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International Journal of Tuberculosis and Lung Disease. 2004 Jan; 8(1):130-138.The Global TB Drug Facility (GDF) is a new initiative to increase access to high quality tuberculosis drugs. The GDF, a project of the Global Partnership to Stop TB, is managed by its secretariat, in the World Health Organization (WHO), Geneva. It aims to provide tuberculosis drugs to treat up to 11.6 million patients over the next 5 years and to assist countries to reach the WHO global TB control targets by 2005. The GDF was launched on 24 March 2001. Six rounds of applications have been completed, with 46 countries and non- governmental organizations (NGOs) approved for support. The GDF is not a traditional procurement mechanism. It has adopted an innovative approach to the supply of drugs, by linking demand for drugs to supply and monitoring, using partners to provide services, using product packaging to simply drug management and linking grants to TB programme performance. This paper describes the GDF operational procedures and experience gained so far. Key achievements to date are also outlined, including the creation of a flexible supply system to meet differing to meet differing programme needs, rapid establishment of procedures, reduction in TB drug prices--a catalyst for DOTS expansion in countries, standardisation of products, and collaboration with partners. The GDF is flexible enough to meet the needs of countries with a TB burden. The GDF experience could be used as an example for global procurement of drugs and commodities for other diseases, such as HIV/AIDS and malaria. In the future it is likely that the GDF will expand to include second-line drugs and diagnostic materials for TB and could assist other partnerships to develop similar mechanisms and facilities to meet country needs. (author's)
Arlington, Virginia, Management Sciences for Health [MSH], Center for Pharmaceutical Management, Rational Pharmaceutical Management Plus Program, 2001. iv, 9 p. (USAID Contract No. HRN-A-00-00-00016-00)As part of its contribution to USAID’s SO5—reduce the threat of infectious diseases of major public health importance, the Rational Pharmaceutical Management (RPM) Plus program is providing technical support to the national Tuberculosis (TB) program in Vietnam through the SO5 ID/TB Activity 3: Conduct TB drug procurement training in Vietnam. The RPM Plus assistance will facilitate Vietnam’s procurement of TB drugs under a secured World Bank project. Thomas Moore of RPM Plus and Hugo Vrakking of Royal Netherlands Tuberculosis Association (KNCV) traveled to Vietnam to conduct the training course. The Ministry of Health (MOH) has recently reorganized its procurement department, devolving procurement activities to respective vertical programs such as Tuberculosis, Malaria, and Hematology. Course participants (listed in Annex 1: Proceedings of the Training Workshop—Vietnam) are members of the management committee of the national TB program (NTP). All are expected to play some part in the procurement of TB drugs. (excerpt)
Lancet. 1998 Mar 28; 351(9107):966.On March 19, 1998, Arata Kochi, director of the Global Tuberculosis Programme of the World Health Organization (WHO), announced that the WHO goal of curing 85% of new infectious tuberculosis (TB) cases by the year 2000 would not be achieved. An estimated 70 million more people will die from TB by the year 2020, if control is not improved. While speaking in London at the launch of the 1998 WHO global TB control report, Kochi stated that 22 countries account for 80% of all TB cases. Viet Nam, Tanzania, and Peru were making good progress toward control goals. The Democratic Republic of the Congo and Bangladesh had increased cure rates two-fold by using the directly-observed treatment, short-course (DOTS) approach; parts of China had achieved a 94% cure rate through its use. According to Kochi, progress had stalled in 16 countries because the global threat of TB had not been taken seriously. In spite of the slow rate of progress, WHO continues to believe in DOTS; Richard Bumgarner, senior program management officer of the WHO Global Tuberculosis Programme, considers DOTS to be cost-effective and the best possible use of funds. When asked if claims for DOTS were unrealistic and if more effort should be put into drug development, Bumgarner said that such research was important, but that it did not weaken DOTS. He said that better diagnostics, drugs, and vaccines might be 10-20 years down the line. Such research includes Action TB, a research initiative between GlaxoWellcome and academics, that received extra funding (10 million pounds) on March 24. On March 19, the British Lung Foundation stated that a new test for multidrug-resistant TB, which had been developed by Rory Shaw (Imperial College, London), decreased the time for diagnosis of rifampicin resistance from 8-10 weeks to 3-4 days.
Approaching STDs and AIDS on a global scale. Interview with Peter Piot, Associate Director, Sexually Transmitted Diseases, Global Programme on AIDS (GPA), World Health Organisation (WHO).
AIDS BULLETIN. 1993 Jul; 2(2):4-5.Dr. Piot became involved with the World Health Organization (WHO) Global Program on AIDS (GPA) through his early involvement as Chairman of the WHO Steering Committee on the Epidemiology of AIDS. He responds to questions about the HIV pandemic. Although researchers realized early on that HIV could be transmitted sexually and suspected that condom use could confer protection against HIV infection as it does against other STDs such as gonorrhea and syphilis, only minimal light was shed to the public on the association of HIV with STDs. The delay in clearly pointing out the association stemmed from professionals' lack of desire to further stigmatize HIV/AIDS by designating it as a STD. Furthermore, many Western hematologists had little interest in STDs, and STD control in many countries tended to be coercive. Regarding the risk of HIV infection, Dr. Piot notes that the presence of a genital ulcer caused by syphilis, chancroid, or herpes increases one's risk 10-20-fold; risk increases 3- to 4-fold where gonorrhea or chlamydia are present. Acknowledging the association between STDs and the risk of contracting HIV and understanding the need to control STDs for the prevention of HIV/AIDS, the WHO's STD program was brought under the auspices of and integrated with the GPA. People, and especially women, who may present at STD clinics for treatment are prime candidates for much needed help in avoiding HIV infection; Dr. Piot notes that unlike men, many women do not realize they are infected with an STD until complications develop. Dr. Piot's recent appointment at GPA means the WHO will increase its focus upon the prevention and treatment of STDs. The WHO favors an integrated program approach. Additionally, the GPA plans to develop a short-list of recommended drugs for treating STDs and hopes to develop ways for developing countries to buy them affordably with help from UNICEF and the World Bank. Finally, Dr. Piot explains that, with some exceptions, the prevalence of STDs is lower in developed countries and, therefore, less of a prevention priority.
Geneva, Switzerland, WHO, EPI, 1984 Oct. 14 p. (Logistics and Cold Chain for Primary Health Care 7; EPI/LOG/84/7)The objective of this module is to enable the users to estimate the 1st requirement for chloroquine tablets. This could be for a new health center or an existing center receiving chloroquine tablets for the 1st time. The 5 steps are as follows: estimate the size of the target population; estimate the incidence of malaria; estimate the coverage; decide on the standard treatment; and calculate the amount of chloroquine tablets needed for the 1st month's supply. Exercises are included.
Geneva, Switzerland, WHO, EPI, 1985 Feb. 9 p. (Logistics and Cold Chain for Primary Health Care 6; EPI/LOG/83/6)The objective of this module is to enable the user to estimate the supply requirements for 5 supply items: chloroquine tablets, oral rehydration salts (ORS) for diarrhea, vaccines for 6 diseases, maternal and child health supplies -- contraceptives and iron tablets, and 34 essential drugs. The method is presented in outline form. A detailed explanation for each of these 5 items is given in 5 other modules. This module thus should be used first and 1 or more of the 5 detailed modules should be read subsequently. These 6 modules describe a method for calculating how much stock should be ordered for the 1st time. The method given in all of these modules can be used for any of the 5 supply items and it can be used in the health center store, the district store, or the regional store. A figure provides an example of the 5 steps for each of the main headings of this course. The 5 steps are: estimate the size of the target population; estimate the disease incidence; estimate the coverage; decide on the standard treatment; and calculate the amount required for each month's supply.
Geneva, Switzerland, WHO, EPI, 1985 Feb. 21 p. (Logistics and Cold Chain for Primary Health Care 5; EPI/LOG/84/5)This module provides instructions for controlling the quality of the supplies in a store and for distributing or dispensing supplies. The module advises the user on how to decide if a product (a condom, pill, or a vaccine) is still good to use. Simple tests can be performed to determine if a product is still good. These tests are described under the headings of: vaccines; oral rehydration salts (ORS) packets; maternal and child health supplies; essential drugs; and chloroquine. There are 4 ways of controlling the quality of vaccines: by regularly monitoring the storage temperature; by potency testing; by checking if it has been frozen; and by using a cold chain monitor. Vaccines should not be used if they have passed their expiration date; if they have been exposed to high temperatures; if a vial has been partly used in a previous session; if the cap on the vial is leaking or damaged; if the label has come off and the vaccine cannot be identified; if they have been to the field 2 or 3 times without being used; and if DPT, DT, or TT have been frozen. ORS in sealed laminated aluminum foil can be kept for about 3 years. If the content of ORS packets is brown, dark brown, or liquified, it should not be used. Tables provide information on when one's stock of maternal and child health items is still good to use and when to throw away drugs.