Analytical summary - Medical products, vaccines, infrastructures and equipment
Nine countries still have to develop a national medicines policy. It is important for countries to systematically revise, update and harmonize their medicines policies with those of other countries and to integrate traditional medicine policies and strategies where these are used. Regulatory systems for medicines are inadequate in many countries, which is an issue of serious public health concern.
A recent survey showed that only 4% of countries have an acceptable level of regulatory capacity. All countries need to take measures against the entry and circulation of medicines of unacceptable quality, which occurs all too frequently with limited and complex registration procedures. A limited number of quality control institutions are operational, but more are needed.
About 50% of the population in sub-Saharan Africa lacks regular access to essential medicines, while traditional medicine remains insufficiently integrated into conventional health services. Problems of insufficient access can be attributed to:
- inadequate human resources
- insufficient financing
- high medicine prices, particularly in the private sector
- inadequate management of public sector procurement and supply management systems
- an inadequately regulated pharmaceutical markets.
To ensure universal access, medicines must be suitably priced and regularly available. Causes of irregular supplies include:
- inadequate procurement budgets
- delays in payment and delivery
- unreliable quantification of needs
- weak supply management and distribution systems.
Also, more countries need to implement strategies to promote the rational use of medicines and improve prescribing practices.
The traditionally low priority accorded to health laboratories has now been recognized as inappropriate, but strong support for laboratory networks is needed if they are to play their critical role. Most laboratories now belong to external quality assessment schemes to ensure high performance standards and obtain further training and guidance where needed. Unsafe patient care is recognized as a public health issue of concern across the WHO African Region and present measures need to be maintained and strengthened.
Efforts to improve access to safe blood and blood products should be maintained. In respect of blood safety, the regional target of 80% for voluntary, non-remunerated blood donation has been attained by 20 of the 46 countries of the Region. However, 21 countries have still to collect even half their total blood supply from voluntary, non-remunerated blood donation.
In summary, focus needs to be kept on:
- the further development and updating of national medicine policies;
- the development of national policies and strategic plans to ensure adequate laboratory capacity;
- the development of guidelines, norms and standards on safe health care practices to protect patients in health care settings.
- blood safety programmes need active support.
These activities will enable countries to strengthen their national health systems.