Drug supply situation in Rwanda during COVID-19: issues, efforts and challenges

Uwizeyimana, Theogene; Hashim, Hashim Talib; Kabakambira, Jean Damascene; Mujyarugamba, Jean Claude; Dushime, Jackson; Ntacyabukura, Blaise; Ndayizeye, Remy; Adebisi, Yusuff Adebayo; Lucero‐Prisno, Don Eliseo

doi:10.1186/s40545-021-00301-2

Cited by 26 publications

(28 citation statements)

References 5 publications

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“…The efforts by the Government of Kenya on the promotion of local pharmaceutical manufacturing 27 should be encouraged and strengthened through harmonized policy coherence among ministries to avoid the devastating impact of pharmaceutical supply chain disruption as experienced during the current COVID-19 global pandemic. 25 , 26…”

Section: Discussionmentioning

confidence: 99%

“…24 Overreliance on imported medicines in Kenya increases medicine inaccessibility, pharmaceutical supply chain disruption, and unpredictable medicine pricing to patients, as demonstrated during the current COVID-19 global pandemic. 25 , 26 Though the Government of Kenya has an agenda to promote local pharmaceutical manufacturing, through its “big four agenda”, 27 there still needs to be harmonized policy coherence and an adequate financing model that can spur the industry into self-reliance and ensure medical product security. 24…”

Section: Medicine Access By a Patient Within Kenya’s Health Sub-sectorsmentioning

confidence: 99%

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Patients Access to Medicines – A Critical Review of the Healthcare System in Kenya

Toroitich¹,

Dunford²,

Armitage³

et al. 2022

RMHP

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Access to affordable, safe, effective, and quality-assured medicines by a patient is important for good health outcomes. Unfortunately, there is sparse literature published on the pharmaceutical enablers that may increase the sale of a substandard and falsified (SF) medicine to a patient in Kenya. The review highlights some of the factors that may facilitate the entry of SF medicines into the legitimate pharmaceutical supply chain and discusses their impact on patient access to medicines. Lack of essential medicines in public health facilities is an important factor that may contribute to increased demand for medicine-related out-of-pocket expenses from private health facilities, thus a likelihood for a patient purchasing SF medicine from unlicensed and illegal medicine outlets or unregulated websites. The need to increase medicine availability in the public sector by the Ministry of Health (MOH) is emphasized in addition to the strengthening of public procurement to cushion it from corruption and mismanagement. In addition, the MOH should promote local pharmaceutical manufacturing and implement a medicine pricing containment policy to avoid abuse and prevent overexploitation of patients, increase medicine price transparency, and reduce pharmaceutical supply chain distortion. Recommended regulatory reviews include accreditation of unlicensed illegal medicine outlets to facilitate accountability, regulatory oversight, and active surveillance. The national post-market surveillance regulatory capacity should be strengthened to improve rational medicine use. A 3-year diploma course should be replaced with a shorter 1- or 2-year pharmaceutical support staff training not eligible to superintend a pharmacy. The recommended legislative review includes a mandatory clause to enforce generic prescribing and the implementation of generic substitution by health workers. Unethical manipulative pharmaceutical marketing practices should carry stiffer penalties to deter malpractice. Future research areas include investigation of medicine prescribing and dispensing practices, medicine consumption studies, medicine price differences within different health sub-sectors, and between licensed pharmacies and unlicensed illegal medicine outlets.

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Section: Discussionmentioning

confidence: 99%

Section: Medicine Access By a Patient Within Kenya’s Health Sub-sectorsmentioning

confidence: 99%

Patients Access to Medicines – A Critical Review of the Healthcare System in Kenya

Toroitich¹,

Dunford²,

Armitage³

et al. 2022

RMHP

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“…Given that the supply of drugs and other sanitary materials in most sub-Saharan African countries depends almost exclusively on international production and import, delays in trade due to international lockdowns and the reallocation of resources, including pharmaceuticals, could make drugs' availability even more difficult, especially in semi-urban and rural contexts. In Rwanda, with the emergence of COVID-19, the drug supply system was interrupted leaving both local pharmacies and the big medical stores running out of stock [57]. More than half (59.6%) of respondents reported having difficulties accessing medicinal drugs, as shown by a cross-sectional online survey in Zimbabwe [58].…”

Section: Non-communicable Diseasesmentioning

confidence: 99%

The impact of COVID-19 on communicable and non-communicable diseases in Africa: a narrative review

2022

Infez Med

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The global pandemic of coronavirus disease 2019 (COVID-19) has disproportionately impacted global human health, economy, and security. Because of weaker health-care systems, existing comorbidities burden (HIV, malaria, tuberculosis, and non-communicable conditions), and poor socioeconomic determinants, initial predictive models had forecast a disastrous impact of COVID-19 in Africa in terms of transmission, severity, and deaths. Nonetheless, current epidemiological data seem not to have matched expectations, showing lower SARS-CoV-2 infection and fatality rates compared to Europe, the Americas and Asia. However, only few studies were conducted in low-and middle-income African settings where high poverty and limited access to health services worsen underlying health conditions, including endemic chronic infectious diseases such as HIV and tuberculosis. Furthermore, limited, and heterogeneous research was conducted to evaluate the indirect impact of the pandemic on general health services and on major dis-SUMMARY eases across African countries. International mitigation measures, such as resource reallocation, lockdowns, social restrictions, and fear from the population have had multi-sectoral impacts on various aspects of everyday life, that shaped the general health response. Despite the vast heterogeneity of data across African countries, available evidence suggests that the COV-ID-19 pandemic has severely impacted the control and prevention programs, the diagnosis capacity and the adherence to treatment of major infectious diseases (HIV, TB, and Malaria) -including neglected diseasesand non-communicable diseases. Future research and efforts are essential to deeply assess the medium-and long-term impact of the pandemic, and to implement tailored interventions to mitigate the standstill on decades of improvement on public health programs.

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“…More so, the emergence of the COVID-19 pandemic has resulted in a shortage of medicines across the continent due to the global travel bans and lockdowns, which affect medicines manufacturing and importation [23,24,25]. The urgent need to have access to medicines among the populace, due to the high diseases burden, is a potential route that can facilitate the circulation of fake and counterfeit medicines on the continent and the presence of porous supply chain systems worsen this further.…”

Section: High Burden Of Infectious Diseases and Non-infectious Diseasesmentioning

confidence: 99%

Revisiting the issue of access to medicines in Africa: Challenges and recommendations

Adebisi

Nwogu

Alaran³

et al. 2022

Public Health Challenges

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Background: Access to safe, effective, affordable, and quality medicines is an essential component of the right to health and is also one of the targets in the global development agenda. In this review article, we extensively discuss the challenges and issues surrounding access to medicines in the African region as well as provides recommendations for ensuring medicines security on the continent. Methods: We conducted narrative review with the use of data reported in published literature, reports, and grey literature available in African countries on topics pertaining access to medicines. The authors also snowballed further data to gather information for this review and narrative synthesis was conducted. Results: Africa faces a double burden of infectious and non-communicable diseases and the need for effective universal access to medicines cannot be deemphasized. However, access to medicines on the continent is not without issues and challenges. Some of which are the high burden of infectious diseases and non-infectious diseases, limited pharmaceutical industries and high costs of raw materials, overdependence on countries abroad for medicines, poor supply chain systems, lack of government investment in the pharmaceutical sector, unfavourable manufacturing conditions, limited health workforce, lack of sustainable health financing mechanisms, lack of infrastructures and technical know-how, low investment on research and development, and circulation of fake and counterfeit medicines among others. Conclusion:This review reifies that access to medicines in Africa faces numerous challenges and it emphasizes the urgent need to address these issues as the continent geared towards strengthening its health systems for universal health coverage.

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Drug supply situation in Rwanda during COVID-19: issues, efforts and challenges

Cited by 26 publications

References 5 publications

Patients Access to Medicines – A Critical Review of the Healthcare System in Kenya

Patients Access to Medicines – A Critical Review of the Healthcare System in Kenya

The impact of COVID-19 on communicable and non-communicable diseases in Africa: a narrative review

Revisiting the issue of access to medicines in Africa: Challenges and recommendations

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