Inappropriate drug donations: the need for reforms

Snell, Beverley

doi:10.1016/s0140-6736(01)05712-9

Cited by 12 publications

(8 citation statements)

References 1 publication

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“…None of the short shelf-life donations was requested, and aid workers reported that they could not be distributed and used before the expiry date." 5 The issue of drug expiration is very relevant to anesthesiology. For a long time, it was considered appropriate to donate expired but unopened medications to LMICs.…”

Section: Medications: Many Of the Drugs Donated To Lmicsmentioning

confidence: 99%

“…6 This is based on the simple principle that there should be no double standards in quality: if a drug is unacceptable in the donor country, it is unacceptable in the recipient country. 5 Therefore, a useful mental exercise is to reverse the situation: if someone were to bring drugs from a LMIC into your clinical practice, what would you demand as to quality? Well, LMICs demand the same.…”

Section: Medications: Many Of the Drugs Donated To Lmicsmentioning

confidence: 99%

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The Goose and the Gander

Durieux

2016

Anesthesia &Amp; Analgesia

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Section: Medications: Many Of the Drugs Donated To Lmicsmentioning

confidence: 99%

Section: Medications: Many Of the Drugs Donated To Lmicsmentioning

confidence: 99%

The Goose and the Gander

Durieux

2016

Anesthesia &Amp; Analgesia

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“…Experiences from recent humanitarian emergencies in middle-income countries reveal repeated underestimation of local capacities by authorities, specialists and the public in high-income countries. This leads to over-supply of inadequate materials and drugs [13][14]. Governments and organisations in high-income countries should carefully assess how they react to tragic disasters, especially in middleincome countries with considerable domestic capacities.…”

Section: National and International Aidmentioning

confidence: 99%

Emergency Care following the Terrorist Attack in Beslan, North Ossetia, Russian Federation, 2004

Schreeb

Kalmykov²,

Riddez

et al. 2004

International Journal of Disaster Medicine

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more than 1300 people were taken hostage in a school in the town of Beslan in the Republic of North Ossetia-Alania, Russian Federation. The crisis ended 52 hours later in extreme violence with gunshots, grenade explosions and fire that directly killed 329 persons, including 164 children, and injuring many hundreds. As external assessors we rapidly reviewed the medical care provided to the injured. Results: We found that more than 500 doctors, 1000 regular hospital beds and 100 intensive care beds were well prepared to care for the victims at their arrival to the 4 hospitals situated within 20 km of the school in Beslan. In the rapidly unfolding emergency with many hundreds of injured only limited on-site triage was carried out. Civilians took the majority of injured directly to the hospitals in private cars in spite of 57 ambulances being available at the site. Following a few chaotic hours adequate emergency care was available to all the injured. Of the 661 hospitalised victims, 110 required intensive care. Seven deaths were recorded during the first 24 hours and 12 more during the next 6 days, yielding a case fatality rate of 3%. Within 7 days all 110 injured patients in intensive care had been adequately evacuated to more specialised care in Moscow or Rostov. In contrast to earlier emergencies, Russia requested international assistance and up to 11 September, 15 cargo planes from 10 countries delivered medical materials, drugs and food to Beslan, but an estimated 70% of the drugs were deemed inappropriate. Substantial amounts of toys and other goods were delivered to aid the victims. Within a month private initiatives also raised more than 30 million USD in cash, mainly from Russian sources. Following the first week of emergency care the focus in Beslan is to provide psychosocial support through a variety of national and international initiatives. Conclusion: We conclude that the medical emergency care was well handled by local and national health staff under the coordination of the Ministry of Health and the Russian Ministry for Civil Defence and Emergencies (EMERCOM). The international response was largely in excess and not adapted to the local needs, probably because the international community underestimated the local and national capacity and the Russian authorities underestimated the international willingness to help. Key words: Beslan, terror attack, emergency care, rapid assessment, healthcare needs, international humanitarian assistance.

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“…Donated medicines can sometimes bypass these initial checks, making verification of their quality more challenging. Indeed, studies have shown that some donated medicines are more likely to be close to their manufacturer expiry date or have exceeded their shelf-life [12]. …”

Section: Introductionmentioning

confidence: 99%

Anti-malarial medicine quality field studies and surveys: a systematic review of screening technologies used and reporting of findings

Lalani

Kitutu

Clarke

et al. 2017

Malar J

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Background: Assessing the quality of medicines in low-middle income countries (LMICs) relies primarily on human inspection and screening technologies, where available. Field studies and surveys have frequently utilized screening tests to analyse medicines sampled at the point of care, such as health care facilities and medicine outlets, to provide a snap shot of medicine quality in a specific geographical area. This review presents an overview of the screening tests typically employed in surveys to assess anti-malarial medicine quality, summarizes the analytical methods used, how findings have been reported and proposes a reporting template for future studies. Methods:A systematic search of the peer-reviewed and grey literature available in the public domain (including national and multi-national medicine quality surveys) covering the period 1990-2016 was undertaken. Studies were included if they had used screening techniques to assess the quality of anti-malarial medicines. As no standardized set of guidelines for the methodology and reporting of medicine quality surveys exist, the included studies were assessed for their standard against a newly proposed list of criteria. Results:The titles and abstracts of 4621 records were screened and only 39 were found to meet the eligibility criteria. These 39 studies utilized visual inspection, disintegration, colorimetry and Thin Layer Chromatography (TLC) either as components of the Global Pharma Health Fund (GPHF) MiniLab ® or as individual tests. Overall, 30/39 studies reported employing confirmatory testing described in international pharmacopeia to verify the quality of anti-malarials post assessment by a screening test. The authors assigned scores for the 23 criteria for the standard of reporting of each study. Conclusions:There is considerable heterogeneity in study design and inconsistency in reporting of field surveys of medicine quality. A lack of standardization in the design and reporting of studies of medicine quality increases the risk of bias and error, impacting on the generalizability and reliability of study results. The criteria proposed for reporting on the standard of studies in this review can be used in conjunction with existing medicine quality survey guidelines as a checklist for designing and reporting findings of studies. The review protocol has been registered with PROSPERO (CRD42015026782).

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Inappropriate drug donations: the need for reforms

Cited by 12 publications

References 1 publication

The Goose and the Gander

The Goose and the Gander

Emergency Care following the Terrorist Attack in Beslan, North Ossetia, Russian Federation, 2004

Anti-malarial medicine quality field studies and surveys: a systematic review of screening technologies used and reporting of findings

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