Introduction Redistribution of essential medicines and health supplies (EMHS) is a mechanism to address supply chain uncertainty by moving excess stock of health commodities from health facilities that are overstocked to health facilities with shortages where it is most needed. It prevents the wastage of scarce resources and improves efficiency within a health supply chain system. Many public health facilities in Uganda experience stock-outs, overstocking, and expiry of essential medicines. This study assessed the compliance of public health facilities with the Uganda Ministry of Health redistribution strategy for EMHS in Mbale district, Eastern Uganda. Methods A mixed-methods study was conducted among 55 respondents at public health facility level and five key informants at the district level. Audio-recorded data were transcribed and coded to develop themes. Thematic analysis was performed using ATLAS.ti Version 8.5. Quantitative data were analysed using IBM SPSS Version 24.0. Results About a third (33%) of the surveyed health facilities complied with EMHS redistribution guidelines. Respondents agreed that EMHS redistribution had helped reduce health commodity expiries and stock-outs in health facilities. Respondents who did not know about the timely release of funds for redistribution were 68% less likely to comply, and those who said the guidelines were never shared were 88% less likely to comply with the guidelines. Conclusions Compliance with the EMHS redistribution guidelines was low and associated with failure to share the guidelines with staff and inadequate awareness about release funds for EMHS redistribution. The district local government should allocate more funds to the EMHS redistribution.

Resource constraints and widespread poverty among populations undermine disease prevention in low‐ and middle‐income countries (LMICs) and ensure that these countries carry a disproportionate share of the global disease burden. Lack of access to efficacious medicines in LMICs further exacerbates this inequity. Addressing inequitable access to medicines and assuring their sustainable use is critical to the well‐being of these populations. Whilst inadequate access to medicines in LMICs has drawn much attention, less is known about the sustainable use of available medicines, particularly to ensure their efficacy and mitigate harm to the population and the environment. Uganda has adopted various measures to ensure sustainable medicines use, including a national medicines policy, essential medicines list, medicines regulation framework and promotion of domestic medicines production. Despite progress, challenges remain to achieving sustainable medicines use in the country, including fragmented access, inappropriate use, poor quality and inappropriate disposal. There is a need to consolidate the globally embraced One Health approach (fostering collaboration between human, animal and environmental health sectors) to addressing these challenges as espoused in the country's One Health strategic plan. Medicines supply chain management in public sector health facilities needs to be strengthened to minimize inventory shortages (stock‐outs). A strategy for universal health insurance can minimize economic barriers to medicines access. Enhanced professional and medicines regulation in the private health market needs to be implemented. There are opportunities to build further capacity in Uganda, particularly infrastructure for regulation of its healthcare systems, policy and governance, workforce capacity building, and population action and engagement.

Introduction Redistribution of essential medicines and health supplies (EMHS) is a mechanism to address supply chain uncertainty by moving excess stock of health commodities from health facilities that are overstocked to health facilities with shortages, where it is most needed. It prevents the wastage of scarce resources and improves efficiency within a health supply chain system. Many public health facilities in Uganda experience stock-outs, overstocking, and expiry of essential medicines. This study assessed the compliance of public health facilities with the Uganda Ministry of Health redistribution strategy for EMHS in Mbale district, Eastern Uganda. Methods A mixed-methods study was conducted among 55 respondents at public health facility level and five key informants at the district level. Audio-recorded data were transcribed and coded to develop themes. Thematic analysis was performed using ATLAS.ti Version 8.5. Quantitative data were analysed using IBM SPSS Version 24.0. Results About a third (33%) of the surveyed health facilities complied with EMHS redistribution guidelines. Respondents agreed that EMHS redistribution had helped reduce health commodity expiries and stock-outs in health facilities. Respondents who did not know about the timely release of funds for redistribution were 68% less likely to comply, and those who said the guidelines were never shared were 88% less likely to comply with the guidelines. Conclusions Compliance with the EMHS redistribution guidelines was low and associated with failure to share the guidelines with staff and inadequate awareness about release funds for EMHS redistribution. The district local government should allocate more funds to the EMHS redistribution.

Background: Outputs from the quantifications are used to advocate and allocate funding and develop supply plans to ensure the availability of medicines. However, the actual consumption is not always equal to the forecast, and thus forecasting teams often adjust further to improve the forecast accuracy. The study aimed to determine the forecast accuracy of the final forecast, the effect of adjustments, and the factors that affect the forecast accuracy of ARVs in Uganda. Methods: A descriptive study was conducted using quantitative and qualitative data collection methods. The statistical forecasts, final forecasts, and actual consumption data from January 2016 to December 2018 were collected retrospectively from the Ministry of Health and the web-based ordering and reporting system (WAOS). Microsoft Excel was used for data analysis. The mean average percentage error (MAPE) was used to measure forecast accuracy, and a student t-test was used to determine the significance of adjustments. Key informant interviews were done to determine the factors affecting forecast accuracy. Thematic approach was used to analyse qualitative data. Results: The national final forecast MAPE ranged from 2.33% to 5.15% (Jan 2016 -Jan 2019), while the statistical MAPE ranged from 2.65% to 4.31% (Aug 2017 - Jan 2019). The MAPEs for adult ARVs were generally lower than those of pediatric ARVs, and a variation in forecast accuracy with one of the central warehouses was noted. Adjustments generally lowered the MAPE for adult ARVs but increased the MAPE for most pediatric ARVs. Adjustments were significant for 53.8% (n=13, p=0.05) of the ARVs. Factors including dispensing practices, the complexity of the quantification, adherence to treatment guidelines, data quality, product availability, and quantification team attributes were identified to affect the forecast accuracy Conclusions: The final and statistical forecasts had good accuracy, and adjustments improved the accuracy of adult ARV forecasts while decreasing the accuracy for pediatric ARVs. The accuracy of the forecast was affected by the quantification complexity, product usage, availability, and team attributes. Forecast accuracy of new drugs and the degree of significance of the factors affecting forecasting should be studied further. Trial registration: Not Applicable

Tropical Africa has one of the world's largest endowments in medicinal plant diversity. However, this potential has not been translated into pure drugs of proven efficacy and safety synonymous with modern pharmaceuticals. The basis for the slow translation of Tropical Africa's medicinal plant wealth into value-added medicines acceptable in the doctor's clinic is not clear. In this work, we sought to understand the patterns of research on African medicinal plants in general, and the capacity of sub-Saharan universities to conduct value-building research on plant-derived medicines in particular, using an extensive online search. A near-exponential growth in number of publications over the period 2000 to 2015 was found. However, most of the primary literature is on preliminary pharmacological assays and ethnobotany/ethnopharmacology. Only 6% of the publications are on advanced investigations such as isolation, structure elucidation and semi-synthetic optimization of natural compounds, structural studies of drug targets, ligand binding studies and cell biological assays, yet they are fundamental to progression of lead compounds into useful drugs. Assessment of the current biomolecular infrastructure in 25 sub-Saharan universities found severe shortage of essential equipment in many of them. Only 64, 68, 36 and 68% of the sampled universities have high performance liquid chromatography (HPLC), gas chromatography-mass spectrometry (GC-MS), liquid chromatographymass spectrometry (LC-MS), and nuclear magnetic resonance (NMR) equipment, respectively. East, Central and West Africa are particularly deficient in most of the key equipment, and some available are non-functional. The purchase cost of most biomolecular research equipment is between USD 30,000 and USD 500,000. Further analysis shows that the cost of establishing comprehensive biomolecular research infrastructure in at least one university per sub-Saharan nation is negligible relative to their gross domestic products (GDPs). Thus, even with the current economic resources, sub-Saharan African countries would upgrade biomolecular research capabilities in their leading universities without disrupting other economic priorities.