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[e-drug] Ebola and Essential Medicine issues

E-DRUG: Ebola and Essential Medicine issues
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[Thank you for sharing this Murtada.  We would welcome further discussion on 
the 
essential medicines  life-or- death issues that cropped up during the Ebola 
epidemic and also that have occurred or might occur during outbreaks of other 
emerging infections.  BS. Moderator]

Dear E-Drug Colleagues,
Greetings and best wishes for 2015 from Freetown!

Now that the dense dust of Ebola appears to be thinning out and settling down, 
I 
thought I would stimulate some discussion in this forum on some of the 
essential medicines  life-or- death issues that cropped up and may have 
remained 
unresolved, as far as I am aware in Sierra Leone, in the hope that some 
clarity or consensus may emerge in readiness for the next epidemic.

I will start with the choice between Oral versus Intravenous 
fluid replacement as part of the supportive care package. 

I read in social media here in Sierra Leone about claims that whereas  a 
fully Sierra Leonean-managed treatment facility primarily used IV 
therapy, this was not the case with some other foreign-managed 
facilities who used ORS instead . The Hastings Treatment Centre using mainly IV 
therapy as part of their overall Ebola supportive care was given much credit 
for their relatively high survival rates.

It is probably too early to see peer-reviewed evidence on this matter, 
where this exists, but I believe it is an important area worth 
discussing even from an academic-only perspective.

At some point at the peak of the social media debate, and as I saw it as a 
matter of 
life-and death, usually within days!,  I suggested out of sheer 
desperation, that I did not see why the use of ORS and IV should be 
mutually exclusive and that, therefore,  the two sides should consider 
reducing their preference  by 50%, and replace with the other option(OR 
or IV), to harmonise their fluid replacement approaches. This of course would 
be in addition to any other best  clinical practices, including monitoring of 
other blood electrolytes.

I would be very interested in views on  this matter, including the 
related stock investment strategies to adopt at the outbreak of the next
 epidemic.

As I say, there are quite a few Essential Medicines issues
 that caught my attention and I intend to raise them here, as we move on
 with the fight to get Ebola out of Sierra Leone and indeed West Africa.

Murtada M. Sesay BPharm.  MSc. MMI.  MCIPS.
Health Supply Matters
[Control Selection - Control Spend - Control Service]
38 Milton Margai
College Road 
Goderich,
Freetown
Sierra Leone
Mobile: +232 79 82 72 00
Email: kindiatown@hotmail.com                             

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