* Marthe Everard visited Jordan as short-term consultant for WHO in 1997 and 1998, when she was Manager of the WHO Collaborating Centre, The Robert Gordon University, Aberdeen, Scotland, UK.
Although affected by global economic recession, the Hashemite Kingdom of Jordan has impressive social and health indicators, illustrating its Government’s strong commitment to health, education and other social programmes. Literacy is over 80%, and the country has a surplus of skilled human resources, despite limited economic and natural resources.
Jordan is in the process of developing reform policies to overcome its current economic difficulties. It is moving towards a competitive market economy, while determined to improve the existing social safety net. Health sector reform is central to the country’s plans and the World Bank is providing the necessary technical and financial support. Although the health system for the population of four million is relatively well developed in terms of coverage (80%) and health outcomes, provision is expensive. Health service delivery is inefficient in terms of overall management, procurement, storage and distribution, pricing policies, and the rational use of medicines.
In January 1997, Jordan launched the Health Sector Reform Project. Based on developing the current system’s strengths, reforms focus on improving:
• management structures in the public and private health sectors;
• efficiency, by introducing more cost-effective health care delivery strategies;
• clinical practice and pharmaceutical care, including quality assurance;
• financial and geographic access to health services.
National Drug Policy development
Developing a national drug policy was a precondition of World Bank support, and drafting began during the first half of 1997. The work was done by staff from various Health Ministry Departments; university faculties of medicine and pharmacy; the Royal Medical Services; the local pharmaceutical industry; private drug importers and wholesalers; and retail pharmacists. WHO provided technical advice.
Comprehensive framework agreed
In October 1997, the draft Policy was officially passed to the Ministry of Health for comment, and regular discussions were arranged with the various stakeholders. The Policy was adopted in July 1998, and provides a comprehensive framework for developing Jordan’s pharmaceutical sector. The Policy aims to:
• ensure the availability of affordable essential drugs and vaccines;
• ensure the safety, efficacy and quality of all medicines;
• improve the rational use of drugs by health practitioners and the public;
• support the national pharmaceutical industry, with a focus on essential drugs.
National Drug Policy priorities
• revise and update drug legislation and regulations;
• make the Drug Directorate a semi-autonomous body;
• reorganize the quality control laboratory;
• support the domestic pharmaceutical industry;
• set up a Joint Procurement Coordination Council for the public sector and quantify requirements;
• establish an autonomous drug supply corporation;
• undertake a cost-benefit analysis of generic drug use and generic substitution;
• study the impact of changes in drug pricing policy;
• study the effect of the population’s ageing on drug use.
In November 1998, the new Policy was presented to some 300 Government staff, consumer representatives and the private sector at a national workshop. Opened by the Minister of Health, the workshop received good media coverage, with radio and television broadcasts explaining why the Policy is so important.
Realistic action plan
The National Drug Policy Committee has drawn up a comprehensive five-year implementation plan. This prioritises activities and lists the responsible body, timetable and budget. The Committee took care to ensure that activities were neither over-ambitious nor unrealistic for the first phase up to 2003. An independent Monitoring and Evaluation Committee will supervise Policy implementation.
Jordan’s National Drug Policy is the outcome of years of comprehensive preparation, hard work and wide consultation, backed by strong Government commitment. It should provide a firm foundation for the country to achieve its goals in pharmaceutical sector reform.
The old town of Jordan’s capital, Amman. The new National Drug Policy is being translated into action to improve the health of the whole population (Photo: M.M. Everard)