adopted the DOTS strategy in 1993 and it was implemented at the lowest level of the health care system through DOTS centers. The storage conditions of anti-tuberculosis (TB) medicines at DOTS centers have been a concern because of the high ambient temperatures in Namibia, particularly during the summer months. The Ministry of Health and Social Services (MoHSS) decided that a full-scale pharmaceutical system assessment should be done to focus on first- and second-line TB medicines to identify any gaps in the system to ensure that patients receive quality, safe, and efficacious medicines, and hence improved treatment outcomes...

Findings on policy and guidelines showed that almost all health facilities visited during the assessment had a copy of the most current version of national TB treatment guidelines except for a few DOTS sites. Regarding the treatment of DR-TB, it appears that there has been slow adoption of the latest guidelines, as many clients are still being managed according to the previous version of the guidelines. It also revealed that there has been some communication gap between the National Tuberculosis and Leprosy Program (NTLP) and the Central Medical Store (CMS) in relation to planning for the implementation of new guidelines.

Findings also showed that not all TB medicines on the TB tracer medicine list are selected according to international recommendations. For example, when the WHO Model List of Essential Medicines (16th edition, updated March 2010) was compared with the tracer list of anti-TB medicines in Namibia, it was found that 10 of the 13 (76.92%) medicines listed in the tracer list were in the WHO Model List. When compared with the list of medicines on the Global Drug Facility (GDF) catalogue list, 84.62% (11 out of 13) of the first-line TB medicines were included in the GDF list. For second-line treatment, 70% of the TB medicines in the trace list were included in both the WHO Model List and the GDF catalogue list. The discrepancy was in the group five medicines (amoxicillin/clavulanate 875/125 mg, clarithromycin 500 mg, and clofazimine 100 mg)...

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