Ensuring access to health care and medicines during COVID-19: critical challenges and feasible policy options for the medicines retail sector

对任何政府来说，管理流行病和确保持续获得药品都是一项艰巨的任务。在大多数高收入环境中，这可以通过以公共卫生系统为重点的活动来实现。然而，在乌干达等国家，40%-70%的治疗发烧、头痛和咳嗽的药物是通过药店、私人诊所和药店提供的。各国政府需要制定政策和计划，使药品零售部门能够继续为疟疾和细菌性肺炎等常见传染病提供治疗；不成为疾病传播的“热点”；并在疾病暴发期间积极为公共卫生应对做出贡献。政府很难知道如何让药品零售部门参与到新冠肺炎的应对行动中来。几乎没有什么指导方针可供参考。世界卫生组织正在想方设法更好地支持私营部门行为者，使他们能够成为新冠肺炎应对措施的有效组成部分，并继续为其他疾病提供护理。他们的工作因缺乏证据而受阻。这个项目是乌干达、英国和丹麦研究人员长期合作的一部分。它将以零售部门最近的研究为基础，迅速创造和传播新的证据，内容涉及：当前政策(包括封锁和宵禁)对MRS和社区获得治疗的影响；MRS成员愿意以何种方式参与新冠肺炎公共卫生应对(健康教育、检测、监测)；以及这将需要多少成本才能在该国推广。

Managing pandemics and ensuring ongoing access to medicines is a difficult task for any government. In most high income settings, this can be achieved by activities focussed on public health systems. In countries such as Uganda, however, 40-70% of medicines for fever, headaches and cough are delivered through drug shops, private clinics and pharmacies. Governments need to create policies and programmes so that the medicines retail sector (MRS) can continue to provide treatment for common infectious diseases like malaria and bacterial pneumonia; does not become a 'hotspot' for disease transmission; and can actively contribute to the public health response during disease outbreaks.It is difficult for governments to know how to involve the MRS in responses to COVID-19. There are few guidelines to draw upon. The World Health Organisation is seeking ways to better support private sector actors so that they can be an effective part of the COVID-19 response and continue to provide care for other illnesses. Their work is stymied by a lack of evidence.This project is part of a long standing collaboration between researchers in Uganda, UK and Denmark. It will build on recent research in the retail sector to rapidly create and disseminate new evidence on: the impact of current policies (including lockdown and curfew) on the MRS and community access to treatment; the ways in which members of the MRS are willing to be involved in COVID-19 public health response (health education, testing, surveillance); and what this would cost to scale up in the country.