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[e-drug] Better drug and antibiotic use is associated with more policy implementation (3)

E-DRUG: Better drug and antibiotic use is associated with more policy 
implementation (3)
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I am very pleased that this paper has been published. To repeat the paper is at 
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001724 

This paper brings together two streams of work. The first initiated by INRUD 
and then continued by Kathy was the development of interventions to improve 
medicine use that were thoroughly evaluated. Kathy put together and maintained 
a data base that gathered these hundreds of studies in a way that the key 
elements could be extracted. A number of different people including Verica 
Ivanovska and others helped with this process.

The second stream was the work done by WHO in developing pharmaceutical country 
profiles. Many people in many different countries contributed to these profiles 
most of which are published on the WHO web site at 
http://www.who.int/medicines/areas/coordination/coordination_assessment/en/index1.html
 . The outcome of all this work came together in this paper.

The key take home message from the paper is that creating an enabling 
environment through policies, structures and implementation activities does 
improve the use of medicines as an outcome. But the paper also creates a 
question. When countries spend so much on medicines (30-40% of total Health 
expenditure) why then do they spend so little and expend such limited human 
resources on improving the use of these medicines? If just 1% of medicines 
budget was spent on improving the use of medicines the outcomes would be 
dramatic as this paper shows.

Kathy in her new position as the regional adviser in SEARO working in the 11 
countries of that region has tried to move this process forward by doing 
country assessments with implementation plans. These are all discussed on their 
regional web site at http://www.searo.who.int/entity/medicines/en/  with their 
country situational analysis reports at 
http://www.searo.who.int/entity/medicines/country_situational_analysis/en/ . 
Well worth a look.

So congratulations to Kathy and David. This is a most important paper that will 
be cited for years to come. I just hope we do not need to wait 25 years before 
it is updated.

Richard

Richard Laing
Professor International Health
Boston University School of Public Health,
801 Massachusetts Avenue Boston MA 02118
Tel 617 414 1445 (Office) 617 435 7860 (Mobile)
http://www.bu.edu/pharm/the-program/
E mail richardl@bu.edu

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