Afghanistan Pharmaceutical Sector Development: Problems and Prospects

Harper, Jonathan; Strote, G.

doi:10.5655/smr.v4i1.75

Cited by 12 publications

(13 citation statements)

References 3 publications

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“… 14 A component of the BPHS is the provision of medicines through public health sector clinics which relies on funding from international donors and partners such as the U. S. Agency for International Development (USAID), the World Bank, and the European Commission and is implemented by NGOs operating under the stewardship of the Ministry of Public Health (MoPH). 15 Afghanistan has no formal pharmaceutical industry and all drugs, including antimalarials, are imported with the private sector thought to have over 200 importers.…”

Section: Introductionmentioning

confidence: 99%

Substandard Antimalarials Available in Afghanistan: A Case for Assessing the Quality of Drugs in Resource Poor Settings

Lalani¹,

Kaur²,

Mohammed³

et al. 2015

The American Journal of Tropical Medicine and Hygiene

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Good-quality antimalarials are crucial for the effective treatment and control of malaria. A total of 7,740 individual and packaged tablets, ampoules, and syrups were obtained from 60 randomly selected public (N = 35) and private outlets (N = 25) in Afghanistan. Of these, 134 samples were screened using the Global Pharma Health Fund (GPHF) MiniLab® in Kabul with 33/126 (26%) samples failing the MiniLab® disintegration test. The quality of a subsample (N = 37) of cholorquine, quinine, and sulfadoxine/pyrimethamine tablets was assessed by in vitro dissolution testing following U.S. Pharmacopeia (USP) monographs at a bioanalytical laboratory in London, United Kingdom. Overall, 12/32 (32%) samples of sulfadoxine/pyrimethamine and quinine were found not to comply with the USP tolerance limits. Substandard antimalarials were available in Afghanistan demonstrating that continuous monitoring of drug quality is warranted. However, in Afghanistan as in many low-income countries, capacity to determine and monitor drug quality using methods such as dissolution testing needs to be established to empower national authorities to take appropriate action in setting up legislation and regulation.

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Section: Introductionmentioning

confidence: 99%

Substandard Antimalarials Available in Afghanistan: A Case for Assessing the Quality of Drugs in Resource Poor Settings

Lalani¹,

Kaur²,

Mohammed³

et al. 2015

The American Journal of Tropical Medicine and Hygiene

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“…Prior to 1979, Afghanistan had sufficient domestic pharmaceutical manufacturing to meet local demand, as well as export capacity [ 1 , 2 ]. Due to decades of conflict, the pharmaceutical industry collapsed and remained “understudied” [ 3 ], being one of the least developed industrial sectors in the world, functioning with many weaknesses and in a disorganised manner [ 4 ]. According to WHO, the overall pharmaceutical situation in Afghanistan has deteriorated because health infrastructure, machinery, laboratories and buildings have been seriously damaged or destroyed [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…For example, no licensing authority that issues Good Distribution Practices (GDP) licenses exists and there are no national guidelines on GDP [ 2 ]. The medicine supply system is critically under-regulated with weak provincial management leading to an erratic supply situation [ 4 ]. There is no national Good Manufacturing Practice (GMP) or Adverse Drug Reaction (ADR) guidelines, and a medication error reporting system is lacking.…”

Section: Introductionmentioning

confidence: 99%

Community pharmacists’ attitudes toward the quality and price of locally manufactured generic medicines in Kabul, Afghanistan

Bashaar

Saleem

2015

J of Pharm Policy and Pract

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ObjectiveTo report the attitudes of community pharmacists in Kabul, Afghanistan, concerning the quality and price of locally manufactured medicines.MethodsA cross-sectional descriptive study, involving a sample of 198 community pharmacists was conducted in Kabul city.ResultsWith a response rate of 100%, most of the respondents 70.7% had 11–20 years experience working as a pharmacist. About 84.3% of the pharmacists dispensed imported generic medicines from Pakistan, Iran, India, and the UAE. Only 15.7% of pharmacists were dispensing locally produced generics from Ariana (i.e. a local pharmaceutical manufacturer). Exactly half of the pharmacists 50.0% reported that locally produced generics were equally safe and efficacious as the imported generics, while 70.7% of the respondents believed that the local manufacturers of generic products had reliable logistics and supply systems. However, 80.8% of respondents expressed concerns regarding their own credibility when stocking the medicines. Consequently, 80.3% of the sample only stocked well-advertised domestic generics, which were likely to be seen by consumers as more credible alternatives. Most of the respondents 82.8% were confident that the locally manufactured generics were cheaper than imported generics. Interestingly, 80.8% of the respondents favoured the establishment of a national brand substitution policy. Furthermore, 90.4% of the respondents believed that it was the responsibility of the Afghan regulatory authorities to educate pharmacists on the quality of domestic generics.ConclusionAlthough community pharmacists had a positive attitude towards the quality and affordability of locally manufactured medicines, due to lack of resources most of their medicines are imported. Despite their positivity towards the quality and price of generics, the community pharmacists only dispense them to a minimal degree, because of low local production levels among other reasons. The findings call for improvements in the local pharmaceutical industry in order to substitute imported medicines with local generics. The government must take firm steps to formulate and reinforce pharmaceutical pricing and brand substitution policies to help in controlling healthcare costs. Further research, especially a countrywide survey, is required.

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“…Some studies and public discourse suggest that the state’s efforts have been reasonably successful. On the other hand, key informants pointed out that the system is fragmented, there is a distinct lack of coordination between donors and the ministry, and it is unclear where the accountability lies for meeting goals [9-11]. Low coordination extends to the public pharmaceutical sector.…”

Section: Resultsmentioning

confidence: 99%

An examination of pharmaceutical systems in severely disrupted countries

Köhler

Pavignani

Michael³

et al. 2012

BMC Int Health Hum Rights

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This research assesses informal markets that dominate pharmaceutical systems in severely disrupted countries and identifies areas for further investigation. Findings are based on recent academic papers, policy and grey literature, and field studies in Somalia, Afghanistan, the Democratic Republic of Congo and Haiti. The public sector in the studied countries is characterized in part by weak Ministries of Health and low donor coordination. Informal markets, where medicines are regularly sold in market stalls and unregulated pharmacies, often accompanied by unqualified medical advice, have proliferated. Counterfeit and sub-standard medicines trade networks have also developed. To help increase medicine availability for citizens, informal markets should be integrated into existing access to medicines initiatives.

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Afghanistan Pharmaceutical Sector Development: Problems and Prospects

Cited by 12 publications

References 3 publications

Substandard Antimalarials Available in Afghanistan: A Case for Assessing the Quality of Drugs in Resource Poor Settings

Substandard Antimalarials Available in Afghanistan: A Case for Assessing the Quality of Drugs in Resource Poor Settings

Community pharmacists’ attitudes toward the quality and price of locally manufactured generic medicines in Kabul, Afghanistan

An examination of pharmaceutical systems in severely disrupted countries

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