ACCESS TO MEDICINES IN EMERGENCY WHO Technical Briefing Seminar on Access to Essential Medicines 17-21 November 2009 Stéphanie Arsac ICRC Head Pharmacist.
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ACCESS TO MEDICINES IN EMERGENCY WHO Technical Briefing Seminar on Access to Essential Medicines 17-21 November 2009 Stéphanie Arsac ICRC Head Pharmacist ICRC : Who are we ? The International Committee of the Red Cross (ICRC) is a Swiss-based humanitarian organization and founding member of the International Red Cross and Red Crescent Movement (1863). This Movement is composed of the ICRC, National Red Cross and Red Crescent Societies and the International Federation of Red Cross and Red Crescent Societies. The ICRC is mandated by the international community to be the guardian and promoter of international humanitarian law. We work around the world providing assistance to people affected by armed conflict and other situations of violence. The organization has delegations and missions in some 80 countries around the world and employs a staff of over 12,000 people, most of them nationals of the countries in which it works. About 800 people work at the ICRC’s headquarters in Geneva, Switzerland, Access to medicines in Emergency : Key success factors Quality control of medicines via centralized purchase Availability of stocks Strong logistic set-up Trained and experienced people in health & logistics Key Success Factors on a Global Scale Geneva Peshawar Amman Panama under process Abidjan Kuala Lumpur Nairobi under process Corporate coverage Emergency stock Regional coverage Logistic Hub Sub-regional coverage Flying support Pre-positioning of Stock The logistic set-up is defined by the positioning and the sizing of Emergency stocks to serve the first phases of large emergency operations Logistic hubs to store and regulate the flows Flying supports, who are human resources mobilised for training, support to intense activities or background actions of anticipation Set-up and infrastructures have different coverage depending on their situation. International set-up covers all the operation theatres, regional covers 4 to 6 bordering countries, sub-regional covers 1 to 3 bordering countries. It is to be noticed than most of flying support and emergency stock can be mobilised all over the world in case of large emergency operation Pre-positioning of Stock 92 000 sqm of warehouses worldwide Use of kits during the first stage of emergency Re-order in bulk after health assessment Kits pre-positioned (1) A BASIC/PRIMARY/PUBLIC HEALTH KMEDKIAE01B IAEHK, BASIC, 1.000 pers./3m, no malaria KMEDKIAE01BM (iaehk, basic,1.000 pers./3m) MALARIA module KMEDKIAE01S (iaehk, suppl.,10.000 pers./3m) NO NARCO/PSYCHO/MALARIA/PEP KMEDKIAE01SM (iaehk, suppl.,10.000 pers./3m) MALARIA module DINJINSH10VI INSULIN, INTERMEDIATE ACTION, 100IU/ml, human, 10ml, vial DINJINSH10VR INSULIN, RAPID, 100IU/ml, human, 10ml, vial KMEDKCHO01 KIT, CHOLERA (001), 625 treatments with infusions KSANKHEF01 KIT, HAEMMORRHAGIC FEVER, material for 100 patients KMEDZGVA081 (kit reproductive health)CLEAN DELIVERY Ref 2A/UNFPA KMEDZGVA082 (kit reproductive health)CLEAN DELIVERY Ref 2B/UNFPA KMEDZGVA091 (kit reproductive health)POST-RAPE MANAGEMT.Ref 3/UNFPA KMEDZGVA083 (kit reproductive health)CONTRACEPTION SET Ref: 4/UNFPA KMEDZGVA084 (kit reproductive health)SIT KIT Ref: 5 / UNFPA KMEDZGVA093 (kit reproductive health)PROF. MIDWIFERY Ref: 6/UNFPA KMEDZGVA094 (kit reproductive health)UNSAFE ABORT. MANAGEMT.Ref:8/UNFPA KMEDZGVA095 (kit reproductive health) SUTURE Ref:9/UNFPA KMEDZGVA096 (kit reproductive health)VACUUM EXTRACTION Ref:10/UNFPA KMEDZGVA097 (kit reproductive health) Referral Surgical equip. Ref:11a KMEDZGVA098 (kit reproductive health)Referral Surg.drugs/disp.Ref 11b KMEDZGVA099 (kit reproductive health)TRANSFUSION Ref: 12/UNFPA Kits pre-positioned (2) B TRAUMA / WEAPON-WOUNDED KMEDMDRE01 MODULE, DRESSING KMEDKWWF05 KIT, 50 WAR WOUNDED, FIRST AID & TRIAGE, MEDICAL- single use KMEDMFAT50BE (module, f.aid-tri.B) SET, EQUIPMENT+misc.mat., 50 w.w./cas. Field Surgical Team material + equipment (see separate worksheet) KMEDKFAT50 KIT, FIRST AID-TRIAGE, 50 war wou./casualties, modules A/B/C KMEDKWWH05 KIT, 50 WAR WOUNDED, HOSPITALIZED, RENEWABLES KMEDSLINSR50S SET, LINEN, SURGICAL, single use,for 50 wounded hospitalised KMEDSANE05B SET, ANAESTHESIA, BASIC MATERIAL, for 50 hosp. single use KMEDSDRU05SS SET, DRUGS FOR SURG. AND ANAEST., SUPLEMENTARY, 50 patients KMEDSTEA01 SET, TETANUS VACCINE AND IMMUNOGLOBULINS XSEQSTRE1X STRETCHER, foldable in width XSTEAUTO90 AUTOCLAVE, COMBINED, 90 l, elec./kero., incl. kero. burner Kits pre-positioned (3) C SURGICAL INSTRUMENT SETS KMSISAMP01 SET, AMPUTATION, instruments KMSISBON01C set, basic bone surg, comple., CURETTES KMSISBON01 SET, BASIC BONE SURGERY, complementary, instruments KMSISBAS01 SET, BASIC SURGERY, instruments KMSISBOR01 SET, BONE WIRING & KIRSHNER, 8 sizes + instruments KMSISCRA01 SET, CRANIOTOMY, complementary, instruments KMSISDEN01 SET, DENTAL EXTRACTION, instruments KMSISDRE01 SET, DRESSING, instruments KMSISFIX02LF SET, EXTERNAL FIXATION, LARGE, FIXATORS, Hoffmann II KMSISFIX01LF SET, EXTERNAL FIXATION, LARGE, FIXATORS, Synthes KMSISFIX02LI SET, EXTERNAL FIXATION, LARGE, INSTRUMENTS, Hoffmann II KMSISFIX01LI SET, EXTERNAL FIXATION, LARGE, INSTRUMENTS, Synthes KMSISGYN01 SET, GYNAECOLOGY (dilat. & curettage), instruments KMSISLAP01 SET, LAPAROTOMY, (+ caesarian), instruments KMSISPLA01 SET, PLASTER CASTS REMOVAL, instruments KMSISSKI01 SET, SKIN GRAFT, instruments KMSISSUT01 SET, SUTURE, instruments KMSISTHR01 SET, THORACOTOMY, complementary, instruments KMSISSKE01 SET, TRACTION, instruments + 10 bows KMSISURE01 SET, URETHRAL SOUNDS, instruments KMSISVAS01 SET, VASCULAR, complementary, instruments KMSISWOU01 SET, WOUND EXCISION, instruments XSEQSPLIBA2P SPLINT, BOHLER-BRAUN, 70cm, size 2, 3 pulley, foldable XSINMEDI507308 SPECULUM, SIMS, 23cm, open blade 23 x 80 mm, rectal Logistic Key Figures 2740 vehicles / trucks 11 aircrafts Logistic Key Figures 65 Log people in HQ 132 Log expatriates 2800 Log delegation employees Different expertise Red Cross & Red Crescent Movement ICRC can rely on, or support a network of 186 National Societies and 97 Millions of volunteers Quality Assurance and central purchase of medicines To avoid counterfeits & Sub-standards Products registered in highly regulated countries If not, products assessed trough the Interagency Product Questionnaire Good Manufacturing Practices audits of pharmaceutical manufacturers by expert auditors = limited number of manufacturers to follow up Local purchase of medicines local purchase of medicines sometimes needed to fill specific or urgent needs or to supply specific treatments for chronic disease Medical logisticians (pharmacists), are trained to identify reliable sources of medicines and avoid counterfeits and substandards 3 pharmacists in HQ dedicated to Quality Assurance and supporting the field www.icrc.org