Area | Risks | Recommendations | Stakeholders |
---|---|---|---|
Assuring the financing and supply of essential medicines and vaccines | -Poor financial capability of national health and economic systems to purchase the basic basket of essential medicines and vaccines -Disruption of global supply network due to COVID-19 -International partners focusing only on COVID-19 at the expenses of other major diseases and internally | -Resource allocation informed by CRA -Include sustainable financing and stable supply of EMV in the workstreams of COVID-19 supply task forces -Integrate logistics system of COVID-19 with those of other major diseases -Joint tenders and contract awarding at regional level -Joint price negotiation and supplier selection at regional level -Joint market research, monitoring, and evaluation at regional level -Strategic procurement and regional information sharing about suppliers and prices | -World Health Organization -Regional intergovernmental organizations and economic communities -National governments -Nongovernment organizations -Private sector |
Making essential medicines and vaccines affordable | -Reduced availability of suppliers -Reduced capacity of patients to purchase health services because most people in the productive age work in the informal sector, with household income based mainly on daily earning -Unavailability of transportation and/or long distance to health facilities -Inefficiency or inexistence of effective social protection programmes | -Mobile clinics -Fees exemption for under-served and vulnerable segments of society -Microfinance loans (with transparent selection of participants informed by literature of predictors of repayment rate) -CHW programmes (conditional on significant increase in ODA and/or important innovations in health financing) -Multi-month dispensing of essential drugs for selected diseases -Integrated service delivery | -National and subnational governments -Private sector -Nongovernment organizations |
Assuring the quality and safety of medicines to prevent harm to patients | -Limited human and technical capability -Poor transparency in procurement of essential drugs (e.g., lack of competitive bidding, corruption embedded in health systems) -Restrictions to national and international business and travel imposed as part of national COVID-19 responses | -Investment in good governance at global, national, and local levels -Investment in sustainable financing at global, national, and local levels -Strategic investment in human and technical capacity building -Joint market research, monitoring, and evaluation at regional level -Regional information sharing about suppliers and prices -Medicines regulatory harmonization at regional level -International cooperation to equip LMIC with the necessary technology for post-marketing surveillance of medicines | -United Nations Development Programme -International and national financial institutions -World Health Organization -National governments -Regional intergovernmental organizations and economic communities -International and national financial institutions |
Promoting quality use of essential medicines to ensure better health outcomes | -Increased workload per HCW because of change in work modality as part of COVID-19 measures -Reduced quality of HCW because of risks to health work force regeneration processes -Reduced capacity of the health sector to make payments -Poor health literacy and numeracy of patients -Limited health-literate healthcare organization | -Task delegation -Telephone triage -Sustainable international exchange of HCW targeting jointly delivery of clinical services (immediate needs) and capacity building of LMIC to generate quality health workforce efficiently (improve preparedness) -Payment of risk allowances to frontline HCW -Investment in health literacy and numeracy of populations and patients -Careful staff recruitment -Detailed training of HCW -Authorization to provide autonomous care -Reliable data systems -Fair and performance-based compensation of HCW | -National governments -Bilateral partners |
The need for global research and policy framework to develop missing essential medicines | -Limited availability of high-level human, technological, and financial capability -Patents restrictions -Low investment in R&D -Poor medicines regulatory capacity | -Substantial increase in investment in R&D capability -Sustainable technology transfer and international financing -Strategic investment in human and technical capacity building -Facilitate cross-border trade of pharmaceutical goods in the region | -National governments -United Nations Industrial Development Organization -World Trade Organization -Regional intergovernmental organizations and economic communities -Private sector -Universities and research institutions -International and national financial institutions |