ACCESS TO MEDICINES IN EMERGENCY

WHO Technical Briefing Seminaron Access to Essential Medicines

17-21 November 2009

Stéphanie ArsacICRC Head Pharmacist

ICRC : Who are we ?

The International Committee of the Red Cross (ICRC) is a Swiss-based humanitarian organization and founding member of the International Red Cross and Red Crescent Movement (1863). This Movement is composed of the ICRC, National Red Cross and Red Crescent Societies and the International Federation of Red Cross and Red Crescent Societies.

The ICRC is mandated by the international community to be the guardian and promoter of international humanitarian law.

We work around the world providing assistance to people affected by armed conflict and other situations of violence.

The organization has delegations and missions in some 80 countries around the world and employs a staff of over 12,000 people, most of them nationals of the countries in which it works. About 800 people work at the ICRC’s headquarters in Geneva, Switzerland,

Access to medicines in Emergency : Key success factors

Quality control of medicines via centralized purchase Availability of stocks Strong logistic set-up Trained and experienced people in health & logistics

Key Success Factors on a Global Scale

Nairobi

Abidjan

Amman Peshawar

Geneva

Corporate coverage

Regional coverage

Sub-regional coverage

Panama Kuala

Lumpur

Flying support

Logistic Hub

under process

under process

Emergency stock

Pre-positioning of Stock

The logistic set-up is defined by the positioning and the sizing of Emergency stocks to serve the first phases of large emergency

operations

Logistic hubs to store and regulate the flows

Flying supports, who are human resources mobilised for training, support to intense activities or background actions of anticipation

Set-up and infrastructures have different coverage depending on their situation. International set-up covers all the operation theatres, regional covers 4 to 6 bordering countries, sub-regional covers 1 to 3 bordering countries. It is to be noticed than most of flying support and emergency stock can be mobilised all over the world in case of large emergency operation

Pre-positioning of Stock

92 000 sqm of warehouses worldwide

Use of kits during the first stage of emergency

Re-order in bulk after health assessment

Kits pre-positioned (1)A BASIC/PRIMARY/PUBLIC HEALTH

KMEDKIAE01B IAEHK, BASIC, 1.000 pers./3m, no malaria

KMEDKIAE01BM (iaehk, basic,1.000 pers./3m) MALARIA module

KMEDKIAE01S (iaehk, suppl.,10.000 pers./3m) NO NARCO/PSYCHO/MALARIA/PEP

KMEDKIAE01SM (iaehk, suppl.,10.000 pers./3m) MALARIA module

DINJINSH10VI INSULIN, INTERMEDIATE ACTION, 100IU/ml, human, 10ml, vial

DINJINSH10VR INSULIN, RAPID, 100IU/ml, human, 10ml, vial

KMEDKCHO01 KIT, CHOLERA (001), 625 treatments with infusions

KSANKHEF01 KIT, HAEMMORRHAGIC FEVER, material for 100 patients

KMEDZGVA081 (kit reproductive health)CLEAN DELIVERY Ref 2A/UNFPA

KMEDZGVA082 (kit reproductive health)CLEAN DELIVERY Ref 2B/UNFPA

KMEDZGVA091 (kit reproductive health)POST-RAPE MANAGEMT.Ref 3/UNFPA

KMEDZGVA083 (kit reproductive health)CONTRACEPTION SET Ref: 4/UNFPA

KMEDZGVA084 (kit reproductive health)SIT KIT Ref: 5 / UNFPA

KMEDZGVA093 (kit reproductive health)PROF. MIDWIFERY Ref: 6/UNFPA

KMEDZGVA094 (kit reproductive health)UNSAFE ABORT. MANAGEMT.Ref:8/UNFPA

KMEDZGVA095 (kit reproductive health) SUTURE Ref:9/UNFPA

KMEDZGVA096 (kit reproductive health)VACUUM EXTRACTION Ref:10/UNFPA

KMEDZGVA097 (kit reproductive health) Referral Surgical equip. Ref:11a

KMEDZGVA098 (kit reproductive health)Referral Surg.drugs/disp.Ref 11b

KMEDZGVA099 (kit reproductive health)TRANSFUSION Ref: 12/UNFPA

B TRAUMA / WEAPON-WOUNDED

KMEDMDRE01 MODULE, DRESSING

KMEDKWWF05 KIT, 50 WAR WOUNDED, FIRST AID & TRIAGE, MEDICAL- single use

KMEDMFAT50BE (module, f.aid-tri.B) SET, EQUIPMENT+misc.mat., 50 w.w./cas.

  Field Surgical Team material + equipment (see separate worksheet)

KMEDKFAT50 KIT, FIRST AID-TRIAGE, 50 war wou./casualties, modules A/B/C

KMEDKWWH05 KIT, 50 WAR WOUNDED, HOSPITALIZED, RENEWABLES

KMEDSLINSR50S SET, LINEN, SURGICAL, single use,for 50 wounded hospitalised

KMEDSANE05B SET, ANAESTHESIA, BASIC MATERIAL, for 50 hosp. single use

KMEDSDRU05SS SET, DRUGS FOR SURG. AND ANAEST., SUPLEMENTARY, 50 patients

KMEDSTEA01 SET, TETANUS VACCINE AND IMMUNOGLOBULINS

XSEQSTRE1X STRETCHER, foldable in width

XSTEAUTO90 AUTOCLAVE, COMBINED, 90 l, elec./kero., incl. kero. burner

Kits pre-positioned (2)

Kits pre-positioned (3)C SURGICAL INSTRUMENT SETS

KMSISAMP01 SET, AMPUTATION, instruments

KMSISBON01C set, basic bone surg, comple., CURETTES

KMSISBON01 SET, BASIC BONE SURGERY, complementary, instruments

KMSISBAS01 SET, BASIC SURGERY, instruments

KMSISBOR01 SET, BONE WIRING & KIRSHNER, 8 sizes + instruments

KMSISCRA01 SET, CRANIOTOMY, complementary, instruments

KMSISDEN01 SET, DENTAL EXTRACTION, instruments

KMSISDRE01 SET, DRESSING, instruments

KMSISFIX02LF SET, EXTERNAL FIXATION, LARGE, FIXATORS, Hoffmann II

KMSISFIX01LF SET, EXTERNAL FIXATION, LARGE, FIXATORS, Synthes

KMSISFIX02LI SET, EXTERNAL FIXATION, LARGE, INSTRUMENTS, Hoffmann II

KMSISFIX01LI SET, EXTERNAL FIXATION, LARGE, INSTRUMENTS, Synthes

KMSISGYN01 SET, GYNAECOLOGY (dilat. & curettage), instruments

KMSISLAP01 SET, LAPAROTOMY, (+ caesarian), instruments

KMSISPLA01 SET, PLASTER CASTS REMOVAL, instruments

KMSISSKI01 SET, SKIN GRAFT, instruments

KMSISSUT01 SET, SUTURE, instruments

KMSISTHR01 SET, THORACOTOMY, complementary, instruments

KMSISSKE01 SET, TRACTION, instruments + 10 bows

KMSISURE01 SET, URETHRAL SOUNDS, instruments

KMSISVAS01 SET, VASCULAR, complementary, instruments

KMSISWOU01 SET, WOUND EXCISION, instruments

XSEQSPLIBA2P SPLINT, BOHLER-BRAUN, 70cm, size 2, 3 pulley, foldable

XSINMEDI507308 SPECULUM, SIMS, 23cm, open blade 23 x 80 mm, rectal

Logistic Key Figures

2740 vehicles / trucks 11 aircrafts

Logistic Key Figures

65 Log people in HQ 132 Log expatriates 2800 Log delegation

employees Different expertise

Red Cross & Red Crescent Movement

ICRC can rely on, or support a network of 186 National Societies and 97 Millions of volunteers

Quality Assurance and central purchase of medicines

To avoid counterfeits & Sub-standards Products registered in highly regulated countries If not, products assessed trough the Interagency

Product Questionnaire Good Manufacturing Practices audits of

pharmaceutical manufacturers by expert auditors

=

limited number of manufacturers to follow up

Local purchase of medicines

local purchase of medicines sometimes needed to fill specific or urgent needs or to supply specific treatments for chronic disease

Medical logisticians (pharmacists), are trained to identify reliable sources of medicines and avoid counterfeits and substandards

3 pharmacists in HQ dedicated to Quality Assurance and supporting the field

www.icrc.org