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Improving Access to Essential Medicines. The Experience of Kenya. Background. Key Strategies for Access. Create enabling policy & legal framework in pharmaceuticals Provide a basic package of essential medicines Special focus on the needs of levels I, II & III
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Improving Access to Essential Medicines The Experience of Kenya PHC & Health Systems in Africa: Ouagadougou, 28-30 Apr 08
Background PHC & Health Systems in Africa: Ouagadougou, 28-30 Apr 08
Key Strategies for Access • Create enabling policy & legal framework in pharmaceuticals • Provide a basic package of essential medicines • Special focus on the needs of levels I, II & III • Review financing options to increase affordability • Improve procurement & supply systems • Strengthen drug regulation & quality control • Address pharmaceutical HR constraints • Develop/adapt appropriate M&E mechanisms PHC & Health Systems in Africa: Ouagadougou, 28-30 Apr 08
Key Achievements • Availability • Functioning procurement & supply systems • Improved availability in public sector • Basic package defined; periodically reviewed • Strategy developed for community level health services • Financing & Affordability • Increased government expenditure on medicines • Medicines free of charge for HIV,TB, Malaria; children <5yrs (public & mission facilities) • No taxes levied on medicines; reduced user charges • Government subsidy (medicines) to faith based facilities PHC & Health Systems in Africa: Ouagadougou, 28-30 Apr 08
Monitoring of Medicine Prices and Availability • Quarterly monitoring by MOH • Supported by WHO & HAI-Africa • Data collected at facility level • Availability and price to the patient • Basket of selected essential medicines • Source of regular information to: • Policy makers, consumers, h/sector partners • Focus: strategies to make essential medicines available & affordable PHC & Health Systems in Africa: Ouagadougou, 28-30 Apr 08
Medicines for Malaria PHC & Health Systems in Africa: Ouagadougou, 28-30 Apr 08
Medicines for HIV/AIDS ART Coverage in Kenya (Actual to 2007: Projected to 2010) PHC & Health Systems in Africa: Ouagadougou, 28-30 Apr 08
Challenges • Inadequate funding for medicines • Procurement, warehousing & distribution • Market regulation: inspection, surveillance, quality control • Many players in pharmaceuticals • Coordination, alignment, regulation • HR constraints (numbers & skills) • Inadequate numbers at lower levels • Low emphasis on rational use of medicines • Limited tools to measure access PHC & Health Systems in Africa: Ouagadougou, 28-30 Apr 08
Lessons Learnt (1) • Polices & Strategies in place are bearing fruit • Affordability requires special focus • Enhance procurement, explore options of pooling • Promote use of generics • Expand health insurance coverage for medicines • Subsidies for critical life-saving medicines • e.g. Insulin, Inhalers, medicines for hypertension • Weed out un-authorized sale of medicines • Strengthen systems for medicines regulation • Enhance laboratory capacity - WHO prequalification PHC & Health Systems in Africa: Ouagadougou, 28-30 Apr 08
Lessons Learnt (2) • Rational Use of Medicines • Systems for monitoring & enforcement • Increase pharmaceutical HR capacity (especially for lower levels of care) • Role of Traditional Medicines • Explore applications through research • Ensure safety and quality • Measuring progress on access to medicines • Develop/adapt robust M&E tools PHC & Health Systems in Africa: Ouagadougou, 28-30 Apr 08
Asante sana • Thank you PHC & Health Systems in Africa: Ouagadougou, 28-30 Apr 08