A lot of work concerning Medication Safety still has to be done as can be the conclusion from the article in the Expert Review of Clinical Pharmacology; ‘Pharmacovigilance in resourve-limited countries’ (June 2015).
Abstract; ‘In the past 20 years, many low- and middle-income countries have created national pharmacovigilance (PV) systems and joined the WHO’s global PV network. However, very few of them have fully functional systems. Scientific evidence on the local burden of medicine-related harm and their preventability is missing. Legislation and regulatory framework as well as financial support to build sustainable PV systems are needed. Public health programs need to integrate PV to monitor new vaccines and medicines introduced through these programs. Signal analysis should focus on high-burden preventable adverse drug problems. Increased involvement of healthcare professionals from public and private sectors, pharmaceutical companies, academic institutions and the public at large is necessary to assure a safe environment for drug therapy. WHO has a major role in supporting and coordinating these developments.’
Pharmacovigilance in resource limited countries 2015
Within Universal Health Care programs an important role is defined for Medicines Benefit programs.
MSH is a very active organisation in that theme: MSH: managing medicines_benefits_making_universal_health_coverage_a_reality (29-02-216)
Conclusion of the MSH publication: “The objective is to create awareness of the key considerations for designing a sustainable medicines benefit program in LMICs. Ultimately, if people can better incorporate medicines in their [universal health coverage] programs, then we will be meeting the objective [of universal health coverage], which is to reduce out of pocket payments and ensure equitable access to quality care.’
At the GIMS office we think; besides the needed Medicines Benefits Program a parallel Medication Safety Program should be created!
Today, 25th of May 2016, a side event was organised by the WHO at the 69th World Health Assembly with a clear focus; Medication Safety.
“Addressing the Global Challenge of Medication Safety to Improve Patient Safety and Quality of Care”.
The side event session will review the problem of unsafe medication practices and existing challenges to medication safety; explore key strategies for the safety of medication practices, and reduction of medication errors and medication-associated harm to improve patient safety and quality of care; and introduce the next WHO Global Patient Safety Challenge on Medication Safety for high-level advocacy and call for concerted global and country actions on medication safety.
The side event is co-chaired by:
His Excellency Piotr Stachazyk, Ambassador, Permanent Representative of
Poland to the UN Office in Geneva
Sir Liam Donaldson, WHO Envoy for Patient Safety
Dr Edward Kelley, Director, Service Delivery and Safety Department, WHO
The side event is sponsored by Poland and co-sponsored by Malaysia, Oman
and Sri Lanka.
For additional information, please contact
Dr Neelam Dhingra, Coordinator, Patient Safety and Quality Improvement, WHO
We look forward to your attendance!
Shelby Kemper, PharmD, MPH
Patient Safety and Quality Improvement Unit
World Health Organization
In Middle-income country Mongolia pharmacy business is economically booming and therefor also the number of pharmacies and pharmacists. But is the health of the Mongolians themselves also booming?
After a personal working visit the following conclusions could be made:
- Pharmacies function primarly as a logistic service for the general public and just use ICT for logistics and financial administration.
- Professional patient pharmaceutical counseling (e.g. controls on dosage, interactions, contra-indications) is very, very limited.
- Both policy makers, academia as well as pharmaceutical professionals realise that progress (both in education as well as ICT-tools) is necessary in the theme of Medication Safety in order to protect the general public from health risks originating from medication .
Mongolia is a place where GIMS can/should be of help.
Since considerable time big medicine distribution programs (mainly on HIV and TB) have been enrolled by entities like WHO and the Global Fund.
How is the aspect of Medication Safety covered in these programs? Both policy wise and practically?
Utrecht University student Christiaan van Bommel BSc Pharm, and almost graduated as MSc Pharm, will look into this more deeply.
Results are to be expected by the end of July 2016.
As stated in January, Aradhana Kohli, BSc Pharmacy will do her MSc research project at GIMS.
Research project The GIMS model definitive
1) Create a theoretical research framework, i.e. a (international applicable) screening and rating model of all structures, processes, actors, factors and the corresponding critical dynamics (Attitude, Knowledge, Tools) between them, concerning Medication Safety in a country (to be called the ‘GIMS model’).
2) Evaluate and adapt the screening model.
3) Produce an article, e.g. for the Pharmaceutical Weekly, international scientific magazines.
On the 11th of April the ‘Universities Allied for Essential Medicines‘ (UAEM) organised a debate in Maastricht.
GIMS was invited as a speaker and was also possible to make the point that ‘better acces to medicines ALSO means better safety measures are necessary’.
Utrecht University MSc-student Aradhana Kohli starts this month at GIMS for her MSc-theses. In preparation for her research project she made a summary of the two BSc-theses which where conducted in 2015 year at GIMS.
Summary BSc-theses 2016
Based on this research there are large differences found in regulations and legislation, prescription and delivery, availability and access to medicines among the countries studied. Factors such as education, war, government, culture and religion and economic state of a country have a significant impact on both regulating and monitoring these rules. The level of passive awareness among the healthcare specialists was high for nearly all the studied critical dynamics for all the countries. However the level of active awareness (in a way that one sees, or participates actively in, progress) was low in especially low and middle income countries.
This study didn’t provide hard outcomes, but can certainly provide a basis for a follow-up study in the field of global medication safety. Especially firstly in the analysis of the obstructions for increasing the active awareness of healthcare professionals.
Medicines are by their nature always ‘poisons’ as they can influence (drastically) the fysiology of an organism.
So let’s turn around the general idea that medicines can have negative side effects and correct it into;
only by carefull prescription and use the patient can benefit from the positive side effects of potential ‘poisons’.
That’s why at GIMS we use this back side on our business cards.
In the ever intensifying discussions about the cost of new, and very expensive (oncology) drugs, a widely heared argument from industry is that they are ‘obliged’ to their shareholders to perform financially this well. Otherwise they would not be able to attract investors and therefor their output of innovative medicines will be endangered.
An interesting development is that there is building up more pressure from big investors, like pension funds and ‘society sensitive’ banks, to also consider the effects on society as a whole of the strict financial focus Big Pharma feels it has to oblige to.
Can activistic share holders alter the direction of the developments?
Then they might also take in consideration that ‘inviting’ or pushing , Big Pharma to take active co-responsibilty for the Medication Safety related issues is a desirable societal goal aswell. GIMS can help!