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The State of Medicine Quality in the Mekong Sub-Region

Sauwakon Ratanawijitrasin
Souly Phanouvong

7 - Improving the state of medicine quality in the mekong subregion

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1Because of the wide availability of poor quality medicines and the broad and serious impacts generated by their use, many recommendations have been made on policy intervention in the aim to tackle this problem.

2Key recommendations proposed by many concerned parties include:

  1. national medicines policy and medicines quality assurance system;
  2. strengthening of medicines regulatory authorities (MRA);
  3. regular inspections of pharmaceutical premises;
  4. establishment of medicines quality control laboratory with adequate equipment and trained personnel;
  5. effective law enforcement;
  6. measures to reduce corruption;
  7. judicial procedures and policies that reflect the seriousness of the problem and the offence;
  8. reducing the price and increasing the availability of genuine medicines;
  9. raising awareness among health professionals for heightened vigilance;
  10. developing reporting systems for health professionals;
  11. educating consumers to differentiate the curative from the dangerous medicines;
  12. good practices on the part of pharmaceutical manufacturers, wholesalers, and traders to ensure quality;
  13. using technologies to help in identification and monitoring, for example: electronic track-and-trace mechanisms, radiofrequency identification (RFID), authentication technologies;
  14. fostering international cooperation in the control of pharmaceuticals;
  15. development of an international convention to control the trade in counterfeit and substandard medicines (WHO 2011, Laven 2006, USP-DQI 2004 and 2007).

3The majority of these recommendations involve supply-side measures. These are important strategies in the fight against poor quality medicines. Nonetheless, there are gaps and areas for improvement in the efforts to reduce poor quality medicines. This study also highlights the importance of the demand-side of the medicine quality issue. It proposes increased emphasis on the following four key supply-and-demand strategies:

4(1) Increase the power of intelligence:
Develop a system that helps to enhance the use of intelligence and timely information sharing among key stakeholders to perform a rapid alert system. This can be achieved by creating an international database to make better use of data from various quality monitoring studies, continuously updating and analysing the data, applying geographical information techniques, and using them to track problem areas and issuing alerts to all relevant parities.

5(2) Improve understanding of the demand behaviour:
Generate knowledge about demand behaviour as related to the use of quality medicines through qualitative and quantitative research.

6(3) Empower consumers:
Develop and implement a multi-prong approach to help raise awareness and empower consumers to appropriately select and use medicines. This can be done through public education and campaigns, and through the advice of health professionals. In addition, creating a system to make relevant information readily available to consumers, such as web-based information, will help put know ledge at the consumers’ fingertip. Outreach awareness and education programmes on medicines quality and the danger of using counterfeit and substandard medicines for the marginal and less advantaged population groups should also be carried out.

7(4) Expand health services and insurance:
Access to quality-assured medicines is a key factor in helping to reduce the use of medicines with questionable quality. Making health services and quality medicines available and affordable can be achieved by expanding health and medicine service settings in the more remote areas. Providing health insurance coverage to people in need will help solve the issue of affordability.

© Institut de recherche sur l’Asie du Sud-Est contemporaine, 2014

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