2013-15 Challenge: Prescribers and Users of Medicines
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The HIFA 2013-15 Challenge: “Every prescriber and user of medicines will have access to reliable information on medicines to protect their own health and the health of others”
Access to reliable, unbiased information on medicines is fundamental to health care. Prescribers and users lack such information, especially in low-resource settings. Some have no information at all, or the information that they do have is commercially biased. As a result, countless people suffer harm, and sometimes death, as a result of prescribing errors such as the wrong medicine, or the wrong dose. Furthermore, irrational prescribing promotes the emergence of drug resistance. Countless people are already dying from multi-drug resistant tuberculosis and other drug-resistant strains that have emerged largely because of irrational prescribing. There is a real and growing threat to the human species from new microbes that are resistant to all known treatments.
Rational use of medicines can be defined as: “patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community”.
“Irrational use of medicines is a major problem worldwide. WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them correctly. The overuse, underuse or misuse of medicines results in wastage of scarce resources and widespread health hazards. Examples of irrational use of medicines include: use of too many medicines per patient (“poly-pharmacy”); inappropriate use of antimicrobials, often in inadequate dosage, for non-bacterial infections; over-use of injections when oral formulations would be more appropriate; failure to prescribe in accordance with clinical guidelines; inappropriate self-medication, often of prescription-only medicines; non-adherence to dosing regimes.”
As WHO has proclaimed: “Appropriate use of antibiotics [and other medicines] is only possible if healthcare workers and the public have access to reliable, unbiased information on medicines. Universal access to reliable information on medicines is readily achievable and should be a cornerstone of efforts to promote rational prescribing. There is an urgent need for concerted action.”
What we can do
Our vision is that every prescriber and user of medicines will have access to the information and knowledge they need to use medicines effectively.
We are bringing together a working-group of HIFA volunteers to take this forward. The group will:
1. promote discussion on HIFA2015 around relevant issues, including drivers and barriers to the availability and use of reliable information on medicines
2. promote discussion on issues that are particularly relevant to different groups of (1) prescribers and (2) users
3. harness insights and perspectives from HIFA members and incorporate these into the HIFA Knowledge Base (currently in development).
We also seek to define, with the HIFA membership at large, at least one SMART Goal that is Specific, Measurable, Achievable, Relevant, and Time-bound.
This goal might be very specific and achievable within a short time span. For example, we may seek to persuade a publisher to make a vital publication freely available to all. Or it may be more ambitious, and require a longer effort. Or indeed, we may do both.
HIFA 2013-2015 Challenge Team
Atai Okokon leads the HIFA 2013-2015 Challenge with support from HIFA coordinator Neil Pakenham-Walsh and the HIFA Steering Group. Atai is a pharmacist with a passion for the availability and use of reliable information on medicines. Atai trained in Nigeria, and is currently doing a Masters in Global Health at the University of Oxford.
We invite all HIFA members with an interest to join the HIFA 2013 Challenge team to contact Atai at: atai.okokon AT gtc.ox.ac.uk
All HIFA volunteers are proactive and available for regular skype meetings.
Sean Banigo Adonye is an ENT Doctor in the NHS, England. firstname.lastname@example.org (HIFA-Zambia only)
Christa Cepuch is a Regional Pharmacist at Medecins Sans Frontiere’s (MSF) in Kenya. Professional interests: access to medicines, access to unbiased and objective medicines information, ethical medicines promotion, quality and safety of medicines.
Imti Choonara is a Professor in Child Health at the University of Nottingham, UK. Professional interests: Paediatric clinical pharmacology International child health with an interest in access to medicines and treatment of epilepsy. Strong links with Cuba.
Joseph Fadare is a Physician/Clinical Pharmacologist at the Obafemi Awolowo University in Ile-Ife, Nigeria. Professional interests: Pharmacoepidemiology, Drug utilization studies, Adverse drug reactions/Pharmacovigilance.
Siu Luen Sally Ho is a registered Pharmacist in the UK, currently reading Master of Public Health at The Chinese University of Hong Kong. Professional interests: Secure Healthcare, Pharmacy, Primary Healthcare, Elderly, Polypharmacy, Drug access, Health Promotion and Prevention, Prevention of NCDs and communicable diseases.
Elisheba Muturi Kihara is a Program Analyst, British Columbia Ministry of Health Services, Canada. She started her career in the education sector in Kenya and later studied international development and worked in health research. She has worked for International Development Research Centre and now works for the BC Ministry of Health Services. As a medical librarian and consumer health specialist, she is interested in the dissemination of health information to both clinicians and patients. In addition to doing clinical research on drug safety and effectiveness, she delivers community workshops on medication safety. Her topics of interest include: social media/web 2.0 & mobile technology for health information, health literacy and plain language, collaborative health care/patients as partners, electronic health records, evidence-based medicine, health librarianship and global health. While currently working in North America, she is particularly interested in supporting health literacy, access to health information and evidence-based practice in developing countries. Blog: http://shebamuturi.wordpress.com/
Folasade Olufunke Lawal is a Pharmacist at Victory Drugs, Nigeria.
Subhash C Mandal is Co-ordinator, Drug Information Centre, Kolkata, India. Professional interests include Improving access to health care services especially access to medicines; Achieving MDG 4,5 &6; Health Policy & Pharmaceutical Policy; Publishing weekly Drug Information Bulletin, Running a Drug Information Centre.
Eleonora Morais is a Doctor based in Portugal. Professional interests: I’m a pharmacist with a Masters degree in Pharmaceutical Care. My professional interests include: access to independent medicines information, pharmacoepidemiology, access to life-saving medicines, rational use of medicines and public health.
Neil Pakenham-Walsh is the coordinator of the HIFA2015 campaign and co-director of the Global Healthcare Information Network. He is also currently chair of the Dgroups Foundation (www.dgroups.info), a partnership of 18 international development organisations promoting dialogue for development. He started his career as a hospital doctor in the UK, and has clinical experience as an isolated health worker in rural Ecuador and Peru. For the last 20 years he has been committed to the global challenge of improving the availability and use of relevant, reliable healthcare information for health workers and citizens in low- and middle-income countries. He is particularly interested in the potential of inclusive, interdisciplinary communication platforms to help address global health and international development challenges. He has worked with the World Health Organization, the Wellcome Trust, Medicine Digest and INASP (International Network for the Availability of Scientific Publications). He is based near Oxford, UK. www.hifa2015.org neil.pakenham-walsh AT ghi-net.org
Vivienne Sserumaga Mulema is a pharmacist with the AIDS Control Program, Ministry of Health, Uganda, seconded from the Clinton Health Access Initiative. Professional interests: Operational research, Drug utilisation and health services, Grant writing and management, Supply chain management, Health policy analysis and implementation.
Carla Rodrigues is a PhD candidate at the Amsterdam Institute for Social Sciences Research, University of Amsterdam (where she lives currently) and a researcher at the Centre for Research and Studies in Sociology, University Institute of Lisbon. My main research areas are Sociology of Health and Education, specifically lay rationalities in health; therapeutic pluralism; and pharmaceuticals consumption. I have been conducting fieldwork in Portugal and Mozambique.
Sandeep Saluja is an internist at Saran Ashram Hospital, Dayalbagh, Agra, India. He is also a rheumatologist and was earlier with the All India Institute of Medical Sciences. He has volunteered to work in remote inaccesible parts of India for no personal or commercial reasons.
Larry D. Sasich, Pharm.D., M.P.H., F.A.S.H.P. is a consultant for the Saudi Food and Drug Authority in Riyadh, Saudi Arabia and has been working and consulting in The Kingdom since 1990. Dr. Sasich received his Bachelor of Science in Pharmacy from Idaho State University, a Doctor of Pharmacy degree from University of the Pacific, and a Master of Public Health from the George Washington University. He completed an American Society of Health-system Pharmacists accredited residency in nuclear pharmacy at the University of New Mexico and has been elected as a Fellow in the American Society of Health-system Pharmacists. He has served as the consumer representative on the US Food and Drug Administrations (US FDA) Science Board, an advisory committee to the US FDA Commissioner. Dr. Sasich is a co-author of Worst Pills, Best Pills: A Consumer’s Guide to Avoiding Drug-Induced Death or Illness. He is also a co-author of Knowing Your Medications: A Guide to Becoming a Better Informed Patient and has co-authored a chapter in the last three editions of Applied Therapeutics: The Clinical Use of Drugs. He has held academic positions as clinical coordinator, acting associate dean for student affairs, and as a department chair and his main interest remains drug information especially risk information for patients.
Massimo Serventi is a paediatrician at AISPO (Associazione Italiana per la Solidarieta fra I Popoli), Italy. Professional interests include child malnutrition, pediatric hospitals, drugs for children, sustainability of services for children.
Veronika Wirt is a Researcher and Lecturer at the Center for Global Health and Development, Boston University, USA. Professional interests: Pharmaceutical policy analysis, health systems research and quality of care.
Atai Okokon and Neil Pakenham-Walsh
On behalf of the HIFA Steering Group