Ghana and Tanzania improving access to new health technologies together
Stronger systems are being put into place in Ghana and Tanzania to access new health technologies for the detection, prevention and treatment of malaria, tuberculosis and the group of neglected tropical diseases (NTDs). TDR is supporting training for implementation research and strengthening drug safety systems.
The work comes out of the Access and Delivery Partnership (ADP), a distinct collaboration between UNDP, TDR and PATH, with support from the Government of Japan.
“Access and delivery of health technologies is a complex issue … and requires a holistic approach,” said H.E. Masaharu Yoshida, Ambassador of Japan to the United Republic of Tanzania, who opened a recent forum on the partnership.
Ghana: enhancing tuberculosis and NTD programmes
“We have sensitized high-level stakeholders on what implementation research is, and trained a cohort of experts to carry it out effectively,” said Dr Evelyn Ansah, Deputy Director of the Research and Development Division of the Ghana Health Service.
Fifteen health researchers and implementers from national disease programmes for tuberculosis (TB), malaria and NTDs have been trained as experts in implementation research (IR).
IR challenges are now a top priority in the national research agenda: “This document is used widely by different health stakeholders,” said Ansah. “They refer to the document quite often when determining their priorities in terms of IR and the work that they are doing.”
The expert group has already developed research proposals and mobilized domestic funding of US$ 80 000 to address bottlenecks, she said.
The first study will explore how to improve outcomes of community-wide preventive treatment of lymphatic filariasis. Researchers want to “drill down” into operational issues to identify why cases of lymphatic filariasis persist in some areas despite long-term mass drug administration.
The second study will focus on ways to increase TB case detection among people living with HIV; increased TB screenings at ARV treatment clinics could be a way to better detect cases.
Looking forward, the country will expand activities to other areas of the country: “We are looking to bring together other actors in the access and delivery value chain, so that together, we can determine how IR can help address their implementation challenges,” she explained.
Tanzania: expanded capacity to identify barriers to access
According to Dr Paul Kazyoba, chief research scientist of the National Institute for Medical Research in Tanzania, the ADP effort has achieved quite a lot: “We have produced a national agenda that sets out the priorities for health system research focusing on the disease control programmes,” he said.
A total of 32 public health researchers, programme officers and health workers at the district level have been trained on how to identify barriers to access and develop IR proposals to help address the problems, he explained.
An estimated US$ 160 000 of domestic investments has been mobilized for IR research on malaria, TB and NTDs.
“The important point here,” he said, “is that whenever there are new technologies, medical devices, medicines, we are able to quickly understand how these technologies can be efficiently delivered.”
The Tanzania participants also shared lessons learned from their experience:
- Health programmes benefited from combining efforts, from multi-themed health days to boost screenings, to cross-mentoring of health workers.
- Sharing skills and resources, and moving from vertical to more horizontal planning, accelerated progress.
And, according to Dr Neema Rusibamayila of the Ministry of Health: “We now recognize that different parts of a national system must work together to enable effective access to, and sustainable delivery of, new health technologies.”
Drug safety and monitoring
Ghana and Tanzania have natural links: both countries have built good systems for safety monitoring during clinical trials of potential new medicines – including consumer reporting and electronic management of incidents. These systems have been developed through sharing of information, and are available for other low- and middle-income countries.
The two countries are now finalizing two-year work plans: from suggesting cooperative activities that strengthen the tracking and reporting of adverse events, to development of risk management training materials and response plans.
Christine Halleux, TDR ADP focal person on drug safety who is working with the countries, says, “Improved drug safety and monitoring can better enable countries to introduce new medicines and technologies, a key goal of the ADP project.”
Work during the next 12 months will focus on applying implementation research across the entire access and delivery value chain and assessing the feasibility of electronic health records to improve safety monitoring.