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Access to medicines track

Access to medicines track. Track team Maryam Bigdeli * - AHSPR/WHO - Switzerland Brenda Colatrella – Merck - USA Brian Gunn – MoH – Sultanate of Oman Joel Lexchin – York University - Canada Vera Lucia Luiza* - NSPH - Brazil Zafar Mirza – WHO - Switzerland

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Access to medicines track

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  1. Access to medicines track Track team Maryam Bigdeli* - AHSPR/WHO - Switzerland Brenda Colatrella – Merck - USA Brian Gunn – MoH – Sultanate of Oman Joel Lexchin – York University - Canada Vera Lucia Luiza* - NSPH - Brazil ZafarMirza – WHO - Switzerland Mohamed Bin Shahna*- WHO - Egypt

  2. Key lessons learnedMulti-stakeholder approach • There may be benefits in the pooling of ideas, innovations, data and funds but there are still many challenges to be addressed. • Value chain on access to medicines is only effective if all links work but processes are not linear: reflective, adaptive system. • Private sector is an important player but it is important to ensure equal balance of power among stake holders. • There are also multiple stakeholders at health care delivery level, and mechanisms exist to include them and improve performance (e.g. DTC, ADDO, etc.)

  3. Policy recommendationsMulti-stakeholder approach • In using pooling mechanisms it is important to identify how to incorporate expertise from the LMIC. • Assure a good balance of relevant stakeholders in round tables on access to medicines, empowering them all. • An independent body should be established at government level covering all Ministries to sort out inappropriate incentives on medicines use. • DTC and pharmacotherapy training were pointed out as important mechanisms to improve medicines use. • Partnership between academic teaching institutions and services delivery is crucial.

  4. Research gapsMulti-stakeholder approach • How does the private sector perform related to rational use of medicines and what are the main determinants?. • Research is needed on developing effective pooling approaches. • There is a need for more research on effectiveness of DTC in low resource countries. • Explore the use of traditional medicines resources for access and better information on efficacy and safety.

  5. Key lessons learnedGender and inequities • Multiple determinants of poor access include social, demographic, institutional etc. • Problem on access to medicines is exacerbated for chronic diseases and private sector. • Population based information is important for policy and WHO proposed indicators are useful tools. • There are gender inequities in outcomes but evidence in inequities in prescribing does not exist. • Gender inequities have more complex determinants.

  6. Policy recommendationsGender and inequities • Improving access to medicines needs looking as issues over and beyond financial access, such as structural factors, social issues, safety etc.. • It is critical to address demand side issues such as: health seeking behavior, self medication, self exclusion etc., especially for chronic illness. • Governments should institutionalize initiatives on rational use of medicines. • Gender based programs need to take into account the complexity of determinants of gender inequity.

  7. Research gapsGender and inequities • National household surveys, e.g. DHS, should consider incorporating access to medicines issues. • Joint facility and household surveys are required to be able to link the issues. • Future studies on access to medicines should consider social determinants and behavioral issues such as adherence, patients preferences, etc.. • There is a need for validation of analytical methods used to do country comparisons on medicines use.

  8. Key lessons learnedInnovation and Information technology • Availability of selected drugs improved after introduction of innovative interventions (e.g., SMS, internet, mapping services, etc.) • Success factors for innovative technology interventions are missing to be determined.

  9. Policy recommendationsInnovation and Information technology • New information technologies for access to medicines need to be developed but contextualized to resource poor settings. • Innovative education to providers and users - individuals and communities - need to be designed and implemented.

  10. Research gapsInnovation and Information technology • Need to examine the cost-effectiveness of introducing new technologies in public health system (independent assessment). • Can new technologies be scaled up and how? • There is a need for innovating in routine monitoring and use of data in a sustainable way.

  11. Thank you !!! Acknowledgements to moderators and rapporteurs

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