Reproductive Health Essential medicines and commodities:

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1 Reproductive Health Essential medicines and commodities: A public health priority Margaret Usher-Patel, Scientist Department of Reproductive Health and Research, World Health Organization July 2008

2 Increasing access to contraceptives is a best practice Just by increasing access to contraceptives has the potential to reduce poverty and hunger, avert 32% of all maternal deaths, nearly 10% of childhood deaths, contribute to womens' empowerment achievement of universal primary schooling and long term sustainability Lancet: Sexual and Reproductive Health: September 2006

3 Improving access to quality Reproductive Health Essential Medicines and Commodities PARTNERSHIP Action The World Health Organization, Department of Policy Standards and Medicine (WHO/PSM) WHO Department of Reproductive Health and Research, United Nations Population Fund, (UNFPA) PATH and other partners of the Reproductive Health Supplies Coalition (RHSC)

4 Harmonization and consensus building To develop evidence-based guidelines, technical tools (3 Publications) The Interagency List of E s s e n t i a l M e d i c i n e s i n R e p r o d u c t i v e H e a l t h HO_PSM_PAR_2006.1_eng.pdf 16 Policy Briefs on key essential reproductive health medicines In WHO model list of essential medicines : core list (revised March 2005) tions/essmeds_rhealth.pdf Essential Medicines for Reproductive Health: Guiding Principles for Their Inclusion on National Medicines Lists Meds_RHealth.pdf

5 WHO and UNFPA ensures the quality of essential medicines Through a prequalification scheme: Is a formal and systematic process designed to determine the experience, capability and capacity of a manufacturer to produce a consistent quality product in accordance with international standards and WHO requirements and specifications. Reduces the risk of awarding a contract to a manufacturer who is unable to meet quality requirements Ensures the availability of supplies of affordable products that are safe to use and retain their effectiveness throughout the stated shelf-life

6 WHO and UNFPA ensures the quality of essential medicines Through a prequalification scheme: Medicines already prequalified include 62 antiretrovirals 33 medicines for HIV/AIDS-related diseases; 2 antimalarial and 6 drugs for tuberculosis WHO and UNFPA are prequalifying a core list of Reproductive Health Essential Medicines including contraceptives, condoms and IUDs

7 Prequalification of RH Essential Medicines Antibiotics included in prequalification azithromycin, cefixime, ceftriaxone, ciprofiloxacin, clindamycin, clotrimazole Prequalification started: Oral and injectable contraceptives To be prequalified Oxytocin (injectable oxytocic). magnesium sulfate injection, misoprostol To be added to the list: levonorgestrel-releasing implant Cyclofem (DMPA+estradiol cypionate) levonorgestrel-releasing implant

8 Prequalification of condoms and IUDs Creating a generic system for UNFPA to maintain a list of prequalified manufacturing sites for condoms and IUDs Supporting the development of international standards male/female condoms and IUDs. Technical meetings to update the IUD specification Reviewed manufacturing process to approve FC2 for bulk procurement

9 Prequalification of condoms and IUDs WHO/UNFPA Pequalification Scheme for Male Latex Condoms and TCu380A published. Guidance documents to implement the prequalification scheme drafted and ready for publication. Revision of IUD specification drafted and manual under development. Male latex condom specification to be updated 2007/8 Publication Male Latex Condom: Guidelines for prequalification and procurement to be revised 2008/9 Systematic review: Copper containing, framed intra-uterine devices for contraception: systematic review of randomized control trials". published 2006, updated 2007: Journal article Contraception, April Supporting the development of international standards male/female condoms and IUDs.

10 6 Capacity Building Workshops Procurement Officers Regulatory Bodies, Reproductive Health Programme Manager West Africa: Dakar, Senegal December 2007 LAC: Managua, Nicaragua January 2008 Europe: Copenhagen, Denmark 2008 Manufacturers, Regulatory Bodies, Bulk Procurement Agencies, International Organizations Beijing, China January 2008 S.E. Asia: Bangkok, Thailand January 2008 New Delhi, India February

11 Proposal for a new work item for IBP partners Procurement, logistics, distribution, programming Project outcome is to develop a web-based resource to improve access to and the use of RH essential medicines. The proposal to partners: To develop "Your questions answered" resource centre 1 page evidence-based answers to frequently asked questions from the field Linked to resources produced by partners Linked to a searchable data-base. Promote sharing and exchange of knowledge in and among countries by supporting virtual on-line Communities of Practice.

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13 Review the YQA Condom resource centre Please sign up to review the YQA Resource Centre. Send your review to Margaret Usher-Patel Please review for: Ease of use Clarity Lack of ambiguity Whether or not you found it a useful tool Web access: Username: yqacondoms Password: info23