Strengths and Weaknesses

1
Strengths and Weaknesses of TB Drug Management
Bangladesh, India, Kenya, The Philippines, and
Uzbekistan
2
Key Weaknesses of TB Drug Management in

• Bangladesh
• India
• Kenya
• Philippines
• Uzbekistan

3
Registration Policy Issues

• Registration of donated products could be a
  problem, and reregistration may be needed.
  
• Standard registration can take a long time (612
  months), and fast-track registration may not be
  possible.
  

4
Procurement Policy Issues

• Prequalification is not in place in the existing
  procurement systemICB can lead to delays
  
• Exemptions to policy are difficult to secure
• GDF support may not conform to national
  procurement procedures
  
• Guidelines for drug procurement may exist, but
  policies and enforcement may be lacking
  
• Lack of dialogue between government, funding, and
  supply agencies
  

5
Quality Policy Issues

• Quality procedures exist in all countries but
  enforcement is weak
  
• Quality control exists but quality assurance does
  not
  
• No systematic quality assurance procedures for
  pre- and postregistration of drugs
  

6
Other Policy Issues

• Need for standardization in treatment regimens to
  impact all aspects of drug policy and management
  support
  
• Issues related to TB are very different from
  other infectious diseases and require a national
  policy to address their unique aspects
  (resistance, long-term therapy, FDCs)

7
Management Support

• Any change in the system will require HR
  investment (training, etc.)
  
• Capturing key information (needs assessments,
  resource allocation, etc.) related to all TB
  operations is necessary to make decisions
  
• Methodology for gathering information exists,
  though implementation is weak