Table 3 - uploaded by Krisantha Weerasuriya
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Source publication
Many factors influence the regulation of pharmaceuticals in a country. The essential drugs concept, formulated by the World Health Organization to assist developing countries in selecting appropriate drugs, also provides a basis for regulation. Sri Lanka has long regulated pharmaceuticals as part of its health policy. Over 70% of 3436 pharmaceutica...
Contexts in source publication
Context 1
... 1 shows the ten commonest drugs, and Table 2 gives a break- down by the anatomical system for drug action. Table 3 shown the ten commonest drugs and Table 4 gives a breakdown by anatomical system. ...
Context 2
... the POM category, the 12 most commonly registered drugs were all from the essential drugs list except for amoxicillin which is an alternative. They were also single preparations except for cotrimoxa- zole, a combination that is in the list (Table 3) Ministry of Health, Sri Lanka. parasitic diseases constituted less than 3% of all registrations. ...
Citations
... Sri Lanka has a strong national health system, which has achieved developed world health outcomes. It has also had a sustained commitment to drug policy ranging from its innovative role in essential drug lists 1 to the most recent iteration of national drug policy, which focuses upon quality use of medicines. 2 Pharmacy training was introduced in the early 1950s, evolving to a diploma of pharmacy. ...
... There is no provision for the participation of advocacy groups or a mechanism for the public to appeal decisions made by the Committee. [41][42][43] In January 2011, as part of a larger qualitative study of the barriers to addressing unsafe abortion in Sri Lanka for my Master's thesis, 11 I interviewed ten key informants in Sri Lanka who were engaged in the field of women's health, either as members of professional or policy-making bodies or as providers of women's health care, about why registration of misoprostol was stalled in 2010. Four of them were members of bodies that had a direct influence on the registration decision. ...
Misoprostol, a WHO essential medicine indicated for labour induction, management of miscarriage and post-partum haemorrhage, as well as for induced abortion and treatment of post-abortion complications, came up for registration in Sri Lanka in December 2010. The decision on registration was postponed, indefinitely. This has wide-ranging implications, as misoprostol is widely available and used, including by health professionals in Sri Lanka, without guidance or training in its use. This paper attempts to situate the failure to register misoprostol within the broader context of unsafe abortion, drawing on data from interviews with physicians and health policymakers in Sri Lanka. It demonstrates how personal opposition to abortion infiltrates policy decisions and prevents the issue of unsafe abortion being resolved. Any move to reform abortion law and policy in Sri Lanka will require a concerted effort, spearheaded by civil society. Women and communities affected by the consequences of unsafe abortion need to be involved in these efforts. Regardless of the law, women will access abortion services if they need them, and providers will provide them. Decriminalizing abortion and registering abortion medications will make provision of abortion services safer, less expensive and more equitable.
Résumé
Le misoprostol, médicament essentiel de l'OMS indiqué pour le déclenchement du travail, la prise en charge des fausses-couches et des hémorragies du post-partum, ainsi que pour l'interruption de grossesse et le traitement des complications de l'avortement, aurait dû être enregistré à Sri Lanka en décembre 2010. La décision sur son enregistrement a été reportée, indéfiniment, ce qui a de vastes conséquences car le misoprostol est disponible et utilisé largement, notamment par les professionnels de la santé à Sri Lanka, sans conseils ni formation à son utilisation. Cet article tente de placer le non-enregistrement du misoprostol dans le contexte plus large de l'avortement à risque, se fondant sur des données recueillies lors d'entretiens avec des médecins et des décideurs à Sri Lanka. Il démontre comment l'opposition personnelle à l'avortement influence les décisions politiques et empêche de résoudre le problème de l'avortement à risque. Toute mesure pour réformer la loi et la politique sur l'avortement exigera un effort concerté, dirigé par la société civile. Les femmes et les communautés touchées par les conséquences de l'avortement à risque doivent être associées à ces activités. Quelle que soit la loi, si elles en ont besoin, les femmes auront accès aux services d'avortement et les prestataires les leur fourniront. En dépénalisant l'avortement et en enregistrant les médicaments, on rendra les services d'avortement plus sûrs, moins onéreux et plus équitables.
Resumen
Misoprostol, uno de los medicamentos esenciales de la OMS indicado para inducción del parto, manejo de pérdidas del embarazo y hemorragia posparto, así como para aborto inducido y tratamiento de las complicaciones postaborto, fue considerado para ser registrado en Sri Lanka en diciembre de 2010. La decisión fue aplazada por tiempo indefinido. Esto tiene implicaciones de gran alcance, ya que en Sri Lanka el misoprostol está disponible y es utilizado extensamente, incluso por profesionales de la salud, sin orientación o capacitación en su uso. Este artículo, basado en datos de entrevistas con profesionales médicos y formuladores de políticas de salud en Sri Lanka, intenta situar el no registrar el misoprostol en el contexto más amplio de aborto inseguro. Se demuestra cómo la oposición personal al aborto infiltra en las decisiones de políticas e impide que se resuelva el problema de aborto. Todo intento de reformar la ley y políticas referentes al aborto en Sri Lanka requerirá un esfuerzo concertado, encabezado por la sociedad civil. Las mujeres y comunidades afectadas por las consecuencias del aborto inseguro deben participar en estos esfuerzos. Independientemente de la ley, las mujeres obtendrán servicios de aborto si los necesitan y los prestadores de servicios se los proporcionarán. Si se despenaliza el aborto y se registran los medicamentos para inducir el aborto, la prestación de servicios de aborto será más segura, menos costosa y más equitativa.
... Almost all countries impose some level of regulation on the role of the private sector in distributing and selling pharmaceutical products. In another example, the government of Sri Lanka developed an essential drug list in order to regulate the public sector, and found that over 70% of the pharmaceutical products registered by the private sector are taken from this essential drugs list as well (Weerasuriya 1993). ...
Diarrhoeal disease, a leading cause of child mortality, disproportionately affects children in low-income countries – where private and non-governmental providers are often an important source of health care. We use 10 Living Standards Measurement Surveys from Latin America to model the choice of care for child diarrhoea in the private sector compared to the public sector. A total of 36.8% of children in the combined data set saw a private provider rather than a public one when taken for treatment. Each additional quintile of household economic status is associated with an increase of 6.5 percentage points in the probability that a child with diarrhoea is taken to a private provider (p<0.001).
However, treatments provided in the private sector are manifestly of worse quality than in the public sector. A total of 33.0% of children visiting a public provider received Oral Rehydration Solution, compared to 13.7% of those visiting a private provider. Conversely, children treated by a private provider are more likely to receive drugs, most commonly unnecessary antibiotics. Ironically, when it comes to treatment for child diarrhoea, wealthier and better educated households in Latin America are paying for treatment in the private sector that is ineffective in comparison with treatments that are commonly and inexpensively available. Copyright
... Almost all countries impose some level of regulation on the role of the private sector in distributing and selling pharmaceutical products. In another example, the government of Sri Lanka developed an essential drug list in order to regulate the public sector, and found that over 70% of the pharmaceutical products registered by the private sector are taken from this essential drugs list as well (Weerasuriya 1993). ...
Private sector providers are the most commonly consulted source of care for child illnesses in many countries, offering significant opportunities to expand the reach of essential child health services and products. Yet collaboration with private providers presents major challenges - the suitability and quality of the services they provide is often questionable and governments' capacity to regulate them is limited. This article assesses the actual and potential contributions of the private sector to child health, and classifies and evaluates public sector strategies to promote and rationalize the contributions of private sector actors. Governments and international organizations can use a variety of strategies to collaborate with and influence private sector actors to improve child health - including contracting, regulating, financing and social marketing, training, coordinating and informing the public. These mutually reinforcing strategies can both improve the quality of services currently delivered in the private sector, and expand and rationalize the coverage of these services. One lesson from this review is that the private sector is very heterogeneous. At the country level, feasible strategies depend on the potential of the different components of the private sector and the capacity of governments and their partners for collaboration. To date, experience with private sector strategies offers considerable promise for children's health, but also raises many questions about the feasibility and impact of these strategies. Where possible, future interventions should be designed as experiments, with careful assessment of the intervention design and the environment in which they are implemented.
... Thus, WHO advocates that every country should have a national drug policy. (6,10) A national drug policy provides the framework and tools for an adequate supply of safe and effective drugs of established quality at an affordable price. It is important to note that developing a national drug policy does not limit physicians' freedom to prescribe drugs. ...
Turkey has a big pharmaceutical industry-of the drugs consumed there, 90% are manufactured domestically. Eighty percent of this manufacturing is run by foreign companies. In this study, the performance of the Turkish pharmaceutical industry in terms of the technology and production is examined and compared with that of some other countries, and the importance of the essential drugs list and national drug policy is discussed. At the end of the study, strategies are suggested toward meeting the main current challenges in the Turkish pharmaceutical industry.
Objectives: To analyze the development and implementation of the national drug policy in order to provide decision-making for the establishment of the Chinese national drug policy. Methods: Nineteen electronic databases, the WHO, the World Bank, and governmental websites were included in this study. A pre-designed data extraction form was used to collect information. The data were analyzed and described by a pre-designed analytic framework. Result: A total of 182 studies were included in this review. The main points of common concern in the national drug policy were: drug regulation and quality assurance, rational use of drugs, drug supply, the selection of essential drugs, human resource development and training, traditional medicine, drug financing and affordability, drug research, monitoring and assessment of the nation drug policy, technical cooperation, and the national pharmaceutical industry. The selection of essential drugs, quality assurance, supply, pricing, and supply of traditional medicine were gradually carried out in China. Pharmaceutical research, monitoring and evaluation, as well as the development of pharmaceutical industry and technical cooperation within it should be further strengthened. Conclusion: China should establish related organizations and working procedures; speed up the implementation of the legislation of national drug policy; integrate the mechanism of essential drugs selection and supply system; regulate the order of medicine production and regulation; establish scientific and reasonable pricing mechanisms for drugs and assessment systems; strengthen the monitoring and evaluation of national drug policy and update and improve the national drug policy.
