Cover photo: Health workers from a local community health centre promote vaccines to residents in Jakarta, Indonesia.
Photo: Fauzan Ijazah/UNDP.

Despite marked improvements in global health, tuberculosis (TB), malaria and neglected tropical diseases (NTD) continue to affect billions of people around the world. The latest figures show that over 500 million people do not have the access they need to preventive chemotherapy for NTDs, and just one-tenth of those who require treatment for multi-drug resistant TB are able to get it. 

The Access and Delivery Partnership (ADP) is taking on these challenges by scaling up its efforts to increase the access and delivery of new treatments for TB, malaria and NTDs in low- and -middle income countries (LMICs). 

ADP has taken steps to enhance the impact, scope and coverage of its work; first by welcoming the World Health Organization (WHO) to the partnership, joining the United Nations Development Programme (UNDP), the Special Programme for Research and Training in Tropical Diseases (TDR) and PATH. Secondly, ADP has expanded the number of its focus countries from the original three of Ghana, Indonesia and Tanzania, to also cover India, Malawi, Thailand and Senegal. 

With the support of the Government of Japan, ADP is leveraging the technical expertise of its partners to help countries address barriers to access and delivery of new health technologies. The partnership supports LMICS to strengthen and harmonize policies and systems, and build the capacities of key people and institutions, to drive the necessary reforms for more sustainable and resilient health systems. 

One of the crucial aspects  of ADP’s work that is being expanded upon in 2019 is the promotion of regional and South–South cooperation, whereby ADP facilitates the exchange of country experiences, knowledge and good practices to tackle some of the most common challenges across health systems. 

During 2013–2018, ADP facilitated regional and South–South exchanges across 38 LMICs, bringing together more than 700 policy-makers, technical experts, academics and other stakeholders. 

A key outcome of this work has been the partnership between ADP, the African Union (AU) and the New Partnership for Africa’s Development (NEPAD) Agency to develop the African Union (AU) Model Law for Medical Products Regulation. This law provides a framework for regulatory harmonization and a regional platform to strengthen the capacities of national regulatory authorities, enabling faster approval and introduction of new health technologies across the 55 AU Member States. In 2019, ADP will work with the AU and the NEPAD Agency to provide policy and technical assistance to AU Member States to help align their national frameworks with the Model Law. 

In Ghana, ADP helped the Ministry of Health develop a national medicines policy, which provides strategic guidance on the governance and regulation of the pharmaceutical sector. ADP also supported the establishment of an electronic management system for reporting of adverse drug reactions. Both initiatives have enhanced the policy and regulatory systems for the safe and effective introduction of new medicines.

A key intervention by ADP in Indonesia has been to support the strengthening of the national pharmacovigilance system to enable the introduction of bedaquiline, one of only two new-generation treatments for multidrug-resistant TB. This support is an important contribution to the government’s efforts to roll-out bedaquiline and update the standard TB treatment guidelines.

In Tanzania, ADP supported the roll-out of mass drug administration programmes for NTDs, through the development of guidelines and training of frontline health workers. This initiative reduced wastage and enabled the timely delivery of preventive chemotherapy to 50 million people at risk of NTDs. 

In 2019, ADP’s in-country work will further expand to India, Malawi, Senegal and Thailand. After country level consultations with stakeholders in 2018 in these countries, ADP will begin to roll out technical support and implement a range of capacity-building interventions based on the needs and priorities identified by country stakeholders. 

The work of ADP in addressing challenges to access and delivery of health technologies for TB, malaria and NTDs is more important today than ever. 

Owing to its wealth of experience from in-country implementation and its established strategic partnerships with regional institutions in Africa and Asia, ADP is uniquely placed to facilitate regional and South–South cooperation, to support national efforts to attain universal health coverage and help countries accelerate efforts to address the access and delivery challenges for these diseases.