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New Managers for Drug Supply in Developing Countries 3rd further-training seminar for pharmaceutical students and pharmacists organised by the GPHF / All participants pass final ZL examination Under the auspices of the Federal Ministry of Health and Social Security, the German Pharma Health Fund (GPHF) organised the third further-training seminar for pharmaceutical students and pharmacists with a view to training them in the field of drug supply in developing countries. During this one-week event which took place at the end of September in the premises of Evangelische Akademie Arnoldshain in the Taunus, all of the 20 participants successfully passed the written final examination before the Zentrallaboratorium Deutscher Apotheker (ZL, Central Laboratory of German Pharmacists). This further-training course, which is also recognised as an official advanced-training module for pharmacists, is organised once a year by the GPHF in co-operation with the Pharmaceutical School of the Mainz University.
Under the auspices of the Federal Ministry of Health and Social Security, the German Pharma Health Fund (GPHF) organised the third further-training seminar for pharmaceutical students and pharmacists with a view to training them in the field of drug supply in developing countries. During this one-week event which took place at the end of September in the premises of Evangelische Akademie Arnoldshain in the Taunus, all of the 20 participants successfully passed the written final examination before the Zentrallaboratorium Deutscher Apotheker (ZL, Central Laboratory of German Pharmacists). This further-training course, which is also recognised as an official advanced-training module for pharmacists, is organised once a year by the GPHF in cooperation with the Pharmaceutical School of the Mainz University. The objective of this seminar - which took place in 2002 for the first time ever - is to provide the participants with practice-oriented solutions in order to prepare them for the specific requirements of drug supply in numerous developing countries. The seminar focuses on several training modules such as drug quality and safety, drug supply and logistics, as well as business management and economic aspects. The individual seminar topics are presented by experienced and competent experts from pharmaceutical practice and from development-aid organisations. This year’s lecturers included representatives from the Pharmaceutical School of the Mainz University, Pharmacists Without Frontiers, Kreditanstalt für Wiederaufbau (a German promotional bank) and Deutsche Gesellschaft für Technische Zusammenarbeit (German Service Enterprise for Development Co-operation). Among the GPHF members, Aventis, Boehringer Ingelheim and Schering had sent experts who had volunteered to share their valuable knowledge with the trainees. The opening lecture was given by Professor Dr Klaus Fleischer from Würzburg. Drawing on his many years’ experience in tropical medicine and in his capacity as a committed development worker, he gave a detailed picture of the health-care systems in developing countries and of the organisation of development co-operation activities in the health-care sector.
The following days of the seminar covered drug supply via public calls for tenders, the logistics and the management of vaccination campaigns and possible funding strategies for health-care projects, etc. These topics were complemented by reports on practical experience acquired in developing countries such as Nepal, Cameroon and India. Positive Response of the Participants The response of the participants to the seminar as a whole, to the individual topics, and to the lecturers was unanimously positive – as in previous years. Many of the participants are planning to work in development co-operation at a later stage and – by having attended the seminar – feel better qualified for this sort of commitment and encouraged in their decision. More detailed information on the seminar entitled "Management of Drug Supply in Developing Countries” can be requested from the GPHF office.
The 150th GPHF-Minilab® New test methods for anti-Malaria drugs / Training courses for Pharmacists Without Frontiers and Vietnamese health-care inspectors
The GPHF-Minilab®, the unique mobile compact laboratory for identifying counterfeit or substandard drugs, continues to meet with tremendous response world-wide. The 150th unit is ready to be shipped. In future, the Vietnamese health-care authorities will be using the Minilab for testing drug quality in this Southeast-Asian country. In total, eleven Minilabs will thus be in operation in Vietnam (see map).
At the same time, the diagnostics facilities of the Minilab are being constantly enhanced. This compact laboratory that comes along in two standard suitcases ensures the identification of 40 of the drugs most commonly used in developing countries. During the past few weeks, Dr Richard Jähnke, the Minilab project manager of the GPHF, has finalised the development of additional tests for anti-malaria drugs. After the inclusion of six antiretroviral drug agents at the end of last year in the Minilab test methodology, the agents amodiaquine, artemether, primaquine and lumefantrine can now be tested by the Minilab. In addition, a new manual presenting the recently developed test methods (see picture) was finalised and is already available in an English and a French version. The Spanish translation is currently being effected. The GPHF website www.gphf.org contains an abstract of this manual as well as a complete survey of the 40 drug agents that can now be tested using the Minilab. Increasing Demand for Training Courses With the interest in the Minilab growing world-wide, the number of the GPHF training courses covering its use is also on the increase. For instance, more than 50 health-care inspectors of the Vietnamese Medical Authorities will be trained on the minilab in October. During two one-week training courses – jointly organised by the World Health Organisation WHO and the Australian Drug Administration – the participants will be familiarised with the test methods of this compact laboratory by Dr Jähnke. This summer, the GPHF has been training seven pharmacists of the German section of the relief organisation Pharmacists Without Frontiers in the use of the Minilab. In future, they will be in charge of similar training courses – in particular in South America – because on this continent, too, the demand for the Minilab tests is constantly increasing. Four Minilabs will be commissioned in Ecuador as part of a rollback malaria project. A further Minilab will be shipped to Bolivia. The GPHF is confident that the successful operation of the Minilabs will result in other countries in the region valuing the efficient and easy-to-use test methods for monitoring drug quality.
Robert Unterhuber Newly Elected Member of the GPHF Board Robert Unterhuber, the VFA’s new Managing Director for Communications, now also is the VFA representative on the GPHF board. He succeeds Michael Raulf who has served on the GPHF board for almost ten years. Unterhuber, who joined the VFA on July 1, 2004, was previously Director for Strategic Communication of the Munich-based Amgen GmbH.
Further donations for the GPHF Project Work The GPHF would like to thank the following companies for their generous support of its project work this year:
Companies Donate AIDS Medicine Since the end of 2003, the GPHF-Minilab® has included test methods for antiretroviral drug agents. And in the meantime, the supply of required reference standards is also ensured. These were donated to the GPHF by various pharmaceutical companies. In this connection, we would like to thank Boehringer Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline and MSD Sharp & Dohme for their generous support. The drugs supplied will be sufficient to initially equip 75 Minilabs with the required reference standards.
A Promising Approach for Improving Health-Care Services in Myanmar For more than ten years now, the GPHF has been supporting the World Health Organisation (WHO) in its fight against parasitic infectious diseases. Joint model projects have been implemented in Tanzania, in the Seychelles, in Laos, as well as in some other countries. In 2002 and 2003, the WHO and the GPHF co-operated in the Southeast-Asian country of Myanmar – the former Burma. The results of this renewed co-operation have now been summarised for an article published in the renowned scientific magazine Tropical Medicine and International Health. More than 1.5 billion people world-wide suffer from worm infections or so-called soil-transmitted helminths (STH). STH infections affect in particular children in developing countries. Such infections constitute a considerable hazard to their physical and mental health. A regular therapy of particularly exposed populations utilising broad-spectrum anti-helminthic drugs constitutes an efficient and cost-effective method for reducing worm infections and the associated morbidity. For the selection of the most suitable intervention strategies, however, reliable basis data for the respective regions and populations are of utmost importance. Missing Data Surveys conducted in the past have shown that worm infections constitute a serious problem for public health in Myanmar. However, most of these surveys covered a only small number of cases or were confined to hospitals. A nation-wide coverage of the prevalence of worm infections did not yet exist. For this reason, the Ministry of Health of Myanmar conducted a survey between June 2002 and June 2003 which was supported and co-funded by the WHO. The objective of this survey was to measure the prevalence of worm infections in school-children in the various regions of Myanmar. In each region, 50 children from five schools were selected at random for examination. For each child, parasitologic parameters and nutrition-status data were collected. Seven of Ten Children Infected In total, the data of 1,000 children were collected and evaluated, with boys and girls being equally represented. The average age of the children was nine years. 69 per cent of the children examined were infected with at least one worm type, 18 per cent showed a moderate to strong infection intensity. The most common worm species was Trichuris trichiura, with a national prevalence of 57 per cent. 22 per cent of the children were found to be anaemic; however, there were no cases of severe anaemia. Successful Pilot Project With a view to testing feasible strategies suitable for a nationwide therapy and control programme and to drawing up a rough cost calculation for such a programme, a pilot project for a regular worm therapy was realised in the city of Nyaungdone. Based on this pilot project, a provisional calculation of expenditure for the purchase and dispensing the medicine – including the training of the staff – was drawn up. The result of this calculation was that a sum of only USD 0.05 per child would suffice. Conclusions This survey clearly shows that the prevalence and intensity of worm infections in the mountainous regions, on the plains and in the delta area of Myanmar are very high. This survey also confirmed the results of previous surveys and highlighted the urgent necessity for implementing a nation-wide control programme. Although the first cost calculations are still very rough, they clearly show that such a programme – especially if implemented as part of an existing infrastructure such as the school system – would represent a simple and in particular cost-effective approach for improving public health in Myanmar.
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