Trends and Challenges in Access to Essential Medicines in Ethiopia and the Contributions of Local Pharmaceutical Production

Decades ago, the United Nations declared that access to essential medicines was a key element of universal human rights. Accordingly, member states have been striving to address this issue through strategic policies and programs. Strengthening local pharmaceutical production has been a pivotal strategy adopted by many developing countries including Ethiopia. The government of Ethiopia identified local pharmaceutical production as a key industrial sector and has been implementing a ten-years strategic plan to improve capabilities and attract investment. Such support is needed because local production could satisfy only 15 to 20% of the national demand, typically from a limited portfolio of medicines in conventional dosage forms. The increasing prevalence of chronic diseases has accentuated the need for a more sustainable supply to reduce reliance on imports and increase access to essential medicines. A full understanding of the structure, constraints and complexities of the Ethiopian pharmaceutical market structure is vital to direct effective policies, target most impactful investments and exploit opportunities for leapfrogging. Hence, the purpose of this review was to assess the trends and challenges in access to essential medicines and local pharmaceutical production in Ethiopia. Literature search through major databases and review of policy documents and performance reports from relevant sector institutions were made to extract information for the review

"De mão-em-mão tramando redes e normas: a vida social das pílulas anticoncepcionais, a partir de suas bulas" / "From hand to hand plotting networks and norms: The social life of contraceptive pills through their patient information leaflet "

Resumo Com o objetivo de descortinar aspectos da vida social das pílulas anticoncepcionais, o artigo analisou o conteúdo de suas bulas publicados no guia de medicamentos Dicionário de Especialidades Farmacêuticas (DEF), entre 1971 e 1990. Procuramos explorar os discursos veiculados nesses dispositivos - a quem se dirigiam, o que propunham e que efeitos pretendiam - e compreender como contribuíram e o que nos revelaram sobre o seu percurso biográfico. As bulas se comportaram como importantes veículos de intercomunicação entre os atores que participaram da trajetória desses medicamentos, desde sua produção pela da indústria farmacêutica, até chegarem às suas consumidoras finais, as mulheres, passando também por médicos, enfermeiros, farmacêuticos, donos e balconistas de farmácias e transitando entre consultórios, serviços de saúde, entidades de planejamento familiar, estabelecimentos comerciais, lares e bolsas femininas. Nessa enorme cadeia de associações produzidas pelas pílulas, as bulas contribuíram para a geração de um mínimo denominador comum que permitiu a normalização e naturalização das práticas de controle da fecundidade hormonal e para a formação do mercado - não só no sentido econômico, mas em sentido sociológico, como redes de interações e trocas, onde circularam bens que agregaram a um só tempo valores econômicos, simbólicos e normativos.

Abstract In order to uncover aspects of social life of pharmaceutical pills and based on the theoretical-methodological perspective of the drugs biography, this paper analyzes the instructions of their leaflets, published in the Dictionary of Pharmaceutical Specialties (DEF), between 1971 and 1990. It seeks to explore the speeches conveyed in papers that accompanied the packaging of the "medicine pill" - to whom they were headed, what they proposed and what social effects they intended - and to understand their participation in the set of associations that allowed the stabilization of oral contraceptives in Brazil. Leaving the pharmaceutical laboratories, the patient information leaflet transited among physicians, nurses, pharmacists, owners and shopkeepers of pharmacies and women, passing from hand to hand, in offices, health services family planning entities, pharmacy counters, medical departments of companies, households and women's bag. They were the important intercommunication vehicles between these actors and in the big chain of associations produced by contraceptive pills, the patient information leaflets contributed to a minimum common denominator that allowed to return a normal and natural control practices of hormone-mediated fecundity and the formation of the fertility control pill market, where goods were giving movement to add economic, symbolic and normative values at the same time.

A pílula da oportunidade: discursos sobre as pílulas anticoncepcionais em A Gazeta da Farmácia, 1960-1981 / The opportunity pill: discourses about the birth control pill in A Gazeta da Farmácia, 1960-1981

Resumo O artigo analisa matérias sobre pílulas anticoncepcionais publicadas em A Gazeta da Farmácia, entre 1960 e 1980, examinando aspectos pouco conhecidos da biografia desses medicamentos e da constituição do seu mercado. Para os profissionais de farmácia, os anticoncepcionais orais se apresentaram como "as pílulas da oportunidade", seja no sentido dos lucros, seja no sentido de resgatar seu prestígio no campo científico, clínico-terapêutico e político. As trajetórias das pílulas anticoncepcionais e do mundo da farmácia se interseccionaram, quando ambos buscavam tecer sua biografia, apadrinhados pela indústria. Farmacêuticos e pílulas se coconstituíram, um sendo importante ponto de passagem para outro.

Abstract The pharmacy world was a mandatory crossing point and active player in the establishment of hormonal contraception in Brazil. Through an analysis of articles published in A Gazeta da Farmácia from 1960 to 1981, the study explores little-known aspects of the birth control pill's biography and the construction of its Brazilian market. For pharmacy professionals, oral contraceptives were "opportunity pills" in two senses: they provided profits and they restored the prestige of these professionals within the scientific, clinical-therapeutic, and political realms. The pathways of the pill and the pharmacy world intersected as both wove their biographies under the patronage of industry. Pharmacists and the pill were co-constructed, and each was an important crossing point for the other.

Os investimentos das indústrias farmacêuticas brasileiras em programas sociais: uma análise dos indicadores sociais de 2006 / Investments of brazilian drug companies in social programs: an analysis of 2006 social indicators

O objetivo deste artigo é analisar a evolução dos investimentos sociais praticados pelo setor industrial farmacêutico brasileiro. A importância do estudo das políticas sociais criadas por esse importante segmento produtivo deve-se à sua forte influência nas mais variadas definições sobre políticas de saúde, entre elas o conflituoso campo de disputa entre a defesa das patentes por parte das empresas e as tentativas de licenciamento compulsório de medicamentos, por parte do governo. Tomamos como fonte de pesquisa os indicadores sociais de 62 indústrias farmacêuticas, relativos ao ano de 2006, publicados pela Federação Brasileira da Indústria Farmacêutica (Febrafarma), em maio de 2007, sob o título Painel Social, apresentados de três formas: dados gerais sobre o número de programas, valores investidos e o número de pessoas beneficiadas; dados gerais classificados segundo um modelo pré-definido e composto de categorias fixas (saúde, educação, comunidade, valorização da vida, cultura, meio ambiente, voluntariado e outros); e dados individualizados por empresa, com a indicação das ementas de cada programa criado. Buscamos com a reflexão sobre esses indicadores averiguar se eles possibilitam realizar um acompanhamento longitudinal das diretrizes e das proposições relacionadas às ações socialmente responsáveis praticadas pelas indústrias farmacêuticas.

The purpose of this article was to analyze the progress of social investments of Brazilian pharmaceutical industry. Studying social policies created by this major productive sector is important due to its strong influence on a wide variety of health policies, among them the conflicting battlefield between company's patent protection and government's compulsory license for patent drugs. The 2006 social indicators of 62 pharmaceutical companies, published in the Social Panel by the Brazilian Federation of Pharmaceutical Companies (Febrafarma) in May 2007, were studied. This publication included information in three different formats: general data on the number of programs; amounts invested and number of beneficiaries; general data categorized according to a predefined model comprising fixed categories (health, education, community, quality of life, culture, environment, and other); and customized data for each company including a summary of each program implemented. The purpose of the study was to assess whether these indicators allow a longitudinal follow-up of policies and proposals concerning social accountability of pharmaceutical companies.

Desabastecimento de medicamentos: determinantes, conseqüências e gerenciamento / Drug shortage: determinants, consequences and management

O artigo analisa o desabastecimento de medicamentos como um problema que transcende o aspecto logístico da área de saúde, discutindo suas implicações para a qualidade, segurança e custo da assistência. A cadeia de abastecimento farmacêutico e os fatores que interferem na capilaridade da distribuição e na disponibilidade do medicamento são discutidos. Ressalta a contribuição da comissão de farmácia e terapêutica para a prevenção e gerenciamento do desabastecimento de medicamentos nos estabelecimentos de saúde. Sugestões de medidas para gestão do desabastecimento de medicamentos são apresentadas. Enfatiza-se a necessidade do medicamento ser considerado pelos componentes da cadeia logística um produto de saúde, com tratamento diferenciado dos bens de consumo comuns.

The present study analyzes drug shortage as a problem reaching beyond the logistic aspect of the health field and discusses its consequences with respect to quality, safety and cost of health care delivery. The pharmaceutical supply chain and the factors that determine the distribution and availability of drugs are discussed. The contribution of the Pharmacy and Therapeutics Committee in preventing and managing drug shortage in health institutions is stressed and measures for drug shortage management are suggested. Finally it is emphasized that drugs should be considered health products rather than consumer goods and as such be given a different treatment by the supply chain.

Marketing Strategy of the Third Medical Terminal after the Implementation of Essential Drug List / 中国药房

OBJECTIVE:To provide suggestion for the marketing of the third medical terminal after the implementation of essential drugs list. METHODS:Retrieved from relevant literatures,the marketing situation of the third medical terminal after the implementation of essential drugs list was analyzed to put forward some advices. RESULTS & CONCLUSION:After the implementation of essential drugs list,market of the third medical terminal such as suburban pharmaceutical market,community clinic and private clinic became important place where pharmaceutical companies raced to enter into. Pharmaceutical enterprises should improve channel management,pay attention to public relation with government and adopt several marketing approaches to develop enterprise according to relevant policies.