COURSE REPORT
ON
DRUG POLICY ISSUES FOR DEVELOPING COUNTRIES
October 27th to November 8th 2002 by
BOSTON UNIVERSITY CENTER FOR INTERNATIONAL HEALTH
IN COLLABORATION WITH
THE MINISTRY OF HEALTH, UZBEKISTAN,
WHO/EURO PROGRAM FOR PHARMACEUTICALS AND WHO/EDM,
AND USAID/ZDRAV-PLUS PROJECT MANAGED BY Abt ASSOCIATES Inc.
Introduction and Background
Over the past 10 years a number of courses have been developed to improve the capabilities of people working to manage pharmaceutical systems in developing countries. Management Sciences for Health (MSH) with IDA offers a short course on Managing Drug Supply in Amsterdam and has developed a multi-volume series of training materials. MSH also has produced the very widely used textbook called Managing Drug Supply. This book was revised by MSH in collaboration with WHO and other experts worldwide. The Robert Gordon University in Aberdeen currently offers a nine-week similar course. The University of Newcastle in New South Wales, Australia, offers a Masters level and diploma course in Pharmaco-epidemiology with a component of distance learning. MSH together with the INRUD network have offered annual courses on "Promoting Rational Drug Use." The University of Groningen has a two-week course for teachers focusing on problem based pharmaco-therapy teaching, which is also taught another venues. The WHO Essential Drugs and Medicines Policy (EDM) group have directly or indirectly supported many of the above courses.
These courses have generally been aimed at middle-level managers or teaching academics. A gap exists for senior managers and policy makers. Within many developing countries, the position of chief pharmacist or director Central Medical Stores or director of logistics is occupied by an experienced official who may not have received any formal training for the position. With the major changes that have occurred over the past few years, a need exists for training for these senior managers. Senior donor officials who interact at a policy and senior management level could also benefit from such a course. Such senior officials would not be able to be away from their posts for long periods; any course aimed at this group would have to be a short course.
In March 1996, the first Drug Policy Issues in Developing Countries Seminar was held in Boston. The course was attended by 38 participants from 32 countries. Those attending included 23 Chief Pharmacists, senior drug regulators, academics, and a representative from industry. The course was a collaborative offering of Boston University School of Public Health Center for International Health and the World Health Organization Essential Drugs and Medicines Policy. The course was positively evaluated by participants and was offered again in 1997 in Boston. In 1998, the course was successfully mounted in South Africa, in India in 1999, in Beirut in 2000 and in Yogyakarta, Indonesia in 2001. This year, 2002, the course was offered in Tashkent and Samarkand, Uzbekistan.
COURSE OUTLINE
Boston University Center for International Health in collaboration with the Ministry of Health Uzbekistan, WHO and USAID supported Zdrav-Plus program offered this two-week course for policy makers and senior managers to provide an overview of policy and programming issues faced in transitional countries. Participants came from Ministry of Health, Drug Regulating Agencies, Donor or Funding Organizations and Industry.
The course topics included: National Drug Policy Process, Selection, Procurement Issues, Production Issues, Donations, Financing Options, Regulatory Issues, Role of Private Sector, Promoting Rational Drug Use, Consumer Roles, Human Resources, Public Health Issues and Pharmaceuticals and Monitoring of National Drug Policies. Materials for the course consisted primarily of review papers and case studies to provide opportunities for insight and discussion. Participants were offered relevant reference materials. The course was a forum for each participant to share their difficulties and achievements in drug policy. The central purpose was to provide participants with alternatives to adapt or adopt when they returned home.
Participants were organized in Russian and English language groups and had ample opportunities for in depth discussions. There were field visits and social activities to broaden the range of experiences in the course. A varied faculty exposed participants to a range of viewpoints and opinions. This was an intensive and participatory course. Resource persons from NIS countries attended to present their relevant experiences at mini conferences, which occured during the course.
OBJECTIVES:
By the end of the course participants were expect to be able to:
1) Discuss the different processes to develop a national drug policy.
2) Manage the development of a national essential drug list, standard treatment guidelines and a national formulary.
3) Understand various procurement options including pricing issues.
4) Discuss production issues, including the industry viewpoint.
5) Compare and discuss different financing options using pharmaco-economic analysis including a discussion of the role of the private sector.
6) Assess mechanisms and options for regulatory controls of the pharmaceutical sector focusing on quality issues.
7) Discuss the assessment of drug use practices and decide which interventions are most likely to be effective in improving drug use in primary care and in hospitals.
8) Identify indicators to rapidly assess a national pharmaceutical sector.
9) Address human resource planning and development in the pharmaceutical sector.
10) Consider public health policy issues in relation to pharmaceuticals.
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OUTLINE
The course had approximately 60 contact hours with lecturers and was be divided into 19 sessions. Each session lasted 3 hours.
DAILY SCHEDULE AND CULTURAL ACTIVITIES
Sessions were be conducted in English and Russian using simultaneous translation in a seminar/workshop format using background papers and case studies to illustrate concepts. Active participation and interaction between participants and faculty as well as among participants occurred. The course was structured in a manner that drew on the knowledge of participants regarding their own systems.
Daily structure:
09:00 am - 09:30 am 30 minutes Review of previous day
09:30 am - 10:00 am 30 minutes Introductory lecture to topic
10:00 am - 11:30 am 90 minutes Small group discussions of a single case study includes or paper. Questions regarding the paper or case study will provide a framework for the group discussion. There will be 5-6 groups, each comprised of 5-7 participants.
11:30 am - 12:30 pm 60 minut es Plenary discussion.
12:30 pm - 2:00 pm Lunch
02:00 pm - 2:30 pm 30 minutes Review of topic.
02:30 pm - 4:00 pm 90 minutes Small group discussion of paper or case study.
Includes break.
04:00 pm 5:00 pm 60 minutes Plenary discussion.
Click here for Detailed Course Program in English Click here for timetable Click here for Participant list
Click here for readings Click here for Presentations
Click here for readings Click here for Presentations