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WHO Medicines Work in Countries: The Kenya Example

WHO Medicines Work in Countries: The Kenya Example. KENYA. Regina M. MBINDYO EDM/NPO, WHO Kenya. General and Health Indicators: Kenya. Total population, 2001 …………………… 31.3 million GDP per capita (US$), 2001 ……………… 453.2 Life expectancy at birth (M/F), 2002 …… 47/49

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WHO Medicines Work in Countries: The Kenya Example

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  1. WHO Medicines Work in Countries: The Kenya Example KENYA Regina M. MBINDYO EDM/NPO, WHO Kenya WHO/UNICEF TBS September 05

  2. General and Health Indicators: Kenya • Total population, 2001…………………… 31.3 million • GDP per capita (US$), 2001……………… 453.2 • Life expectancy at birth (M/F), 2002…… 47/49 • Child mortality (M/F) (per 1000)………… 99/109(probability of dying under age 5 years) • Adult mortality (M/F) (per 1000)……… 560/513(probability of dying between 15 and 59) • Per capita total expenditure on health… 115 (in international dollars, 2000) • Total health expenditure as % of GDP… 8.3 • Adult literacy rate, 2000………………… . 73.6% WHO/UNICEF TBS September 05

  3. EDM Support to Kenya (04-05) • Key Issues & Challenges • Inadequate pharmacy laws and policies • Inadequate & irregular supply of essential medicines • Weak drug regulatory mechanisms • Vibrant private pharmaceutical sector • Irrational prescribing and dispensing by health workers • Lack of policy and legal framework for integration of traditional medicines into health care system • Increasing trends towards regional integration of pharmaceutical services and regulatory mechanisms • WHO EDM support to Kenya focuses on 5 broad areas: • Policy, Access, Quality Assurance, RUM & Traditional Medicines WHO/UNICEF TBS September 05

  4. Baseline Survey - 2003 • Joint collaboration of HAI, MOH & WHO. Completed in Dec 03 • Highlights of findings: • Prescribing according to EDL (81% of medicines prescribed) • 30% of population have access to essential medicines • 50% of population have access to health facilities (within one-hour walking distance) • National Medicines Policy available – last updated in 1994 • However: some areas for improvement • Over-prescribing common (93% of facilities) (prescribing antibiotics to 50% of patients) • No medicines pricing policy, or mechanisms to monitor medicine prices • No policy on traditional medicine • No coordinated programs to promote rational use of medicines • National QC laboratory available, but not operating optimally WHO/UNICEF TBS September 05

  5. EDM Key Activities Implemented in Kenya (2005) • Policy (P) • Formation of IP & Health Group (IPHAG) to articulate & monitor IP issues in MOH • Access (A) • Draft Report of Medicine prices survey produced & disseminated to stakeholders • Capacity Building on Drug Management for MOH procurement Agency (KEMSA) • Technical advice on drug issues to support ART roll-out in the country • Quality (Q) • Installation & training on SIAMED to improve efficiency of Drug Registration • Coordination of Tech. Audits for 2 QC labs pursuing WHO pre-qualification • Rational Use of Medicines (RUM) • Development of National Guidelines for promoting RUM • Training support for 2 nationals on RUM and DTC • Traditional Medicines (TRM) • Commemoration of Africa TRM day • MOH Participation in ongoing review of TRM policy WHO/UNICEF TBS September 05

  6. Progress of EDM Activities – Kenya (2005) WHO/UNICEF TBS September 05

  7. Medicine Prices Survey – 2004 • General Findings • Most public facilities use ‘course of treatment’ pricing. Lowest prices found in the public sector • Essential medicinesmore widely available in themission sector compared to the public sector • Generics widely available in private retail sector – has the highest prices • High generic procurement in public sector - virtually no Innovator Brands of KEDL items • Low procurement prices in both public & mission sectors • Some Policy Implications • Promotion of generic prescribing • Policy to support generic substitution • Promotion of price transparency WHO/UNICEF TBS September 05

  8. Medicine Prices Survey – 2004 Availability: KEDL Medicines WHO/UNICEF TBS September 05

  9. Medicine Prices Survey – 2004 Private Retail Sector Affordability WHO/UNICEF TBS September 05

  10. WHO/HAI-AfricaJoint Collaboration for Action on Medicines in Africa • Goals of the Collaboration Project • Increased access to essential medicines through improved policies and practices • Increased capacity & participation of NGOs & consumers in the development and implementation of medicines policy • Joint priority areas of work: medicines policy, pricing, rational use, IPR issues, operational research • Project countries: Kenya, Uganda, Ghana • Supported by DFID-UK • Country Working Group (CWG) at country level - MOH/HAI/WHO • Develop joint work plans for country activities • Mobilize resources for implementation of agreed work plans • Coordinate implementation of joint work plans • Timely periodic reporting to the Project Management Group (PMG) WHO/UNICEF TBS September 05

  11. MOH WHO/HAI-AfricaOverview of Collaboration • Rationale for the Collaboration • Synergy of expertise & know- how for greater impact • Learn from our different approaches; enhance our commonalities • Enhance broad stakeholder participation in policy development and implementation • Empower CSO & build capacity in the medicines field • Forge dialogue and links between consumers & MOH • Improve coordination and efficient use of resources • Collaborative Activities based on • Country priorities • Likelihood of sustainable impact • Added value in joint activity planning & implementation WHO/UNICEF TBS September 05

  12. WHO/HAI-AfricaCollaboration Activities • Assessment of the Pharmaceutical Situation in Kenya (Baseline Survey - 2003) • A Study of Medicine Prices in Kenya (2004) • MOH capacity strengthening on IPR Issues (ongoing) • Through IP & Health Advisory Group (IPHAG) • Monitoring the impact of patents on access to medicines • Development of Guidelines for Rational Use of Medicines (ongoing) • Establishment of Drug & Therapeutic Committees (DTC) at all levels (ongoing) WHO/UNICEF TBS September 05

  13. Future Activities for EDM -Kenya (2006 – 2007) • Participate in Review of the National Medicines Policy • Initiate activities to promote medicine price transparency • Promote Rational Use of Medicines in the community • Support Incorporation of drug management and RUM in pharmacy training curricula • Support Review of Clinical Guidelines and EDL • Support development of National Policy on Traditional Medicines (TRM), a Legal Framework and Code of Ethics for TRM practitioners • Capacity building in GMP, drug management and rational use in the pharmaceutical sector WHO/UNICEF TBS September 05

  14. Thank You Asante sana! WHO/UNICEF TBS September 05

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