Public health in private sector

1
National Drug Policy Implementation
2
National Drug Policy

• Access -- essential drugs are available
  affordable
• Quality -- safe efficacious drugs
• Rational use -- drugs are used appropriately
  by prescribers, dispensers and patients

3
National drug policy
4
Key components

• Legislation and regulation
• Quality assurance
• Drug selection
• Production and management of the drug supply
  system
• Economic strategies and drug financing
• Rational use of drugs
• Research and human resource development

5
Steps

• Develop a master plan for the pharmaceutical
  sector
• Identify priorities and strategies to implement
  various components
• Identify technical and budget resources

6
Implementation plan

• Master plan
• Programme/work/action plan
• objectives
• strategies
• expected output and target
• responsible group
• resources

7
Who is responsible?

• Ministry of Health/Health Departments
• Lead agency
• NDP expert committee-multidisciplinary,
  represented by key parties
• Working group for each component
• Should oversee and coordinate all components of
  the pharmaceutical system
• Should monitor and assess implementation and
  achievement of targets and objectives
• A unit/group within the ministry/department with
  personnel and budget

8
Other groups with responsibilities

• Drug regulatory agencies
• District/provincial/regional offices
• Health facilities
• Other government agencies (finance, trade,
  economic planning, education and others)
• Private sector -- industries and retailers
• Third parties -- NGO, consumer groups, academia
  and professional organizations

9
Implementation should be strengthened by laws,
legislation and regulations

• should be relevant
• should be updated
• will help in enforcement

10
Policy reform

• Technical challenges
• Political challenges
• Ethical challenges

11
Strategies to meet challenges

• Technical challenges
• Use experts for policy technical soundness
• Invest on people

12
Strategies to meet challenges

• Political challenges
• Alliance, coalitions
• Coordination and public relation
• Bargaining (compromise)
• Mobilize groups (3rd party)
• Create constituents inside and outside government

13
National drug policy

• Political process
• seeks to change who gets drugs
• represents a choice of value
• consequence to distribution/redistribution of
  goods power
• allows/increase competition among groups that
  seek to influence redistribution

Implementation

• Formulation

Monitoring evaluation
14
Politics in pharmaceuticals

• Political analysis is needed for drug policy to
  be effective
• Continuous political exercise from formulation to
  implementation it is more challenging at
  implementation when political impacts are
  apparent
• There are controllable and uncontrollable events
• Groups will defend their own common interest

15
How to select strategy to address issues

• Policy impact
• Political feasibility
• Technical feasibility
• Financial feasibility

16
National drug policy

• Interest group
• Sustain participation/ consultation/coordina
  tion at all phases
• Identify substance of policy and construct a
  process that will bring people together
• Allocate resources for stakeholders

Implementation

• Formulation

Monitoring evaluation
17
Other strategies to implement a NDP

• Appropriate timing
• Start implementation in relatively easy areas
• Flexible approach
• Use experts for policys technical soundness
• Mobilize groups (consumers, media, NGD and other
  key groups)
• Create constituencies inside and outside the
  government
• Get international support

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Implementing a NDP

• Other factors for success
• shared values
• macro-economic situation
• technical expertise
• committed people especial in MOH

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Basic principles

• Linked with basic health goal
• Economic goal should not sacrifice health
  objectives
• Equity -- fairness in access
• Should be concerned with efficiency that gives
  maximum level of service given the available
  resource
• Sustainability and capacity building

20
National drug policy
Implementation

• Commitment of all players
• pharmaceutical master plan
• implement priority strategies
• key pharmaceutical component

21
Impact and outcomes
NDP Implementation
Impact and outcomes

• Access
• Rational use
• Quality drugs