Informal Consultation on Pooled Procurement of Essential Medicines for Pacific Island Countries
Nuku'alofa, Tonga 6 August 2007
** ** * * * * * *** European Commission
(WPR)PIC/EDM/3.2/001 RA/2007/GE/44(TON)
English only
REPORT
~ORMAL CONSULTATION ON POOLED PROCUREMENT OF / ESSENTIAL MEDICINES FOR PACIFIC ISLAND COUNTRIES
Convened by: WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC Nuku'alofa, Tonga 6 August 2007
Not for sale Printed and distributed by: World Health Organization · Western Pacific Regional Office Manila, Philippines November 2007 111?~ World Health ~Organization _,...-
Western Pacific Region
WHOIWPRO LmRARY ~\'1ANILA. PHILIPPINES
2 3 OCT 2008
European Commission
NOTE . The views expressed in this report are those of the participants in the Informal Consultation on Pooled Procurement of Essential Medicines for Pacific Island Countries and do not necessarily reflect the policy of the World Health Organization.
Keywords:
IDrugs, Essential I Pacific islands This report has been prepared by the World Health Organization Regional Office for the Western Pacific for governments of countries and areas in the-Region and for those who participated in the Informal Consultation on Pooled Procurement of Essential Medicines for Pacific Island Countries, which was held in Nuku'alofa, Tonga, on 6 August 2007.
LIST OF ACRONYMS
CIP GCC DIEFPIC EMLs FPSC FPSC/BPS
Cost of the Goods, Insurance & Freight Gulf Cooperation Council Drug Information Exchange for Pacific Island Countries Essential medicines lists Fiji Pharmaceutical Services Centre Fiji Pharmaceutical Services Centre /Bulk Purchasing Scheme Medium Price Ratio Organization of Eastern Caribbean States Pacific island countries Standard treatment guidelines
MPR OECS PIC STGS
SUMMARY
An Informal Consultation on Pooled Procurement of Essential Medicines for Pacific Island Countries was held in Nuku'alofa, Tonga, on 6 August 2007. The objectives ofthe informal consultation were: (1) to discuss the results of the feasibility study on pooled procurement of essential medicines for Pacific island countries; to discuss various possible options and recommend the most feasible option for pooled procurement; and to discuss the procurement mechanism for small island states and countries.
(2)
(3)
These objectives were set to obtain an agreement on the most feasible option for pooled procurement and assist in deciding the future direction for Pacific island countries in the pursuit of a pooled procurement scheme for essential medicines. Ten representatives from nine Pacific island countries (Cook Islands, Fiji, Kiribati, Nauru, Samoa, Solomon Islands, Tonga, Tuvalu and Vanuatu) and one consultant participated in the consuJtation. The consultation consisted of a review of the findings of the feasibility study on pooled procurement of medicines for Pacific island countries and plenary presentations and discussions on medicine procurement. From the study, three options were proposed for consideration as mechanisms for pooled procurement by Pacific island countries, and the main advantages, disadvantages and minimum requirements of each of the options were described: (1) Explore and expand (strengthen) the ongoing Fiji Pharmaceutical Services Centre, Bulk Purchasing Scheme (FPSC/BPS), collaborating with the small island states as equal partners, using a central contracting and purchasing model. (2) Establish a new pooled procurement scheme with the participation of other bigger Pacific island countries, using the group contracting model as a reference. (3) Create a hybrid model of the above two options.
Participants agreed that Option 2 from the feasibility study is the best option, suggesting a group contracting scheme for pooled procurement may likely be feasible for Pacific island countries. In addition, participants agreed to proceed towards making preparations for adapting Option 2, acknowledging that work needs to be started in strategic areas to fulfil pre-requisites, namely harmonization of procurement mechanisms, harmonization of the medicines list, harmonization of criteria for prequalification of suppliers, analysis of the financing system, rules and regulations governing medicine procurement, and the human resources and infrastructures required for such a scheme, in p~cular information and communication. Participants also recommended that, in the mean time, small island states and the Fiji Pharmaceutical Services Centre should strengthen their on¥oing collaboration by cr~ting a partnership, as suggested lUlder Qptio~ 1. The consultation also agreed that a working group, led by a representative of Fiji, would start the process of collating and analysing documents and work on harmonization immediately. A road map, which will lead towards implementation of pooled procurement of medicines in
interested Pacific island countries, was developed and reviewed. The consultation concluded that, in the long run, there is potential for pooled procurement in the Pacific island countries. The participants reached several specific recommendations, addressed to the participating countries, national governments and WHO, to pursue the pooled procurement of essential
medicines in Pacific island r.onntrir.:;;
CONTENTS
LIST OF ACRONYMS SUMMARY 1. INTRODUCTION .............. .............. ..... ......... .. ......... ........ ... ... .... ..... .. .. ... 1
1.1 1.2 1.3 1.4 1.5 2.
Background information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Objectives .............. .............. .............. .............. .............. .............. ... 2 Organization of the consultation .............. .............. ........ ............... .......... 2 Opening remarks ............... ..... ...... .............. .............. .............. ........... 2 Appointment of Chairperson, Vice-Chairperson and Rapporteur ............... ....... 3
PROCEEDIN"GS .... .. .. ... ..... .. .. .............. .............. .............. .............. ......... 3
2.1 Pursuing pooled procurement of essential medicines for Pacific island countries ... 3 2.2 Feasibility of pooled procurement of medicines in Pacific island countries ........... 3 2.3 Countries' views on medicine procurement ........... .. .............. .............. ...... 5 3. CONCLUSIONS AND RECOMMENDATIONS ............... . ... .... .. .. ... .. .. ........ .. .. 6
3 .1 Conclusions .............. ...... .............. .............. ...... ............... .. ... .. .... ..... 7 3. 2 Recommendations .............. .............. .............. .... .... ........ .... .... ... ..... .. . 7 ANNEXES
ANNEX 1 - LIST OF PARTICIPANTS, CONSULTANT AND SECRETARIAT ANNEX 2 - PROVISIONAL AGENDA APPENDIX - REPORT ON FEASffiiLITY STUDY ON POOLED PROCUREMENT OF MEDICIN"ES FOR PACIFIC ISLAND COUNTRIES
1. INTRODUCTION ·
1.1
Background information
Procurement is an important step in efficient drug management and supply, and has become a routine procedure in the existing drug management systems in many countries. An effective procurement process ensures the availability of the right drugs in the right quantities, at reasonable prices, and at recognizable standards of quality. Problems can often be encountered if procurement is carried out without such a systematic process, resulting, for instance, in the needed medicines being out of stock, overstocks and wastage of resources, and purchase of low quality products. 1
"Bulk purchasing" or "pooled procurement" is defined as "purchasing done by one procurement office on behalf of a group of facilities, health systems, or countries. Group members agree to purchase certain drugs exclusively through the group". The primary advantage of pooled procurement schemes is the reduction of medicines costs through economies of scale. At the regional level, other benefits may include harmonizing standard treatment guidelines and essential medicines lists; harmonizing medicine regulatory functions, such as drug registration, among countries; improving quality assurance; improving the service provided by suppliers; and decreasing the administrative workload. The issue of bulk purchasing of pharmaceuticals for Pacific island countries and areas was identified as a priority in the Yanuca Island Declaration. At the conference in Yanuca Island, Fiji" in 1995, it was recognized that "improvements in the quality, safety, efficacy, availability and cost-effectiveness of drugs in the Pacific island countries and areas could be achieved through a bulk purchasing scheme for pharmaceuticals". Collaboration in bulk purchasing schemes should contribute to higher standards of health care through the rational use of drugs, not merely reduce costs. In addition to pooled procurement, the importance of information exchange between countries, development of a common framework for medicines legislations and coordination of sampling and testing was recognized and discussed at meetings of Ministers of Health held in Rarotonga, Cook Islands (1997), and Koror, Palau (1999). More recently, a feasibility study on pooled procurement of medicines for Pacific island countries was carried out by a WHO consultant, in collaboration with counterparts representing the Pacific island group, as a follow up to the recommendations of the Workshop on Pharmaceutical Policies and Access to Good Quality Essential Medicines for Pacific Island Countries, held in Suva, Fiji, in September 2006. The objectives of this feasibility study were to: analyse the strengths and weaknesses of various options for a pooled medicine procurement scheme for Pacific island countries; define the potential savings and the cost of pooled procurement, based on a basket of agteed indicator drugs; and reconimend the most feasible and cost-effective option for a pooled medicine procurement scheme for Pacific island Qountries and ¢.e systematic steps and requirements to pursue that scheme. The Informal Consultation o~
Practical guidelines on pharmaceuticals procurement for countries with small procurement agencies. Manila, WHO Western Pacific Regional Office, 2002
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Pooled Procurement of Essential Medicines for Pacific Island Countries was held in Nuku 'alofa, Tonga, on 6 August 2007to conceptualize the idea of pooled medicines procurement for Pacific island countries, discuss possible pooled medicine procurement options and recommend the most feasible and cost-effective option. The consultation was attended by 10 participants from nine Pacific island countries (Cook Islands, Fiji, Kiribati, Nauru, Samoa, Solomon Islands, Tonga, Tuvalu and Vanuatu) and one consultant (Annex 1). 1.2 Objectives: The objectives of the informal consultation were: ( 1) (2) (3) to discuss the results of the feasibility study on pooled procurement of essential medicines for Pacific island countries; to discuss the various options for pooled procurement and recommend the most feasible; and to discuss the procurement mechanism for small island states and countries.
These objectives were set to obtain an agreement on the most feasible option for pooled procurement and to assist in deciding the future direction for Pacific island countries in the pursuit of a pooled procurement scheme for essential medicines. 1.3 Organization ofthe consultation
The consultation programme consisted of plenary presentations and discussions. The approach was problem-oriented and problem-solving. Participants received presentations and the report of the feasibility study in hard copy and on compact disk. The agenda for the consultation is in Annex 2. 1.4 Opening remarks
Dr Chen Ken, WHO Representative in the South Pacific, opened the meeting by warmly welcoming all participants and thanking the Government of Tonga for hosting the event. He emphasized the fact that strengthening the pharmaceutical sector in the Pacific has become a long-term priority, as reflected in the recommendations of past meetings of Ministers and Directors of Health of Pacific Island Countries. Having the right medicines, of assured quality, in the desired quantities, at the right time and at a favourable cost is the primary means to create sustainable pharmaceutical supply systems. However, to reach this goal, Pacific island countries face many challenges, mainly attributed to limited human resources, infrastructure, and development and implementation of measures that regulate the market and assure the quality of medicines. In this context, pooled procurement of medicines, which will aggregate the purchasing power of countries at the regional level, has been one of the priority issues in the Pacific region. At the Workshop on Pharmaceutical Policies and Access to Good Quality Essential Medicines for Pacific Island Countries, which has held in Suva, Fiji, in September 2006, it was requested that a study on the feasibility of pooled procurement for Pacific island countries be undertaken. That feasibility study, supported by WHO, was completed recently, and demonstrates that such a pooled procurement scheme would be beneficial. The study emphasizes, however, that success would ultimately depend on the willingness and commitment of countries to take the necessary
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steps towards regional integration and harmonization of their requirements for pooled procurement. Considering that the issue of pooled procurement has been discussed for over 20 years in Pacific island countries, Dr Chen invited participants to actively contribute during the one-day informal meeting in order to provide more clarity about the future direction for pooled procurement. 1.5 Appointment of Chairperson, Vice-Chairperson and Rapporteur
The workshop elected Ms Vasiti-Nawadra Taylor from Fiji and Mr William Horoto from Solomon Islands as Chairperson and Vice-Chairperson, respectively, and Dr Maleisi Latasi of Tuvalu as Rapporteur.
2. PROCEEDINGS
2.1
Pursuing pooled procurement of essential medicines for Pacific island countries
Ms Lkhagvadorj Vanchinsuren of the WHO South Pacific Office set the stage by reviewing past activities on pooled procurement in the Pacific region. She recalled the relevant points of the Health Ministers' declarations, as stated in the Yanuca Island Declaration (1995), the Rarotonga Agreement (1997) and the Palau Action Statement (1999). In addition, WHO activities to support the initiative were listed. The supply and procurement medicines in Pacific island countries has been at the centre of many activities undertaken to date. Since 1996, for example, several workshops focusing on strengthening and increasing the efficiency of the drug supply management in Pacific island countries have been held for participants from the region. With regard to pooled procurement, certain necessary harmonization activities have not yet taken place, and the high political commitment already offered has not yet been translated into an administrative, legislative and technical process for implementation. Given the fact that the Pacific Plan calls for development of proposals or strategies for the pooled procurement of pharmaceuticals, and based on the feasibility study already undertaken, it is advisable that a decision be made regarding whether or not pooled procurement should be pursued in the Pacific. 2.2 Feasibility of pooled procurement of medicines in Pacific island countries
Ms Dardane Arifaj-Blumi, WHO consultant, provided an overview of the feasibility study (Annex 3). She first explained the findings of a cost-saving exercise that involved four countries: Fiji, Samoa, Solomon Islands and Tonga. This cost study revealed that the countries sampled for the exercise are currently procuring relatively efficiently compared with the international reference price. The average medium price ratio (MPR) for the basket of medicines was 2.54 for vital items, 1.29 for essential items and 1.12 for high-volume, low-cost items (cost, insurance and freight [CIF] included). It is assumed that, even although the current volumes may increase more than one hundred fold for some Pacific island countries if a pooled procurement system were to be introduced, the economies of scale still may not be reached, since the overall value of the market remains smail, at an estimated US$ 21 million, in addition to the fact that prices are already low. However, no methodology can accurately predict potential cost savings if procurement were to shift from a country level to the regional level.
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Two types of pooled procurement, group contracting and central contracting and purchasing, were described, using their use by the Gulf Cooperation Council (GCC) and Organization of Eastern Caribbean· States (OECS) as models. Ms Arifaj-Blumi advised Pacific island countries to consider the non-financial benefits of a potential pooled procurement scheme. Based on the evidence, it is assumed that a well-designed scheme will, not only improve procurement practices, but will also increase transparency, sustain the supply chain by improving the predictability of needs and prices, ensure better coordination of deliveries and increase suppliers' performance. In addition, pooled procurement will require harmonization of essential medicines lists, registration requirements and quality-assurance mechanisms and consequently of standard treatment guidelines, which will lead to better clinical outcomes and increased efficiency in using existing resources. From the study, three procurement options were proposed for consideration by Pacific island countries, and the main advantages, disadvantages and minimum requirements of each were described: (!)Explore and expand (strengthen) the ongoing Fiji Pharmaceutical Services Centre/ Bulk Purchasing Scheme (FPSC/BPS), collaborating with the small island states as equal partners, using a central contracting and purchasing model (OECS example). (2) Establish a new pooled procurement scheme with the participation of other bigger Pacific island countries, using a group contracting model (GCC example). (3) Create a hybrid model of the above two options. The scheme would be implemented by Heads of Pharmaceutical Services of the participating countries, supported in technical matters by WHO and in non-technical matters by the Pacific Islands Forum Secretariat, as the mandated organization to promote regional integration. The design of the scheme has to be suitable to the region's unique conditions, as well as culturally and politically appropriate, and must not necessarily be tailored to strictly fit a specific model. In deciding whether or not to establish a pooled procurement scheme, discussions should be based first on the willingness and commitment of countries to take full responsibility for benefits and risk-sharing, acknowledging that there is always a degree of uncertainty in making a decision. Ms Arifaj-Blumi illustrated the relevance of the strategy to minimize or prevent risks to successful implementation of the chosen pooled procurement scheme. Prior to making the decision, the following aspects should also be taken into account: • • • Pooled procurement will not hamper a country's sovereignty in respect of decision-making and contracting in the procurement of pharmaceuticals. The budget for the procurement of pharmaceuticals remains in the country and is not managed by a third party. Pooled procurement is a strategy for synchronizing tender cycles among participating countries, streamlining requirements and saving administrative costs, to better control suppliers and improve quality assurance.
In her summary, the speaker stressed that certain critical factors need to be fully addressed
to establish a successful and operational regional pooled procurement scheme, such as strong political commitment; a permanent and autonomous secretariat; harmonization and standardization of lists, procedures and requirements; good pharmaceutical procurement practices; a reliable payment mechanism or financial procedures; and quality-assurance components.
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2.3
Countries' views on medicine procurement
Following the presentation on the feasibility study, participants discussed issues related to the medicine supply system in their respective countries, focusing on the feasibility of a pooled procurement scheme. 2.3 .1 Cook Islands
Medicines are mainly procuring from New Zealand and Australia at a good price. The essential medicines list and the national medicines policy have recently been updated. A lack of human resources has been identified as a constraint in expanding the activities and implementing strategies that are already planned. Option 2 is considered to be most favourable, with the condition that critical technical and non-technical factors are addressed in advance. 2.3.2 Fiji
The inability to settle accounts is a concern. Small island states usually place emergency orders with the Fiji Pharmaceutical Services Centre (FPSC), but payments are often delayed. There is the capacity to expand and share information technology/systems with small island states. In regard to pooled procurement, Fiji supports Option 2. However, until the preconditions for this option are met, Option 1 (FPS/BPS) has to be strengthened. 2.3.3 Kiribati
Poor communications with FPS is a major constraint. Most items are contracted from Australia and only some from Fiji. Currently, the country is undertaking major steps in reviewing its pharmaceutical policies. With regard to pooled procurement, Option 2 is the most feasible provided that that the necessary preconditions are addressed. 2.3.4 Nauru
Nauru is currently purchasing from Australia and only a small proportion of its medicines are purchased from FPS due to logistical constraints: Brisbane is the most convenient port for any shipping to the country. However, Nauru remains eager to participate in a regional pooled procurement scheme in which all participating countries can be treated as equal partners in negotiating with suppliers. From a small island state's perspective, Nauru supports Option 2 when other countries join the scheme. In the mean time, the country supports Option 1. 2.3.5 Samoa
The essential medicines list has been updated recently. A national medicines policy was formulated in 1999, but it is not really being implemented as yet. Standard treatment guidelines need to be developed as they currently exist only for diabetes. Option 2 is considered the most feasible provided the preconditions are fulfilled . However, 20% of Samoa's health budget is spent on pharmaceuticals, and any decision about changing the current procurement practice and adopting a new scheme is considered to be highly political. 2.3.6 Solomon Islands
Solomon Islands stresses the need to have a clear road map on the next steps to be taken towards harmonization of essential medicines lists, prequalification, tender cycles and relevant legal aspects that will help in moving towards regional integration. The decision on pooled
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procurement remains political. Therefore, it is imperative for the technical professionals to inform their political leaders so that they can make an informed decision. Option 2 is considered the most appropriate if a pooled procurement scheme is to be pursued. 2.3.7 Ton11;a
With regard to the future of procurement, reviewing the financial cost savings, pooled procurement may not bring about a significant difference in the short term although it may in the long term. For instance, suppliers' performance can be improved and quality assurance will be strengthened through the enforcement of unified prequalification criteria, which in return will protect the region from counterfeit medicines, a global problem. Option 2 is considered the most suitable, but only when technical and non-technical preparations are completed in advance. 2.3.8 Tuvalu
Pharmaceuticals are currently mostly purchased from New Zealand and partially from Fiji. Persistent problems in procurement include delivery by suppliers of items that are close to their expiry dates, a poor infrastructure, and a lack of communication with suppliers, as well as shipping difficulties. Currently WHO is providing technical support to Tuvalu in efforts to strengthen m,edicines supply management and develop a pharmaceutical procurement plan. For Tuvalu, Option 2 seems to be the most feasible for a regional pooled procurement scheme. 2.3.9 Vanuatu
The legal framework that regulates the pharmaceutical sector has been updated. The Pharmacy Act has been drafted and is awaiting approval. A drug policy has been finalized and the essential medicines list updated. Vanuatu considers Option 2 the most feasible for pooled procurement, provided that critical technical and non-technical conditions are met.
3. CONCLUSIONS AND RECOMMENDATIONS
The informal consultation, held in Nuku'alofa, Tonga on 6 August 2007, discussed issues related to the supply of medicines in Pacific island countries, especially regarding the feasibility of a pooled procurement system, and reviewed the results of the feasibility study on pooled medicines procurement, undertaken by a WHO consultant from 17 March to 12 April2007. 3.1 Conclusions ru.Q,
'fhe consultatip11 ~ll~hHl~ tAAt, !P the Jong · i!;land countries. Pacific the in l : ! ~
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Participants agreed that Option 2 is the best option, suggesting a group contracting scheme for pooled procurement may likely be feasible for Pacific island countries. The process can start with participation of bigger countries, provided that all critical factors are sufficiently addressed. Preparatory work needs to be started in strategic areas to fulfil pre-requisites; harmonization of procurement mechanisms, harmonization of essential medicines lists, · harmonization of criteria for prequalification of suppliers, analysis of the financing system, establishment of rules and regulations governing medicines procurement, and putting in place the
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human resources and infrastructure required for such a scheme, particularly as regards information and communication.
In the mean time, small island states and the Fiji Pharmaceutical Services Centre can strengthen their ongoing collaboration by creating a partnership, as suggested under Option 1 of the feasibility study. 3.2 Recommendations
G~:;neral:
( 1) In pursuing a mechanism for pooled medicine procurement in Pacific island countries, the preparatory strategic steps should be as (ollows: (a) harmonization of procurement systems and procedures; (b) harmonization of essential medicines lists; (c) harmonization of criteria for prequalification of manufacturers, suppliers and medicines; and (d) analysis ofthe legislation governing procurement and financing of medicines in respective countries. (2) Based on these strategies, a 'PIC Pooled Procurement Road Map' should be defined that will lead towards implementation ofthe pooled procurement of medicines in interested Pacific island countries. A working group, led by Fiji, should start collating and analysing documents and working on harmonization immediately. The road map should be as follows: Strategic issues Actions agreed - Identify current tender contract - ldentify current commitment~
A. Hannonization of procurement mechanism
Documents for submission Tender dossiers Template of contract
Responsibility All countries to submit to the working group (Fiji collating documents). The assigned group will do the synfuesis. Assigned group will synthesize the EMLs and produce one hannonizedEML.
Time-line Two weeks after the workshop
Six months Six months
- Tender documents B, Hannonization of selection or essential medicines lists (EMLs) - Collate electronic copies ofEMLs - Identify common medicines and those of different strengths and formulations - l~entify current crit~P!\ ~ m ea.c.ll co1qttl y fqf prequalification ;· _ '1\ I 4
E-copies of the EMLstothe assigned group
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(:;. ~o~on of ' .. l ~ . ~' r'H , -,. ; cntenao · · · prequ3.Iif!cation
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- Hannonize these criteria
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Assigned group will SV\ltheslze the · d~e~ts ~d create a harmonized document applicable to all PIC for prequalification. · · : . •. · : .· - ' <
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Six months
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D. Assessment of legislation and regulatipns governing procurement
- Review legal aspects applicable to public procurement - IdentifY sections that potentially need to be amended
Individual countries to submit laws/regulations on public procurement and public financial systems
Assigned group, with the support of a legal expert, to summarize legal requirements in each country for future pooled procurement
Six months
Participants: (3) Participants should report to their supervisors and draw the attention of their respective Health Ministers to the pooled prQGurement scheme, with the aim of gaining government support for action. Participants should submit a report to their respective governments regarding activities and progress towards pooled procurement. These reports should incl\].de, among others, the steps taken for harmonization and a description of the most favourable option for pooled procurement. Participants should work on the above-listed strategic issues at the country level, as well as at the regional or sub-regional level through the joint working group, with the intention of fulfilling pre-conditions.
(4)
(5)
National governments: (6) National governments should recognize that it is generally accepted that consistent and systematic action is needed to improve the medicine supply system in Pacific island countries, especially the procurement mechanism. National governments should take the action required for harmonization in the strategic areas identified above. National governments should consider involving the Pacific Islands Forum Secretariat and informing them about the initiative, as well as identifying possible grounds for collaboratipn and support for activities that will lead towards harmonization and implementation of the scheme.
(7)
(8)
WHO: (9) WHO should provide technical support to Pacific island countries in their efforts related to the strategic issues identified above and their actions to follow the 'road tmtp',
( 1{)) WHO shoul~ ~sist racific island countries and encour~e participants tg ~optr,jbutt? ' to the eleetromc commUnication network, Drug Infonriation Exchange for Pacific Island Countries (DIEFPIC). (11) WHO should work with the Pacific Islands Forum Secretariat at the request of governments. national" (12) WHO should support the working group in undertaking the necessary steps towards addressing the above-mentioned harmonization tasks.
ANNEXl LIST OF PARTICIPANTS, CONSULTANT AND SECRETARIAT PARTICIPANTS
COOK ISLANDS
Ms Bernadette Helen Sinclair, Project Officer, Ministry of Health P.O. Box l09, Avarua, Rarotonga, Tel: (682) 29 664 Fax: (682) 23 109, Email: h.sinclair@health.gov.ck Mrs Vasiti-Nawadra Taylor, Principal Pharmacist, Fiji Pharmaceutical Services Centre, P.O. Box 106, Suva, Tel: (679) 338 8000 vnawadra@health.gov.fj Fax: (679) 338 8003; Email: Ms loan a Takau, Head of Section, Acting Director of Pharmacy Ministry ofHealth and Medical Services, P.O. Box 268, Bikenibeu Tarawa Tel: (686) 28100, Fax: (686) 28152/28568 Email: Ioana. Taakau@gmail.com Mr Brendoski Limen, Supply Manager, Republic of Nauru Hospital P.O. 'Box 128, Central Pacific, Tel:(674) 444 3883, Email: nghealth@cenpac.net.nr Ms Lepaitai Hansell, Quality Assurance Officer, Ministry of Health P 0 Box 3799, Apia, Tel: (685) 21212 (ext 247), Fax: (685) 21455 Email: LepaitaiH@health.gov.ws
FIJI
KIRIBATI -
NAURU
SAMOA
SOLOMON ISLANDS Mr William Horoto, National Medical Stores Manager Ministry of Health of Medical Services, P.O. Box 349, Honiara Tel: (677) 30890; Fax: (677) 30891; Email: willieh@nms.gov.sb TONGA Mrs Melenaite Mahe, Principal Pharmacist, Ministry of Health P.O. Box 59, Nuku'alofa, Tel: (676) 24 553, Fax: (676) 23 434 Email: melenaitemahe@gmail.com; mahecpms@kalianet.to Mr Siutaka-He-Hau Siua, Senior Pharmacist, Ministry of Health P.O. Box 59, Nuku'alofa, Tel: (676) 24 255; Fax: (676) 23 938 Mobile: (676) 54 255, Email: ssiua@health.gov.to TUVALU Dr Maliesi Latasi, Pediatrician/Medical Officer Princess Margaret Hospital, Private Mail Bag, Funafuti Tel: (688) 2076~ ; F~: (688) 20832; Email: m latasi@yahoo.com
Ms Regina Heheina, Health Pharmacist, Northern District Hospi~ Ministry of Heattb, PMB 06, Luganville Santo; Tel:(678) 36345/ (678) 47084; F~:(678) 36213; Email: reheina@vanuatu.gov.vu
2. SHORT-TER MCONSULT ANT
Mrs Dardane Arifaj-Blumi, Political Advisor to Prime Minister on Health Affairs Cabinet of the Prime Minister, Government ofKosovo, PM Cabinet, Mother Theresa Street, Pristina, Kosovo, Tel:(377) 44 676 474, Fax:(381) 38 211 202, Email: dardanearifaj@yahoo.com 3. SECRETARI AT
Dr Chen Ken, WHO Representative, South Pacific Level 4, Provident Plaza One, Downtown Boulevard, Ellery Street, Suva Tel: (679) 323 4116; Fax: (679) 330 0462; Email: chenk@sp.wpro.whoint Dr Budiono Santoso (Responsible Officer) Regional Adviser in Pharmaceuticals World Health Organization, Western Pacific Regional Office, 1000 Manila, _Philippines Tel: (632) 528 9846; Fax: (632) 526 0279; Email: santosob@wpro.who.int Dr Pratap Jayavanth, Acting Country Liaison Officer in Tonga, World Health Organization Nuku'alofa, Tonga, Tel:(676) 23 217, Fax:(676) 23 938; Email: jayavanthp@wpro.who.int Ms Lkhagvadorj Vanchinsuren , Technical Officer in Pharmaceuticals, World Health Organization, Level4 Provident Plaza One, Downtown Boulevard, 33 Ellery Street, Suv~ Fiji Tel:(679) 323 4125, Fax: (679) 330 0462, Email: lkhagvadorjv@sp.wpro.who.int Mr Yoshihiko Sano, Technical Officer in Pharmaceuticals, World Health Organization Western Pacific Regional Office, 1000 Manila, Philippines, Tel:(632) 528 9849 Fax: (632) 526 0279, Email: sanoy@wpro.who.int Ms Nazarita Tacandong, Tecnnical officer in Pharmaceuticals, World Health Organization · Western Pacific Regional Office, 1000 Manila, Philippines, Tel:(632) 528 9882 tacandongn@wpro.who.int Fax:(632) 526 0279, Email:
ANNEX2
PROVISIONAL AGENDA
1. 2. · 3. 4. 5. 6. 7.
Opening ceremony Introduction: consultation objectives Pursuing pooled procurement for Pacific Island Countries FinditJgs of the feasibility study on pooled medicines procurement for Pacific island countries Countries' view on pooled procurement of medicines Plenary discussions on pooled procurement of medicines Conclusions
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