Ensuring uninterrupted supplies of antiretroviral drugs in resource-poor settings: an example from Malawi
Ensuring uninterrupted supplies of antiretroviral drugs in resource-poor settings: an example from Malawi
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DOI：
10.2471/blt.06.032060
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发表时间：
2007-02-01
期刊：
影响因子：
--
通讯作者：
Lungu, Douglas
中科院分区：
文献类型：
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作者：
Harries, Anthony D;Schouten, Erik J;Lungu, Douglas
问题 许多资源匮乏国家的药品采购和分配做法薄弱，这是无法获得药品的主要原因。随着许多国家扩大抗逆转录病毒治疗 (ART) 的规模，避免药物供应中断至关重要，这会导致耐药性和治疗失败。方法马拉维根据该国结核病控制规划采用的模型采用了一种模型，以允许合理的 ART 药物预测。当地环境该模型包括重点关注一种标准化的一线 ART 方案；设施一线抗逆转录病毒治疗药物的“推动系统”和“天花板”；使用入门包和延续包套件；每季度监测设施层面的患者治疗结果和抗逆转录病毒疗法药物库存；在设施层面提供三个月的抗逆转录病毒治疗药物缓冲库存；经验教训 重点关注单一一线治疗方案、一线 ART 药物的“上限”和计算药物需求的季度数据收集（分别针对新患者和随访患者），以及使用独立的采购设施，可以提前 6-9 个月下达药物订单。这些措施迄今已确保该国不出现抗逆转录病毒疗法药物缺货的情况。
Problem Drug procurement and distribution practices are weak in many resource-poor countries, and are a major reason for lack of access to medicines. With many countries scaling up antiretroviral therapy (ART), it is vital to avoid interrupted drug supplies, which would lead to drug resistance and treatment failure.Approach Malawi has adapted a model, based on that adopted by the country's Tuberculosis Control Programme, to allow rational ART drug forecasting.Local setting The model includes a focus on one standardized first-line ART regimen; a "push system" and "ceilings" for first-line ART drugs for facilities; use of starter pack and continuation pack kits; quarterly monitoring of patient outcomes and ART drug stocks at facility level; provision of a three-month buffer stock of ART drugs at facility level; and use of a procurement and distribution system outside central medical stores.Lessons learned The focus on a single first-line regimen, "ceilings" for first-line ART drugs and quarterly data collections to calculate drug needs (for new and follow-up patients, respectively), as well as the use of an independent procurement facility, allow drug orders to be made 6-9 months ahead. These measures have so far ensured that there have been no ART drug stock-outs in the country.