August 2009

This has been an exciting past month. The DRWG held a three hour panel on drug resistance at the 10th Commonwealth Pharmacists Association meeting in Accra and began filming a drug-resistance specific video that we plan to complete by the year’s end. As discussed in my recent blog “Invading the Commonwealth,” the panel session served to both raise awareness of resistance among, and to share our draft recommendations with, pharmacists and the broader pharmacy community, as they play a vital role in the health system. Other important developments include the launch, touched upon in last month’s guest column, of a laboratory accreditation initiative in Africa.

Our guest column this month, by colleagues from Management Sciences for Health (MSH), shares the experience of Accredited Drug Dispensing Outlets (or ADDOs) in Tanzania. The success of this experience lends weight to the importance of seeking to preserve currently effective drugs through development, replication and scale-up of dispenser certification programs that encourage more rational dispensing of drugs and dispensing of high-quality drugs. More on this topic soon!

As always, we welcome your thoughts at [email protected].

Regards,

by Edmund Rutta, Keith Johnson, Martha Embrey, Center for Pharmaceutical Management, Management Sciences for Health

Many people in developing countries buy medicines from retail drug shops, because they are convenient and often have drugs available when public health facilities are out of stock. In Tanzania, these shops are called duka la dawa baridi, which historically have been authorized by the Tanzania Food and Drugs Authority (TFDA) to provide only nonprescription medicines. With thousands of shops located around the country, often in rural and periurban areas, duka la dawa baridi have been the most widespread source of medicines for purchase in Tanzania. However, a 2001 assessment showed that the shops’ dispensing staff generally lacked basic qualifications and training and often sold prescription-only medicines illegally; in addition, the shops had little regulation enforcement or supervision. Inappropriate dispensing of medicines resulting in inappropriate patient use is one of the key factors driving drug resistance around the world.

To address issues with duka la dawa baridi, Management Sciences for Health’s Strategies for Enhancing Access to Medicines Program began working with the government of Tanzania to create a public-private partnership with the goal of improving access to affordable, quality medicines and pharmaceutical services where few or no registered pharmacies exist. The accredited drug dispensing outlet (ADDO) program established new shops called Duka La Dawa Muhimu (Swahili for “essential drug shop”) that must adhere to standards related to product and service quality to achieve and maintain government accreditation.

READ MORE

Bacteria (Besides TB)

• United States FDA position on limiting use of antibiotics in animals (Reuters.com)
• Drug-resistant salmonella causes ground beef recall (Press Democrat.com)

TB

• Reflections on MDR-TB from an innovation (or lack thereof) viewpoint (Fast Company) Part I and Part II
• Fighting TB in South Africa (New York Times)
• Drug Resistant TB Can Spread as Easily as Drug Sensitive TB, Study Says (Kaiser Family Foundation.org)
  

Malaria

• Battling resistance in South-East Asia (Crosscut.com)

HIV

• Lower levels of resistance in individuals taking HAART as compared with those receiving ZDV/sdNVP (Times of India)
• New agreements to reduce cost of 2nd line ART in developing countries (Clinton Foundation press release)

OTHER

• Mapping essential drug stock-outs in four African countries: still a critical problem (Stopstockouts.org)
• Swine flu update (Scidev.net)
• Swine flu taking health authorities by surprise in the UK (Guardian)
• Oseltamivir-resistant strains of H1N1 in Thailand (Bangkok Post)
• No evidence of resistant strains of swine flu in Vietnam (Vietnam News)
• Using Google flu trends as a predictor of flu activity (Global Health Magazine)
• Bug Resistant to Antibiotics Enters UK (The Independent)