72. Ensuring Supplies of Appropriate Drugs and Vaccines

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Abstract

Richard Lord, www.rlordphoto.com

Although access to essential medicines in developing countries has improved significantly in recent years, 30 percent of the world's population still has no effective access to modern drugs or vaccines. The majority of these people are extremely poor or living in remote rural areas.

Ensuring that needed essential medicines and vaccines are available is critical for the success of any disease control program. Important components of a supply system include careful selection of a short list of the most needed drugs and vaccines, procurement from qualified suppliers, proper storage and distribution using secure, reliable channels, and assurance of rational use and correct dispensing.

The World Health Organization (WHO) has set standards and norms for the selection and use of vaccines; however, where other pharmaceuticals are concerned, problems exist in procurement, quality assurance, and management of large stocks of donated drugs. Problems also exist in drug dispensing: for example, drugs dispensed by untrained staff members to patients who do not understand the drug's purpose can go to waste. The presence of "dispensing doctors" whose income depends on how much they prescribe has been associated with a failure to follow accepted guidelines.

Depending on the circumstances, either the public or private sector, or a combination of both, can efficiently deliver quality–assured medicines and vaccines. Essential medicines and vaccines can be reliably delivered to poor people using approaches that include bulk purchases of generic drugs, procurement from nonprofit suppliers, purchase of WHO–prequalified products, and use of private transporters or computerized systems to lower delivery costs and improve management of logistics.