RAA Foundation supports the approaches of “Marius Nasta Institute regarding the reconsideration of the decentralized anti-TB drugs procurement.
21st of February, 2008
At the beginning of 2008, the Ministry of Public Health (MOH) has initiated the procedure of de-centralizing the Romanian sanitary system. All together with this process, MOH decided to transfer the responsibility of TB drugs procurement to the sanitary units that are insuring medical assistance for TB patients.
Romanian Angel Appeal Foundation (RAA) is the Principal Recipient for the funds provided to support the implementation of the Global Funds projects within the 6th Round, being responsible with the coordination of the programs that consolidate the NTP (National TB Program).
The projects implemented during the 6th Round of Global Fund's Grant will expand TB control activities by introducing innovative activities and in the meantime they will continue the implementation of the activities that have already proven their efficiency in decreasing the TB burden in Romania.
For the well ongoing of NTP activities and the accomplishment of impact planned indicators, RAA Foundation has sent a Memorium of supporting the approach initiated by the "Marius Nasta" Pneumophtisiology Institute and the NTP, related to the proposal of de-centralizing TB drugs procurement.
This Memorium was sent to the National Agency for Health Programs, the Public Health Authority, both of them from MOH and to the National Health Insurance House.
The centralized procurement of TB drugs is one of the major recommendations of World Health Organization (WHO) for insuring the TB control!
In the Memorium were presented the following arguments:
- In Romania, the TB control is based on the DOTS Strategy (Directly Observed Treatment Short-course Chemotherapy), recommended by WHO as the only efficient strategy in TB control;
- One of the five components of DOTS Strategy is the insurance of uninterrupted supply with high quality anti-TB drugs;
- Another important element of DOTS Strategy is the insurance of TB treatment under directly medical observation, which means that a medical worker or a responsible person surveys how the patient swallows each dose of TB drugs, with prescribed medication, in efficient doses, till the patient is cured;
- This condition can't be insured if the patients will receive their treatment from pharmacies with a open system; as a consequence, they will not present themselves regularly for receiving each TB drugs dose under directly observation;
- Interrupting the treatment, due to the discontinuities in TB drugs procurement or due to the fact that the patient feels "much more better" after a while, or even due to some side effects to TB drugs, leads not only to at non-cured patient but also to the selection of drug-resistant strains that can spread into population;
- In plus, being available in pharmacies with an open system, TB drugs can be used for other diseases treatment (for example ORL or dermatological diseases). This situation represents for a person with a non-diagnosed TB a mono-therapy, leading to a selection of chemo-resistance to that TB drug;
- In Romania, it was elaborated and distributed a "Management of anti-TB drugs", a practical guideline, with technical assistance from WHO and Management Sciences for Health Organization, global leader in drugs management. The document, representing a useful instrument for medical practitioners, was elaborated based on several meetings with representatives from all institutions with responsibilities in TB control field;
- The centralized TB drugs procurement and application of DOTS Strategy, successfully used in the past 5-6 years, have proven their effectiveness, demonstrated by a successful rate close to the WHO's target of 85% and a TB decreasing incidence with the condition of uninterrupted supply with TB drugs for sanitary units;
- Also, with a centralized procurement system costs are significantly decreasing, up to 30%, in conditions of high amounts procurement;
- A centralized procurement implicates quarterly orders and distribution and also insurance of drug stocks at the producer level and at the TB units, according to the international recommendations.
Anti-TB drugs, from friend they can turn into enemies: their irrational and uncontrolled use can lead to the selection of rdrug resistant strains, transforming a 95% curable disease into an incurable one.
Romanian Angel Appeal will continue to support the efforts and approaches initiated by "Marius Nasta" Pneumophtisiology Institute and the NTP till it will be identified a reliable solution in the benefit of TB patients.
Click here to see the English translated version of RAA Foundation's Memorium!
