Source: World Health Organization (2002). Promoting Rational Use of Medicines: Core Components – WHO Policy Perspectives on Medicines. No. 005.

UNDP’s approach

While the World Health Organization (WHO) is the lead agency mandated to provide technical assistance in the area of rational use of medicines and pharmacovigilance, UNDP’s service level agreements with governments to strengthen pharmaceutical management can include aspects related to rational use and pharmacovigilance. UNDP can also support the strengthening of the regulatory agencies and systems in regulating, controlling and monitoring the use of authorized medicines in the countries. As part of national strategic laboratory plans, UNDP has solid experience in contracting for installation, calibration and maintenance services of complex diagnostics for tuberculosis and HIV.

For countries funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), and according to the Global Fund policies for procurement and supply chain management, UNDP supports the rational use of medicines by ensuring that countries follow WHO evidence-based treatment guidelines. The WHO guidelines recommend the use of the most appropriate and evidence-based medicines, including the indication of formulation, dosage, administration route and treatment duration.

Pharmaceutical management support includes the prescribing and dispensation of medicines and checking patient adherence to treatment measures and resistance surveillance. Patient adherence to treatment is normally assessed routinely within health programmes and during external national programme reviews. Notification of adverse drug reactions is promoted within national pharmacovigilance systems.

Similarly, for diagnostics and other health products, the correct use is ensured by adopting WHO guidance and recommendations for use at different levels of the health system. UNDP can support the development of strategies for improving adherence to treatment. For diagnostics technologies, UNDP supports countries to install, calibrate and set up a maintenance plan for equipment and train staff on this. In Zimbabwe, for example, UNDP provided technical assistance to the National Regulatory Agency to upgrade the national pharmacovigilance system from a paper-based to an electronic system for reporting adverse drug reaction.

UNDP’s approach to the optimal use of health products includes upfront reduction of waste by engaging with manufacturers to optimize packaging, e.g. carton-less bottles, and working on waste management including for specific pharmaceutical categories.