Others - Medical products, vaccines, infrastructures and equipment
Traditional medicine policy and strategy
Traditional medicine is widely used in a number of African countries. Hence policies and regulation measures, and appropriate methods of interface with allopathic systems, are required. Thirteen countries (Cameroon, Central African Republic, Congo, Cote d’Ivoire, Democratic Republic of the Congo, Ghana, Kenya, Nigeria, Rwanda, United Republic of Tanzania, Uganda, Zambia, Zimbabwe) have developed national policies on traditional medicine, legal frameworks for the practice of traditional medicine, codes of ethics and strategic plans.
Guidelines for the clinical study of traditional medicines have been developed for adaptation to specific country situations. Research and development has been carried out to generate evidence on the safety, efficacy and quality of traditional medicines, with some encouraging results. A strong focus in traditional medicine research has been on medicinal plants, particularly for the treatment of malaria, opportunistic infections in people living with HIV/AIDS, diabetes, hypertension and sickle-cell disease. Some African countries are developing national herbal pharmacopoeias to scientifically document useful medicinal plants that have been found efficacious in the management of various ailments.
Advocacy for traditional medicine, networking and information exchange is promoted through the annual African Traditional Medicine Day. This event raises the profile of traditional medicine, creating opportunities for improving the interface between traditional medicine and conventional medicine, and enhancing efforts to integrate traditional medicine into national health systems.
Role of strong laboratory facilities
Health laboratory services are a critical component of the health system. Despite their central role, strengthening nationally coordinated laboratory services has, until recently, received inadequate attention in many countries. Laboratory services have therefore received very low priority in respect of financing, planning and service delivery.
Given the emphasis on evidence-based medical and public health practices, it is imperative that health laboratories, and laboratory systems and networks, are strengthened if they are to provide critical inputs to informed decisions. For this reason, the WHO Regional Committee for Africa adopted Resolution AFR/RC58/R2 on Public Health Laboratory Strengthening in 2008. This has led to work on establishing effective regional public health laboratory networks. These networks include regional reference laboratories with the capacity to diagnose a variety of viruses, including influenza.
Most of the national reference laboratories are involved in external quality assessment schemes, which validate laboratory capacity to perform diagnostic tasks. As needed, technical guidance on topics such as on-site training, and development and dissemination of standard operation procedures are provided to laboratories found to be performing poorly.
Lack of national health laboratory policies and plans is one of the most important challenges for African countries. To address this issue, a guidance document has been developed and published in collaboration with Centers for Disease Control and Prevention and other partners. Technical support has been provided to over 15 countries to develop national laboratory policies and strategic plans.
To build capacity in laboratory biosafety and biosecurity, more than 200 nationals from all 46 countries in the WHO African Region have been trained. The aim of the training workshops was to enhance Africa’s capacity to diagnose dangerous emerging and re-emerging pathogens, including haemorrhagic fever viruses and the highly pathogenic influenza virus H1N5.
In the area of patient safety, most African countries lack national guidelines, norms and standards. Although much of the evidence on the burden of harm from medical care is derived from developed nations, enough evidence exists in developing countries and countries with economies in transition to suggest that unsafe care is a universal problem.
Prevalence studies on hospital-wide health care associated infection from some African countries have reported high infection rates (18.9% in Mali, 14.8% in the United Republic of Tanzania and 9.8% in Algeria), those most affected being patients undergoing surgery. Hospital-associated infections generate considerable additional health care expenditure, representing a significant burden to patients, health care workers and health systems alike. To address this, a regional network for patient safety has been established in West African French-speaking countries. This network has organized national campaigns to improve hand hygiene as a measure to limit or prevent infections in health care settings.
The WHO African Region, through document AFR/RC58.8 adopted by the WHO Regional Committee in September 2008, has prioritized 12 action areas for strengthening patient safety. The prevention and control of infection is at the heart of these actions. Since early 2009, hospital-to-hospital partnerships between the UK and mainland Europe, and hospitals in African countries, have been established. Each partnership is committed to systematic action to improve patient safety.
Regarding safety in respect of clinical procedures, the WHO situational analysis tool to assess essential and emergency surgical care was employed in 15 countries. Baseline emergency and surgical conditions for evidenced-based planning were identified and severe shortages were noted in all aspects of infrastructure (including hospital beds), personnel and supplies required for delivering surgical care. If the Basic Package of Health Services, including emergency surgical care, is to be delivered, additional resources and manpower will have to be generated.
In connection with clinical procedures, a regional consultation on organ donation and transplantation was organized. This meeting provided an opportunity to review the topic, and promote national responsibilities on donation and transplantation of cells, tissues and organs.
- ↑ Guidelines for clinical study of traditional medicines in WHO African Region. Brazzaville, World Health Organization Regional Office for Africa, 2004 (AFR/TRM/04.4)
- ↑ Traoré M et al. In vitro and in vivo antiplasmodial activity of “saye”, an herbal remedy used in Burkina Faso traditional medicine. Phytotherapy Research, 2008, 22:550–551
- ↑ Nikiema JB et al. Stratégie d’utilisation des substances naturelles dans la prise en charge des personnes vivant avec le VIH : expérience du Burkina Faso. Dossier Spécial: médecine traditionnelle en Afrique. Ethnopharmacologie, 2009, 43
- ↑ Patient safety in African health services: issues and solutions. In: Fifty-eighth session of the WHO Regional Committee for Africa, Yaoundé, Cameroon, 1─5 September 2008. Final Report (pdf 449.11kb). Brazzaville, World Health Organization Regional Office for Africa, 2008 (AFR/RC58/8) http://apps.who.int/iris/bitstream/10665/19987/1/AFR-RC58-8.pdf