Ref. Perrin C, Cloez S, Dujardin C, Ravinetto R. Europe should lead in coordinated procurement of quality- assured medicines for programmes in low- income and middle- income countries. BMJ Global Health 2020;5:e003283. doi:10.1136/ bmjgh-2020-003283

Dear Friend,


I am happy to share a commentary just published by our group in the BMJ Global Health, and based on the results of a stakeholder survey carried out at the end of 2019, to investigate the procurement policies adopted by a sample of European donors and implementing actors of the national cooperation programmes. We would be grateful if you could share it in your respective networks.


Our survey showed that most European donors are aware of the problems of poor-quality medicines in low- and middle-income countries (LMICs), but that awareness is not always translated into formal QA policies and guidelines. Nonetheless, there are some positive examples of targeted QA policies, in particular for ECHO, Belgium, Sweden and the UK. Furthermore, awareness can be translated into other initiatives, e.g. QA trainings for staff and implementers, capacity building for national procurement units or regulators, and support to key-international mechanisms such as the WHO Prequalification Programme and the WHO Global Surveillance and Monitoring System for Sub-standard and Falsified products.


In an ideal world, each country could count on a stringent regulator, and bilateral and multilateral donors should contribute to reinforcing under-resourced regulatory authorities. Meanwhile, they can also support partner countries, by setting explicit and stringent QA policies for procurement of medicines in the programmes they fund. We argue that by doing so, they would be accountable about the optimal and ethical use of resources, both to recipient countries, and to tax payers and parliaments in their own countries.


We also suggest that efforts to build a common approach across European donors should be further encouraged, by building on the existing best practices and by seeking the input of aid recipient countries, so as to co-design policies and procedures which respond to needs. But European donors could be more ambitious, and develop a joint guiding position to affirm how the European donor community should and can collectively ensure equitable access to and availability of quality-assured health products, including during public health emergencies.

Compared to other approaches that focus on developing market opportunities, or that fail to integrate concerns about pharmaceutical quality, European donors can collectively take leadership in promoting the universal right to safe, quality-assured medicines internationally, in equal partnership with their counterparts from LMICs. This would require awareness and political will at institutional level, enhanced coordination, and consideration for the hidden – yet high – cost of inaction for individual and public health.

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Have a nice reading,
Raffaella

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