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[e-drug] Comments about PEPFAR (2)

E-DRUG: Comments about PEPFAR (2)

Dear E-Drug members:

I apologize for such a late reply to Eva Ombaka's email about PEPFAR.  I 
hope it's not too late to comment?

EPN discusses the multi-cadre system that might arise in an health facility 
due to PEPFAR's requirement that drugs for OIs be FDA approved.  In fact, 
this could be a significant threat to both PEPFAR but other delivery 
programs (including the GFATM) which uses quality-assured, 
non-FDA-approved, medicines.  A "two drug system" will cause jealousies 
among patients, and conflicts between patients and providers, as patients 
realize that they are not all receiving the same treatment.  Other delivery 
programs could see patients drop out if they perceive they are receiving 
"inferior" medicines.

Thank you to EPN for putting together this statement and bringing it to our 
attention.  Do other E-Drug members have thoughts on the (lack of) capacity 
building and the data exclusivity that EPN discussed?  If these two items 
are ignored, how will countries take over service delivery when PEPFAR 

Warm regards,

Libby Levison
Pharmaceutical management consultant

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