Drug Supply in the Public Sector: Mauritius

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Managing The Supply Chain For Pharmaceuticals In the Public Sector| 26 avril 2011
Aiming to guarantee the continuous flow of products from the point of manufacture to the point where they are used by consumers. | Sarita Pulton Boolell|

A. Introduction

The leitmotiv of the supply chain for pharmaceuticals in the Public Service is the six RIGHTS:

The right pharmaceutical
In the right quantity
Of the right quality
At the right place
At the right time
At the right cost

In other words we aim to procure and supply drugs in the most efficient, safest and least costly way possible.

However, it must be understood the drugs used in a country is normally the exact reflection of the prevalent diseases. The epidemiological landscape is ,very often, a less thought influencing factor on the Pharmaceutical Supply Chain logistics . In a country where non- communicable chronic diseases represent the biggest health burden, the supply chain needs to guarantee ,in priority, the continuous flow of drugs ,being given that the stabilization of a condition will depend above all of the patient’s continuous compliance to his treatment. Chronic diseases also imply that the patient once started on a medication will have to take it for a life time.

Among other influencing factors are the level of training of the Health Care personnel in supply chain , the number of distribution points, the legal framework ,the procurement methods, the policy and political decisions for the pharmaceutical sector.

We aim in this report to critically examine the different operations of the Supply Chain for pharmaceuticals in the Public Sector.

B. Country Background

With a per capita income of about US$ 260 at the time of independence in 1968, Mauritius emerged from an under-developed economy to that of an upper middle income economy. In 2006 Mauritius had a per capita income of US$ 6431 or $11 643 in purchasing power parity (PPP) terms. Mauritius witnessed a shift from a mono-crop agricultural economy to an exported oriented manufacturing economy, with a buoyant tourism and service sector.

Mauritius is classified as upper middle income country by the World Bank.

C. Health Profile

Mauritius has reached an advanced stage in its epidemiological transition. Communicable diseases, problems of maternal and child health has markedly decline and are controlled effectively. On the other hand non-communicable and chronic diseases are on the rise. Non-communicable diseases in Mauritius represent 74 per cent of the total burden of disease in men and 76 per cent in women and include diabetes, hypertension, cerebrovascular diseases, cancer, mental illness and substance related diseases linked to tobacco use and alcohol abuse.

The rapid industrialization along with the openness of the island to the external world has brought in its wake changes in life styles in turn impacting on the health and nutritional welfare of the communities. Prevalence of obesity and overweight is high.

Negative effects that arise from a more sedentary life style are associated with lowered physical activity; issues related to time allocation; tendency to consume more convenient foods; and preference to settle for less strenuous recreational activities.

Cancer is the third most common cause of death in men. This pathology is likely to increase with the aging population and the increase of risk factors related to changes in lifestyles.

The HIV epidemic in Mauritius is classified as ‘Concentrated’ with prevalence of around 30 – 60% among vulnerable groups such as prison inmates, intravenous drug users and commercial sex workers

Mauritius provides state health services throughout the country free at the point of use to all its 1.2 million people.
The state health services employ over 650 doctors, 2,700 nurses, about 50 dentists and 17 pharmacists.

At primary care level, the state...
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