Monitoring of Pharmaceutical Supply, Eastern Europe and Central Asia, 2007

Through a training and workshop regional groups were exposed to international and regional expertise in relevant issues and planed research and reporting. Research was conducted based on a standardized set of parameters and unified approach to information collection. Research was carried out in 5-7 countries of the region (Russia, Kazakhstan, Kyrgyzstan, Tadzikistan, Ukraine, Moldova, Estonia). The final reports served to call attention to specific areas for improvement and making constructive suggestions. They were presented at the national level and in major regional and international events in 2008 – EECAAC, UNGASS, WAC etc.
Access to ARVs in the region of Eastern Europe and Central Asia is ranked by UNAIDS as second lowest in the world with only approximately 15% of those in need receiving the drugs. Access by people from stigmatized vulnerable groups is thought to be even lower. The national and regional reports show that the number of people on treatment is increasing but problems with quality, sustainability, uninterrupted supply and cost have been noted.

Interruptions in supply have been noted in several countries in the region. Most countries in the region are largely dependent on foreign donors for the purchase of pharmaceuticals and price reductions will likely be necessary to ensure a sustainable supply of ARVs. Tendering procedures are not always transparent. Governments have not appropriately used opportunities to reduce prices by using generic medicines and there are cases when generics of questionable quality (those that have not been prequalified by WHO) have been purchased. Pharmaceutical companies (both generic and brand) have faced difficulties in registering their products.

Civil society and PLHIV groups are not adequately empowered to take a meaningful role in the pharmaceutical procurement process. Civil society and PLHIV activists often lack adequate information on the stages of treatment procurement process, transparency standards and the degree to which national procedures live up to them, pharmaceutical pricing and the degree to which it is appropriate given national needs, pharmaceutical quality standards and the degree to which they are upheld by procurers.

International and regional evidence has shown that when PLHIV advocate groups are empowered to meaningfully participate in process related to pharmaceutical procurement, prices can be reduced, sustainability can be increased and quality can be increased. In April of 2007, representatives of ECUO, ITPCru, and RUPLHIV met in St. Petersburg with the support and participation of EATG, UNAIDS and WHO and identified PLHIV involvement in pharmaceutical procurement as a priority for interaction.

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