Pharmaceutical Sector Country
Profiles
Experiences and Plans
Dr Gilles Forte
Dr Richard Laing
Essential Medicines and Health
Products Department
WHO HQ
Issues to address
 A vast amount of information exists on the
pharmaceutical sector of countries;
 BUT this information is often not available to the public
or even to decision makers in the countries involved;
 Duplication of efforts with multiple data collection
initiatives in the same country; not always endorsed;
 This information is not always reliable.
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
WHO Pharmaceutical Sector Monitoring Tools
High-level policy information (Country
Profiles), through a global survey
•Questionnaire to Ministry of Health
•Indicators on structures, policies and
outcomes;
•Carried out every four years
CP
High-level information
Mostly structures and
policies
Health facility and household surveys
(Level II)
•Surveys based on interviews
•Indicators on policy outcome
•Upon country request
Topic-specific studies (Level III)
•More detailed indicators for monitoring
and evaluating specific areas/components
•Upon country request
Level II
Core outcome/impact indicators
& household survey
Level III
Indicators for specific components of the
pharmaceutical sector:
Pricing
Rational use
Human Resources
Assessing regulatory capacity
Procurement and Supply
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
Content of the Country Profile questionnaire
 The questionnaire is divided into 9 chapters:
–
–
–
–
–
–
–
–
–
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Health and Demographic data.
Health Services.
Policy Issues.
Medicines Trade and Production.
Medicines Regulation.
Medicines Financing.
Pharmaceutical Procurement and Distribution.
Selection and Rational Use.
Household data/access.
WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
Rationale for Country Profiles
 Assist countries produce reliable indicators and information on structures,
processes and outcomes; using existing data e.g. pricing & availability;
 Support countries to establish a unique and reliable source of information for
identifying gaps, carrying out policy dialogue and policy formulation;
 Information available for coordination of international partners in countries;
 Global survey in 193 Member States every four years; comparisons among
large number of countries (156 in 2007; 130 in 2011), regions and income
groups;
 Systematic data collection allows comparison over time (2003,2007,2011);
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
2011 Survey: ensure quality of information
 Year and source of each piece of information is recorded and key documents are
provided and stored in the WHO Medicines Library. Fields for comments are provided to
allow respondents to provide more nuanced information;
 A manual with instructions to fill in the questionnaire has been developed to guide data
collection; English, French and Spanish;
 A glossary with definitions of key items has been produced to make sure questions are
interpreted consistently across countries and regions;
 Names and contacts of respondents are collected and interactions with WHO are taking
place for data quality checking;
 Data is endorsed by a senior Official at the Ministry of Health as official country information
and authorisation for disclosure granted;
 Quality checking of information is supported by WHO at HQ and Regional Offices. This is
done through:
– Checking with previous information available for the country;
– Checking for consistency within the questionnaire;
– Cross checking with other sources and profiles (for example, National Health
Accounts);
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
2011 Survey: reduce burden of data
collection in countries
 Core and supplementary indicators defined; Mostly Yes/No questions; limited
financial and human resources needed;
 Questionnaires have been prefilled for 193 Member States with all information
available at WHO HQ. About 50% of each questionnaire has been prefilled.
Countries are asked to verify the information provided and fill in gaps; WHO support
provided for quality checking;
 The Country Profile is meant to be an official and unique source on
pharmaceutical sector information in the country for national and international
experts; It is expected that the availability of reliable information will reduce data
collection initiatives in countries;
 The questionnaire has been endorsed by The Global Fund to replace GF Health
Products Management (PHPM) Profile. In 2011, It has been an important source of
information and step for GF grant signing; Joint data collection between WHO and
GF has been carried out in countries;
 Discussions are ongoing to align the questionnaire with other International agencies
e.g. Unicef, World Bank;
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
Countries involvement and WHO support
 The survey is coordinated by the Ministry of Health in countries and involves
relevant national institutions e.g. MRA, NHA etc.;
 EMP and 6 Regional Advisers are involved in the coordination of WHO support for
country profiles completion and for collaboration with GF;;
 At country level, WHO Medicines and Health systems experts collaborate and
support the Ministry of Heath for collection of quality information, coordination with
national institutions and GF representatives and for use of data for policy dialogue
and formulation;
 Country profiles are meant to be updated and published every four years;
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
WHO: 193 Member States
6 Regional Offices
(Source: http://www.who.int/about/regions/en/index.html)
= Medicines Adviser
= Collaborating Centre
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Regional Office AFRO
Regional Office EMRO
Regional Office EURO
Regional Office WPRO
Regional Office SEARO
Regional Office AMRO
WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
WHO HQ Geneva
Country Profiles
http://www.who.int/medicines/areas/coordination/coordination_assessment/en/index1.html
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
Regional, Global and Technical reports
 Africa, Europe, Western Pacific, Americas, Caribbean
and Eastern Mediterranean Regions
 Technical include Financing and Pricing, Selection
Rational Use & ? Regulation
 Global report
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
RESULTS
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
Global Report
 1. Introduction
2. Methods
3. Health and Demographic Results
4. Health Services
5. Medicine Policy Issues
6. Medicines Trade and Production
7. Medicines Regulation
8. Medicines Financing
9. Pharmaceutical procurement and
Distribution
10. Selection and rational use of
medicines
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
Health expenditure as % of govt budget
Percentage of government budget (%)
16
Abuja Target
14
14.0
11.7
12
11.5
10.8
9.8
10
8
6
4
2
0
Low (36)
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Lower-middle (53)
Upper-middle (56)
Income Group (# countries )
WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
High (52)
Global (197)
Table 4.1.5: Total Pharmaceutical Expenditures (2010)
Country
group
(number of
countries)
WHO region
Africa (43)
Americas
(35)
Eastern
Mediterranea
n (19)
Population
Total Pharmaceutical Expenditure
Millions
%
Million US$
%
%THE
%GDP
Per
capita
(US$)
819
12.1%
$19,464
1.7%
23.0%
1.3%
$10.59
923
13.6%
$436,004
38.7%
19.8%
1.3%
$87.30
573
8.4%
$20,763
1.8%
20.1%
1.2%
$50.31
896
13.2%
$331,683
29.5%
21.5%
1.6%
$308.4
8
$41,157
3.5%
33.2%
1.3%
$13.05
$276,362
24.6%
18.7%
1.2%
$37.90
Europe (52)
South-East
Asia (10)
1,783
26.2%
Western
Pacific (27)
1,800
26.5%
World Bank income group
High-income
(49)
Uppermiddleincome (55)
Lowermiddleincome (50)
Low-income
(32)
Global
Global (186)
1,092
16.1%
$775,305
68.9%
18.5%
1.4%
$463.5
9
2,474
36.4%
$283,864
25.2%
21.2%
1.3%
$96.78
2,480
36.5%
$59,580
5.3%
23.6%
1.3%
$26.28
749
11.0%
$6,683
0.6%
27.7%
1.6%
$8.01
20.8%
1.4%
$68.78
6,795
$1,125,433
Source: World Health Organization Global Health Observatory Database, 2013
National Health Accounts, 2013
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
Median number of pharmacists per 10,000 by
WHO Region
8
7.12
N
Number of pharmacists per 10,000 people
7
6.20
6
5
4.40
4
3.24
3.07
3
2.16
2
1
0.35
AFRO
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AMRO
EMRO
EURO
WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
SEARO
WPRO
Other
La
o
Th
ai
la
nd
M
on
go
De
lia
Ca
m
oc
m
bo
ra
t ic
d
Pa
Re ia
pu
pu
a
N
ew blic
G
G
u
ui
n e ine
a
aBi
ss
a
Ur u
ug
Ph ua
ilip y
pi
n
Bo es
ts
wa
El
n
Sa a
lv
ad
or
Le
so
So
th
o
ut
h
Af
ric
a
Bo
liv
i
Na a
m
Si
ib
Un
er
ia
ra
ite
L
d
eo
R
ne
ep
ub
G
lic
ab
of
on
Ta
nz
M
an
ad
i
ag a
as
ca
Ar
r
ge
nt
in
a
Pe
op
le
's
Taxes on medicines
VAT on Pharmaceuticals
25%
20%
20%
15%
10%
17 |
12% 12%
7%
13%
14% 14%
WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
21%
18% 18%
15% 15% 15%
10% 10% 10% 10% 10%
8%
5%
0%
Upper middle Lower middle
income
income
Low income
2003
High income
HIV/AIDS antiretrovirals provided free at primary
healthcare facilities over time by income group
2003
10/24
2007
25/26
2011
33/33
2003
19/33
2007
31/35
2011
48/49
2003
19/25
2007
27/28
2011
45/46
10/15
2007
15/19
2011
31/37
0%
20%
40%
60%
80%
100%
Note: Different countries may have responded with data related to different years, the years represent the WHO Level 1 and
Country Profile survey dates. Numbers to the right indicate number of "yes" / total respondents.
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
Global,Regional and Technical Reports
 Web Publications of Country Profiles and
Data available at:
http://www.who.int/medicines/areas/coordin
ation/coordination_assessment/en/index1.h
tml
 Regional Reports for AFRO, EURO, WPRO
produced by Regional Offices and Utrecht
University CC
 Global Report produced by HQ Team,
University of Utrecht CC, Jonny Meldrum,
Catherine Shih
 Technical Reports on
– Financing and pricing
– Selection
– Rational Use
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
Evaluation of 2011 PCP Survey
 Quantitative Evaluation
– Data from 143 responders and 54 prefilled
– Response rates over 60% for the core indicator questions
highest was Health and Demographic data, 84% and was lower
for Procurement (57%), Medicines Financing (48%) and
Household data (22%)
– 324 questions out of the 493 core and supplementary
questions were prefilled, representing a 66% average prefill
rate for the entire questionnaire.
– Of these 324 prefilled questions, 208 were changed by one or
more of the respondents, representing an average change rate
of 65% for the entire set of prefilled questions
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
 Qualitative Evaluation
– 37 respondents replied with follow up in depth telephone
interviews were undertaken with 7 respondents. A conference call
was also made with the EMRO senior staff.
– Prefilling was recognized as being helpful and efficient in the
validation and completion of the questionnaire and focussed
country attention on data to be checked and/or changed.
– The length of the questionnaire was considered reasonable.
– The Instruction Manual and Glossary were not always thought to
be useful in their current format
– There was frequent criticism of the use of the Word based
instrument including problems with macros with strong support for
the use of a web based software for the next survey.

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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
Plans for 2015 Country Profile Activities
 Evaluation of 2011 Survey Quant and Qual 3 months 2 BU interns
 Meet with NPOs and Regional Advisers Sept 2013
 Revise pilot questionnaire and consult Technical units Oct 2013
 Generate and Prefill questionnaire Nov Dec 2013
 Revise manual, glossary and questionaire
 Work with RA’s and 12 Pilot countries Feb 2014
 Send out March 2014 to 12 pilot countries complete by end May 2014
 Clean, analyze and write 2 reports (Summary and Process) June-July 2014
 Revise Global questionnaire, prefill and set up instrument Aug-Dec 2014
 Send out Jan 2014 with regional and HQ support Jan-April 2015 * * * * * * *
 Clean analyze and write country reports May-July 2015 * *
 Write global, regional and technical reports Aug-Dec 2015 * *
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WHO/GF Pharmaceutical Sector Country Profiles | October 7, 2015
Global Health Observatory
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