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Essential Medicines Programmes Sudan now Now: Essential Medicines programmes In 2010 , health expenditures • The public per capita expenditure is US$ 40, Now: NDP • The NDP is increasingly act as a framework for managing the pharmaceutical sector. Now: Essential Medicines • It guides the procurement of medicines in the public sector, health insurance, donations, and local medicine production. • It is part of training programme of graduated pharmacists. • Today, both public tender prices and C&F prices for private sector are publically available in websites. Now: Public Supply System • Management system improved significantly – Computerized system at central – SOPs and adherence to basic standards in drug supply management – Monitoring and evaluation systems, – Managerial auditing system • Delivery to states through RDF project – Branch in each state with 8% less in price; Now: Health Insurance – Coverage is only 30% of population; – Based on essential medicines; – Patient pay 25% of the treatment cost; – Branch in each state Now: Health Partners • Obtaining health partners and donors support to expand the drug supply & management component; – GF delivering free medicines for the TB, HIV and Malaria – programmes for control neglected and communicable diseases e.g Meningitis outbreaks, – EPI, – RH • EHA, in areas where the Government is not available Now: Availability • In 2007, the availability essential medicines in public sector was 86% and 95% in private sector • In 2010, availability of essential medicines at public sector was 80.6%, and in private sector was 93.0% In 2007, only 67 % are affordable. Now: RUM • In 2007; 73% of prescribed medicines in public sector were from the EML, • 45% were prescribed by generic name Now: Regulations essential medicines • In 2007, independent MRA was established and Policies separated from regulations; • With support of WHO/EC roadmap for QC PQ is in place since 2008. • Pharmaco-vigilance unit established in 2009; • Being Uppsala member supported by EC Other changes • WHO Good Governance started in 2010 • Pharmaceutical Country Profile, in 2010 • Global Fund Project for 5-years support • Licensed pharmacists was 1.53/10,000 compared to 0.5/10,000 in 1990, • HR mapping was conducted – framework for HRD developed; Challenges 1. Fragmented health system, with inequitable distribution of resources; – Verticality of supplies by different programme 2. Instability of policies towards public supply system; 3. Poor data and information management system; 4. Efficacy and quality, yet is a question; 5. Distribution and delivery at state level; 6. Accessibility is still low; 7. Low coverage of health insurance; 8. Irrational use of medicines (36% of health expenditures); 9. Capacities to adsorb all available budgets is limited; 10. Policies implementation and monitoring Thank you