Good management of essential medicines is fundamental to the provision of good quality health care for all. However, management is often poor in low- and middle-income countries, resulting in poor access and inappropriate use, which in turn cause poor patient outcome, adverse events, antimicrobial resistance, and waste of resources. The causes are multifactorial, involving many different stakeholders, in both the public and private sectors, and from inside and outside the health sector.
Unfortunately progress in improving access and appropriate use of essential medicines, has been slow. Most interventions implemented have been small-scale and time-limited with temporary small to modest effects. Many countries still do not monitor how medicines are managed, nor implement policies to improve access and appropriate use. The complexity of health care systems and the complexity involved in managing essential medicines are major reasons for slow progress.
The speaker will describe a new approach undertaken in South-East Asia where government staff were involved in rapid 2-week country appraisals of medicines management, collecting and analysing data, presenting the findings at national level, developing recommendations, and acting upon them. The approach aims to stimulate policy development and action, taking into account complexity theory and treating medicines management systems in health care as complex adaptive systems.
About the Speaker: Kathleen Holloway is a public health doctor specialising in pharmaceuticals. She worked in the NHS as a clinical doctor for 10 years, NGOs in Asia (Myanmar, India, Nepal) for 10 years and latterly with WHO for 16 years. In WHO Geneva she led the global program to promote rational use of medicines and in WHO South-East Asia she was the regional advisor in medicines. After retirement from WHO, she joined IDS as a visiting fellow.