e-Pharmalink is an electronic newsletter of the Ecumenical Pharmaceutical Network (EPN), an independent, non-profit Christian organization, whose mission is to support churches and church health systems provide and promote just and compassionate quality pharmaceutical services through networking, access to medicine and treatment literacy programmes.

This newsletter aims at providing health professionals with current information that could support them in their efforts to provide effective and efficient services. It is a summary of news reported by a wide range of publications or organizations and includes web links to the original sources. Subscription to this newsletter is open to all interested parties.

This edition includes:

News
Essential medicines
Antimicrobial Resistance
HIV and AIDS
Human Resources
Others

Resources
Training opportunities
Publications

NEWS

Essential medicines

WHO publishes First Model Formulary for Children
The WHO Model Formulary for Children provides information on how to use over 240 essential medicines for treating illness and disease in children from 0 to 12 years of age. The Formulary will help health-care providers prescribe the right medicine, in the right formulation and the right dose. It also highlights what precautions to take, what adverse reactions may need to be monitored, and what kind of interactions may occur if the patient is taking other medications.
http://www.who.int/mediacentre/news/releases/2010/medicines_children_20100618/en/index.html

Second edition of Sources and Prices of Selected Medicines for Children available
The guide, published annually by UNICEF and WHO, offers up-to-date information on the availability and price of 240 drug items in 612 different paediatric formulations selected from the ‘WHO Model List of Essential Medicines for Children’, including therapeutic food, and vitamin and mineral supplements, to treat major childhood illnesses and disease. The information is vital for development and health partners involved in policy and programme planning who procure and supply essential medicines for children.
http://www.unicef.org/supply/index_47129.html

Report highlights novel ways of developing affordable vaccines to improve children's access to them, increasing their chances of survival
In a new report published in May, Medecins Sans Frontieres (MSF) and Oxfam International warn that the global approach to ensure access to life-saving vaccines for children in the poorest countries is hampered by high prices and is now facing an acute funding crisis. The report titled “Giving developing countries the best shot” shows how it still takes years for expensive new vaccines developed for wealthy countries to reach children across the developing world and indicates how the problem can be addressed.
http://www.oxfam.org/en/policy/giving-developing-countries-best-shot-vaccine-access

European pharmaceutical companies outcompete their US counterparts in making medicines available to people in developing countries
In the second Access to Medicine Index (2010), six of the ten highest-ranking originator companies are based in Europe, while four are US-based. Two years ago, seven European companies got a top-10 ranking. The Access to Medicine Index independently assesses how individual pharmaceutical companies perform in promoting universal access to essential medicines.
http://www.accesstomedicineindex.org/content/european-drug-companies-lead-access-medicine-index

Antimicrobial Resistance

A recent study in Tanzania provides essential information to formulate a policy for management of neonatal sepsis
The cross sectional study involving 300 neonates determined the prevalence of neonatal sepsis, predictors of positive blood culture, deaths and antimicrobial susceptibility. Findings suggest that lethargy, convulsion, inability to feed, cyanosis, PROM and meconium stained liquor are significantly associated with positive blood culture in both early and late onset disease.
http://www.biomedcentral.com/1471-2431/10/39

Systematic literature review and meta-analysis shows the effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients
A study by the University of Bristol, UK found that individuals prescribed an antibiotic in primary care for a respiratory or urinary infection develop bacterial resistance to that antibiotic. The effect is greatest in the month immediately after treatment but may persist for up to 12 months. This effect not only increases the population carriage of organisms resistant to first line antibiotics, but also creates the conditions for increased use of second line antibiotics in the community.
http://www.bmj.com/cgi/content/full/340/may18_2/c2096

Antibiotic Use and Environmental Exposure are Key Factors Affecting Antibiotic-Resistant E. coli Carriage
A new study published in the May issue of the American Journal of Tropical Medicine and Hygiene indicates that direct and indirect exposure of young children to antibiotics through medical and agricultural usage can increase their risk for carriage of resistant E. coli. In poor communities in developing countries, with inadequate protection of excreta and water, contamination of the environment with antibiotic-resistant bacteria appeared to play at least as great a role in children's carriage of resistant E. coli as did the children's own antibiotics use.
http://www.infectioncontroltoday.com/hotnews/antibiotic-resistant-e-coli-carriage.html

HIV and AIDS

Survey on children accessing HIV services in Zimbabwe finds major differences in the problems faced by young children and by adolescents
Rashida Ferrand et al. concluded that for adolescents, the most common issues were psychosocial problems (56%), including lack of resources to seek help for these issues; erratic drug taking (36%); and lack of disclosure of HIV status (21%). Interventions for the large cohort of adolescents who are receiving HIV care in Zimbabwe need to target the psychosocial concerns and poor drug adherence reported by staff as being the main concerns in this age group.
http://www.who.int/bulletin/volumes/88/6/09-066126.pdf

Médecins Sans Frontières (MSF) publishes special report on funding gap for HIV/AIDS Treatment
After years of political willingness and financial commitment to combat HIV/AIDS, MSF reports that, in the majority of the worst-affected countries in sub-Saharan Africa, donors now seem to be disengaging from the fight, leaving behind people who are still in dire need of life-saving treatment. These are the findings of in-depth field analyses carried out by MSD in 2009-2010, in eight key countries - Malawi, Mozambique, Zimbabwe, South Africa, Lesotho, Kenya, Uganda and Democratic Republic of Congo (DRC).
http://www.doctorswithoutborders.org/publications/article.cfm?id=4492&cat=sp

Swiss study evaluates once-a-day treatment
A study on a total of 2410 individuals, who were followed for a median of 2.7 years, showed that although once-a-day treatment regimes can be expected to make adherence easier to handle, they are not necessarily best for all patients. If a person does miss doses, the clinical consequences are more serious than if a person misses doses from a twice-a-day regime. For patients taking once-daily treatment, missing any doses increased the risk of viral load rebounding. The risk increased with the number of doses missed. Moreover, patients taking their HIV treatment once a day who reported missing three or more doses had a significantly increased risk of death. Missed doses did not have such serious consequences for patients taking twice-daily therapy.
http://www.aidsmap.com/en/news/269A4795-AD63-4B07-831B-516E7481FFBA.asp?Tracking=Bulletin&Referrer=1412299

Healthcare providers rarely recognize common symptoms in people with HIV
Patients with HIV can experience a wide range of symptoms. These can not only be a warning of serious health problems, but also reduce quality of life, and have been associated with poorer adherence to HIV treatment. US investigators report that nine symptoms in people with HIV were associated with health outcomes, but consistently under recognized by healthcare providers. This means that, in many cases, appropriate treatment to alleviate symptoms is often not provided.
http://www.aidsmap.com/en/news/C8FAEA39-8A3A-43D3-980F-4C319988D13A.asp?Tracking=Bulletin&Referrer=1412299

Human Resources

63rd World Health Assembly adopts the WHO global Code of practice on the international recruitment of health personnel from poor countries to rich countries
The Code of Practice sets forth ten articles advising both source and destination countries on how to regulate the recruitment of health personnel in a way that mitigates damage to low-income countries struggling to meet the basic health needs of their populations in a setting of serious workforce deficits.
http://www.who.int/workforcealliance/media/news/2010/codestatementwha/en/
http://apps.who.int/gb/ebwha/pdf_files/WHA63/A63_R16-en.pdf

Research finds different benefits attract nurses to rural areas in Kenya, South Africa & Thailand
The study by the Consortium for Research on Equitable Health Systems confirms that Discrete Choice Experiments can be designed to assist policy-makers in choosing more effective human resource policy interventions to address the shortage of health professionals in rural and remote areas. Intervention packages tailored to local conditions, for example with rural allowance or improved housing, are more likely to be effective than standardized global approaches.
http://www.who.int/bulletin/volumes/88/5/09-072918.pdf

A study by Michael Kent Ranson et al. finds common staffing priorities for health workers in low- and middle-income countries
A study involving interviews with key informants, including health policy-makers, researchers and community and civil society representatives, in 24 low- and middle-income countries in four regions, found many common concerns such as the number and distribution of healthcare workers, the performance of health personnel and a lack of stewardship from the highest levels.
http://www.who.int/bulletin/volumes/88/6/09-066290.pdf

Others

WHO/Euro launches new website
On May 25, 2010, the WHO/EURO office launched a new website on health topics, health systems, governance, human rights and activities in the European region.
http://www.euro.who.int/en/what-we-do/health-topics/Health-systems/stewardship-and-governance/activities/health-and-human-rights

First Sub-Saharan pharmaceutical manufacturer prequalified by WHO
In March 2010, the World Health Organization (WHO) pre-qualified a Ugandan pharmaceutical manufacturer, for production of anti-HIV and anti-malarial drug products. Quality Chemical Industries Ltd (QCIL) was inspected in January 2010 and found to comply with WHO good manufacturing practice (GMP). This does not constitute prequalification by WHO of the products manufactured by QCIL.
http://apps.who.int/prequal/WHOPIR/WHOPIR_QCIL25-28January2010.pdf

PSM Toolbox website updated
The PSM Toolbox website is a central repository for a wide range of health-related procurement & supply management tools. It features a user-friendly search engine that allows you to find the tool best fitted to your needs, regularly updated content, a forum to share tool use experiences, etc. The newly updated website contains 185 English tools and 62 French tools.
www.psmtoolbox.org

RESOURCES

Training opportunities

Netherlands Fellowship Programme for NGO staff
The Netherlands Ministry of Foreign Affairs is funding the Netherlands Fellowship Programme which allows NGOs in developing countries to gain skills and build their capacities internationally through training and education. Mid-career staff working in organizations in 61 developing countries can apply for this fellowship programme. It provides Fellowships for Master’s Degree Programmes, Fellowships for Short Courses, Fellowships for PhD studies and Refresher courses.
http://www.fundsforngos.org/nfp10nuffic

Publications

Where there are no pharmacists
This book (ISBN: 978-967-5412-17-2) by pharmacy professionals Sarah Andersson and Beverley Snell is about managing medicines. It explains how to order them, store them, prepare them, dispense them and use them safely and effectively. The book provides advice on all these aspects for people working with medicines as well as information to help communities benefit from the use of medicines, thus providing guidance for anyone who is doing the work of a pharmacist; anyone who sells, dispenses, prepares, manages, or explains to others how to use medicines.
More information on the content and how to order can be found on: http://www.twnside.org.sg/title2/books/HAI.htm

WHO publishes Continuity and change - Implementing the third WHO Medicines Strategy 2008-2013
The publication provides practical guidance to WHO and stakeholders on how the essential medicines concept and WHO’s expertise will be used to promote universal access and patient-centred health care for all. It presents priorities for action by WHO as a guide for future investment and planning decisions, and serves as a user-friendly document for stakeholders.
http://www.who.int/medicines/publications/medstrategy08_13/en/index.html

Incentives for global health publishes a report on universal access to new medicines
The report “The Health Impact Fund: Making New Medicines Accessible for All” shows how the Health Impact Fund supports both innovation and real access, extending the best of the ideas and initiatives by academics, NGOs, governments, and international agencies into one comprehensive, unified solution that makes substantial progress toward a rational system of developing and distributing worldwide the pharmaceuticals we all need.
http://www.yale.edu/macmillan/igh/hif_book.pdf

WHO publishes World Health Statistics 2010
The report on progress on the health-related Millennium Development Goals is available in 6 languages. It contains WHO’s annual compilation of data from its 193 member states and provides a comprehensive summary of the current status of national health and health systems in the following nine areas: mortality and burden of disease; cause-specific mortality and morbidity; selected infectious diseases; health service coverage; risk factors; health workforce, infrastructure and essential medicines; health expenditure; health inequities and demographic and socioeconomic statistics.
http://www.who.int/whosis/whostat/2010/en/index.html

Ecumenical Pharmaceutical Network (EPN) is a Christian, not for profit, independent organization committed to the provision of quality pharmaceutical services as a means to achieving global goals and targets on health and access to medicines.
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