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Murombedzi C, Chirinda L, Chareka GT, Chirenje ZM, Mgodi NM. Efficient regulatory approval of two novel HIV prevention interventions in a resource-limited setting: experiences from Zimbabwe. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1279124. [PMID: 38034413 PMCID: PMC10682080 DOI: 10.3389/frph.2023.1279124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/19/2023] [Indexed: 12/02/2023] Open
Abstract
The global burden of HIV remains unacceptably high despite significant progress made in HIV treatment and prevention. There is an urgent need to scale up the comprehensive HIV prevention strategies that include pre-exposure prophylaxis (PrEP). Oral PrEP is highly effective in preventing HIV acquisition when taken regularly, but this remains a challenge for some at-risk individuals. Therefore, there is a need for other HIV prevention options. The dapivirine vaginal ring (DVR) and long-acting injectable cabotegravir (CAB-LA) are novel biomedical interventions that are safe and efficacious for HIV pre-exposure prophylaxis, as demonstrated in recently completed clinical trials. Timely roll-out and scalability of efficacious interventions depend on the registration process with the national medicine regulatory authorities (NMRAs). The Medicines Control Authority of Zimbabwe (MCAZ) was the first NMRA globally to approve the DVR in July 2021 and the first in Africa to approve CAB-LA for HIV prevention in July 2022. The regulatory review process for DVR and CAB-LA by MCAZ took 4.5 and 5.5 months, respectively. This efficient review process of the two interventions by MCAZ, a regulatory body in a resource-limited setting, provides important lessons to shorten timelines between the completion of the clinical development process and the registration of essential medicines.
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Affiliation(s)
- Caroline Murombedzi
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Clinical Trial Research Centre, Harare, Zimbabwe
| | - Libert Chirinda
- Pharmacovigilance and Clinical Trials Division, Medicines Control Authority of Zimbabwe, Harare, Zimbabwe
| | - Gift T. Chareka
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Clinical Trial Research Centre, Harare, Zimbabwe
| | - Z. Mike Chirenje
- School of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Nyaradzo M. Mgodi
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Clinical Trial Research Centre, Harare, Zimbabwe
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2
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Shi J, Chen X, Hu H, Ung COL. Benchmarking Drug Regulatory Systems for Capacity Building: An Integrative Review of Tools, Practice, and Recommendations. Int J Health Policy Manag 2023; 12:8100. [PMID: 38618782 PMCID: PMC10699822 DOI: 10.34172/ijhpm.2023.8100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 09/30/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Benchmarking has been increasingly used on drug regulatory systems to achieve sustainable pharmaceutical system strengthening. This study aimed to identify the scope, tools and benefits of benchmarking regulatory capacities and the most recent development in such phenomenon. Method: This study employed an integrative and critical review of the literature and documents on benchmarking drug regulatory capacities identified from 6 databases and 5 websites of related organizations and government agencies in compliance with the Preferred Reporting Items for Systematic Review (PRISMA) guidelines. RESULTS Forty-three studies and 6 documents about regulatory benchmarking published between 2005 and 2022 were included in this review. Five benchmarking assessment tools or programmes recommended or adopted by international organizations or government agencies had been identified, which collectively covered 12 major regulatory functions (4 at system level and 8 at operational level) involving 9 indicator categories and 382 sub-indicators. Benchmarking drug regulatory systems was reportedly employed at national, regional and international levels for either internal assessment (mostly on regulatory system establishment, drug review process and post marketing surveillance) or external evaluation (mostly on regulatory standards, drug review process and pharmacovigilance systems) to assess current status, monitor performance, determine major challenges and inform actions for capacity building. Priority of actions in areas such as regulatory process, resources allocation, cooperation and communication, and stakeholder engagement have been suggested for strengthening drug regulatory systems. Nevertheless, the evidence about benchmarking in optimizing regulatory capacities remained underreported. CONCLUSION This integrative review depicted a framework for decision-makers about why and how benchmarking drug regulatory systems should be undertaken. For effective benchmarking, well-informed decisions about the goals, the scope, the choice of reference points and benchmarking tools are essential to guide the implementation strategies. Further studies about the positive effects of regulatory benchmarking are warranted to engage continuous commitment to the practice.
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Affiliation(s)
- Junnan Shi
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Xianwen Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
- Centre for Pharmaceutical Regulatory Sciences, University of Macau, Macao SAR, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
- Centre for Pharmaceutical Regulatory Sciences, University of Macau, Macao SAR, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
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3
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Yemeke TT, Umaru FA, Ferrand RA, Ozawa S. Impact of the COVID-19 pandemic on the quality of medical products in Zimbabwe: a qualitative study based on key informant interviews with health system stakeholders. BMJ Open 2023; 13:e068923. [PMID: 37290943 PMCID: PMC10254804 DOI: 10.1136/bmjopen-2022-068923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/26/2023] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE To explore the impact of the Coronavirus disease 2019 (COVID-19) pandemic on the quality of medical products in Zimbabwe, including market risks for substandard and falsified products and impacts on quality assurance activities. DESIGN Qualitative study based on in-depth key informant interviews. SETTING Health system stakeholders across the medical product supply chain in Zimbabwe. PARTICIPANTS 36 key informants were interviewed between April and June 2021. RESULTS We found that the COVID-19 pandemic disrupted quality assurance and regulatory activities of medical products in Zimbabwe, resulted in observations of poor-quality personal protective equipment (PPE) and other COVID-19-related products and led to increased risks to quality. Risks to quality due to COVID-19-related disruptions included increased layers of agents in the supply chain and an influx of non-traditional suppliers. COVID-19-related movement restrictions reduced access to health facilities and thus may have increased the usage of the informal market where smuggled and unregistered medical products are sold with less oversight by the regulator. Most reports of poor-quality medical products were for PPE, such as masks and infrared thermometers, used for the COVID-19 response. Besides these reports, many participants stated that the quality of essential medicines in the formal sector, not related to COVID-19, had largely been maintained during the pandemic due to the regulator's stringent quality assurance process. Incentives for suppliers to maintain quality to retain large donor-funded contracts, and the need for local wholesalers and distributors to comply with quality-related aspects of distribution agreements with global manufacturers of brand-name medical products, mitigated threats to quality. CONCLUSIONS The COVID-19 pandemic presented opportunities and market risks for circulation of substandard and falsified medical products in Zimbabwe. There is a need for policymakers to invest in measures to safeguard the quality of medical products during emergencies and to build resiliency against future supply chain shocks.
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Affiliation(s)
- Tatenda T Yemeke
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Farouk A Umaru
- Department of Global Public Health, United States Pharmacopeia, Rockville, Maryland, USA
| | - Rashida A Ferrand
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Sachiko Ozawa
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Maternal Child Health, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Owusu-Asante M, Darko DM, Asamoah-Okyere KD, Asante-Boateng S, Kermad A, Walker S, Salek S. Evaluation of the Food and Drugs Authority, Ghana Regulatory Review Process: Challenges and Opportunities. Ther Innov Regul Sci 2023; 57:372-385. [PMID: 36352343 PMCID: PMC9646276 DOI: 10.1007/s43441-022-00478-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE This study aimed to assess the current regulatory review process of the food and drugs authority (FDA) Ghana by identifying key milestones, target timelines, good review practices and quality decision-making practices and evaluating the overall regulatory performance from 2019 to 2021, as well as the challenges and opportunities for improvement. METHODS The FDA Ghana representatives completed the optimising efficiencies in regulatory agencies (OpERA) questionnaire, including data identifying the milestones and overall approval times for all products registered by the FDA Ghana from 2019 to 2021. RESULTS Of the new active substances approved from 2019 to 2021, 91% were biologicals processed by full or abridged reviews pathways. Timelines for these reviews were within authority targets but were longer compared with generics. Of generics approved from 2019 to 2021, 97% were pharmaceuticals processed by the full review pathway, with timelines within authority targets and shorter compared with new active substances. Regardless of the review model used, approval times for new active substances increased from 84 to 355 calendar days 2019-2021 due to the impact of the pandemic. Guidelines, standard operating procedures and review templates were in place and the majority of indicators for good review practices were implemented. Several quality decision-making practices were implemented, although currently there is not a systematic structured approach. CONCLUSION The FDA Ghana monitors regulatory performance and currently meets its target timelines. To achieve World Health Organization Maturity Level 4 status, an electronic tracking system, benefit-risk assessment framework and template and the publication of assessment reports are recommended.
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Affiliation(s)
- Mercy Owusu-Asante
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- Food and Drugs Authority, Accra, Ghana
| | | | | | | | - Adem Kermad
- Centre for Innovation in Regulatory Science, 70, St Mary Axe, London, EC3A 8BE, UK
| | - Stuart Walker
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
- Centre for Innovation in Regulatory Science, 70, St Mary Axe, London, EC3A 8BE, UK.
| | - Sam Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- Institute of Medicines Development, Cardiff, UK
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Samunda BT, Sithole T, Khoza S. A Retrospective Analysis of Applications for Registration of Generic Medicines Processed by the Medicines Control Authority of Zimbabwe. Ther Innov Regul Sci 2023; 57:287-294. [PMID: 36269550 PMCID: PMC9905184 DOI: 10.1007/s43441-022-00469-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 09/30/2022] [Indexed: 10/24/2022]
Abstract
BACKGROUND Many applications for registration of medicines are rejected because applicants fail to submit or resolve critical deficiencies in the quality, efficacy, and safety of the medicines. The study aimed to establish approval rates, processing timelines, and common deficiencies of generic medicines applications processed by the Medicines Authority of Zimbabwe (MCAZ). METHOD A retrospective study of applications finalized by MCAZ between 2018 and 2020 was conducted. Data were collected from the assessment reports and verified with copies of letters sent to the applicants. Deficiencies were classified as administrative, quality, efficacy, and safety. Other characteristics collated included time to finalization, dosage form, region of origin, and therapeutic class. RESULTS Of the 579 finalized applications, 74.1% were approved while 25.9% were refused. Approved applications had more review cycles (median = 3 cycles) compared to refused applications (median = 2 cycles). However, refused applications had longer review times (median = 25 months) compared to approved applications (median = 18 months). The majority of applications (83.0%) were from Asian manufacturers and intended for oral administration (66.1%). Medicines for the endocrine system (50.0%) and rheumatism/gout (53.3%) had lower approval rates compared to other therapeutical classes (p < 0.001). The most common reasons for refusal of applications included failure to respond to review queries (52.6%), deficiencies in the API information (54.7%), FPP specifications (42.7%), FPP stability data (36.0%), and pharmaceutical development (31.3%). CONCLUSION To improve the quality of applications and evaluation outcomes, there may be a need for the regulatory authority to engage applicants through training and pre-submission meetings.
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Affiliation(s)
| | - Tariro Sithole
- Medicines Control Authority of Zimbabwe, 106 Baines Avenue, Avenues, Harare, Zimbabwe
| | - Star Khoza
- grid.8974.20000 0001 2156 8226University of the Western Cape, Robert Sobukwe Rd, Bellville, Cape Town, 7535 South Africa
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6
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Sithole T, Mahlangu G, Walker S, Salek S. Regulatory Authority Evaluation of the Effectiveness and Efficiency of the ZaZiBoNa Collaborative Medicines Registration Initiative: The Way Forward. Front Med (Lausanne) 2022; 9:898743. [PMID: 35547217 PMCID: PMC9082034 DOI: 10.3389/fmed.2022.898743] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/01/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction ZaZiBoNa, the work-sharing initiative in the Southern African Development Community (SADC) that has been in operation for 8 years has successfully assessed over 300 dossiers/applications, with an overall median time to recommendation of 12 months. All 16 SADC countries participate in the initiative as either active or non-active members. While the successes of ZaZiBoNa are evident, some challenges still exist. The aim of this study was to solicit the views of the participating authorities on the effectiveness and efficiency of the current operating model of the ZaZiBoNa initiative. Methods Data were collected in 2021 using the Process, Effectiveness and Efficiency Rating (PEER) questionnaire developed by the authors. The questionnaire was completed by the focal person in each country and approved by the head of the authority. Results ZaZiBoNa serves as a platform for work sharing, information exchange, capacity building and harmonisation of registration requirements. One of the benefits to regulators has been the improvement in the capacity to conduct assessments. Manufacturers have benefited from compiling one package (modules 2–5) for the initial submission as well as a single response package to the consolidated list of questions, which saves time and resources. Respondents were of the view that patients have benefited as the ZaZiBoNa has contributed to an improved availability and accessibility to quality-assured medicines. Some of the challenges identified were the inadequacy of resources and differences in time to the implementation of ZaZiBoNa recommendations by the individual countries. The establishment of a regional unit hosted in one of the member countries to enable centralised submission and coordination was identified as the best strategy to improve the effectiveness and efficiency of the initiative in the interim, with the long-term goal being the establishment of a regional medicines authority. Conclusion The study identified the strengths of the ZaZiBoNa initiative as well as the opportunities for improvement. The recommendations made would further strengthen this initiative.
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Affiliation(s)
- Tariro Sithole
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Medicines Control Authority of Zimbabwe, Harare, Zimbabwe
| | - Gugu Mahlangu
- Medicines Control Authority of Zimbabwe, Harare, Zimbabwe
| | - Stuart Walker
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Centre for Innovation in Regulatory Science, London, United Kingdom
| | - Sam Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Institute for Medicines Development, Cardiff, United Kingdom
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7
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Sithole T, Mahlangu G, Walker S, Salek S. Pharmaceutical Industry Evaluation of the Effectiveness and Efficiency of the ZaZiBoNa Collaborative Medicines Registration Initiative: The Way Forward. Front Med (Lausanne) 2022; 9:898725. [PMID: 35547215 PMCID: PMC9082673 DOI: 10.3389/fmed.2022.898725] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/01/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction The common technical document (CTD) format harmonised the requirements for the registration of medicines, which had traditionally differed from country to country, making it possible for countries to collaborate and conduct joint reviews of applications. One such collaborative medicines registration initiative is the Southern African Development Community ZaZiBoNa, established in 2013. A recent study was carried out with the nine active member regulatory authorities of the ZaZiBoNa to determine their views on its operational effectiveness and efficiency. Having obtained the authorities' views, the aim of this study was to evaluate the effectiveness and efficiency of the current operating model of the ZaZiBoNa initiative including the challenges it faces as well as identifying opportunities for improvement from the applicants' perspective. Methods Applicants who had submitted registration/marketing authorisation applications for assessment under the ZaZiBoNa initiative during 2017-2021 were recruited into the study. Data was collected in 2021 using the Process, Effectiveness and Efficiency rating questionnaire (PEER-IND) developed by the authors. The questionnaire was completed by a representative responsible for ZaZiBoNa submissions in each company. Results The pharmaceutical industry was of the view that the ZaZiBoNa initiative has achieved shorter timelines for approval of medicines, resulting in increased availability of quality-assured medicines for patients in the SADC region. Harmonisation of registration requirements and joint reviews have reduced the workload for both the pharmaceutical industry and the regulatory authorities. Some of the challenges identified were the lack of a centralised submission and tracking system, and the lack of information for applicants on the process for submission of ZaZiBoNa dossiers/applications in the individual countries, including contact details of the focal person. The establishment of a regional unit hosted in one of the member countries to centrally receive and track ZaZiBoNa dossiers/applications was identified as the best strategy for moving forward in the interim with the long-term goal being the establishment of a regional medicines authority. Conclusion There was consensus between the pharmaceutical industry and the regulatory authorities as to the way forward to improve the effectiveness and efficiency of the ZaZiBoNa initiative. Implementation of the recommendations identified in this study will lead to enhanced regulatory performance.
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Affiliation(s)
- Tariro Sithole
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Medicines Control Authority of Zimbabwe, Harare, Zimbabwe
| | - Gugu Mahlangu
- Medicines Control Authority of Zimbabwe, Harare, Zimbabwe
| | - Stuart Walker
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Centre for Innovation in Regulatory Science (CIRS), London, United Kingdom
| | - Sam Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Institute for Medicines Development, Cardiff, United Kingdom
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8
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Sithole T, Salek S, Mahlangu G, Walker S. Comparison of the registration process of the medicines control authority of Zimbabwe with Australia, Canada, Singapore, and Switzerland: benchmarking best practices. Expert Rev Clin Pharmacol 2021; 15:109-119. [PMID: 34645359 DOI: 10.1080/17512433.2022.1987883] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Benchmarking regulatory systems of low- and middle-income countries with mature systems provides an opportunity to identify gaps, enhance review quality, and reduce registration timelines, thereby improving patients' access to medicines. The aim of this study was to compare the medicines registration process of the Medicines Control Authority of Zimbabwe (MCAZ) with the regulatory processes in Australia, Canada, Singapore, and Switzerland. METHODS A questionnaire that standardizes the review process, allowing key milestones, activities and practices of the five regulatory authorities was completed by a senior member of the divisions responsible for issuing marketing authorizations. RESULTS The MCAZ has far fewer resources than the regulatory authorities in the comparator countries, but employs three review models, which is in line with international best practice. The MCAZ registration process is similar to the comparator countries in key milestones monitored, but differs in the target timelines for these milestones. The MCAZ is comparable to the comparator authorities in implementing the majority of good review practices, although it significantly lags behind in transparency and communication. CONCLUSION This study identified the MCAZ strengths and opportunities for improvement, which if implemented, will enable the achievement of its vision to be a leading regulatory authority in Africa.
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Affiliation(s)
- Tariro Sithole
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Medicines Control Authority of Zimbabwe, Zimbabwe
| | - Sam Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Institute for Medicines Development, Cardiff, UK
| | | | - Stuart Walker
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Centre for Innovation in Regulatory Science (Cirs), London, UK
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Sithole T, Mahlangu G, Capote V, Sitoie T, Shifotoka S, Gaeseb J, Padayachee S, Sehloho T, Khea A, Fimbo A, Munkombwe Z, Mwale B, Salek S, Walker S. Evaluation of the Good Review Practices of Countries Participating in the Southern African Development Community: Alignment and Strategies for Moving Forward. Front Med (Lausanne) 2021; 8:742181. [PMID: 34513893 PMCID: PMC8429788 DOI: 10.3389/fmed.2021.742181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/06/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: National medicines regulatory agencies are faced with challenges including limited resources and technical capacity, resulting in countries collaborating and sharing resources to improve efficiency of the review process to facilitate access to quality-assured medicines by their populations. One such collaboration is the Southern African Development Community (SADC) medicines registration collaborative initiative, ZaZiBoNa. Countries participate in the initiative by contributing to regulatory reviews and good manufacturing practices inspections. The aim of this study was to review and compare the registration processes of regulatory authorities of Mozambique, Namibia, South Africa, Tanzania, Zambia, and Zimbabwe to identify strategies for better alignment. Methods: A senior member of the division responsible for issuing marketing authorisations completed an established and validated questionnaire, which standardises the review process, allowing key milestones, activities and practices of the six regulatory authorities to be identified and compared. The completed questionnaires were validated by the heads of the respective agencies. Results: The six countries vary in population and in the size of their respective regulatory agency and the resources allocated to regulatory reviews. The review processes of the six agencies were similar; however, differences were noted in the milestones recorded; for example, two of the countries did not record the start of the scientific assessment. Additionally, decisions for marketing authorisation were made by an expert committee in four of the countries and by the head of the agency and the Minister of Health in two countries. All six agencies implemented the majority of good review practices; however, the need for improvement in the areas of transparency and communication and quality decision making practices was a common finding for all six countries. Conclusions: Participation in the ZaZiBoNa initiative has improved the way in which the six agencies perform regulatory reviews in their countries, highlighting the realisation of one of the key objectives of the initiative, which was building the expert capacity of member countries. Other agencies in the SADC region and beyond can use the results of this study to identify best practices, which in turn, could improve their regulatory performance.
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Affiliation(s)
- Tariro Sithole
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Medicines Control Authority of Zimbabwe, Harare, Zimbabwe
| | - Gugu Mahlangu
- Medicines Control Authority of Zimbabwe, Harare, Zimbabwe
| | - Velma Capote
- National Directorate of Pharmacy, Mozambique Ministry of Health, Maputo, Mozambique
| | - Tania Sitoie
- National Directorate of Pharmacy, Mozambique Ministry of Health, Maputo, Mozambique
| | - Saren Shifotoka
- Namibia Medicines Regulatory Council, Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | - Johannes Gaeseb
- Namibia Medicines Regulatory Council, Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | | | - Tohlang Sehloho
- South African Health Products Regulatory Authority, Pretoria, South Africa
| | - Akida Khea
- Tanzania Medicines and Medical Devices Authority, Dodoma, Tanzania
| | - Adam Fimbo
- Tanzania Medicines and Medical Devices Authority, Dodoma, Tanzania
| | | | - Bernice Mwale
- Zambia Medicines Regulatory Authority, Lusaka, Zambia
| | - Sam Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Institute for Medicines Development, Cardiff, United Kingdom
| | - Stuart Walker
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Centre for Innovation in Regulatory Science, London, United Kingdom
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Semete-Makokotlela B, Mahlangu GN, Mukanga D, Darko DM, Stonier P, Gwaza L, Nkambule P, Matsoso P, Lehnert R, Rosenkranz B, Pillai GC. Needs-driven talent and competency development for the next generation of regulatory scientists in Africa. Br J Clin Pharmacol 2021; 88:579-586. [PMID: 34346098 PMCID: PMC9291465 DOI: 10.1111/bcp.15020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/18/2021] [Accepted: 07/09/2021] [Indexed: 12/13/2022] Open
Abstract
Capacity building programmes for African regulators should link education, training and research with career development in an approach that combines an academic base and experiential learning aligned within a competency framework. A regulatory ecosystem that engages with a broad range of stakeholders will mean that expertise in the ever‐expanding field of regulatory science filters into teaching and research in a symbiotic way. In this way capacity development interventions will be a collaborative approach between the learning context (academic and training institutions) and the performance context (regulatory agencies and industry), which will ultimately best serve the patients. Monitoring and evaluation of capacity development interventions will be essential to show value of investments and ultimately guide continued funding and sustainability. This paper reviews the skills and human capacity gaps, reports on regulatory assessment pathways used in Ghana, South Africa and Zimbabwe and outlines a staged tactical approach for Africa that builds on previous efforts to strengthen African regulatory ecosystems.
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Affiliation(s)
| | | | | | | | - Peter Stonier
- Pharmaceutical Medicine Department, Institute of Pharmaceutical Sciences, Faculty of Health Sciences and Medicine, Kings College London, UK
| | | | - Portia Nkambule
- South African Health Products Regulatory Authority, Pretoria, Gauteng, South Africa
| | - Precious Matsoso
- Department of Pharmacy & Pharmacology, Faculty of Sciences, University of the Witwatersrand, South Africa
| | - Regine Lehnert
- GHPP-PharmTrain project, Federal Institute for Drugs and Medical Devices (BfArM), Germany
| | - Bernd Rosenkranz
- Fundisa African Academy of Medicines Development, Cape Town, South Africa.,Division of Clinical Pharmacology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Goonaseelan Colin Pillai
- Division of Clinical Pharmacology, University of Cape Town, South Africa.,CP+ Associates GmbH, Basel, Switzerland.,Pharmacometrics Africa NPC, Cape Town, South Africa
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