Focus countries

Rolling out a digital system to support the distribution of COVID-19 vaccines

A key focus of ADP support since Bhutan’s inception as a focus country in 2021 has been on improving the national response to the COVID-19 pandemic. ADP facilitated the transfer of technical knowledge on digital systems that promote rapid, efficient and equitable distribution of COVID-19 vaccines, resulting in the successful development and roll out of the Bhutan Vaccine System. These efforts have enabled Bhutan to implement one of the fastest COVID vaccination drives in the world, where over 90 percent of its entire adult population was double dosed by July 2021.

Promoting the safety, efficacy and quality of health technologies

ADP also supported Bhutan’s drug regulatory authority in strengthening the capacity of regulatory inspectors on implementing good distribution practices and quality-risk management during regulatory inspections. Improving the skill level of regulatory inspectors will ensure quality and integrity of medicines during all aspects of the distribution process.

Promoting the sustainability of UHC

Working with the Ministry of Health and in collaboration with the Health Intervention and Technology Assessment Program (HITAP) and Hitotsubashi University, ADP is promoting the financial sustainability of the UHC programme in Bhutan, by supporting the institutionalization of health technology assessment as a systematic tool to inform the prioritization and selection of cost-effective medicines, vaccines and diagnostic tools. ADP is currently supporting a study on estimating the cost-effectiveness threshold to inform the expansion of the UHC benefits package, as well as the institutionalization of the health technology assessment (HTA) approach within the decision making process for healthcare priority-setting and resource allocation.

Strengthening the national tuberculosis (TB) programme during the COVID-19 pandemic

In 2021, ADP supported the national TB programme to maintain its prevention, care and treatment services during the COVID-19 pandemic, by building the capacity of local researchers and programme managers on the use of implementation research to identify COVID-19-related challenges and to inform policy measures for sustaining crucial services during the pandemic. ADP also supported the national TB programme to monitor and manage adverse events of new TB medicines, and to advocate for the inclusion of alternative health care providers in pharmacovigilance (PV).

Promoting the safety, efficacy and quality of health technologies

ADP also worked towards improving the quality, safety and efficacy of medicines, vaccines and diagnostic tools in Burkina Faso. ADP strengthened the institutional and technical capacity of Direction Générale de la Pharmacie, du Médicament et des Laboratoires, the national regulatory authority (NRA), by supporting a self-assessment using the WHO Global Benchmarking Tool as a prerequisite for a formal benchmarking by WHO and the development of an institutional development plan in 2022.

ADP also improved the monitoring and assurance of quality and integrity of medicines and vaccines throughout the supply chain by strengthening capacities of a range of key functions, including: good distribution practices of regulatory inspectors; the evaluation of the quality of medicines and the detection of substandard and falsified medicines by quality control laboratories; and the detection and reporting of adverse reactions to medicines and vaccines by pharmacists and medical doctors.

Strengthening policy coherence and integrated planning

In line with the Health Sector Medium Term Development Plan (2018–2021), ADP has focused its support on strengthening integrated approaches and multi-sectoral coordination across the health system to accelerate progress towards UHC.

This was achieved through promoting policy coherence and integrated planning among various national stakeholders through the strengthening of national multi-sectoral platforms and policy guidance for effective introduction and cross-sectoral governance of new health technologies. Through these platforms, ADP has contributed to the development of the National Medicines Policy (NMP) (3rd edition) in 2017 and the establishment of a consortium for the SAVING project (‘Building capacity to address implementation challenges for sustainable access and delivery of new vaccines in Ghana’) in 2019.

The NMP, adopted by the Cabinet in May 2018, aims to fill an existing policy gap by setting out updated cross-sectoral policy guidance for the governance and regulation of the pharmaceutical sector; while the SAVING platform facilitates cross-disciplinary and integrated planning for the national roll-out of the new RTS,S malaria vaccine, which has the potential of averting at least 50,000 malaria cases in its initial roll-out phase. These initiatives provide an important guiding framework for enhanced access and delivery of a broad range of medicines, vaccines and diagnostic tools.

Promoting the safety, efficacy and quality of health technologies

ADP contributed towards a stable, well-functioning and integrated regulatory system in Ghana by providing ongoing support for the institutional capacity strengthening of the Ghana Food and Drug Authority. In May 2020, Ghana became only the second country in the WHO African Region to attain ‘Maturity Level 3’, which is classified as a stable and well-functioning regulatory system.

As part of regional efforts to promote regulatory system harmonization and capacity, and accelerate market access of new medicines, ADP is supporting a review of the legal and policy framework for the domestication of the AU Model Law on Medical Products Regulation.

ADP has also contributed to enhanced safety of medicines and vaccines in Ghana by strengthening the surveillance system to monitor and report on adverse events. ADP supported the piloting and roll-out of ‘Safety Watch’, a national electronic management system for individual case safety reports, and the MedSafety app that facilitates fast and direct community reporting of adverse drug reactions (ADRs) and adverse events following immunization (AEFIs). As Ghana scaled up its COVID-19 vaccination drive, health workers from 30 health facilities across 6 regions received capacity strengthening on the MedSafety app, which is being used to monitor, manage and report adverse events following immunization.

Improving the implementation of disease control programmes

To strengthen the implementation of disease control programmes, ADP supported the development of the National Health Research Agenda 2015–2019, which provided a systematic framework and action plan to prioritize efforts and resources for research to address bottlenecks within the TB, malaria and neglected tropical diseases (NTDs) control programmes. Health researchers and programme implementers from health research centres across all 10 regions in Ghana were also trained on implementation research and have been successful in raising external funding to investigate priority health challenges relating to TB and lymphatic filariasis.

Alongside UHC, the elimination of NTDs is a key national priority. ADP helped to improve the effective implementation of mass drug administration (MDA) campaigns for NTDs by establishing standard operating procedures, guidelines and a national curriculum on managing the logistics of preventive medicines for MDAs, as well as building the capacity of frontline health workers. These efforts have been critical to increasing access to needed medicines and control of NTDs for 25 million people in Ghana at risk of at least two of the five major NTDs (lymphatic filariasis, onchocerciasis, soil-transmitted helminthiases, schistosomiasis and trachoma).

As one of the six countries selected in the first phase of a renewed WHO global campaign for yaws eradication, ADP also supported implementation planning and drug safety monitoring for the community-based MDA of azithromycin, which is the preventive chemotherapy for yaws, targeting 90 percent of at-risk populations in three pilot districts. Through these efforts, ADP built the capacity of NTDs programme staff and frontline health workers on disease mapping and management, drug safety monitoring and implementation research to address important operational challenges of MDA campaigns, including the prevention of gender- and stigma-related barriers.

Promoting cost-effectiveness and affordability of health technologies

ADP has supported the institutionalization of HTA and promotion of effective pricing regulation and policies to inform decision-making within the context of the national health insurance scheme (NHIS), which will contribute towards ensuring access to cost-effective medicines and the sustainability of the NHIS. These efforts included the establishment of the national HTA committee, the development of national HTA guidelines and providing technical legal guidance on HTA legislation. ADP also strengthened technical capacities within the Ministry of Health and at major universities and research institutes, and supported the piloting of the HTA approach for reviewing the standard treatment guideline for hypertension, which found potential for significant health improvements and cost savings if treatment regimens were changed to use better value first-line medicines. Furthermore, ADP also supported the National Medicine Pricing Committee on developing national guidelines and strengthening technical capacities for medicines price regulation and creation of a medicines price observatory to monitor medicines prices across public and private sector supply chains.

Contributions to knowledge exchange

India plays an important role as an ADP resource country, whereby its significant and innovative policy, expertise and programmatic experience have been leveraged for capacity strengthening in ADP focus countries and other LMICs. A range of policy-makers and technical experts from India have been identified and drawn from the public and academic sectors to share their experience and expertise. ADP partners have also facilitated linkages between technical institutions in India with those in other ADP focus countries to replicate successful approaches and a greater depth of support in ADP interventions, especially in the areas of HTA, digital health and implementation research (IR).

Digitalizing vaccine cold-chain management

ADP has actively leveraged the significant policy and programmatic experience of India in the national roll-out of the Electronic Vaccine Intelligence Network (eVIN) – an innovative digital technology platform for strengthening the vaccine cold-chain system – to address key infrastructure and information management constraints across the vaccine cold-chain. In digitizing inventories and record-keeping at all storage sites and cold chain points, eVIN has addressed a number of key infrastructure and information management challenges, including significant improvements in vaccine availability and reductions in wastage. Building on the success in India, ADP facilitated South-South technical cooperation and technology transfer to enable the accelerated uptake and scale-up of the system in Indonesia. In 2021, eVIN was successfully adapted to support the distribution of the COVID-19 vaccines, an experience ADP has documented and shared with other LMICs, including Afghanistan, Bhutan, Bangladesh and Nepal, to inform the process to digitalize their COVID-19 vaccination programmes.

Improving evidence-based decision making on vaccinology

ADP has worked with the Ministry of Health and Social Welfare on the development of an institutional framework to enhance the use of HTA in health priority-setting for selection of new health technologies to improve evidence-based policy-making and good practice related to epidemiology and surveillance, clinical trials and health economics of vaccines. Working in partnership with HITAP, the London School of Hygiene & Tropical Medicine and the National University of Singapore, ADP leveraged expertise in clinical and policy research on vaccinology from Indian institutions - the Translational Health Science and Technology Institute and the Jawaharlal Institute of Postgraduate Medical Education and Research - to improve capacities of national immunization programmes from 10 LMICs on evidence-based policy-making and good practice related to epidemiology and surveillance, clinical trials and health economics of vaccines.

Promoting the safety, efficacy and quality of health technologies

Following the formal assessment by WHO using the Global Benchmarking Tool, ADP has supported the continuous improvement of the Central Drugs Standard Control Organization (CDSCO) of India, the national regulatory authority, through the implementation of an institutional development plan, which has guided ADP’s collaboration with CDSCO to address the identified capacity gaps. In this connection, ADP supported CDSCO in strengthening capacities of drug inspectors on good manufacturing practice and good distribution practice, which are essential aspects of quality assurance that ensures pharmaceutical products are regulated across the entire value chain.

Promoting policy coherence and multi-sectoral collaboration

ADP supported the establishment of a policy review mechanism that contributes to a coherent and enabling policy and regulatory framework for cross-sectoral decision-making on issues related to innovation, competition and cost-containment of health technologies. ADP facilitated partnerships and ongoing collaboration between the Ministry of Health, the Ministry of Law and Human Rights, the National Competition Commission (KPPU), the National Drug and Food Control Agency (BPOM) and the National Public Procurement Agency (LKPP) to promote effective integration of public health perspectives into the national policy and regulatory frameworks.

ADP’s integrated approach includes ensuring that capacities and systems across disciplines are strengthened, particularly in conducting IR to identify and address bottlenecks in disease control programmes. ADP worked with the National Institute for Health Research and Development and Gadjah Mada University to develop the National Strategy for Implementation and Operational Research for Prevention and Control of TB, Malaria and NTDs (2016–2019), which guided the prioritization of research and training on the management and control of TB, malaria and NTDs, with the aim of enhancing introduction and scale-up of new health technologies.

Regulatory system strengthening

ADP contributed to stable, well-functioning and integrated regulatory systems by conducting formal benchmarking of BPOM and the NRA using the WHO Global Benchmarking Tool and addressing the institutional capacity gaps identified. Building on these efforts, ADP supported the National Quality Control Laboratory of Drug and Food on improving medicines safety and quality, by building its capacity to conduct post-marketing surveillance, and improve understanding of policy and practice relating to medicines quality and safety among regional laboratories and pharmaceutical industry actors.

Improving the response to multidrug-resistant TB (MDR-TB)

In collaboration with BPOM and the national TB programme, ADP helped to establish an active safety monitoring system that was instrumental in the introduction of bedaquiline, as part of a more effective and shorter combination therapy for drug-resistant TB (DR-TB) in adults, and its inclusion in the national standard treatment guidelines for TB. ADP also supported the training of health care providers and pharmacists and cohort event monitoring of bedaquiline treatment at three pilot sites.

Building on these efforts to scale-up treatment of DR-TB, ADP supported the development of a National Action Plan on the implementation of Active Drug Safety Monitoring and Management for TB, in line with the latest WHO treatment guidelines, and further strengthened PV data management in TB treatment programmes. In addition, arising from the National Strategy for Implementation and Operational Research for Prevention and Control of TB, Malaria and NTDs (2016–2019), an implementation research project to improve the use of the GeneXpert technology to increase detection and diagnosis of MDR-TB was conducted.

Enhanced vaccine distribution for routine immunization and COVID-19 vaccination

ADP contributed to enhanced efficiency and integrity of the national immunization programme by facilitating the knowledge transfer for the development and rollout of SMILE (Sistem Monitoring Imunisasi Logistik secara Elektronik), a digital cloud-based logistic management system that optimizes efficiency and integrity of the vaccine supply chain and cold-chain. The introduction of SMILE has led to significant reductions in vaccine stock-outs and wastage, and increased availability and cost-savings. As a result of the successful pilot, the Ministry of Health, with the support of UNDP Indonesia, is now in the process of scaling up SMILE to all 10,000 health facilities across the country, reaching over 34 million infants, children and pregnant women. In 2021, the SMILE system was rapidly adapted and scaled up to support the national deployment of COVID-19 vaccines, and is now widely promoted by the Government of Indonesia as a core digital tool in its COVID-19 vaccination strategy.

Promoting cost-effective and affordable access to medical products and equipment

Recognizing the need to ensure financial sustainability of the national health insurance scheme and achieving UHC, ADP has supported efforts to strengthen strategic and policy approaches for cost-effective selection, prioritization and procurement of health technologies in the public sector.

At the request of the Ministry of Health, ADP commissioned a price comparison study for a list of high-volume and high-cost government-procured essential medicines, with a view to inform future measures and policy approaches to ensure affordable access to medicine. ADP also built the technical and decision-making capacities of experts from the Ministry of Health and LKPP on implementing effective pharmaceutical pricing strategies and regulations.

To ensure the long-term sustainability of UHC in Indonesia, ADP also supported the institutionalization of the HTA process for systematic selection and prioritization of the most cost-effective and appropriate health technologies. ADP supported the development of a national HTA road map and strengthened technical capacity within the Ministry of Health and affiliated academic institutions to support policy-relevant HTAs. ADP supported pilot HTAs to evaluate the economic case for off-label use of prescription medicines and peritoneal dialysis as first-line treatment for end-stage renal disease.

ADP supported LKPP to effectively plan for and procure medical and laboratory equipment, based on technical and quality standards and prices. A training module was developed and incorporated into the national procurement training curriculum used to enable effective supply chain management decisions for medical and laboratory equipment in regional and provincial hospitals across Indonesia. This will ensure the availability of essential equipment for the timely and accurate diagnosis of TB, malaria and NTDs, particularly in geographically remote provinces.

Promoting policy coherence and integrated planning of health programmes

ADP is working with the Government of Malawi in meeting its goal of achieving equitable and affordable UHC, by strengthening institutional capacities for prevention and control of diseases. ADP has provided significant technical support to the Ministry of Justice and Constitutional Affairs (MOJCA) in convening a multi-sectoral Technical Working Group mandated to recommend relevant enabling policy and legal reforms that improve coherence across innovation, access and delivery of health technologies.

ADP has also supported the Ministry of Health and Population (MOHP) in building national capacity on the application of IR and the multi-disciplinary approach to addressing barriers to health service access and uptake of new health technologies. Efforts included training of biomedical and social scientists and health programme implementers involved in disease control, immunization, health service delivery, disease surveillance and laboratory testing. These trainings focused on the identification and prioritization of implementation challenges of health programmes, as well as the development of research protocols and funding proposals for studies that aim to overcome barriers to more effective access, utilization and scale-up of health interventions.

Regulatory system strengthening

Through its partnership with the African Union Development Agency, ADP is supporting the process of domestication of the AU Model Law on Medical Products Regulation. Following the recentadoption of national legislation domesticating the provisions of the AU Model Law, ADP has initiated discussions with both the MOHP and MOJCA on technical support for the policy, legal and regulatory requirements for effective implementation of the legislation.

ADP is also supporting the institutional capacity strengthening of the Malawi Pharmacy, Medicines and Poisons Board by facilitating a self-benchmarking exercise that identified specific capacity gaps within the regulatory system and prioritized key improvements in regulatory functions. Part of these efforts included the capacity strengthening of the national quality control laboratory to conduct market surveillance of medicine quality.

ADP has also promoted drug and vaccine safety by strengthening the institutional and technical capacities of the recently established National Pharmacovigilance Centre. Personnel from the National Pharmacovigilance Centre and PV focal pointswere trained on best practices for PV and systems for data flow and sharing, while a new PV system to monitor, report and manage ADRs and AEFIs was integrated across 5 tertiary hospitals and 29 district hospitals. ADP also supported a public awareness-raising campaign on the importance of reporting ADRs and AEFIs along with the roll-out of a mobile platform to simplify ADR and AEFI reporting for health professionals and consumers.. These interventions will contribute to enhanced safety monitoring and data management, in turn strengthening the national PV system that is crucial to the ongoing roll-out of new vaccines for COVID-19, malaria and other diseases.

Improving procurement of health equipment and diagnostic tools

ADP has also supported the Central Medical Stores Trust (CMST), MOHP and the Public Procurement and Disposal of Assets Authority to identify priority health procurement challenges. This support led to the development of a training module to improve medical equipment procurement planning and technical specification development for CMST personnel. In addition, ADP collaborated with the national NTD control programme to document challenges in the procurement of a diagnostic test for onchocerciasis, as a learning tool to inform future procurement planning exercises.

Regulatory systems strengthening

ADP has contributed to the strengthening of Senegal’s regulatory system by supporting the Direction de la Pharmacie et du Médicament to address several key priorities. First, ADP supported the self-benchmarking of the national regulatory system to identify key capacity gaps and necessary interventions. This exercise is in preparation for a formal benchmarking exercise conducted using the WHO Global Benchmarking Tool. ADP has also strengthened the capacity of regulatory inspectors, hospital pharmacists and suppliers on conducting regulatory inspection using principles of good distribution practice and quality risk management. These new capacities will improve risk-based regulatory inspection and implementation of the minimum standards required to ensure the quality and integrity of the pharmaceutical supply chain. ADP also provided legal and policy support to domesticate the AU Model Law on Medical Products Regulation, which provides a strategic framework to guide systematic and speedier approval of new health technologies.

ADP has also contributed to improved safety monitoring of medicines and vaccines, and strengthening of the national PV system. To address the weak technical capacity among health staff and the poor reporting of adverse events, ADP supported the National Pharmacovigilance Centre in training key personnel on best practices, with the aim of improving reporting and management of adverse events across the major disease control programmes. In the midst of the COVID-19 pandemic in 2020, health workers across 22 COVID-19 treatment centres in 5 regions were trained to conduct active surveillance of over 5,600 patients to analyze the frequency of ADRs among COVID-19 patients.

Strengthening the implementation of disease control programmes

ADP collaborated with the Ministry of Health and Social Action to establish a multi-disciplinary coordinating platform to identify and address barriers that limit or prevent the implementation of national disease control programmes and identified health research priorities for the Health Research Strategic Plan for Senegal (2019–2024). Through this platform, which involved government policy-makers and technical experts from across national and sub-national agencies, ADP was able to support the capacity building of programme managers and researchers on principles and best practices in conducting IR; and to conduct IR studies on the impact of COVID-19 on national malaria, TB and NTD control programmes, to inform the development of risk mitigation plans and policy measures.

Promoting the sustainability of UHC

To address poverty and reduce the health system’s dependency on out-of-pocket spending, the Government of Senegal has made a commitment to ensuring access to affordable health services for all citizens and achieving UHC. As such, ADP is currently working with the Agence de la Couverture Maladie Universelle on strengthening the technical capacity and systematic approach to evidence-informed priority-setting and the cost-effective implementation of the community-based health insurance scheme. Upcoming activities will introduce stakeholders to best practice tools and models for conducting health economic evaluation and obtaining a better understanding of the evolving role of HTA in the context of policy- and decision-making for the sustainability of UHC in Senegal.

Integrated planning and policy coherence for the roll-out of new health technologies

In collaboration with a cross-section of key national agencies, including the Ministry of Health, Ministry of Industry and Trade, the Tanzania Commission for Science and Technology, the Tanzania Medicines and Medical Devices Authority (TMDA) and the National Institute for Medical Research, ADP facilitated the establishment of a national multi-stakeholder platform to identify the most pressing access and delivery priorities in the country, and ensure policy coherence and coordination among public health, industrial and research and development objectives. Key capacity-building and technical support were provided to government stakeholders on the strengthening of an enabling policy and legal framework that is conducive to meeting national health and development objectives.

Another example of ADP support on integrated planning relates to the creation of the Paediatric Praziquantel formulation for Schistosomiasis (STEPPS) initiative. This platform aims to facilitate integrated work planning to fast track the roll-out of paediatric praziquantel, in anticipation of marketing approval, to address the treatment gap for 15 million children at risk of schistosomiasis. The STEPPS initiative exemplifies the multi-disciplinary and systemic approach to identifying implementation challenges and prioritizing research questions, which can provide a useful model for improving access and delivery of new medical interventions.

Regulatory system strengthening

ADP has provided ongoing institutional and technical support to TMDA in strengthening the United Republic of Tanzania’s regulatory system. This includes understanding and implementing WHO prequalification requirements, improving the capacity of the Quality Control Laboratory and training of TMDA drug inspectors on good distribution practices for quality assurance across the entire supply chain. These efforts are necessary to ensure that TMDA maintains the Maturity Level 3 classification achieved in December 2018 – making Tanzania the first country in Africa to achieve a stable and well-functioning regulatory system for medical products. In addition, ADP supported the National Pharmacovigilance Centre in rolling out a new drug safety monitoring system, and training of health care providers and master trainers in public and private health facilities across 20 districts, resulting in a two-fold improvement in the national reporting rate of ADRs.

Promoting cost-savings and affordability

In line with national priorities set out in the Tanzania Development Vision 2025 and the Health Sector Strategic Plan V (2021–2026), ADP promoted the adoption of policies and processes that enhance cost-effectiveness and affordability of health technologies, and contributed to the sustainability of the National Health Insurance Fund (NHIF). An analysis of public sector medicine prices identifed key drivers of medicine consumption and cost, which informed prioritization of the reimbursement list and improved the cost-effectiveness, financial sustainability and service coverage of the NHIF benefits package.

In partnership with the Pharmaceutical Services Unit in the Ministry of Health, Community Development, Gender, Elderly and Children, ADP also built key capacities of a core group of national experts and provided technical support to incorporate a systematic process for economic evaluation and priority-setting of the National Essential Medicines List and the Standard Treatment Guidelines. This was achieved through the institutionalization of HTA mechanisms, which included the establishment of the national HTA committee, the development of national HTA guidelines and processes, and the prioritization of research efforts.

Improving the implementation of disease control programmes

A major health priority remains in addressing the high prevalence of NTDs in the United Republic of Tanzania, where almost the entire population is at risk of contracting at least one NTD. ADP has contributed to improved implementation of disease control programmes by strengthening capacities for research and supply chain management. In collaboration with the National Institute for Medical Research, ADP supported the development of the National Agenda for Health Systems Research for TB, Malaria and NTDs to guide and prioritize key areas for IR efforts and resources; and training of senior-level researchers, implementers and policy-makers on leading and conducting IR to systematically identify and address barriers to the effective use of health technologies. These efforts have resulted in the successful mobilization of funding for priority research activities, including those aimed at strengthening MDA campaigns against NTDs and improving the early diagnosis and treatment of MDR-TB.

In light of the prevalence of NTDs in Tanzania, ADP has focused its efforts on strengthening the logistics and supply chain management for NTD medicines in MDA campaigns. ADP supported the development of guidelines and training curricula and the roll-out of the training programme to health workers, community drug distributors and pharmacists in over 100 districts with the highest prevalence of NTDs. The guidelines and training tools have now been adopted by the Government of the United Republic of Tanzania as the official documents for use in MDA training programmes, ensuring that all 67,000 MDA health workers are effectively capacitated to deliver preventive chemotherapy to over 50 million people at risk of NTDs.

Contributions to knowledge exchange

The UHC policy of Thailand, now established for 20 years, has enabled the provision of essential preventive, curative and palliative health services to the whole population, and at all life stages. Building on such an extensive repository of experience and expertise, Thailand has been engaged primarily as an ADP resource country with the objective of facilitating a process of South-South knowledge transfer and learning towards multi-disciplinary policy- and decision-making to address challenges to UHC. In particular, Thailand has shared experience on the challenge of balancing increasing demands and rising costs, and the need to lower excessive spending without lowering net health service delivery or impact. ADP has collaborated with HITAP, which is a semiautonomous technical agency within the Ministry of Public Health, to strengthen technical capacities across ADP focus countries on conducting multi-disciplinary research examining the cost, clinical effectiveness and other implications (e.g. sociocultural and ethical issues) of health services and technologies. The institutional expertise and experience of HITAP on HTA have been leveraged to provide technical assistance, capacity building and institutionalization support to LMICs, including Bhutan, Indonesia, Ghana, Kenya, Lao People’s Democratic Republic, Malawi and Senegal, to inform the selection of priority health technologies for national health insurance packages and coverage under UHC programmes.

Apart from HITAP, other key institutions from Thailand have also contributed to greater understanding and learning among other LMICs on policy, programmatic and technical solutions to address major challenges across the access and delivery value chain. The Thai Food and Drug Administration, the National Health Security Office, the International Health Policy Programme and the national TB programme have participated in various regional ADP platforms to provide South-South exchange and learning on a broad range of issues relating to regulatory systems, strategic pricing and procurement of medical products, local pharmaceutical manufacturing, competition law, communicable disease prevention and control, health policy research and national health insurance schemes.

Regulatory system strengthening

In addition to leveraging expert resources from Thailand, ADP also contributed to strengthening the capacities of the Thailand regulatory system by supporting the global benchmarking assessment of the NRA, and strengthening capacities on clinical trials inspection to ensure data quality and safety of human subjects. Capacities for risk-based regulatory inspection for distribution and manufacturing, as well as quality control laboratory testing, were also strengthened to ensure enforcement of pharmaceutical quality and integrity standards throughout the supply chain. These efforts have resulted in the Thailand Food and Drug Administration reaching Maturity Level 3 for vaccines in August 2021, with ongoing efforts to expand NRA maturity to medicines and other medical products.