Background Resilient pharmaceutical systems and supply chains are critical in the control of COVID-19, a pandemic that has mostly devastated public health systems and livelihoods in resource-limited countries in sub-Saharan Africa. Objective To evaluate the impact of COVID-19 on pharmaceutical systems and supply chain in a resource-limited setting. Methods A descriptive qualitative survey using a phenomenological approach was conducted among key informants in the public and private pharmaceutical sectors of Namibia. Data were collected on the perceived impact of COVID-19 pandemic on the supply chain, as well as access and availability of essential medicines among the distributors and points of care in the private and public sectors. Qualitative themes of the impact were analyzed using Tesch's approach. Results Of the 21 key-informants, 57.1% were female and 85% were from the private versus the public pharmaceutical sector. Overall, key informants reported a negative impact on access and availability of essential medicines, particularly sanitation and hygiene products, and antimicrobials. Most medicine outlets, experienced longer lead times, attributed to reduced inter-country transportation of goods and services and limited in-country capacity and capabilities to manufacture. The main thematic challenges included bureaucratic bottlenecks and lack of emergency readiness of the medicine's logistics supply chain in Namibia. Conclusion COVID-19 pandemic aggravated the inequitable access to essential medicines in the public and private sectors of Namibia. Governments in resource-limited countries need to strengthen in-country Private-Public Partnerships as well as regional treaties for Universal Health Coverage in context of the COVID-19 pandemic.

Despite the universal scale‐up of pharmacovigilance systems globally, adverse drug reaction (ADR) reporting remains suboptimal among resource‐limited countries. Few studies in sub‐Saharan Africa evaluate the effectiveness of adverse drug reaction (ADR) reporting programmes. A cross‐sectional survey using a self‐administered questionnaire to assess ADR reporting knowledge, attitude and practices among healthcare workers in Namibia's public sector was conducted between September and December 2018. The primary outcome were practices, knowledge and attitude of the respondents towards ADR reporting. Quantitative and qualitative data were analysed using descriptive statistics and thematic analysis, respectively. Of the 197 healthcare workers surveyed, 43.1% were nurses, 63.4% of the respondents knew about the ADR reporting system in Namibia, 76.7% knew the pharmacovigilance/ADR reporting centre in Namibia, while 37.3% had reported an ADR before. Nurses were less likely to be knowledgeable and report ADRs. The independent predictor of ADR reporting was the nursing cadre; adjusted odds ratio (aOR) = 0.17 (95% CI: 0.07, 0.401, P < .01). Pre‐ and in‐service trainings including introduction of electronic reporting platforms were some of the identified ways of optimizing the pharmacovigilance and ADR reporting systems by the respondents. As pharmacovigilance in Namibia relies on spontaneous reporting of ADRs, there is a need for advocacy and workforce strengthening for ADR reporting in the public health sector.

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Growing burden of communicable and non-communicable diseases in sub-Saharan Africa has necessitated the need for increased medicine use among the African population. Owing to the limited manufacturing capacity of medicines in the sub-continent, it became imperative for governments and Central Medical Stores to source medicines from countries such as India, Bangladesh and China. Such procurements were due to the affordability of generic products manufactured by manufacturers in these countries compared to innovator s, which might come at exorbitant prices and costs that might be prohibitive for most developing countries such as the ones in sub-Saharan Africa. Ascertaining the quality and efficacy of these products are always reliant on the judgment of national regulatory authorities (NRA), which might be ill equipped in most instances; human capacity both in knowledge and number are some of the banes of such NRAs. Aforesaid, pharmacovigilance does not take the front seat in most discussions rather the burden of diseases, thus the emphasis on medicines availability. Different researchers have highlighted the link between medicines/drugs availability and the need for pharmacovigilance among healthcare workers, policy makers and patients. Such approach will tend to limit the procurement of medicines that are substandard, falsified or fake, with the aim of protecting public health.

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