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Procurement &supply chain management. 5 th Joint International Monitoring Mission. Overall observations . Increased funding for procurement of anti-TB drugs; No stock outs of anti-TB drugs & lab reagents;
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Procurement &supply chain management 5th Joint International Monitoring Mission
Overall observations • Increased funding for procurement of anti-TB drugs; • No stock outs of anti-TB drugs & lab reagents; • Availability and use of anti-TB fixed dosage combination drugs (FDCs) increased since 2007; • Well established Pharmacovigilliance system; • Ancillary drugs available for management of ADRs; • Functioning drug distribution system; • Good storage practices 5th Joint International Monitoring Mission
Challenges • Fragmented procurement: NHSO, SSO, CSMBS, BTB (GF), hospitals – higher cost, un-assured quality, frequent delays; • Numerous formulations/strengths procured: complicates drug management, leads to errors, stock outsand oversupply; • Still limited use of FDCs: poor treatment adherence and unfavorable outcomes; • Lack of pediatric anti-TB formulations; • OTC dispensing of anti-TB drugs: irrational use & amplification of resistance; • Large amount of drugs issued to MDR TB patient at once: amplify resistance & cause serious toxicity 5th Joint International Monitoring Mission
1 MONTH MDR TB PATIENT TREATMENT 5th Joint International Monitoring Mission
Recommendations • Single & streamlined procurement of quality assured anti-TB medicines; • Limit procurement of anti-TB medicines to essential formulations & strengths; • Procure & promote use of fixed dosage combination drugs through all stakeholders & partners; • Procure & avail nationwide child-friendly fixed dosage anti-TB formulations; • Ban OTC dispensing of anti-TB medicines through legal sanctions; • Ensure treatment enabler or observer for M/XDR TB patients 5th Joint International Monitoring Mission