Search

Background: The medicines retail sector (MRS) enables access to life-saving health commodities. Despite efforts to harness this market for public health goals, in low- and middle-income countries it is rarely incorporated into pandemic preparedness. This paper analyses the role of the MRS in the response to COVID-19 in Uganda, the extent to which it was incorporated into national planning and in the continuity of essential services., Methods: We conducted a cross-sectional study using sequential mixed methods in two purposively sampled rural districts in central Uganda. Qualitative research comprised 27 focus group discussions with drug shop vendors (DSVs), pharmacists, clinic staff and community members across two districts ( n  = 250); key informant interviews at national ( n  = 6) and district ( n  = 11) levels. Qualitative findings were used to modify a facility-based survey conducted in MRS outlets ( n  = 625). A household survey focusing on household dynamics and treatment seeking during COVID-19 was conducted in both districts ( n  = 1680)., Results: At the national level, attempts were made to involve the MRS in policy and technical advice but this was not sustained. At the district level, almost no effort was made to include the MRS in the response to COVID-19. In the community, residents described their reliance on the MRS to provide medicines, especially during lockdowns. Medicine sellers subject to stringent rules on their movement during lockdown, reported some disruptions in tracer medicine stocks and an increase in prices at their suppliers. They adapted, finding new ways to purchase medicines but overall sales of medicines fell., Conclusions: The MRS is critical to the distribution of medicines in many countries. This remains the case or can be heightened during health crises. Pandemic preparedness must incorporate strategies to support medicine sellers to ensure ongoing access to commodities during public health emergencies., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Background: Within the context of increasing transparency around public contributions, a framework for reporting and analysing public contributions to research and development (R&D) was previously developed and is piloted here using the example of antibiotics. The aim of this work is to check whether the category system is feasible, to revise and adjust the granularity of the category system where necessary, and to expand the range of sources for detailed analyses., Methods: All antimicrobial medicinal products in development, discontinued and approved in the last 10 years were identified in the literature. Thereafter clinical trials and company information was searched generating a list of 56 compounds where primarily small to medium-sized enterprises (SMEs) were involved in antibiotics development. Information on clinical trials, university spinouts and public funding for SMEs was then gathered from various sources. The framework for classifying public contributions was then applied., Results: We found that around one-third of antibiotics are developed by SMEs. We identified numerous public funding sources for SMEs that develop antibiotics. At both early-stage and late-stage development, public research funding is the most common public funding reported by SMEs, ahead of other public sources like public equity funds, private-public partnerships and philanthropic sources. A deep-dive into one antibiotic drug, Venatorx, revealed public funds investment of approximately $655 million, dwarfing private investment funds. We found the classification framework generally practicable and we suggest recommendations to improve its granularity and applicability., Conclusion: In this paper we piloted and revised a framework that has been developed to classify types of public contributions to pharmaceutical products at different stages of development. The framework, together with work we have done on identifying sources for funding, can be applied to support pharmaceutical price negotiations that reflect the level of public contribution to product development. Trial registration: EU Clinical Trials Register identifier: 0004-2083-2207. Trial registration: EU Clinical Trials Register identifier: 0003-1754-9422., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Background: Nepal piloted a multipronged supervision, performance assessment, and recognition strategy (SPARS), to improve medicines management (MM) in public health facilities. This paper describes the SPARS pilot intervention and reports on MM performance at baseline., Methods: To build MM capacity at public sector health facilities, health workers were trained as MM supervisors to visit and supervise government health facilities, assess MM performance, and use the findings to provide support in MM practices. Performance was assessed using a SPARS indicator-based tool containing 25 indicators covering five MM domains: dispensing quality, prescribing quality, stock management, storage management, and ordering and reporting. From the middle of 2022, we trained 60 MM supervisors who began conducting supervisory visits at 284 health facilities in 12 randomly selected pilot districts located in three provinces. The intent, pending funding, is to continue supervision and expand SPARS to achieve national coverage., Results: The overall MM baseline median score was 8.5 (34%) (maximum 25) with an inter-quartile range (IQR) of 6.4-10.7. Median facility domain scores (maximum 5) were: storage management, 2.0 (IQR 1.4-2.6); stock management 0.3 (IQR 0.0-1.0); ordering and reporting 2.5 (IQR 1.7-3.5); dispensing quality 1.3 (IQR 0.9-1.6); and prescribing quality 2.3 (IQR 1.3-3.3). The overall score did not differ significantly by level of care; however, hospitals had the lowest overall baseline score and individual domain scores., Conclusion: The baseline assessment using the SPARS tool provides valuable information on the current state of MM in Nepal, which was poor, assessed by the 25 SPARS indicators covering stock and storage management, ordering and reporting, prescribing, and dispensing. Assessing and building national capacity in MM is needed at health facilities at all levels of care., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)