Paraguay Community Pharmacies Provide Low-Cost Medicine
FrontLines
- November 2004
ASUNCION, Paraguay—Although sick people in the developing world often cannot afford or find medication, Cecilia Gonzalez gets cheap medicine from her community’s “social pharmacy” in the southern area of Itapua.
Gonzalez, a young mother, is from one of 26,000 low-income families who have access to the community pharmacies, where drugs cost about 50 percent less than at commercial pharmacies. Gonzalez’s income is less than $1,500 a year.
In 1996, USAID/Paraguay began working with local governments, health officials, and citizens to design the program. To date, the Agency has invested about $1 million in technical assistance to set up more than 100 pharmacies in four regions of southern and central Paraguay.
“Poor people now have access to low-cost medicines,” said Graciela Avila, the health program officer for USAID/Paraguay.
Money for the pharmacies is channeled through a revolving fund that is managed by local health councils. The fund’s managers are responsible for stocking the pharmacies. They select, purchase, and distribute pharmaceuticals
and supplies.
Prices at the community pharmacies are kept low because the revolving fund allows local government to buy medicines in bulk from suppliers.
“In Itapua, we started the social pharmacy program with 50 million guaranies [about $7,500] provided by the departmental government and 18 basic medicines,” said Victoria Baez, a voluntary coordinator of the program in Itapua. “Now we have more than 100 medicines and more than 300 million guaranies [about $44,000] in the revolving fund.”
The pharmacies are typically housed within health posts or clinics run by the Ministry of Health. Some are also located in private houses.
They are run by volunteers who have some background in healthcare. Each community’s
pharmacy warehouse is also managed by volunteers who have the medical knowledge
to administer pharmaceuticals.
Most communities in Paraguay suffer chronic shortages of drugs, contraceptives, and medical supplies. This often leads people to speculate on the causes and cures of what ails them and to self-medicate. Many people are also too poor to afford any drugs: Paraguayans annually spend only about 4.2 percent of their income for healthcare, according to the Ministry of Health.
The health ministry and donors such as the World Bank have expressed interest in replicating the USAID-funded community pharmacies program in other regions of the country.Such pharmacies are just one way USAID has worked to improve access to affordable medicine for people in poor countries.
In Ghana, the Agency supported a program that developed a franchise to improve access to and use of essential medicines. And in Tanzania USAID funded a program that accredits non-pharmacy drug shops.
But programs supporting revolving drug funds, as in Paraguay, have proven particularly successful, said Anthony Boni, pharmaceutical management advisor with the Bureau for Global Health. USAID has supported a similar program in Nepal and Tajikistan.
|
