Best Practices in Medical Donations Logistics, Safety and Distribution

1
Best Practices in Medical DonationsLogistics,
Safety and Distribution

• Matthew Krzyston Chuck Clark
• Director Distribution Manager
• RPX Project HOPE
• Dr. Gil Irwin Steve Chupa
• Founder/President Director of Security
• Medical Missionaries JJ Worldwide Sec.

2
The Common Goal

• All donations serve to provide valuable
  assistance to vulnerable populations.
• Disaster Relief
• Rapid, focused response to WHO list and reality
  on the ground
• Every disaster has its own face
• Response to bioterrorism will differ from tsunami
  relief
• Missionary Support
• Assessment of professional capacity is critical.
  What is delivery mechanism?
• Without assessment - Focus on basic supplies,
  over the counter treatments.
• Single Disease Initiatives (TB, HIV, STD,
  Pneumonia)
• Continuity is critical (3-5 year commitment).
• Drug purchase may be required if break in
  continuity.
• Institutional Support
• Focused on sustainable development, Requiring
  extensive in-country knowledge
• Pharmaceutical Benefit Initiative USAID funded
  program designed to support PHC, development of
  mandatory health insurance in Kyrgyzstan
• Not everyone shares this perspective

3
Potential vs. Perception

• Potential
• Life saving assistance for
• vulnerable populations
• Perception
• Expired Product, Diversion,
• Dumping, Dangerous
• Need best practices for everyone
• NGOs, Donors, PQMD

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PQMDs KEY COMPONENTS OF MEDICAL DONATIONS

• Useful NGO guidance on the following program
  elements
• NEEDS ASSESSMENT
• APPROPRIATENESS OF THE DONATION
• QUALITY AND QUANTITY
• PACKAGING
• TRANSPORTATION
• UTILIZATION OF HUMAN RESOURCES
• EVALUATION
• Action required from NGOs, Donors, and PQMD

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NGO ACTIONTraits of Effective Distributions

• Work with MOH (no parallel systems)
• Pharmacist in selection process
• Professional logistics mechanics (HOPE)
• Knowledgeable MD in distribution
• Accountability measures built-in
• Patient-focused benchmarks (not )
• Justified Selection - V.E.N. (Focus on Essential)

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PQMD ACTIONPromoting Excellence

• NGO Inclusiveness
• Growth of PQMD will serve to advance best
  practices
• Advocate for Donor best practices
• Program threats can be reduced, and efficacy
  enhanced, through improved donor practices

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DONOR ACTIONDiminish Threat - Magnify Efficacy

• Adopt Demand-driven giving policy
• Filling more requests for essential drugs
• Generous Dating
• Give until it hurts.?

8
FOUS ON SELECTION

• V.E.N.
• Vital Life saving medicines, targeted to urgent
  needs in hospital settings at tertiary and
  secondary health system levels.
• Examples I.C.U. drugs, cancer drugs, anesthesia
• Essential Important for chronic disease
  management, because interruption of treatment may
  lead to life-threatening complications. Critical
  for reducing hospitalization by providing good
  quality medical service at the PHC level.
• Examples some antibiotics, anti-hypertensive
• Necessary Medicines that address symptoms, but
  do not treat disease/illness.
• Examples oral analgesics, anti-diuretics

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FOCUS ON SELECTIONBest Option Essential
Medicines

• Donations of essential medicines are always
  appropriate, providing the most effective
  assistance to both beneficiaries and the
  healthcare system as a whole.
• Favored by WHO and MOH Country EDL is on file
  with every MOH - Generic EDL issued by WHO
• Vital Meds Require training, fewer
  beneficiaries, threat of non-use/waste
• Necessary Meds Raise questions about cost
  benefit vs. local purchase

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POTENTIAL VS. PERCEPTION Action Required

• NGO Action
• Professionalism Best Practices
• PQMD Action
• NGO Inclusiveness vs. Elitism
• Donor Action
• Reduce Threat Supply-driven vs. Demand-driven
• Everyone
• Promote achievements and support one another

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Reality Check

• If NGOs are unable to adhere to guidelines, they
  should bow out
• Professionalism counts, NGO size does not
• If Donors maintain supply-driven policies, they
  should not expect positive press
• If PQMD does not promote inclusiveness and higher
  standards, standards will stall