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首页> 外文期刊>AIDS care. >Scaling up access to antiretroviral drugs in a middle-income country: public sector drug delivery in the Free State, South Africa.
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Scaling up access to antiretroviral drugs in a middle-income country: public sector drug delivery in the Free State, South Africa.

机译：在中等收入国家扩大抗逆转录病毒药物的获取：南非自由州的公共部门药物供应。

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摘要

This article describes the distribution and management of drugs and supplies in scaling up access to public sector antiretroviral treatment (ART) in a middle-income country. More specifically, a case study of the Free State Province of South Africa is presented focusing on: the mobilisation and training of pharmaceutical staff for ART, processes related to the ordering, distribution and storage of medicines, continuity of ART supplies and the impact of ART delivery on other drugs and supplies. Data were obtained from longitudinal research conducted between April 2004 and July 2006 comprising three surveys of the first 20 health facilities providing ART in the province, key informant interviews and observations made of provincial ART Task Team meetings. The supply of ART in the Province was managed through the existing drug supply system but with special mechanisms to ensure integrity of ART supplies and security of stock within the existing supply system. Initial hiccups in the procurement of antiretroviral (ARV) drugs for South Africa (a national function) caused delays in putting patients on ART, although these supply problems were short-lived. At provincial level, not all pharmacist posts created for the programme were filled, and pharmacists working in the rest of the health system were subsequently trained to take on ART programme functions. Electronic systems were not established at all service sites, which in part contributed to delays in the delivery of drugs and supplies to more peripheral units. Adequate space to safely store ARV drugs remained problematic. The introduction of the ART programme did not create disruptions in the supply of non-ART essential drugs, which in fact improved over the period of observation. It is concluded that despite some process, human resource and infrastructural challenges, the drug management system in the Free State succeeded in incorporating public sector ART within its existing drug distribution network and functions, at least in the initial phase of scale up.
机译：本文介绍了在中等收入国家扩大公共部门抗逆转录病毒治疗（ART）可获得性的药物和供应品的分配和管理。更具体地讲，本文以南非自由州省为例，研究重点是：动员和培训抗逆转录病毒药物的医务人员，与药品订购，分配和储存有关的过程，抗逆转录病毒药物供应的连续性以及抗逆转录病毒疗法的影响其他药物和用品的交付。数据来自2004年4月至2006年7月进行的纵向研究，包括对全省提供抗逆转录病毒治疗的前20个医疗机构的三项调查，主要知情人访谈和省抗病毒治疗特别工作组会议的观察结果。省内抗逆转录病毒药物的供应是通过现有的药物供应系统进行管理的，但具有确保抗逆转录病毒药物供应的完整性和现有供应系统内库存安全的特殊机制。尽管这些供应问题是短暂的，但为南非（国家职能部门）采购抗逆转录病毒（ARV）药物最初遇到的麻烦导致了推迟患者接受抗逆转录病毒治疗。在省一级，并非为该计划创建的所有药剂师职位都已填补，随后在卫生系统其他部门工作的药剂师也接受了接受ART计划职能的培训。并非在所有服务地点都建立了电子系统，这在一定程度上导致了向更多外围单位的药品和物资供应的延迟。安全存储抗逆转录病毒药物的足够空间仍然存在问题。引入抗逆转录病毒治疗计划不会造成非抗逆转录病毒基本药物供应的中断，实际上在观察期内有所改善。结论是，尽管有一些过程，人力资源和基础设施方面的挑战，但自由邦的毒品管理系统至少在扩大初期就成功地将公共部门抗逆转录病毒纳入其现有的毒品分配网络和职能中。

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