Strategies for Working with Countries – Regional and Sub-Regional Perspective and Experiences

Essential Drugs and Medicines Policy WHO South-East Asia Region

Krisantha Weerasuriya, Regional Adviser

Technical Briefing Seminar, Geneva, October 2007

World Health Organization

WHO Medicines Strategy 2004 – 2007: 4 objectives, 7 components, 44 expected outcomes

OBJECTIVES• Policy

• Access

• Quality and safety

• Rational use

COMPONENTS1. Implementation and monitoring of medicines policies2. Traditional and complementary medicine

3. Fair financing and affordability4. Medicines supply systems

5. Norms and standards6. Regulations and quality assurance systems

7. Rational use by health professionals and consumers

HTP

TCM

PSM

Other WHO

Clusters

Coordinated efforts between HQ Departments Regional & Country Offices

Coordinated efforts between HQ Departments Regional & Country Offices

Primary interaction

Secondary interaction

AFRO

AMRO

EMRO

EURO

SEARO

WPRO

Country Offices

NPO

NPO

NPO

NPO

Headquarters:

•Strategy and policy making

•Planning & monitoring

•Partnerships and Collaboration

•Resource Mobilisation

•Provide specific technical& policy support

• Support in HR development & training

Roles and responsibilities for supporting implementation of WHO Medicine Strategy

Roles and responsibilities for supporting implementation of WHO Medicine Strategy

Strategy, policy guidance, support and collaborations

Regional Offices:

• Oversee country operations • Planning and monitoring of country support

• Technical, policy and management support to countries

• Human resources development & training

• Partnerships and collaborations at regional level

Country Offices:

• Assess needs and identify priorities for technical support

• Plan & implement WHO work

•Provide technical and policy support to countries

• Assist in coordination

•Partnerships & collaborationsin countries

•Feedback and report

Ministries of Health:

• Identify needs & priorities

• Plan, implement and monitor action

• Coordinate with other Ministries and national bilateral and multilateral agencies and CSO's.

Planning, implementation, monitoring

Brief Description of South-East Asia Region

Eleven countries Bangladesh, Bhutan, DPRK, India, Indonesia

Maldives, Myanmar, Nepal, Sri Lanka, Thailand & Timor-Leste (11)

Enormous variation in medicines situationSelf sufficient --- Totally dependent on imports

One common feature – all developing countries Country needs and regional cooperation form basis of

activities

What is the framework for cooperation?(Common for all Regions)

Country Budget & Workplan Decided at the beginning of the biennium after

consultation between countries, Regional Office (RO) & HQ.

Based on WHO Medicines StrategyAdditional funds may become available depending on

particular initiatives Workplan – mixture of activities (workshops), specific

supplies, and training (in-country and outside)WHO is NOT a funding agency – does not fund routine

service activities

How does specific collaboration come about ?

Country driven – they have a specific issue – Good Manufacturing Practices – how can we develop our guidelines ?Registration of Medical Devices – how can it be done, what is the experience of the other countries?

Country driven – emergency – Tsunami - donationsWHO Initiative – as part of WHA Resolution or Regional

Committee Resolution. Bulk Procurement scheme for the Region

Both WHO and Country concerns (Avian influenza)

Examples of collaboration

Drug Donations – TsunamiIndia & Thailand – no donations pleaseSri Lanka – posted what was needed (but included non-emergency medicines)Indonesia – all donations acceptedStudies on donations done with WHO assistance in Sri Lanka and IndonesiaCountry driven – emergency – Tsunami - donations

Intellectual Property Rights and Pharmaceutical Patents (Regional Collaboration based on Inter Governmental Working Group on Public Health, Innovation & Intellectual Property.Indian Patent Legislation, Thailand Compulsory Licensing, Indonesia “Govt” use.

National Essential Medicines Lists – Regional Workshop – 30th Anniversary – WHO Initiative with country participation

Examples of collaboration Counterfeits – Global Initiative – Biregional (SEARO-WPRO)

Activity – learning from each otherDeveloping common definitionsDeveloping common methodsSharing informationUnderstanding how to tackle the problems

Controlled Substances (not taken up by countries) – use of opioids in pain relief in terminal illness

Pharmacovigilance – Uppsala Center, encouraging countries to be part of global scheme

Specific country activities – evaluation of the DRA as joint activity –HQ/RO/Country – Situation analysis and suggestions for improvement

Developing norms – adopt WHO ones but where necessary adapt

Summary

Country cooperation based on WHO Medicines Strategy

Regular workplans based on country needsInitiatives outside the workplans are

accommodated when necessaryWHO support - Technical assistance and not

fundingContinuing long term work + “when needed”

assistance