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Stolbrink M, Chinouya MJ, Jayasooriya S, Nightingale R, Evans-Hill L, Allan K, Allen H, Balen J, Beacon T, Bissell K, Chakaya J, Chiang CY, Cohen M, Devereux G, El Sony A, Halpin DMG, Hurst JR, Kiprop C, Lawson A, Macé C, Makhanu A, Makokha P, Masekela R, Meme H, Khoo EM, Nantanda R, Pasternak S, Perrin C, Reddel H, Rylance S, Schweikert P, Were C, Williams S, Winders T, Yorgancioglu A, Marks GB, Mortimer K. Improving access to affordable quality-assured inhaled medicines in low- and middle-income countries. Int J Tuberc Lung Dis 2022; 26:1023-1032. [PMID: 36281039 PMCID: PMC9621306 DOI: 10.5588/ijtld.22.0270] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 05/30/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND: Access to affordable inhaled medicines for chronic respiratory diseases (CRDs) is severely limited in low- and middle-income countries (LMICs), causing avoidable morbidity and mortality. The International Union Against Tuberculosis and Lung Disease convened a stakeholder meeting on this topic in February 2022.METHODS: Focused group discussions were informed by literature and presentations summarising experiences of obtaining inhaled medicines in LMICs. The virtual meeting was moderated using a topic guide around barriers and solutions to improve access. The thematic framework approach was used for analysis.RESULTS: A total of 58 key stakeholders, including patients, healthcare practitioners, members of national and international organisations, industry and WHO representatives attended the meeting. There were 20 pre-meeting material submissions. The main barriers identified were 1) low awareness of CRDs; 2) limited data on CRD burden and treatments in LMICs; 3) ineffective procurement and distribution networks; and 4) poor communication of the needs of people with CRDs. Solutions discussed were 1) generation of data to inform policy and practice; 2) capacity building; 3) improved procurement mechanisms; 4) strengthened advocacy practices; and 5) a World Health Assembly Resolution.CONCLUSION: There are opportunities to achieve improved access to affordable, quality-assured inhaled medicines in LMICs through coordinated, multi-stakeholder, collaborative efforts.
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Affiliation(s)
- M Stolbrink
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, Stellenbosch University, Tygerberg, South Africa
| | - M J Chinouya
- Education Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - S Jayasooriya
- Academic Unit of Primary Care, University of Sheffield, Sheffield, UK
| | - R Nightingale
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, IcFEM Dreamland Mission Hospital, Kimilili, Kenya
| | | | - K Allan
- Healthcare Consultant, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, The Gambia
| | - H Allen
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, The Gambia
| | - J Balen
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - T Beacon
- Medical Aid International, Bedford, UK
| | - K Bissell
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - J Chakaya
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, Department of Medicine, Therapeutics and Dermatology, Kenyatta University, Nairobi, Kenya
| | - C-Y Chiang
- International Union Against Tuberculosis and Lung Disease, Paris, France, Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - M Cohen
- Asociación Latinoamericana del Tórax, Forum of International Respiratory Societies, Guatemala
| | - G Devereux
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - A El Sony
- The Epidemiological Laboratory (Epi-Lab) for Public Health, Research and Development, Khartoum Sudan
| | - D M G Halpin
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - J R Hurst
- UCL Respiratory, University College London, London, UK
| | - C Kiprop
- IcFEM Dreamland Mission Hospital, Kimilili, Kenya
| | | | - C Macé
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - A Makhanu
- IcFEM Dreamland Mission Hospital, Kimilili, Kenya
| | - P Makokha
- IcFEM Dreamland Mission Hospital, Kimilili, Kenya
| | - R Masekela
- Department of Paediatrics and Child Health, School of Clinical Medicine, University of KwaZulu Natal, Durban, South Africa
| | - H Meme
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - E M Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia, International Primary Care Respiratory Group, Larbert, Scotland, UK
| | - R Nantanda
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - C Perrin
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - H Reddel
- The Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia, Global Initiative for Asthma (GINA), Fontana, WI, USA
| | - S Rylance
- Noncommunicable Diseases Department, World Health Organization, Geneva, Switzerland
| | | | - C Were
- GlaxoSmithKline, Brentford, UK
| | - S Williams
- International Primary Care Respiratory Group, Larbert, Scotland, UK
| | - T Winders
- Global Allergy & Airways Patient Platform, Vienna, Austria
| | - A Yorgancioglu
- Department of Pulmonology, Celal Bayar University Medical Faculty, Manisa, Turkey, Global Alliance Against Chronic Respiratory Diseases, Geneva, Switzerland
| | - G B Marks
- International Union Against Tuberculosis and Lung Disease, Paris, France, University of New South Wales, Sydney, NSW, Australia
| | - K Mortimer
- International Union Against Tuberculosis and Lung Disease, Paris, France, University of Cambridge, Cambridge, UK
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Tabu JS, Otwelo JA, Koskei P, Makokha P. Hazard analysis of Arid and semi-Arid (ASAL) regions of Kenya. East Afr J Public Health 2013; 10:410-415. [PMID: 25130021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION This paper describes a situationanalysis on hazards in the Arid and semi-Arid lands of Kenya. The leading hazards affecting the Arid and semi-arid lands are mainly natural and include among others drought, floods, and landslides. Other hazards of importance were found to be war and conflict, HIV/AIDS and fires. Over 80% of these are weather related. OBJECTIVES The overall objective of this study was to prioritize hazards in the ASAL region. Specifically, the study identified the top ten hazards in the ASAL Districts of Kenya, determined Probability of occurrence; Analyzed the potential impact of the hazard and utilizing multiplier effect prioritized the Hazards using a hypothetical model. METHODOLOGY This was a descriptive study conducted in over half of the Kenya's ASAL Districts in four regions of Lower and Upper Eastern, North Eastern and part of the Coast region. Six Districts were purposively selected per region with six officers from each District all totaling one hundred and forty four. The sectors where respondents were sourced from were Agriculture, Health, local Government, and Provincial Administration, Environment and NGO. The members through a consensus process analyzed hazards in groups of their respective districts using a tool that had been developed and respondents trained on its use. RESULTS One hundred and forty four (144) officers from Twenty four Districts in the four regions were recruited. One hundred twenty seven (81%) were male and only 27 (19% ) were female The representation of participants per sector was Governance 25% followed by Civil society organizations 21%, Health 16%, Agriculture and arid lands 15%, Research and scientific institutions 13%. The top Priority Hazards identified using the mean score were Drought and famine (5.4) Epidemics and epizootics (3.8), HIV/AIDS (3.6), War and conflict (2.5), Floods (2.5) CONCLUSIONS: The exercise confirmed the priority hazards in the Arid and semi-arid regions of Kenya and described vulnerability factors that included water scarcity, poverty and low educational levels. The region suffers from a variety of hazards in particular Drought and famine, Epidemics including HIV/AIDS and War and conflict. Environmental degradation though given a low score may be more of a perception. There is need to undertake a comprehensive hazard and Vulnerability analysis at regional and country level to inform interventions and other developmental activities. Women should be targeted at the community and leadership level, and efforts to empower them should be stepped up.
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