Analyze the Uganda National Medicines Policy 2015 by detailing the public issues the policy sought to address.

The Uganda National Medicines Policy 2015 was formulated to address various public health challenges. Firstly, the policy addressed the issue of medicines use, where a World Bank report indicated that only 20% of health practitioners could correctly diagnose common ailments. Moreover, individuals used antibiotics without a prescription, and no surveillance mechanism was in place to monitor drug resistance in health facilities. Additionally, generic substitution was commonly practice, but lacked legal support.

The policy also examined the state of pharmaceutical manufacturing in Uganda. Although some incentives, such as reduced import tariffs on pharmaceutical equipment and a preferential rate in public procurement, were in place for local manufacturers, it appeared that these incentives were not being fully implemented.

Traditional and Complementary Medicine was also addressed in the policy as indigenous medicines were widely available in Uganda but insufficiently regulated. This lack of regulation led to many unfounded claims being made regarding the efficacy of traditional and complementary medicines. Media outlets were flooded with advertisements from traditional healers about their products and their supposed capabilities of treating various diseases.

The report also examined the current state of human resources in the pharmaceutical sector. The pharmacist-to-population ratio was found to have increased, although new pharmacist positions, created in the public service, were not adequately filled. Although different professional cadres were trained to function as medicines management supervisors, district pharmacists were still required for lower level health facilities to manage, supervise, and support medicine management.

The importance of introducing computerized inventory management systems was also highlighted by the policy. Currently, the logistics management information system is mostly paper-based at the facility and district levels. The central warehouses have computerized all their key functions but have no interface or linkage between the health facility logistics systems and the central warehouses. A pharmaceutical information portal is currently being developed to allow users to easily access and analyze data from various sources.

The policy also aimed to ensure that a range of essential medicines and health supplies (EMHS) were available to the people of Uganda based on needs. It aimed to ensure efficient use of the available limited resources. As more medicines are being supplied and distributed, better medicines management at district and facility levels becomes even more important to promote sound and cost-effective use of resources. Several financing strategies, including donor support, were put in place to meet the needs for universal health coverage.

The quality of care was also emphasized in all applicable areas of policy implementation. Investments in quality of care increase the effectiveness of service delivery and improve patient safety. Additionally, the national drug authority was responsible for assuring the quality of all medical products in the country. It had a drug control laboratory that was pre-qualified by WHO in January 2015. There has been a marked improvement in the quality of pharmaceutical products imported into the country as evidenced by the drop in products failing quality test.

Finally, government financing for essential medicines and health supplies was found to be low, with only 219 billion Ugandan shillings invested in 2013/2014. Donor support for medicine financing was significant, amounting to about US $250 million in 2013/14, more than three times the amount the government invested in EMHS in the same year. Medicine pricing was also addressed in the policy.

Choosing and Measuring Medicines

The Uganda Clinical Guidelines and Essential Medicines and Health Supplies List was revised in 2012. These tools hold great importance as they guide decision-making in the selection, procurement, training, supervision, and pricing of medicines within the public and PNFP sector. In addition, a national medicines formulary has been initiated to offer standardized information about all registered medicines.

Procurement, Warehousing, and Distribution

The National Medical Stores is the governmental entity accountable for acquiring, storing, and distributing pharmaceutical products to public health facilities and JMS concerning faith-based organizations. Alongside the government's pharmaceutical support services, Medical Access Uganda and the Uganda Health Marketing Group provide significant contributions. In 2012/13, an assessment revealed that medicine storage was absent in 15% of health facilities, and 29% lacked appropriate dispensing accommodations.