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We remember how the Communauté Baptiste au Centre de l’Afrique (CBCA) was ‘born’ in EPN. The first contact was at Abuja, in Nigeria, during a workshop of the Pre-ICASA conference where faith-based organizations came together from December 1st to 3rd 2005. Mrs Eva Ombaka presented the EPN activities and we were interested by the treatment literacy. When we approached her in the hallways, Eva was uncomplicated and shared the conditions for membership with us. In the following year, CBCA officially became part of the EPN family. Hence, the 30 years celebrations of EPN correspond to the 6th anniversary of CBCA's membership. Are we the baby of the family? Yes, maybe, but even at this age, EPN has supported us so much. Of course you know how much time children require from their parents.
We remember our first participation in the workshop for religious leaders, about HIV and AIDS treatment literacy, held in Nairobi from November 12th to 18th 2006. We were brand new then and we had a lot of time to learn. We were in contact with faith-based organizations that have experience of many years with taking care of people living with HIV, with the challenges of treatment, the care of children. The action plan that we developed has been an eye-opener to such an extent that in the Democratic Republic of Congo, and most of all in North and South Kivu, the other member churches of the Eglise du Christ au Congo said - ironically - that we had brought HIV and AIDS to the church.
This is not all! During a training on Standard Operating Procedures held at Yaoundé in Cameroon, we reviewed the flaws of the medical department, as far as the pharmaceutical domain was concerned. First, with 151 health institutions, the department did not have a qualified pharmacist, we did not have written and standardized procedures, etc.
The visit of Anke Meiburg to Goma, Bukavu, Butembo and Beni was a strong signal for us that we were really part of the network. This resulted in consolidating the acquired knowledge in Yaoundé through a local training on standard operating procedures and to the recruitment of a qualified pharmacist of university level. This pharmacist has very recently, in October 2010, taken part in a workshop on pharmaceutical issues, in Douala. Being the pharmaceutical professional, he received innovating ideas that have allowed us to renew the job description of Hospital Pharmacist and to start a Medicines and Therapeutics Committee (MTC) in the general referral hospital of Katwa. This noble idea of a MTC would never have been born without the foundation laid out in Douala. Having reached this level is a direct result of the membership to the Ecumenical Pharmaceutical Network.
For the future, even though we may face common challenges in the pharmaceutical domain, some challenges are local. We cite the non functional supply system of medicines in DRC. Through its vision, EPN can strive to strengthen its members and to reinforce their ability to face these international and local challenges. Uniting the members of one country in a network instead of working in a scattered manner can also bear more fruits. We, the members of the network, need to promote the consolidation and the growth of the network. Indeed, new potential members exist in our regions, but they are currently outside of the network looking for individual interests that risk not being very productive for the population.
And finally, we can state that EPN’s awareness campaign on antimicrobial resistance has changed our lives profoundly, as well as our attitude towards this category of medicines. It is true that if this issue is not taken seriously, the future generation is at risk of a true catastrophe. Imagine that while you read this sentence, several health professionals are prescribing antibiotics irrationally. Several patients are abusing antibiotics right now. Several members of our community re-use prescriptions for antibiotics and self-medicate. The work ahead is enormous. Goma, March 21st 2011
Communauté Baptiste au Centre de l’Afrique
Dr. Olivier Musongya
http://www.cbca-kanisa.org/ Back to top 
ASSOMESCA (Association des Œuvres Médicales des Eglises pour la santé en Centrafrique) was born in 1989 as an initiative of the Evangelical Lutheran Church of Bouar, Central African Republic. At the end of 2004, we joined the Ecumenical Pharmaceutical Network. With over 550 staff, 4 hospitals, 48 health centres, 8 warehouses and many more infrastructures, we welcomed EPN’s support with open arms. This membership became tangible when our Director, Dr Ione Bertocchi, returned from the 2006 EPN Forum in Germany, with a certificate of membership.
In August 2007, EPN organized a meeting in Lagos, Nigeria, bringing together several members. During this meeting, there were presentations and issues to be discussed, concerning EPN and the problems members were facing. EPN wanted to assist its members to tackle these problems. This is how I got to know the activities of EPN. The training organized by EPN on standard operating procedures and the 2008 Forum in Yaoundé, Cameroon, have left a considerable mark on us. These occasions have allowed us to really comprehend what EPN does: its activities focused on health and its support to pharmaceutical supply agencies.
Our encounter in Douala, for the seminar on pharmaceutical issues and the advocacy workshop, both organized by EPN, have made an impression on us and impacted our lives. The workshop allowed us to engage in advocacy with the Global Fund, to improve the distribution network of ARVs and reactants, and the distribution of medicines and reactants by the Global Fund.
Looking back, we can say that EPN’s work in the last 30 years has had a great impact on ASSOMESCA and the individuals within our association that have benefited from EPN’s support. We have gained knowledge and our institution has learnt a lot through the newsletters of the EPN secretariat.
The Good Governance policy and quality assurance of care will help faith-based networks be durable. When we think of the future of EPN, it is our hope that wherever there is a WHO office, there will one day be EPN representation and visibility. Bangui, April 20th 2011
Association des Œuvres Médicales des Eglises pour la santé en Centrafrique
Noel Ningalao Back to top Pooled Procurement of Medicines: a useful experience to improve access to quality essential medicines at a reasonable price!
Access to medicines of good quality at a good price, and their rational use is a core concern of the Ecumenical Pharmaceutical Network (EPN) and its members. This action area is part of the network’s priorities. The difficulties with regard to access are felt differently by the EPN members. These problems are more underscored when a member country is interlocked or when the capacity for supply is limited.
Chad, a landlocked country, is one of the countries where the cost of medicines for the sick in faith-based health structures is highest. In this country, the supply sources for generic essential medicines are limited and often lead to stock-outs. In order to be able to face this painful problem of stock-outs, 3 faith-based hospitals (Béré, Bébalem, Koyom) have joined hands to organise a pooled procurement from the Mission for Essential Drugs and Supplies (MEDS), also an EPN member, in Kenya. A simple test or the actual start of a solution to improve the availability of quality medicines for patients?
From the feasibility study to the order
Getting involved in such a grand operation of pooled procurement without a preliminary study could be dangerous, if not to say ‘suicidal’. It was necessary to collect data from at least 4 different sources: 2 from Chad and 2 from abroad (IDA and MEDS). The input of Mr Albert Petersen, Chair of the EPN Board was very useful, thanks to his active participation. This preliminary comparison study consisted of selecting 25 products, regularly used in the hospitals, estimating their consumption per trimester and comparing the price of different supply sources. It was quite clear that external procurement was best with regard to the price for patients.
The success of this first phase opened a door for us, to enter into the second phase, i.e. to engage with MEDS for the pooled procurement.
The big operation
It started with the reception and distribution to the participating hospitals, of the up-to-date list of medicines and consumables offered by MEDS. Each hospital expressed its needs, based on its financial capacity, and liaised with Koyom hospital which assured the coordination of the grouped order.
Once the order was placed, MEDS prepared the products with the utmost detailed care, under the supervision of Gladys Mburu, and following the internal preparation code which serves to avoid any possible confusion at the time of reception.
On March 15th 2010, the cargo left the MEDS grounds, destined for the port of Mombasa, Kenya, to then continue overseas to Douala, Cameroon. On June 13th 2010, the day of arrival and opening of the 40-feet container (carrying the products) was here. To our satisfaction, we found all the products that had embarked in Nairobi, to be intact.
Lessons learnt
Apart from the feeling of unity and the desire to work together between the faith-based hospitals in Chad, the first pooled procurement was the proof that Unity Is Strength, a strength that can allow us to go further, even across borders.
If pooled procurement makes it possible to temporarily resolve stock-outs in our hospitals, this is estimated necessary in a country such as ours, so as to make medicines financially accessible for the sick. Providing however that the time and the external and internal conditions do not change. The positive results of this first pooled procurement encourage us to repeat this experience in the future.
Details - The duration of order to delivery was 3 months. This is within the limits of what is acceptable for a country without a waterfront.
- The cost for the patient is acceptable and better than had the order been made in Chad. However, out of 100 medicines, 9 were rather expensive in comparison with local prices.
- The transport amounted to 26% of the cost of the medicines. The bigger the order, the better the ratio of the transport expenses.
N'Djamena, July 2010
Hôpital Evangélique de Koyom, Chad
Ndilta Djékadoum
http://www.hopitalkoyom.org/ Back to top
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