A multi-country campaign in Africa is using cell phone technology to expose stock-outs of essential medicines at public health facilities and put pressure on governments to address the issue.
"Stop the Stock-outs" was launched earlier this year in Kenya, Uganda, Malawi and Zambia by Health Action International (HAI) Africa, a regional network of NGOs, healthcare providers and civil society organizations, in partnership with Oxfam, the UK-based aid and developmental charity, and civil society organizations in several countries.
A key component of the campaign has been the use of text messages by activists and members of the public to report stock-outs of essential drugs at their local clinic or hospital pharmacy.
During a "pill check week" in June, information from text messages relayed from the four countries was compiled on an online map that displayed red dots in areas where medicines were out of stock. Internet users could click on the dot to read which drugs were unavailable.
Research by HAI Africa revealed that many government health facilities in Africa were routinely running out of, or simply not stocking, essential medicines to treat common diseases such as malaria, pneumonia, diarrhoea, HIV and tuberculosis (TB).
"We were finding availability levels in rural, lower-level health facilities of 40 or 50 percent for essential medicines," said Christa Cepuch, a pharmacist at HAI Africa.
The reasons varied from one country to another, but the failure to allocate sufficient funding for essential medicines was a common factor: for example, HAI Africa calculated that the Kenyan government was only spending 20 shillings (US$0.27) per person per year on essential medicines; corruption in the medicine supply chain, human resource shortages, and poor management of drug stocks were contributing factors in many countries.
The global financial crisis has exacerbated the problem: stock-outs of antiretroviral (ARV) drugs have recently been reported in a number of countries, including Uganda and South Africa.
Stock-outs often mean that poor patients, who cannot afford to travel to other health facilities or to buy drugs from the private sector, simply go without, risking serious health consequences.
Partners in each country have devised their own campaigns to address local issues. In Malawi the lack of a training institution for pharmacists until recently meant pharmacy assistants were used to alleviate a severe shortage of qualified pharmacists. The Malawi Health Equity Network (MHEN) is calling for more pharmacists to be trained, and increased government spending on essential medicines.
The organization took advantage of recent presidential elections to ask candidates to pledge their commitment to stopping drug stock-outs, and have urged those elected to make good on their promises.
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"We launched the campaign in February and there's been some increased awareness and support from the [health] ministry," said Martha Kwaitaine, executive director of MHEN "We've also seen cases of people who were stealing drugs being found and fined."
Zimbabwe, which has experienced severe stock-outs of essential drugs in recent years, launched its own campaign this week.