[health-vn] China CCM Perspective: Reform of Global Fund Drug Procurement Policy

[Vern Weitzel]

Subject: 	[AIDS ASIA] China CCM Perspective: Reform of Global Fund Drug
Procurement Policy
Date: 	Tue, 5 Jan 2010 19:26:46 +0800
From: 	AIDS ASIA<AIDS_ASIA at yahoogroups.com>
Reply-To: 	AIDS_ASIA at yahoogroups.com
To: 	AIDS_ASIA at yahoogroups.com





Reform of Global Fund Drug Procurement Policy

Since 1 July 2009, a new quality control policy has been adopted by the
Global Fund (the largest independent funding and donation organization
relating to AIDS, TB and Malaria in the
world) in their purchasing system for pharmaceutical and hygiene products.

At the same time, the gPrice & Quality Reportingh System has been
updated. This may be seen as a sign for new improvement of the whole region.

Professor Qiang Zhengfu, representative of the Chinese
Centre for Disease Control & Prevention and Executive director of PRs
(Principal Recipient) of the GF China, suggested to the China GF Country
Coordinate Mechanism (CCM) in March 2009, that a work group should be
set up under the China CCM to control pharmaceutical and
hygiene products.

This would be a response to the improvement of the GF region, and would
bring new opportunities for promoting access to medicines in China.

With regard to implementation of the new policy in China I have a few
opinions to share.

1. The new purchasing policy of the GF should be used as a lever for
improving connections between National AIDS Treatment Scheme and the
essential medicine management system. The existing quality control
policy should still be emphasized; selection of final pharmaceutical
products should be performed strictly in accordance with Manual of the
WHO and National Standard Treatment or in accordance with the List of
essential Medicines.

Nationwide second-line treatment for AIDS has been started;
medicines for national free treatment for AIDS have also been listed in
the 2009 edition of the List of Essential Medicines, which underpins the
improvement of the national health system.

2. Standards for clinical medicine adopted in the quality control policy
should be used to improve prescriptions for national AIDS treatment. In
the clinical standards, the quality
control policy gstrongly recommendsh the main recipients to provide a
fixed dose of composite medicine and daily prescriptions. This has
become common practice in many countries and has proved to be effective
in improving treatment compliance, but these medicines are still not
listed in the manual of national standard treatment.

3. The price requirements in the purchasing policy of the GF should
serve to stimulate the integration of the policies and actions for the
supply of AIDS medicines in China.

Although second-line treatment has been started, some medicines which
according to the manual of treatment of the WHO can be used as preferred
medicines for both first-line and second-line treatments, are still
denoted in the manual of national treatment as gbased on supply, to be
used for second line treatment onlyh.

Furthermore, due to reasons such as patent protection, main medicines
used for second-line treatment still need to be imported from original
developers; this keeps the purchasing and treatment costs high.

Under the pressure of fixed purchasing budget and increased need for
second-line treatment, no doubt it would be important, for the
purpose of ensuring sustainable medicine supply in future, to make use
of legal rules such as compulsory licensing and to broaden the range of
pre-certification that domestic
manufactures may obtain from the WHO.

4. The GF greatly emphasizes matching between price and quality in the
new purchasing policy and implements stricter policies for quality
control and bidding. These policies, together with the ongoing upgrade
of standards for Good Manufacture Practice (GMP)
in domestic pharmaceutical industry, should generate a greater push on
quality assurance for domestic produced antiviral medicines.

For those antiviral medicine manufactures who wish to develop
international markets, these policies should also serve to urge them to
participate in the quality pre-certification system of the WHO.

More importantly, these policies send a clearer message through the GF
that life saving medicines should not only be obtainable at low costs
but also be safe and sustainable.

Patients in developing countries should enjoy more than just the rights
to live; they also have the rights to live with fairness and dignity.

The improvement in purchasing policies and execution mechanisms by the
GF and representatives of CCM China, as well as the gap between domestic
antiviral medicine related policies and medicine accessibility, have
opened new topics and prospective for community
based promotion of medicine accessibility. Lack of interaction between
governments, communities and academics would result in decision-making
and policy-design not being able to always reflect the interests of
those who are in need.

As a mechanism for managing interests of different stakeholders, CCM may
provide opportunities for deep discussions regarding the
impact of the new purchasing policy on medicine accessibility in future.

However, any efficient discussion will always depends on the
stakeholders and their knowledge in terms of the issue.

The gAccess to Medicine Research Group in Chinah, a volunteer
based research team include people from WHO Beijing office, the Third
World Network, the China Global Fund Watch and some other legal experts
in Beijing, Geneva and other areas, is trying to push hard on access to
medicine issues by promoting public participation, enhance
research capacity and to build advocacy network among stakeholders.

In 2009, the research group translated several books on promotion of
antiviral medicines in Thailand and carried out research in legal and
policy aspects regarding access to medicine in China. We hope that these
activities and materials would provide basic information and
directions for the infected and other interested parties, so that those
who wish to participate in discussions on CCM medicine purchasing and
supply may conveniently and efficiently do so.

iAuthored By Joan Hu, Translated by RAN Handong,Jenkins Firmj
"Reproduced from the China Global Fund Watch Newsletter, a service of
the China Global Fund Initiative."

China Global Fund Watch Initiative
Add: Room 1508, 4th Building,SOHO
88,JianGuo Road, Chao Yang District
Beijing, 100020, China
Tel:8610-85897408/98
Fax:8610-85897408
Email:gfwatch at gmail.com <mailto:gfwatch%40gmail.com>