Access to essential medicines to treat chronic respiratory disease in low-income countries

2016 ◽  
Vol 20 (6) ◽  
pp. 717-728 ◽  
Author(s):  
K. Bissell ◽  
C. Perrin ◽  
D. Beran
Keyword(s):  
Respiratory Disease ◽  
Low Income ◽  
Chronic Respiratory Disease ◽  
Essential Medicines ◽  
Low Income Countries ◽  
Access To Essential Medicines

scholarly journals Impact of COVID-19 Pandemic on Palliative Care Workers: An International Cross-sectional Study

2021 ◽  
Vol 27 ◽  
pp. 299-305
Author(s):  
Tania Pastrana ◽  
Liliana De Lima ◽  
Katherine Pettus ◽  
Alison Ramsey ◽  
Genevieve Napier ◽  
...  
Keyword(s):  
Palliative Care ◽  
Low Income ◽  
Online Survey ◽  
International Association ◽  
Essential Medicines ◽  
Low Income Countries ◽  
Direct Patient Care ◽  
Future Research ◽  
Access To Essential Medicines ◽  
The Impact

Objectives: The COVID-19 pandemic and the measures taken to mitigate spread have affected countries in different ways. Healthcare workers, in particular, have been impacted by the pandemic and by these measures. This study aims to explore how COVID-19 has impacted on palliative care (PC) workers around the world. Materials and Methods: Online survey to members of the International Association for Hospice and PC during the initial months of the COVID-19 pandemic. Convenience sampling was used. Statistical descriptive and contingency analyses and Chi-square tests with P < 0.05 were conducted. Results: Seventy-nine participants (RR = 16%) from 41 countries responded. Over 93% of those who provide direct patient care reported feeling very or somewhat competent in PC provision for patients with COVID-19. Eighty-four felt unsafe or somewhat safe when caring for patients with COVID-19. Level of safety was associated with competence (P ≤ 0.000). Over 80% reported being highly or somewhat affected in their ability to continue working in their PC job, providing care to non-COVID patients and in staff availability in their workplace. About 37% reported that availability and access to essential medicines for PC were highly or somewhat affected, more so in low-income countries (P = 0.003). Conclusion: The results from this study highlight the impact of COVID-19 on the provision of PC. It is incumbent on government officials, academia, providers and affected populations, to develop and implement strategies to integrate PC in pandemic response, and preparedness for any similar future events, by providing appropriate and comprehensive education, uninterrupted access to essential medicines and personal protective equipment and ensure access to treatment and care, working together with all levels of society that is invested in care of individuals and populations at large. The long-term effects of the pandemic are still unknown and future research is needed to monitor and report on the appropriateness of measures.

scholarly journals A Study on Service Availability and Readiness Assessment of Non-Communicable Diseases Using the WHO Tool for Gazipur District in Bangladesh

2016 ◽  
Vol 7 (2) ◽  
pp. 1-13 ◽  
Author(s):  
Mohammad Rashemdul Islam ◽  
Shamima Parvin Laskar ◽  
Darryl Macer
Keyword(s):  
Respiratory Disease ◽  
Chronic Respiratory Disease ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Essential Medicines ◽  
Service Availability ◽  
Diabetes Diagnosis ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Service Readiness

Non-communicable diseases (NCDs) disproportionately affect low and middle-income countries where nearly three quarters of NCD deaths occur. Bangladesh is also in NCD burden. This cross-sectional study was done on 50 health facilities centres at Gazipur district in Bangladesh from July 2015 to December 2015 to introduce SARA for better monitoring and evaluation of non-communicable diseases health service delivery. The General Service readiness index score was 61.52% refers to the fact that about 62% of all the facilities were ready to provide general services like basic amenities, basic equipment, standard precautions for infection prevention, and diagnostic capacity and essential medicines to the patients. But in case of non-communicable diseases, among all the health facilities 40% had chronic respiratory disease and cardiovascular diseases diagnosis/ management and only 32% had availability of diabetes diagnosis/management. Overall readiness score was 52% in chronic respiratory disease, 73% in cardiovascular disease and 70% in diabetes. Therefore, service availability and readiness of the health facilities to provide NCD related health services were not up to the mark for facing future targets.  A full-scale census survey of all the facilities of the study area would give a better understanding of the availability and service readiness.

scholarly journals Examination of WHO/INRUD Core Drug Use Indicators at Public Primary Healthcare Centers in Kisii County, Kenya

2020 ◽  
Author(s):  
Faith A. Okalebo ◽  
Eric M. Guantai ◽  
Aggrey O. Nyabuti
Keyword(s):  
Drug Use ◽  
Low Income ◽  
Primary Healthcare ◽  
Essential Medicines ◽  
World Health ◽  
Low Income Countries ◽  
Rational Use ◽  
Health Organization ◽  
Consultation Time ◽  
Primary Healthcare Centers

ABSTRACTBackgroundIrrational drug use is a global problem. However, the extent of the problem is higher in low-income countries. This study set out to assess and characterize drug use at the public primary healthcare centers (PPHCCs) in a rural county in Kenya, using the World Health Organization/ International Network for the Rational Use of Drugs (WHO/INRUD) core drug use indicators methodology.MethodsTen PPHCCs were randomly selected. From each PPHCC, ninety prescriptions from October to December 2018 were sampled and data extracted. Three-hundred (30 per PPHCC) patients and ten (1 per PPHCC) dispensers were also observed and interviewed. The WHO/INRUD core drug use indicators were used to assess the patterns of drug use.ResultsThe average number of drugs per prescription was 2.9 (SD 0.5) (recommended: 1.6– 1.8), percentage of drugs prescribed by generic names was 27.7% (recommended: 100%); the percentage of prescriptions with an antibiotic was 84.8% (recommended: 20.0–26.8%), and with an injection prescribed was 24.9% (recommended: 13.4–24.1%). The percentage of prescribed drugs from the Kenya Essential Medicines List was 96.7% (recommended: 100%). The average consultation time was 4.1 min (SD 1.7) (recommended: ≥10 min), the average dispensing time was 131.5 sec (SD 41.5) (recommended: ≥90 sec), the percentage of drugs actually dispensed was 76.3% (recommended: 100%), the percentage of drugs adequately labeled was 22.6% (recommended: 100%) and percentage of patients with correct knowledge of dispensed drugs was 54.7% (recommended: 100%). Only 20% of the PPHCCs had a copy of KEML available, and 80% of the selected essential drugs assessed were available.ConclusionThe survey shows irrational drug use practices, particularly polypharmacy, non-generic prescribing, overuse of antibiotics, short consultation time and inadequacy of drug labeling. Effective programs and activities promoting the rational use of drugs are the key interventions suggested at all the health facilities.

scholarly journals Assessing variation among the national essential medicines lists of 21 high-income countries: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045262
Author(s):  
Michael Sergio Taglione ◽  
Nav Persaud
Keyword(s):  
Low Income ◽  
Essential Medicine ◽  
Cross Sectional Study ◽  
High Income ◽  
Essential Medicines ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Essential Medicine List ◽  
Income Status ◽  
Essential Medicines Lists

ObjectiveEssential medicines lists have been created and used globally in countries that range from low-income to high-income status. The aim of this paper is to compare the essential medicines list of high-income countries with each other, the WHO’s Model List of Essential Medicines and the lists of countries of other income statuses.DesignHigh-income countries were defined by World Bank classification. High-income essential medicines lists were assessed for medicine inclusion and were compared with the subset of high-income countries, the WHO’s Model List and 137 national essential medicines lists. Medicine lists were obtained from the Global Essential Medicines database. Countries were subdivided by income status, and the groups’ most common medicines were compared. Select medicines and medicine classes were assessed for inclusion among high-income country lists.ResultsThe 21 high-income countries identified were most like each other when compared with other lists. They were more like upper middle-income countries and least like low-income countries. There was significant variability in the number of medicines on each list. Less than half (48%) of high-income countries included a newer diabetes medicines in their list. Most countries (71%) included naloxone while every country including at least one opioid medicine. More than half of the lists (52%) included a medicine that has been globally withdrawn or banned.ConclusionEssential medicines lists of high-income countries are similar to each other, but significant variations in essential medicine list composition and specifically the number of medications included were noted. Effective medicines were left off several countries’ lists, and globally recalled medicines were included on over half the lists. Comparing the essential medicines lists of countries within the same income status category can provide a useful subset of lists for policymakers and essential medicine list creators to use when creating or maintaining their lists.

Right Idea, Wrong Result—Canada's Access to Medicines Regime

2008 ◽  
Vol 34 (4) ◽  
pp. 567-584 ◽  
Author(s):  
Paige E. Goodwin
Keyword(s):  
Low Income ◽  
Essential Medicine ◽  
Developed Countries ◽  
Access To Medicines ◽  
Production Costs ◽  
Essential Medicines ◽  
World Health ◽  
Low Income Countries ◽  
Brand Name ◽  
Middle Income

In 2007, an estimated 33.2 million people were living with HIV, 2.5 million had become infected, and 2.1 million died from the virus. The majority of infected individuals reside in Africa, where in some countries as many as 33.4% of adults have HIV. In developed countries, effective drug therapies have reduced AIDS-related deaths by over seventy percent each year. These drugs have been so effective that over the last two years the global number of individuals dying from AIDS-related illness has actually declined. These therapies, however, are currently sold for $10,000 USD a year, a purchase price that is not feasible for low income countries where the annual health expenditure may be only $29 per person. A lack of essential medicine is not only a problem for those suffering from AIDS. Low and middle-income countries are disproportionately burdened by many additional chronic and infectious illnesses. The World Health Organization (“WHO”) estimates that one third of the world's population cannot regularly access essential medicines. The WHO cites the high cost of drugs as one of the major hurdles countries face in obtaining access to medication. However, the high cost of these brand-name medications does not reflect their minimal production costs. Drug manufacturers can produce generic versions of these drugs for as little as 1/30th of the cost of their brand-name counterparts.

scholarly journals The burden of chronic respiratory diseases in adults in Nepal: A systematic review

2021 ◽  
Vol 18 ◽  
pp. 147997312199457
Author(s):  
Winifred Ekezie ◽  
Alex Robert Jenkins ◽  
Ian Philip Hall ◽  
Catrin Evans ◽  
Rajendra Koju ◽  
...  
Keyword(s):  
Lung Disease ◽  
Low Income ◽  
Lung Diseases ◽  
Disease Burden ◽  
Airflow Obstruction ◽  
Chronic Respiratory Disease ◽  
Low Income Countries ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Chronic Lung Diseases

While chronic lung disease causes substantial global morbidity and mortality, global estimates have primarily been based on broad assumptions. Specific country data from low-income countries such as Nepal are limited. This review assessed primary evidence on chronic respiratory disease burden among adults in Nepal. A systematic search was performed in June 2019 (updated May 2020) for studies through nine databases. High levels of heterogeneity deemed a narrative synthesis appropriate. Among 27 eligible studies identified, most were low-moderate quality with cross-sectional and retrospective study design. Chronic lung diseases identified were chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis and restrictive lung diseases. Studies were categorised as: (i) community-based, (ii) hospital-based and (iii) comorbidity-related and disease burden. Reported disease prevalence varied widely (COPD, 1.67–14.3%; asthma, 4.2–8.9%). The prevalence of airflow obstruction was higher among rural dwellers (15.8%) and those exposed to household air pollution from domestic biomass burning as opposed to liquid petroleum gas users (Odds Ratio: 2.06). Several comorbidities, including hypertension and diabetes mellitus added to the disease burden. The review shows limited literature on lung disease burden in Nepal. Publications varied in terms of overall quality. Good quality research studies with prospective cohorts related to respiratory conditions are required.

scholarly journals Access to fludrocortisone and to hydrocortisone in children with congenital adrenal hyperplasia in the WHO Eastern Mediterranean Region: it takes a village…

2021 ◽  
Vol 6 (10) ◽  
pp. e007195
Author(s):  
Amanda Rowlands ◽  
Asma Deeb ◽  
Asmahane Ladjouze ◽  
Rasha T Hamza ◽  
Salwa A Musa ◽  
...  
Keyword(s):  
Congenital Adrenal Hyperplasia ◽  
Low Income ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Essential Medicines ◽  
Low Income Countries ◽  
Pharmaceutical Companies ◽  
High Morbidity ◽  
Adrenal Hyperplasia

Congenital adrenal hyperplasia (CAH), if untreated, carries high morbidity and mortality. A higher incidence of CAH is expected in countries where consanguinity is common, such as in the countries of the WHO Eastern Mediterranean Region (EMRO). CAH is managed through lifelong treatment with fludrocortisone and hydrocortisone. In this analysis, performed in the 22 EMRO countries and territories plus Algeria, we review which countries offer a neonatal screening programme for CAH and describe the barriers and opportunities to access oral fludrocortisone and oral and injectable hydrocortisone. Neonatal CAH screening was only available nationally in Qatar, Kuwait and partially in Lebanon and Saudi Arabia. We reviewed the national lists of essential medicines (NEMLs) and found that 13/23 (57%) countries included fludrocortisone and 18/23 (78%) included oral hydrocortisone. Fludrocortisone was not included by any of the low-income countries and oral hydrocortisone was only included by one low-income country. We then contacted paediatric endocrinologists in each country to assess perceived availability of these medicines. Overall, there was a relatively good consistency between inclusion of fludrocortisone and hydrocortisone in the NEML and their actual availability in a country. We propose several mechanisms to improve access, including prequalification by the WHO, a common registration process for groups of countries, pooled procurement, working with local pharmaceutical companies, special access status for medicines not yet registered in a country and compounding. We suggest that access to medicines requires a collaboration between health professionals, families of patients, health authorities, pharmaceutical companies and the WHO.

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