Access to medicines p pt 17 10-2015

1. Facts Finding on
situational analysis oF
Pharmaceutical sector
DR. THIDA HLA
Director
(Medical Care, Medical Cover and
Medical Board)
Project Manager
Myanmar Essential Medicines Project
Department of Medical Services

2. Access Framework
1. Rational
Selection & Use
3. Sustainable
financing
4. Reliable
health and
supply
system
2. Affordable
prices
ACCESS

3. Medicines In Health Care Delivery In
Myanmar
Situational Analysis ; October 2014
• (led by Regional Advisor, SEARO, WHO)
• Medicines supply,
• Medicines selection,
• Medicines use,
• Medicines regulation and
• Medicines policy

4. Medicines supply
• "Push" to "pull system"
• Government expenditure for medicines
0.2 to 3 US$/person/year
• Availability of key essential medicines -
75-80% in Hospitals, 59% in RHCs & SubRHCs
• Decentralized Procurement System - no
economies of scale and inefficient "pull" system
• Computerized Inventory Management System -
in process to establish

5. Medicines selection
• NEML (2010) contains 341 medicines (Essential
and Complementary)
• Procurement of Essential Medicines -
90% - in the CMSD
70 - 84% - in Tertiary Hosp: and

6. Medicines Use
• Consumption - greatly increased since 2011
• Avg no of medicines prescribed per pt - 3.2-3.3 in
public hospitals
• % of prescribed medicines belonging to NEML -
75-89% in public sector and 54% in private sector
• % of medicines prescribed by generic name - 54-
73% in public and 26% in private sector
• % of URTI with antibiotics - 73-92%
• Vitamin use - 39-57% in public and 23%
in private sector
• Monitoring & Promotion of RU - little
• STG - at primary care level

7. Medicines Regulation
• FDA - Division to Department, Divisions at
States/Regions
• Registered Medicine Products - over 17,000
• Manufacturing Units - 8
• Importers/Wholesalers - 170
• Medicine Retail Pharmacies - over 10,000
• National medicine testing lab - over 1,000
samples/yr (3-5% fail)
• Mini labs - establish in States/Regions
• Post Marketing Surveillance - Suboptimal

8. Medicines Policy
• National Medicine Policy - not developed yet
• Myanmar Essential Medicines Programme -
needs to strengthen

9. Supply Chain Management System

10.  National Supply Chain Management Strategic
Planning Workshop in November agreed to a
shared vision of an integrated national supply
chain led by the MoH.
 A key recommendation, endorsed by MOH, was
to conduct a national supply chain baseline to
provide a evidence-based platform that will guide
future system strengthening efforts and inform
areas of collaboration

11. National Supply Chain Baseline Survey
USAID/PEPFAR and 3MDG co-funded the
exercise which was conducted jointly by the MOH
and PFSCM.
Data was collected through March-April 2014,
validated and analyzed in May-June 2014 and the
report was submitted to the MOH.

12. Data collection teams visited 285 facilities
across all States/Regions
12
Central Warehouse: 2, Central Program Warehouse: 4
Regional Warehouses (Program/CMSD): 29
Transit Camps: 3, Central Lab: 2
General Hospitals:34
Specialist Hospitals: 25
District Hospitals: 27
Township Hospitals: 69
Station Hospitals: 22
Rural Health Centers: 44
NGOs: 23
State Health Department: 1

13. What Should be achieved
National Medicines Policy
• Organize high level medicines policy discussions
regarding roles of public and private sectors in
procurement and supply, review fiscal
requirements, review national medicines policy
• Strengthen MEMP to be the executive division in
MoH

14. What Should be achieved (cont;)
Medicines Regulation
• Strengthen the FDA Department
• Strengthen national laboratory capacity in quality
testing of medicines
• Strengthen PMS, Registration Process
• Establish a unit to monitor medicines
promotional activities

15. What Should be achieved (cont;)
Medicines Use
• Develop National STGs
• Establish Hospital DTCs
• Monitor Medicines Use
• Establish Medicines Information Centre
• Public Education & CME on RUM

16. What Should be achieved (cont;)
Medicines Selection
• Revise NEML and Implement
• Establish system to review for Non-NEML
Medicines Supply
• An efficient, cost effective and transparent supply
chain that ensures the availability of quality,
efficacious medicines, medical supplies and
equipment at all levels to improve health
outcomes

17. Thank you