PEAH News Flash 398

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

News Flash 398

 

Global Financing Facility now open for public consultation 

International Conference on Sustainable Development ICSD 2020 September 21 – 22, 2020 Online

How big is the SDG backslide? Gates Foundation presents new data 

REGISTRATION – OFFICIAL UN GENERAL ASSEMBLY SIDE EVENT: PROGRESS AND MULTISECTORAL ACTION TOWARDS ACHIEVING GLOBAL TARGETS TO END TB Wednesday, 23 September 2020, 10:00H – 12:00H New York time Virtual event, United Nations, New York  

FORUM SISTEMA SALUTE ottobre-novembre 2020 

WHO’s three messages for UN75 

At 75, is the UN Still Fit for Purpose? 

MSF Position on the European Commission’s Roadmap for Pharmaceutical Strategy 

Coronavirus disease (COVID-19) Weekly Update 

COVID-19’s ‘Slow Burn’ – Africa’s Low Death Rate Puzzles Researchers 

COVID-19: The Sky Hasn’t Fallen Yet In Africa 

Just $5 per person a year could prevent future pandemic, says ex-WHO head 

LANDSCAPE OF EMERGING INFECTIOUS DISEASE RESEARCH AND DEVELOPMENT: PREVENTING THE NEXT PANDEMIC 

COVID-19 Study Links Strict Social Distancing to Much Lower Chance of Infection 

AstraZeneca COVID-19 Vaccine Trials Resume In the UK After Data Review Board Investigates Safety Signal 

Promoting Equitable Access To COVID-19 Vaccines—The Role Of Medicaid 

China’s coronavirus vaccine may be ready for public in November 

What role for One Health in the COVID-19 pandemic? 

Africa’s Innovative COVID-19 Response: The Africa Medical Supplies Platform by Chiamaka P. Ojiako 

Pandemic tech innovation silver lining  

Novartis ties bond sale to malaria treatment access in sustainability push  

Non-Communicable Diseases & Injuries Are The Biggest Killers Of People In The Poorest Billion 

At least 24 million students could drop out of school due to the coronavirus pandemic, UN says 

Barriers For Migrants by Chamid Sulchan

Human Rights Reader 544 

How One Tech Giant’s Commitment to Racial Equity is Taking Shape

We Need All Hands On Deck to Close Gender Pay Gaps 

Is India’s New Education Policy sufficiently inclusive of people with disabilities? 

A World Without Hunger Is Also About Protecting Food 

Liability roadmap for governments to Make Big Polluters Pay 

State-Owned Companies Are Key to Climate Success in Developing Countries, but Are Often Overlooked in the International Dialogue 

 

 

 

 

 

 

 

Africa’s Innovative COVID-19 Response: The Africa Medical Supplies Platform

The Africa Medical Supplies Platform (AMSP) is a non-profit continental online procurement platform designed to resolve Africa’s COVID-19 medical supply predicament. Besides strengthening Africa’s supply management system and bolstering local production of pharmaceuticals the main objective of the platform is to provide equitable access to medicines and medical supplies for all participating countries. The platform pools certified medical suppliers and aggregates demand, thereby creating a larger market that saves time, enables competitive pricing, and ensures the security of the supplies. Sourced and donated medical supplies are distributed proportionately by taking into account the population, disease burden, and vulnerability level of Member States. After quotas are designated, Member States are required to make payment into a holding account at Africa’s Export-Import Bank (Afreximbank) within a stipulated number of days and then the supplies are delivered by designated commercial carriers

 By Chiamaka P. Ojiako

Policy Analyst, Lawyer 

New York University

Africa’s Innovative COVID-19 Response

The Africa Medical Supplies Platform

 

Globally, access to medicines and medical supplies is largely driven by demand and the ability to pay rather than need. Notwithstanding numerous factors that impede access to medicines and medical supplies, this paper will focus on the recent innovations in supply chain management in Africa. These developments are particularly significant as over 70% of all pharmaceuticals consumed in Africa are imported, and less than 2% are manufactured locally.[1]

The heavy reliance on imported pharmaceuticals further strains limited health financing and exposes vulnerable populations to greater inequalities in accessing effective and affordable medicines.[2]

In 2012, the Heads of State at the African Union Summit endorsed the African Pharmaceutical Manufacturing Plan to foster local production of quality and affordable pharmaceuticals.[3] However, demand-side barriers caused by buyer fragmentation, different markets, and the small economic size of several African countries raised feasibility and sustainability concerns.[4] These are valid concerns because a small country’s significant need for medicines might not translate to sufficient demand leading to higher cost and lower availability.[5] Addressing these restraints became more imaginable with the ratification of the Africa Free Trade Agreement (AfCTA), which seeks to create a single continental market for goods and services.[6] The projections of improved harmonization and continental access have opened up possibilities for developing unified continental regulatory standards for the pharmaceutical industry. These uniform standards, if achieved across the continent, would facilitate pooled procurement and local drug production.

Leveraging on the AfCTA, the Small Island Developing States (SID), United Nations Economic Commission for Africa (ECA), and the Intergovernmental Authority on Development (IGAD) advocated for the development of the AfCTA-Anchored Pharmaceutical Project with a three-fold approach of pooled procurement, local production, and improved drug quality.[7] This pilot initiative focused on improving access to maternal and child health care (MCH) products in select countries from Regional Economic Communities (RECS) with existing pooled procurement projects.[8]  The experiences, practices, policies, and lessons learned from implementing successful regional pooled procurement initiatives, like the Southern African Regional Program on Access to Medicines (SARPAM), served as a precursor to Africa’s innovative response to the disrupted global drug supply chain during the COVID-19 pandemic.[9]

In recognition of the vulnerability of the African region to COVID-19 and its adverse effects, the Africa Center for Disease Control (CDC) adopted a containment and mitigation response strategy.[10] While swift containment measures were successfully put in place, mitigating the spread across African countries was difficult mainly due to limited testing capacity and scarce medical supplies.[11] Pharmaceutical companies responded to the disrupted global supply chain with unpredictable price changes and prioritization of the highest bidders. Consequently, several African countries lacked COVID-19 medical supplies and became more vulnerable to substandard pharmaceutical products in circulation.[12] The disparity in accessing essential medical supplies in Africa provided the necessary impetus for creating the Africa Medical Supplies Platform (AMSP), which is an expanded version of the regional pooled procurement arrangement proposed by the AfCTFA-anchored pharmaceutical project.

The AMSP is a non-profit continental online procurement platform designed under the leadership of Strive Musiyiwa, African Union Special Envoy, to resolve Africa’s COVID-19 medical supply predicament. Besides strengthening Africa’s supply management system and bolstering local production of pharmaceuticals the main objective of the platform is to provide equitable access to medicines and medical supplies for all participating countries. Following the launch of the platform, the Member States of the Caribbean Community (CARICOM) have also joined the platform to benefit from the competitive procurement of medical supplies.[13]

The platform pools certified medical suppliers and aggregates demand, thereby creating a larger market that saves time, enables competitive pricing, and ensures the security of the supplies. Sourced and donated medical supplies are distributed proportionately by taking into account the population, disease burden, and vulnerability level of Member States. After quotas are designated, Member States are required to make payment into a holding account at Africa’s Export-Import Bank (Afreximbank) within a stipulated number of days and then the supplies are delivered by designated commercial carriers. Predesignated quotas are exchangeable for needed medical supplies on the platform and the Ministry of Health officials can request the procurement of unavailable medical supplies.[14]

Provision is equally made for countries that have insufficient funds to pay by extending a line of credit to them with the Afreximbank. This funding is sourced from the $3 million Pandemic Trade Impact Mitigation Facility set up by Afreximbank to support African countries’ COVID-19 response effort of which $200 million is designated for financing the production of medical supplies and equipment.[15]

The world’s first continental digital procurement platform has gone beyond improving procurement to boosting indigenous pharmaceutical production with plans in place for establishing an open license for enlisting local manufacturers. Furthermore, African manufacturers are prioritized on the platform by featuring made in Africa options on the first page. These incentives are expected to motivate the diversification of operations by both small and large African companies to address the demand and supply mismatch for protective equipment and COVID-19 supplies in Africa.[16]

The realization of the AMSP during unprecedented times is a testament that the solutions for African problems lie within Africa. This precarious moment, when Africa’s leadership is displaying political commitment to health, should be leveraged upon to increase the capacity of local drug manufacturing in Africa. Therefore, more African countries need to sign and ratify the treaty for establishing the African Medicines Agency (AMA) to ensure that the governance and regulation of medicines in Africa are strengthened and harmonized.

 

References

[1] Supporting the production of pharmaceuticals in Africa. (2015, December 23). Retrieved July 10, 2020, from https://www.who.int/bulletin/volumes/94/1/15-163782/en/

[2]Report of the High-Level Stakeholder Meeting on: The AfCTA: Opportunities for pooled procurement of essential drugs and products and local pharmaceutical production for the continent.( 2019, November 21).  Retrieved July 22, 2020 from  https://www.uneca.org/sites/default/files/uploaded-documents/AfCFTA-Pharma 2019/pharma_high_level_meeting_report_final.pdf

[3]Pharmaceutical Manufacturing Plan For Africa: AUDA-NEPAD. Retrieved August 10, 2020, from https://nepad.org/publication/pharmaceutical-manufacturing-plan-africa

[4]O’Donnell, O. (2007, December 01). Access to health care in developing countries: Breaking down demand side barriers. Retrieved August 11, 2020, from https://www.scielosp.org/article/csp/2007.v23n12/2820-2834/

[5]Improving access to essential medicines for mental, neurological, and substance use disorders in Sub-Saharan Africa: Workshop summary. Forum on neuroscience and nervous system disorders. (2014, August 26). Retrieved August 25, 2020 from https://www.worldcat.org/title/improving-access-to-essential-medicines-for-mental-neurological-and-substance-use-disorders-in-sub-saharan-africa-workshop-summary-forum-on-neuroscience-and-nervous-system-disorders/oclc/899280083

[6]African Continental Free Trade Area (AfCFTA) Legal Texts and Policy Documents. Retrieved August 15, 2020, from https://www.tralac.org/resources/our-resources/6730-continental-free-trade-area-cfta.html

[7]Report of the High-Level Stakeholder Meeting on :The AfCTA: Opportunities for pooled procurement of essential drugs and products and local pharmaceutical production for the continent. (2019, November 21). Retrieved August 20, 2020 from  https://www.uneca.org/sites/default/files/uploaded-documents/AfCFTA-Pharma-2019/pharma_high_level_meeting_report_final.pdf

[8] Third Africa Business Forum 2020 on Africa Continental Free Trade Area: An opportunity to accelerate towards the implementation of the 2030 Agenda and Agenda 2063 through pooled procurement of the essential safe and quality drugs and products and local pharmaceutical production for the continent. Retrieved July 28, 2020 from https://www.uneca.org/sites/default/files/uploaded-documents/Africa-Business-Forum/3rd/technical_background_paper_-_health-the_pharma_issue_-_en_-_e2000083.pdf

[9] SADC Pooled Procurement of Essential Medicines and Medical Supplies Situational Analysis and Feasibility Study  Retrieved August 21,2020 from https://www.sadc.int/files/6614/1890/8516/sadc___sadc_pooled_procurement_of_essential_medicines_and_medical_suppli….pdf

[10]Strategic Response Plan in the WHO African Region. Retrieved September 1, 2020 from  https://www.afro.who.int/sites/default/files/2020-06/SPRP%20BUDGET%200520_01.pdf

[11]Kavanagh, M. M., Erondu, N. A., Tomori, O., Dzau, V. J., Okiro, E. A., Maleche, A., Aniebo, I. C., Rugege, U., Holmes, C. B., & Gostin, L. O. (2020). Access to lifesaving medical resources for African countries: COVID-19 testing and response, ethics, and politics. The Lancet395(10238), 1735-1738. https://doi.org/10.1016/S0140-6736(20)31093-X

[12]Jane Bradley, T. (2020, April 19). In scramble for coronavirus supplies, rich countries push poor aside. Retrieved August 11, 2020, from https://bdnews24.com/world/2020/04/10/in-scramble-for-coronavirus-supplies-rich-countries-push-poor-aside

[13] Statement by the Chairman of the Caribbean Community (CARICOM) the Honourable Mia Amor Mottley, Prime Minister of Barbados on Access by CARICOM to the Africa Medical Supplies Platform. (2020, July 01). Retrieved August 23, 2020, from https://caricom.org/statement-by-the-chairman-of-the-caribbean-community-caricom-the-honourable-mia-amor-mottley-prime-minister-of-barbados-on-access-by-caricom-to-the-africa-medical-supplies-platform/

[14]Interview with AU Special Envoy Strive Masiyiwa on the Launch of the Africa Medical Supplies Platform, Milken Institute. (2020, June 18). Retrieved August 15, 2020, from https://covid19africawatch.org/strive-masiyiwa-africa-medical-supplies-platform/

[15]Afreximbank Announces $3-Million COVID-19 Response Grant for African Countries. (2020, July 17). Retrieved August 20, 2020, from https://www.afreximbank.com/afreximbank-announces-3-million-covid-19-response-grant-for-african-countries/

[16] President Cyril Ramaphosa: Launch of Africa Medical Supplies Platform media briefing. (2020, June 18). Retrieved September 1, 2020, from https://www.gov.za/speeches/medical-supplies-platform-19-jun-2020-0000

Barriers For Migrants

PEAH is pleased to republish an article by AFEW partner organization. AFEW is dedicated to improving the health of key populations in society. With a focus on Eastern Europe and Central Asia, AFEW strives to promote health and increase access to prevention, treatment and care for major public health concerns such as HIV, TB, viral hepatitis, and sexual and reproductive health

First published August 25, 2020 

By Chamid Sulchan

AFEW International intern

Barriers For Migrants

 

The main reason why labour migrants from Tajikistan, Moldova, Belarus and Uzbekistan come to Russia is that there is no work for them in their home countries. Often labour migrants have big families; parents, brothers, sisters, wives and children, and they have to take care of them. Working in Russia is often the only way for them to help their families to survive.

Margarita Abramyan, manager at KOVCHEG Anti-AIDS in Rostov-on-Don, a partner of AFEW International in Russia, has been implementing a project called ”HIV and migrant workers in southern districts” in the framework of the regional approach of the “Bridging the Gaps: health and right for key populations” program. She told us what influences migrants’ access to health services in Russia and how to improve this difficult situation.

How would you describe the access to health services for labour migrants in Russia?

So it really depends on whether you are in Russia legally or illegally. If a migrant comes to Russia legally, he/she receives a residence and work permit with medical insurance. If the migrant is in Russia illegally, this person can stay here up to 90 days. They don´t need to undertake all the documentation procedures and therefore don´t have a medical insurance. To get a legal residence permit or a medical card in Russia, you need to be tested for HIV, viral hepatitis and TB. But the thing is that you have to pay for all these tests yourself, and many migrants cannot afford this.

Under the migrant medical policy, emergency ambulance assistance and emergency operations are free. If you need an operation that is not absolutely necessary, then you need to pay for this operation yourself.

What are the consequences if labour migrants do not have access to health services?

There are a lot of consequences of the lack of access to health services for labour migrants in Russia. Migrants who come to Russia often work at construction sites, the kind of jobs that are really dangerous and where it´s common to have serious accidents. When a migrant has a serious accident at a construction site and they do not have access to healthcare, they can become an invalid for life.

The big problem is that migrants are actually afraid to get medical help, because medical workers ask for their documents and check if their papers are valid. If medical workers find out that migrants are illegal, then basically they can be thrown out of the country. Another big problem is that HIV positive migrants who come to Russia cannot get Russian citizenship. However, many of those HIV positive migrants come to Russia anyway. They stay in the country illegally and do not have access to healthcare. They often don´t know the condition of their health and cannot get any ART.

What these migrants sometimes do is that they connect or communicate with the non-profit-organizations from Ukraine or Uzbekistan, with countries that have borders with Russia, and then they can get therapy from there. So they could register in Ukraine, for example, and get therapy there and then go back to Russia. We are in contact with these organizations to support migrants. Of course, now with the coronavirus situation it´s a lot more difficult because the borders are closed. So the migrants can´t go back to their own countries and get treatment there.

What are other factors that influence migrants’ access to health services, besides their legal or illegal status?

So other factors include societal denial and ignorance . Russian people and people who come from post-Soviet countries have a very particular mentality – they believe that HIV will never touch them. They think they will never get sick and if they get something, like a flu, then they just drink some herbs, and everything will be fine.

The other thing is that there is a widespread belief left over from the 90s that only sex workers, LGBTQ+ people and drug users can get HIV, so if you don´t live a “wild life”, you live a so-called a ´normal life´ that is not connected to drugs or sex work, then you definitely will never get HIV. Another thing is that people still have a lot of unprotected sex. Moreover, most of the migrants that come to Russia send their money to their families back home. All the money that migrants earn is sent back to their home countries and they do not want to spend this money on healthcare.

Are culture and language also a barrier for migrants to access health services?

Yes, it’s a very big barrier. Together with my organization we went to one of the detention centres for illegal migrants in February and there is no official interpreter for them there. Migrants are communicating with through signs. Even though there is a lot of medical information about HIV and how to access medical services, there are no interpreters for migrants. For example, of the four people who came from Uzbekistan, only one spoke Russian. The people who cannot speak Russian are trying to figure it out for themselves.

 Is there a governmental programme that tries to help migrants integrate into Russian society?

There is no governmental programme like this, these kinds of activities are mostly done by NGOs. These activities include language training, consultations, cultural trainings and workshops, and it´s mostly just NGOs doing that, as volunteers.

Which services does your organization provide for labour migrants?

We provide peer-to-peer consultations for migrants. We also have lawyers, virologists, and psychologists who support migrants. We are also supporting migrants in getting their Russian citizenship and filling out the documents for work and residence permits. If there are funds, we also try to support migrants financially. We also have rehabilitation centres for drug HIV positive users. Also, we often organize information events for labour migrants where we tell them about access to health services and about treatment and testing for HIV. We also have a lot of contact with local organizations and job centres. If a migrant is looking for a job, we can refer them to our other contacts.

What do you think should be done to improve the access to health services?

On the governmental level, first of all the medical insurance for labour migrants should cover all the medical services that are also available for Russian citizens. On the local level it would be great if NGOs get financial support from the government to pay for HIV treatment and testing for migrants.

There is always hope that things will change. If the government provides enough support, treatment and care to migrants then communicable diseases will not be transmitted. There are migrants who take their health and the health of their families very seriously, but they do not have the same access to health services as Russian citizens.

PEAH News Flash 397

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

News Flash 397

 

WHO: Public health round-up 

WHA73 RESUMED 

A civil society guide to the 73rd World Health Assembly #WHA73 

Launch of the 2020 Global Action Plan for Healthy Lives and Well-being for All progress report 

How to harvest long-term health benefits of the EU4Health programme?  

Five Ways—Beyond Current Policy—To Truly Integrate Telehealth Into Primary Care Practices 

Accelerating access to medicines in a changing world 

Big Pharma, salute e finanza 

MSF: international activity report 2019 

WHO: Coronavirus disease (COVID-19) Weekly Update 

Latest Covid-19 Statistics from African Countries 

The COVID-19 Pandemic Is The Time For The Public Sector To Help Build Greater Social Connection  

COVID-19 could reverse decades of progress toward eliminating preventable child deaths, agencies warn  

COVID-19 and the oxygen bottleneck  

Opinion: African women are leading the fight against COVID-19  

GILEAD FIRST How a Monopoly on Remdesivir Led to Rationing 

Coronavirus: Oxford University vaccine trial paused after participant falls ill 

U.S., European COVID-19 vaccine developers pledge to uphold testing rigour  

Emergency Use Approval Is A “Temporary Solution,” Countries Should Wait For Large Clinical Trials To Finish To Roll Out A COVID-19 Vaccine En Masse 

WHO aiming for 20% of Africa to get initial COVID jabs from access plan  

Could Philanthropy Prevent the Next Pandemic by Stopping Zoonotic Diseases? 

Human Rights Reader 543 

The COVID-19 Solidarity Program for Key Populations in Eastern Partnership countries is launched! Please, apply! 

Gaps in access to essential medicines and health products for noncommunicable diseases and mental health conditions  

“Abhisaran ki aur”: A narrative of empowerment and change 

More than 3 billion people protected from harmful trans fat in their food 

COVID-19 Pandemic an Opportunity to Re-evaluate How we Treat World’s Starving Children 

Preserving Food Security in Africa’s Urban Areas 

Climate breakdown ‘intensifies gender-based violence’ 

Southern Africa’s Hunger Upsurge Blamed on Climate, COVID-19 

Wildlife in ‘catastrophic decline’ due to human destruction, scientists warn