Strategies for Enhancing Access to Medicines

Overview of Potential Strategies for Improving Access and Use

David Lee

Interventions to Improve Access and Use

Procurement and distribution mechanism– El Salvador– Ghana– Tanzania

Interventions to Improve Access and Use (2)

Retail medicines outlets– Brazil (Minas Gerais)– Cambodia– Tanzania– India (Rajasthan)– Ghana

Contracting Inventory Management/Distribution

El Salvador local partners– Ministry of Health-Suppliers and distributors

Incentives– Volume of sales

Product quality– Product monitoring and enforcement program

Service quality– Supplier and distributor performance monitoring

and enforcement program– Rational drug use program

Contracting Inventory Management and Distribution

Ghana local partners– Mission sector supply organization (CDC) - suppliers and

distributors Incentives

– Volume of sales Product quality

– Product quality monitoring and enforcement program by CDC

Service quality– Supplier and distributor performance monitoring and

enforcement by CDC– Consumer education program

Contracting AdditionalPrime Vendor Services

Tanzania local partners– Ministry of Health, Mission/NGO sector - suppliers

and distributors Incentives

– Volume of sales Product quality

– Product quality monitoring and enforcement program

Service quality– Supplier and distributor performance monitoring

and enforcement

Contracting Dispensing Services

Brazil (Minas Gerais) local partners– SUS, State Secretary of Health, Municipalities,

microregional health authority - pharmacies Incentives

– Volume of sales Product quality

– Product quality monitoring and enforcement program

Service quality– Pharmacy performance monitoring and enforcement

by ANVISA and SUS, including patient counseling

Certified Pharmacy and Drug Depot Network

Cambodian local partners– Pharmacists Association of Cambodia -

pharmacies and drug depots – prescriber network Incentives

– Access to prescriber network, low cost, quality products, training, certification

Product quality– Product quality monitoring and enforcement

program by PAC group purchasing arm Service quality

– Training, monitoring, and supervision by PAC, including consumer education program

Network of Accredited Dispensing Drug Outlets

Tanzania local partners– Pharmacy Board, local government - retail drug

outlets Incentives

– Marketing advantage, access to: low cost, quality products, expanded product list, information technology, training, accreditation

Product quality and Service quality– Product quality monitoring and enforcement

program– Standards compliance program, including

consumer education

Rural Pharmacy Network India (Rajasthan) local partners

– State PHC network - local NGOs Incentives

– Access to funding, training, fulfillment of mission Product quality

– Product quality monitoring and enforcement program

Service quality– Training, monitoring and supervision by the

pharmacy network management, including consumer education program

Franchising Essential Medicines

Ghana local partners– Ghana Social Marketing Foundation, chemical sellers

Incentives– Marketing edge, “brand” recognition and promotion,

access to low-cost, quality products, training, accreditation

Product quality– Product quality monitoring and enforcement program by

GSMF Service quality

– Training, monitoring and supervision by GSMF, including consumer education program

Interventions to Improve Access and Use

The devil is in the details …