Rapid Assessment of the Potential Paucity and Price Increases for Suggested Medicines and Protection Equipment for COVID-19 Across Developing Countries With a Particular Focus on Africa and the Implications

Abstract

Background: Countries across Africa and Asia have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding some treatments including hydroxychloroquine where the initial hype and misinformation led to shortages, price rises and suicides. Price rises and shortages were also seen for PPE. Such activities can have catastrophic consequences especially in countries with high co-payment levels. Consequently, there is a need to investigate this further.Objective: Assess changes in utilisation, prices, and shortages of pertinent medicines and PPE among African and Asian countries since the start of pandemic.Our approach: Data gathering among community pharmacists to assess changes in patterns from the beginning of March until principally the end of May 2020. In addition, suggestions on ways to reduce misinformation.Results: One hundred and thirty one pharmacists took part building on the earlier studies across Asia. There were increases in the utilisation of principally antimalarials (hydroxychloroquine) and antibiotics (azithromycin) especially in Nigeria and Ghana. There were limited changes in Namibia and Vietnam reflecting current initiatives to reduce inappropriate prescribing and dispensing of antimicrobials. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries where documented. In addition, generally limited change in the utilisation of herbal medicines. However, shortages have resulted in appreciable price increases in some countries although moderated in others through government initiatives. Suggestions in Namibia going forward included better planning and educating patients.Conclusion: Encouraging to see increases in the utilisation of vitamins/immune boosters and PPE. However, concerns with increased utilisation of antimicrobials needs addressing alongside misinformation, unintended consequences from the pandemic and any appreciable price rises. Community pharmacists and patient organisations can play key roles in providing evidence-based advice, helping moderate prices through improved stock management, and helping address unintended consequences of the pandemic.

Awareness and Acceptance of COVID-19 Vaccines among Pharmacy Students in Zambia: The Implications for Addressing Vaccine Hesitancy

“…In addition, issues of importance for the vaccine (62). This is similar to the misinformation that has existed for potential treatments for COVID-19 including hydroxychloroquine and the subsequent impact on morbidity, mortality and costs (13,14,(70)(71)(72)(73).…”

“…Despite the initial containment of the pandemic in several countries including African and Asian countries through lockdowns and other measures including social distancing, the mandatory wearing of personal protective equipment (PPE), promoting regular hand hygiene, closure of borders and mass testing (12)(13)(14)(15)(16)(17)(18), infection rates continue to increase (19). Alongside this, we have seen the rise in morbidity and mortality from other diseases, including non-communicable diseases (NCDs) as a result of lockdown and other measures (20)(21)(22)(23).…”

The Current Situation Regarding Long-Acting Insulin Analogues Including Biosimilars Among African, Asian, European, and South American Countries; Findings and Implications for the Future

“…Since originator or biosimilar long-acting insulin analogues in these countries are typically dispensed in private community pharmacies or drugs stores, or in private hospitals, feedback from physicians, pharmacists and key personnel working within pharmacies, combined with local knowledge, has been used to provide information on utilisation and prices of the different long-acting insulin analogue preparations together with changes in recent years and any rationale. We have used this approach before when national datasets are not routinely available ( 97 – 99 , 102 ). Similar to previous projects, impressions were provided from physicians and pharmacists when no Ministry of Health or other robust data sets were available to document changes in utilisation and prices of insulin glargine as well as other insulin preparations in recent years.…”

“…Ethical approval for this study was not required according to national legislation and institutional guidelines in line with previous studies in similar circumstances ( 97 – 99 , 102 , 104 , 105 ). However, where pertinent, all pharmacists freely provided the requested information having been allowed to refuse to participate if wished.…”

Potential strategies to reduce inappropriate prescribing and dispensing of antimicrobials in Bangladesh building on the experiences in other developing countries

“…We have seen among LMICs including Kenya, Namibia, the Republic of Srpska and Sri Lanka (Figure 1) that trained pharmacists, coupled with guideline availability, can appreciably reduce inappropriate dispensing of antibiotics especially for ARIs including patients with COVID 19 [48][49][50][51][52][53] . This has important ramifications for countries such as Bangladesh, and it is encouraging to see that community pharmacists in Bangladesh, especially in rural areas, are a preferred and trusted source of information and medicines for managing infections 45 .…”