Defeating Malaria Through Pharmaceutical Systems Strengthening
Defeating Malaria Through Pharmaceutical Systems Strengthening
Originally posted on the Global Health Council website
Between 2000 and 2015, great strides have been made in fighting malaria. Globally, malaria case incidences declined by 41% and mortality rates by 62%. However, approximately 212 million people were infected and 429,000 people died in 2015, with the majority being children under the age of 5 in sub-Saharan Africa. Malaria also places a great financial burden on individuals and health systems. In sub-Saharan Africa alone, the annual cost of case management related to malaria is estimated at USD 300 million.
Much has been done since 2000 to eliminate this disease, and ensuring improved access to and appropriate use of quality-assured malaria medicines is necessary to sustain these gains.
The USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program recently published the results of its activities in eight countries (Angola, Burundi, the Democratic Republic of the Congo, Ethiopia, Kenya, Guinea, Mali, and South Sudan) to control malaria.
This report summarizes systems strengthening interventions that support the prevention and treatment of malaria. With funding from the US President’s Malaria Initiative (PMI) and based on PMI’s priorities, SIAPS provided assistance to build capacity to manage malaria products and to strengthen financing strategies and mechanisms that would improve access to malaria medicines and the quality of pharmaceutical services for malaria patients. SIAPS also collaborated with national malaria control programs and central medical stores to develop and implement activities aimed at strengthening the pharmaceutical management of antimalarial products.
A significant challenge for countries is the lack of accurate and timely information that would enable a steady supply of medicines and accurate quantification and procurement for medicines and other health supplies. To facilitate the use of logistics data, the development of electronic early warning systems must be encouraged.
SIAPS launched the End Use Verification (EUV) tool to help assess malaria commodity stock status and malaria case management practices. Data collected using this tool have helped to monitor and avoid stock-outs and disseminate relevant information that directly supports the availability of commodities at the right place and time. In Ethiopia, as a result of findings from EUV surveys, a manual to guide redistribution of antimalarial medicines among public health facilities was developed to help facilities maintain acceptable stock levels and reduce expiries. In Burundi, the introduction of the EUV tool decreased the time needed for the medicine requisition process from two weeks to two days.
Another issue highlighted in this review is constraints caused by weak human resource capacity, poorly defined supply chain operating procedures, inadequate infrastructure, and poor medicine storage conditions and practices. To reduce malaria mortality, antimalarial medicines must also be provided through systems and services that ensure that the medicines themselves are safe and of good quality. For this reason, medicines need to be properly stored to maintain their quality.
In Angola, SIAPS provided support to reorganize the national central medical store to align with key warehouse functions. SIAPS also conducted trainings on good warehousing practices to support staff capacity and performance. These trainings and the reorganization of the medical store, which integrated and improved supply systems for essential commodities, made the entire warehousing processes more effective and efficient.
Strengthening health systems takes time, but controlling and eliminating malaria is possible. Strong partnerships among stakeholders, web-based tools, and ensuring sustained achievements for a strong and reliable supply chain of medicine help make it possible to increase and maintain effective interventions to support the prevention and treatment of malaria.
About SIAPS | The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program works to ensure access to quality pharmaceutical products and effective pharmaceutical services through systems-strengthening approaches to achieve positive and lasting health outcomes. SIAPS is funded by the US Agency for International Development (USAID) and implemented by Management Sciences for Health. For more information, visit www.SIAPSprogram.org.