The European Union (EU), the African, Caribbean and Pacific Group of States (ACP) and the World Health Organization (WHO) this week meet in Addis Ababa, Ethiopia, to take stock of progress made by a joint four year programme to improve access to quality medicines in 15 Sub-Saharan African countries . The EU/ACP/WHO partnership is one of the leading initiatives attempting to build strong pharmaceutical systems to make quality medicines available to African populations.
 

“We’ve seen many improvements, particularly in the availability of quality medicines in health facilities and strengthened capacities of staff in the sector,” says Dr Matshidiso Moeti, WHO Regional Director for Africa. “However good results require sustained efforts in the long term to obtain public health gains and reach universal health coverage. We need to see greater commitment, higher investment and better governance from countries. Strong healthcare cannot exist without strong and well managed pharmaceutical systems.”

With funding from the EU and technical support from WHO, the programme has made significant strides forward in most sectors of the pharmaceutical system in countries. Some of the achievements it has contributed to include:

• In Ethiopia, the Government has defined the list of priority medicines to be covered by the national insurance scheme, marking a first step towards universal health coverage 
• Pricing surveys conducted in Burundi and Mali have led to new legislation fixing prices in the private sector to limit out of pocket expenditure for patients 
• Regulators from most of the 15 countries participated in training workshops to acquire additional skills to assess and register medicines more efficiently, so that quality treatments may be made available to patients 
• Improved detection techniques have led to the increased capacity of Ethiopia and Mozambique to screen for substandard and counterfeit products at ports of entry
• National essential medicines lists were updated according to the most recent evidence to include more medicines for non-communicable diseases and treatments for children .

The programme has paid a great deal of attention to the quality and safety of medicines as crucial components of access. “Before we had no medicines and people didn’t come to the health facilities,” explains Dr Minkaila Maiga, WHO Medicines Adviser in Mali. “Now that we have the medicines we must make sure that they are of good quality and safe. People’s confidence in the system is based on its ability to treat them.”

As in many other regions of the world, barriers to accessing quality medicines in countries of the African region are often tied to resource constraints in the health sector, insufficient skilled staff, weak implementation of pharmaceutical policies and poorly managed supply chains. These barriers in turn create fertile grounds for the circulation of poor quality and counterfeit pharmaceuticals, unaffordable prices and generally low availability of the needed medicines in health facilities.

“Pricing is a major barrier in Africa,” explains Dr. Suzanne Hill, Director of WHO’s Essential Medicines and Health Products Department. “Generic medicines in low-income countries are only available in about 58% of facilities and on average cost 2.5 times more than the international reference price. Affordability is the next problem. Most Africans have limited access to social protection schemes and pay for medicines out of pocket, often leading to further impoverishment.”

Ending in September this year, the partnership this week will launch discussions on future steps and priorities, such as plans to move towards universal health coverage. Further work will be required for the 15 countries to sustain the progress made and ensure that their populations can fully benefit from it. Other countries in the region are seeking partners to improve their own pharmaceutical systems.

“One of our goals in this area is to help countries build the basis for universal health coverage and ensuring that access to medicines and all health products remains central to that effort,” comments Ambassador Chantal Hebberecht, Head of the EU Delegation in Ethiopia.

“The international community has positioned health as a pillar of the sustainable development agenda,” says Mr John F Kakule, from the ACP. “Access to affordable, quality essential medicines will continue to be a prerequisite for the aspiration of Universal Health Coverage.”

In addition to the EU funded programme, the meeting will discuss progress made to strengthen pharmaceutical systems and improve access to priority medicines for mothers and children in nine francophone African countries through the Fonds Français Muskoka.

Note to Editors

The EU/ACP/WHO ‘Renewed Partnership’ was established in 2012 with 10 million Euros seed funding to contribute to achieving the health-related Millennium Development Goals and universal health coverage. Under the leadership of Ministries of Health, the 15 ACP countries benefit from WHO’s strategic, technical and monitoring support to increase access to quality essential medicines by strengthening their pharmaceutical systems.

The Renewed Partnership kicked off in 2012 and is the sequel to a previous programme on pharmaceutical policies implemented from 2004 to 2010. The specific objectives of the Renewed Partnership are to improve availability, affordability and use of safe, effective and quality-assured essential medicines for priority communicable and non-communicable diseases. It thereby contributes to promoting cost effective health care and better patient health outcomes.