KENYA Stop Stockouts Team Hosts Health Civil Society

The Kenya Stop Stock- Outs (SSO) team on the 4th of November 2009 hosted Health Civil Society Organizations (CSOs) to a half day workshop in Nairobi. The workshop targeted all levels of health CSOs- from those working on policy issues those delivering services especially to the poor and vulnerable. All of the participants at the workshop have been involved in health issues; with some having worked on Access to Medicines issues.
The objectives of the workshop were:
 To share experiences on access to medicines, stock outs of medicines and efforts towards influencing policies and practices that support sustainable access to medicines- including successes and challenges
 To strengthen health CSOs participation in Access to medicines issues
 To promote a joint efforts towards campaigning/ advocating against stock outs of medicine
Besides achieving the above objectives the workshop was expected to popularize the SSO Campaign beyond the four organizations represented in the team.
The participants were very enthusiastic and supportive of the SSO campaign. They shared their own experiences in working on health and Access to medicines issues from which the SSO team should learn from; and made very concrete suggestions some of which are highlighted below:
 Consider linkages with other related issues and focus on strategies with biggest impact. Access to Healthcare is a complex issue affected by many inter- related factors which should not be looked at in isolation, for instance by engaging networks like the International Network for the Rational Use of Drugs (INRUD) to tackle issues of rational use of medicines
 The campaign should focus on decentralizing its message so that there is support even beyond Nairobi. For this to happen there is need for resource mobilization and working with interested CSOs to support activities at their level of operation
 CSOs should not focus on criticizing the government but offer sustainable solutions to the problem
 Deeper engagement of communities so that they can be part of the solution at their own level e.g. through involvement at health center management teams, involvement in developing respective community health strategies, monitoring of medicines availability
 Managing public expectations. Once public awareness has been raised, it is critical to know before hand how to handle their expectations.
 Lobby for rationalization of health ministries to ensure efficient use of available budgetary allocation to Health
 Joint advocacy and community awareness raising
 Take advantage of health related days to capture the public and media attention such the World Aids Day
 Adopt different, more innovative and specific approaches for targeting different stakeholder groups. For instance some approaches may be effective for community awareness and mobilization, but probably not for policy level dialogue
 Effective organization of CSOs to ensure that they are able to take advantage of upcoming opportunities such as the on- going reforms at the Kenya Medical Supply Agency (KEMSA).
 Information sharing, proper coordination and linkages/ networking with other initiatives to avoid duplication and to strengthen respective initiatives.
As we move forward with the campaign, getting the support of other civil society organizations is critical. Some of the organizations are involved at the grassroot level and will be critical in community mobilization while others work at the policy level and their support in policy advocacy around issues of availability of medicines cannot be ignored.

Kenya Stop Stockouts Team to Meet Health Civil Society

The Kenya Stop Stock- Outs (SSO) Team will on the 4th of November 2009 host Health Civil Society Organizations (CSOs) to a half day workshop in Nairobi. The workshop targets all levels of health CSOs- from those working on policy influence to those delivering services especially to the poor and vulnerable.

While majority of the participants are drawn from the Capital, Nairobi, there is deliberate effort to have some representation from the other two cities- Mombasa and Kisumu- to decentralize the campaign.

The Kenyan team has so far been successful in creating of awareness to the public and policy makers through public fora and media engagement. “As we move into policy dialogue with policymakers and politicians, it is critical that we seek the support of other Health CSOs beyond those represented in the SSO team.” Said Emma Wanyonyi of Consumer Information Network

The major objectives of the workshop are:
 Share experiences on access to medicines, stock outs of medicines and efforts towards influencing policies and practices that support sustainable access to medicines
 Popularize the ‘Stop Stock- Outs’ Campaign amongst health CSOs, build support for it and make ‘stock- outs’ a common issue amongst the Health CSOs in Kenya
 Strengthen health CSOs participation in Access to Medicines issues, and promote a joint efforts towards ‘stock outs’ campaign

Launch of the Stock-Out campaign in Zimbabwe

Zimbabwe successfully launched the Stop Stock-Outs Campaign on Thursday 17 September 2009 at a highly attended workshop. The campaign is part of a regional movement that aims to ensure access to essential medicines for all. Affected communities, civil society, media, government and the pharmaceutical industry attending the workshop agreed that stock-outs of essential medicines, particularly in the public sector were wide spread and unacceptable.

Speaking at the launch of the campaign, the Permanent Secretary in the Ministry of Health and Child Welfare (MoH & CW), Dr. Gwinji attributed the stock outs to the economic challenges facing the once thriving
nation. Civil society organisations attending the workshop highlighted pilferage of medicines and low prioritisation of the health sector by government, as the major challenges to accessing essential medicines.

The workshop aimed to;
1. Share experiences on access to essential medicines at local and national level
2. Review the existing public policies and practices surrounding access to medicines in Zimbabwe
3. Develop a civil society plan of action on access to essential medicines

Civil society organisations participating in the workshop, among others SAfAIDS, Women and Aids Support Network (WASN), ActionAid-Zimbabwe, Zimbabwe Congress of Trade Unions (ZCTU), Cancer Association of Zimbabwe and Zimbabwe Diabetic Association (ZDA) resolved that civil society with the coordination of the Community Working Group on Health should take up the following ACTION;

1. Resource mobilisation (Prioritise health)
Participants agreed to engage the Parliamentary Portfolio Committee on Health (PPCH) to ensure the prioritisation of health evidenced by increased allocation of resources. The issue of lack of funding to produce essential medicines should be tackled through parliament in order to influence the national budgetary allocation for health and ensure that the Abuja targets are met as a minimum. However, given the committee’s weaknesses, participants agreed on the need to also engage at a higher level through Parliament at large and line ministries including the ministries of Health and Child Welfare; Finance; Trade and Investment.

2. Community mobilisation and awareness-raising on essential medicines.
There is need for the development of information, education and communication (IEC) materials on Access to Essential Medicines (AEM) for communities, complemented by media outreach to support the campaign. Although medicines are generally not available, this will empower the public to push and demand their rights to access essential medicines.

3. Create Monitoring mechanism on AEM
Participants agreed on the need to conduct independent monitoring of stock-outs through activities such as the SMS pill check. However, this should not be a parallel structure to that of the MoH&CW but would be a civil society initiative. Participating organisations would work with existing government structures where possible. This would expose where stock-outs were occurring within the supply chain and enable evidence-based advocacy. This has proved useful as a best practice in other countries involved in the AEM campaign. It would also allow communities to play an active role in the campaign.

4. Capacity Building
The need to build the capacity of CSOs in Zimbabwe on AEM policy and regulation, as well as basic information on essential medicines was expressed. The campaign should strengthen community groups working on health in Zimbabwe, to institutionalise and to sustain the momentum that the campaign has built at national level.

HIV AIDS FIGHT AND MEDICINES STOCK-OUTS

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Kisumu residents demand for essential medicines

Tuesday 14 July 2009 Kisumu: People thronged the Pollyview Hotel in Kisumu, the third largest town in Kenya, to hear about stock-outs of essential medicines in the country. The overzealous crowd was composed of Kisumu residents from various walks of life including youth groups, health workers from communities and facilities around the city, peer educators, civil society organizations (CSOs) and non-governmental organizations (NGOs), patients and the general public.

The crowd was empowered, knowledgeable and mos of all knew their rights. A prompt from the Kenya Hospices and Palliative Care Association’s (KEHPCA) David Musyoki made them ready to take up the “stop the stock-outs” banner, march the streets and demand that essential medicines be made available to them.

“We have always thought these medicines for opportunistic infections must be bought by ourselves! But now we know that we have a right to get these medicines from public health facilities,” exclaimed Njoki Kimemia, a woman living with HIV in Kisumu.

Eunice Owino, who works for a local community based organization (CBO), said there are serious problems in hospitals in the region in regards to medicines. “As a CBO we are faced with a lot of challenges because patients who are sent away from public health facilities turn to us for medicines which we do not have.”

Patience Aoko, a nurse at New Nyanza Provincial General Hospital, said she has frequent contact with people who need medicines. “I am happy about this stop stock-outs campaign that will ensure access to medicine for all in the country,” she stated.

As a health worker in a government hospital she said the challenge of accessing medicines is real. She added that they turn a lot of patients away because a needed medicine is out-of-stock. “Most public health facilities lack medicines which are essential and treat common illnesses,” she observed.

The Kenya Treatment Access Movement’s (KETAM) James Kamau told the gathering that he was saddened by the fact that people continued to die from preventable and treatable diseases. “Without a healthy nation you cannot achieve development. Our people are dying while letters we write to the Permanent Secretaries at the Ministries of Health regarding serious stock-outs of essential medicines countrywide have not been responded to. It’s been more than a month since we wrote them!” he lamented.

Some of the new issues that emerged form the forum included:
 Taxation on VCT test kits used by NGOs
 There are reported cases of medicines released from the central stores never reaching their intended destination. This calls for transparency and accountability along the supply chain and for full independence of the central medical supplies agency (KEMSA).
 Health workers at the grassroots level have a rich experience of unavailability of medicines in their facilities.

Emma Wanyonyi of the Consumer Information Network (CIN) noted that the public needs to be assertive and take responsibility for their health, including when they are unable to access medicines. From the experience of the health workers, the passive nature of many patients contributes to the inefficiency, negligence and corruption at health facilities. “The public needs to be empowered. This is part of what the “stop the stock-outs” campaign, and the public forum in particular, aims to achieve.”

[caption id="attachment_245" align="aligncenter" width="336" caption="James Kamau of KETAM stressing a point at the Kisumu public forum"][/caption]

SMS pill check findings released to Kenyan media

The Kenyan team held a successful press conference on 30/06/09 with 22 journalists in attendance from various print, electronic and online media houses in the country. Patrick Mubangizi (HAI Africa), Emma Wanyonyi (CIN), David Musyoki (KEHPCA), and James Kamau (KETAM) spoke at the press conference while Eve Odette (OXFAM) moderated the event.

The stock-out story was aired on KTN TV, K24 TV, Kiss FM, Classic FM, Capital FM, KBC Radio, Ramogi Radio, Bibilia Husema, Nairobi Star newspaper, and Africa Science News Services (online) among others. The links to some of the articles that appeared are below.

http://www.capitalfm.co.ke/news/Local/Kenya-health-facilities-lack-drugs,-say-activists-4942.html

http://www.youtube.com/watch?v=mzFvtUWy2DM&feature=channel_page

http://www.rhsupplies.org/about_us.html

During the SMS pill check week, data collectors were able to gather information from over 150 primary health facilities from around the country and with technical assistance from OSI fellow Michael Ballard, the information was uploaded on the stock-out site.

General findings indicated that stock outs of the EM is widespread and covers a wide range of the 10 essential drugs surveyed. The results will be used as an advocacy tool as the Kenyan team seeks to engage the government.

The team is still working towards engaging the government through the relevant Ministries and government agencies involved in medicine procurement and supply. In particular the team has requested a meeting with the two Health Ministries following which we intend to seek out the medicine supply agency (KEMSA).

The team has also written to the Kenya Revenue Authority (KRA) and the Ministry of Finance in relation to taxation of Morphine which still contributes greatly to the unavailability and high cost of this drug. Morphine is commonly used by cancer and HIV/AIDS patients as a pain reliever.

Stop stock-oute press release

Mombasa forum a huge success!

The Kenyan team organised a successful public forum in Mombasa, the second largest city in Kenya, on June 23rd at the Mombasa Municipal Stadium. The public forum was intended to publicize the campaign and its objectives, to create public pressure for reforms within the Kenya Medical Supply Agency (KEMSA) and to publicize the SMS pill check week.

There were about 100 people in attendance comprised of Civil Society organizations (CSOs), Non Governmental Organizations (NGOs) as well as the general public mobilized by the local administration. The attendees were very enthusiastic about the campaign and gave moving testimonies about their stock-outs experiences in the district. They were glad that the forum enlightened and educated them on their right to access medicine and to push government for the same. They said it was a good idea to have a forum such as this to share their plight in accessing essential medicine and to point out negligence among health workers in public health facilities.

The participants were enthusiastic and called on the stock-outs team to advocate for this issue so that it is widespread and called upon the government to act quickly to provide essential medicines in order to avert unnecessary deaths. The Kenyan team also launched the SMS campaign and informed the members of the public to text in when they experience stock-outs in public health institutions.

As a followup, the team intends to continue engaging local organizations and empowering them to be able to further involve the public through the local media. In addition, the team will demand that policymakers, politicians and parliamentarians put issues of essential medicines and drug availability on their agenda. A similar forum is planned for Kisumu, a city in the Western part of Kenya in the second week of July.

Kenyan team organizes two public forums

The Kenya ‘Stop- stock out’ campaign team is organizing two public forums to spread out the campaign message to the people on the ground as well as to create better awareness of stock outs and unavailability of essential medicines around the country.

The public forums will be held on 23 June in the coastal city of Mombasa and in the first week of July in Kisumu in Western Kenya. The forums are expected to bring together policy makers, health professionals, and civil society organizations working on health issues.

The forums will offer a good opportunity for consumers and patients to discuss problems around access to essential medicines including the causes and possible solutions. The forums are also expected to empower the public to put pressure on government to provide essential medicines in public health institutions and demand that the recommendations of the task force put up to look into the Kenya medical Supply Agency (KEMSA) be implemented.

The taskforce had recommended among others that KEMSA be given financial and operational autonomy and procurement functions be solely left to it so that it can comply with Public Procurement Regulations as outlined in the Public Procurement Act.

The two forums are being organized by the Kenyan campaign team members who include Consumer Information Network (CIN Kenya), Kenya Access Treatment Movement (KETAM) and Kenya Hospice and Palliative Care Association (KEPHCA).

Kenya – Public Forum, 25 Feb 2009

Venue: Panafric Hotel
Time: 4.00 pm – 6.00pm
Program: Personal testimonies from 2 consumers, short presentations from civil society representatives, open plenary discussion.
Subject: the low availability fo medicines in government health facilities; the on-going stock-out situation; the costs of medicines are not affordable for Kenyans

Campaign Launch Press Conference

Venue: Panafric Hotel, Nairobi
Time: 9.30am to 12 pm
Subject: Launch of the continental and Kenya campaign to “Stop Stock-outs”