- News
- Fake Drugs Watch: Fake Labelling in DRC
- ARV Supply Issues
- Antibiotic Use and Resistance: Vietnam
- Strategic Information for ARV Programmes
- 'Epidemic' of Traffic Accidents Threatens Developing Countries
- Vaccination News: Polio and Measles
- New Rural ART Programme in Rwanda
- Preventable Oral Disease: WHO Report
- Access to Drugs: IPR precednet in Thailand
- Resources
- Low Cost Healthcare Information System Software
- World Bank HIV/AIDS Procurement Guide
- Fixed-does Combinations Guide
-
Forthcoming meetings
News
Fake Drugs Watch: Fake Labelling in DRC
The latest fake drugs scam involves counterfeit antiretrovirals sold at lower prices in the DRC. It seems that counterfeiters have put fake labels on bottles containing non-ARV pharmaceutical products. Apparently, this illegal circuit of fake products directly target both prescribers and patients, by offering "ARVs cheaper than [...] Cipla". Local health authorities have been informed, and it is important to alert both health staff and patients. MSF, via e-drug: http://www.essentialdrugs.org/edrug/archive/200402/msg00028.php
ARV Supply Chain Issues
The Treatment Action Campaign (TAC) issued a warning that supplies of the paediatric formulation of efavirenz (Stocrin) could be interrupted as supplies were running out in South Africa. TAC accused Merck Sharp and Dohme (MSD) of abuse of its patent rights. “Failure to meet market demand of a life-saving medicine constitutes patent abuse … This unacceptable situation points to the need for multiple suppliers of essential medicines”, they argue. “With more providers there will be less likelihood of all companies running out of stock. Competition will also ensure that companies are more careful about monitoring their stock.”
In Nigeria, drug supply problems have arisen as a result of delay in processing of a grant from the Global Fund to Fight AIDS, TB and Malaria. According to Journalists Against AIDS, patients are being asked to take medicines which are now beyond their expiry dates because the Nigerian government does not yet have the funds to buy new drug stocks.
http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2512
Antibiotic Use and Resistance: Vietnam
A recent PhD review of antibiotic use in Vietnam looks at drug provision in the public and private sectors, antibiotic use and resistance in the community, and case management in private pharmacies in Vietnam. It concludes by saying that promoting Good Pharmacy Practice standards are needed to improve case management.
Abstract at: e-drug: http://www.essentialdrugs.org/edrug/archive/200402/msg00042.php
Thesis in full at: http://diss.kib.ki.se/2003/91-7349-630-8/
Strategic Information for Anti-Retroviral Therapy Programmes
The development of supply chain management and logistics information systems has been emphasized by the World Health Organisation as a key component in scaling up antiretroviral therapy in resource-limited settings. Presentations from a WHO/UNAIDS workshop last year include ‘Monitoring drug and commodity supply chains -- Yasmin Chandari (JSI Deliver)’
WHO: http://www.who.int/hiv/strategic/mt300703/en/
'Epidemic' of Traffic Accidents Threatens Developing Countries
Pharmacists need to be aware of the impact of traffic accidents on the demand for supplies of pharmaceuticals. The heavy social, economic, and health system burdens are a growing problem in developing countries because of the rapid increase in the number of vehicles on their roads. Traffic accidents cause more than 20 million casualties each year. In 2002, 1.2 million people died from road traffic injuries—70% were male. By 2020, road traffic deaths are expected to increase by 92% in China, 147% in India and 80% in many other developing countries.
WHO World Health Report: http://www.who.int/whr/en/
Vaccination News: Polio and Measles
From 23 February, 10 countries will hold simultaneous polio immunization campaigns, targeting 63 million children in Benin, Burkina Faso, Cameroon (20 February), Central African Republic, Chad (joining in March), Ghana, Niger, Nigeria, Côte d’Ivoire, and Togo. As part of the Global Polio Eradication Initiative, polio endemic countries have vowed to eradicate the disease by end 2004.
Meanwhile the virus is still active in West Africa after vaccination uptake falls in northern Nigeria, following funding problems and a boycott of the polio vaccination led by religious leaders who claim the vaccination is designed to sterilise girls.
WHO: http://www.who.int/mediacentre/releases/2004/pr13/en/
The Measles Initiative (WHO, UNICEF, American Red Cross, CDC, and UN Foundation) is on target to reduce measles morbidity in Africa by more than 50% by 2005. Massive vaccination campaigns are having an impact to reduce the estimated 452,000 deaths (in 2000) each year. Measles is one of the most contagious diseases known to man, and most children exposed to it will contract it unless vaccinated.
American Red Cross: http://www.redcross.org/article/0,1072,0_312_2216,00.html
New Rural ART Programme in Rwanda
Ruli District Hospital, near Kigali, launched the first rural antiretroviral therapy (ART) programme in Rwanda, the fourth ART programme in the country supported by the United States Agency for International Development (USAID).
FHI: http://www.fhi.org/en/HIVAIDS/CountryPages/Rwanda_HIV.htm
Preventable Oral Disease: WHO Report
WHO has highlighted that the impact of oral diseases in pain, suffering, impaired function and reduced quality of life, is both extensive and expensive. Oral health systems need to be oriented to primary health care and prevention.
WHO: http://www.who.int/mediacentre/releases/2004/pr15/en/
Access to Drugs: IPR precedent in Thailand
Two Thai PLWHAs have overturned a patent ruling on AIDS medicine, setting a new legal precedent. The case could have important international consequences, as the ruling was based on the fact that patients—whose health and lives can depend on being able to afford a medicine—are injured by patents and have legal standing to sue. This opens the way for generic production of the medicine. The Thai government currently produces a range of generic medicines that are up to 25 times cheaper than the brand version. The Lancet article describes how US trade pressure has limited access to affordable medicines by strengthening patent protection on pharmaceuticals.
MSF: http://www.doctorswithoutborders.org/pr/2004/02-13-2004_pf.html
RESOURCES
Low-Cost Healthcare Information System Software
A healthcare information system used in the US is being made available for use in hospitals and clinics throughout the world. The software system is being adapted by WorldVista for implementation in resource-poor environments and will be provided as ‘open source software’ (OSS), which does not have expensive licence fees.
The Indian health service and several other medical centres outside the US already use it, and it has been used for medication management, reducing errors in giving people the wrong drugs by 90%.
BBC Online: http://news.bbc.co.uk/1/hi/technology/3331739.stm
WorldVistA: http://www.worldvista.org
World Bank HIV/AIDS Procurement Guide
The World Bank has announced the release of the "Technical Guide for HIV/AIDS Medicines and Related Supplies: Contemporary Context and Procurement, February 2004”. The 107-page document addresses the specific requirements and unique features of the medicines and supplies that are part of the HIV/AIDS Care Package. It is now available as a .pdf file on the Bank's external website.
e-drug: http://www.essentialdrugs.org/edrug/archive/200402/msg00051.php
World Bank: http://siteresources.worldbank.org/INTPROCUREMENT/Resources/Technical-Guide-HIV-AIDS.pdf
Also Supply Chain Management and HIV: http://www1.worldbank.org/hiv_aids/docs/short%20version%20-%20SCM%20and%20HIV.pdf
Fixed-dose Combinations Guide
MSF has published a useful 4-page briefing note, “Two pills a day saving lives,” explaining fixed-dose combinations (FDCs) of ARVs, including: advantages of FDCs, WHO pre-qualification, and the role of national drug regulatory authorities.
e-drug: http://www.essentialdrugs.org/edrug/archive/200402/msg00037.php
MSF: http://www.accessmed-msf.org/documents/factsheetfdc.pdf
Forthcoming Meetings
World Federation of Public Health Associations (WFPHA)
10th International Congress on Public Health: “Sustaining Public Health in a Changing World: Vision to Action”
19–22 April 2004, The Brighton Centre, Brighton, UK.
http://www.phaworldcongress.com/
World Congress of Pharmacy and Pharmaceutical Sciences
4–9 September 2004, New Orleans
http://www.fip.org/neworleans/
Health Systems Management Program
An advanced leadership and capacity building program for health professionals
29 April–17 May 2004, Galillee College, Israel
Tuition scholarships available.
http://www.galilcol.ac.il
Focus on WHO Pharmaceuticals Newsletter
The aim of this Newsletter is to disseminate information on the safety and efficacy of pharmaceutical products, based on information received from the WHO/EDM network of "drug information officers" and other sources such as specialized bulletins and journals. The information is produced in the form of résumés in English, and is about 15 pages or 400-500Kb to download. Unfortunately the postal mailing list is currently full, and there is no electronic mailing list at present, but organisations can request library copies and we will continue to include a link to new issues of the Newsletter. The current issue includes:
- Lapdap—a threat or an opportunity? A fixed-dose combination antimalarial is being introduced in Africa without labelling regarding the contraindication for Glucose-6-Phosphate Dehydrogenase (G6PD) enzyme deficiency, which is prevalent in Africa.
- Pyrazinamide and rifampicin: the combined regimen should not be offered as a first-line treatment to persons with latent tuberculosis infection (LTBI), as high rates of serious liver injury have been reported.
Issue No. 1, 2004: http://www.who.int/medicines/library/pnewslet/1news2004.pdf
Archive page: http://www.who.int/medicines/organization/qsm/activities/drugsafety/orgpharmanews.shtml
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