PROgramme background<strong>WHO</strong> BENEFITS FROM PREQUALIFICATION?People at risk from and/or infected with HIV/AIDS,TB and/or malaria: For HIV/AIDS patients, in particular,scaled-up access to medicines of assured quality isleading to a vastly improved quality of life. It is also helpingto reduce wasted expenditure on substandard medicines,be this at household level for medicines purchasedby individuals and their families, at national level formedicines purchased by central medical stores, or at thelevel of global treatment initiatives. In other words, moreWorkshop 1: MalaysiaFebruary (5 days)Subject: Dossier requirements for TB products(pharmaceutical quality, bioequivalence and GMP).Workshop 2: ChinaFebruary/March (5 days)Subject: Dossier requirements for HIV products(pharmaceutical quality, bioequivalence and GMP).Workshop 3: South AfricaApril and June/July (2 x 5 days)Subject: GMP for inspectors of South Africa’sMedicines Regulatory Authority.programme activities in 2005patients are being treated optimally.National medicines regulatory authorities(NMRAs): In resource-limited settings, in particular,Workshop 4: ChinaMay (9 days)Subject: GMP for inspectors of the State Food and DrugAdministration of the Jiangsu and Zhejiang Provinces.the Prequalification Programme is helping medicinesregulatory staff to increase their technical capacity tomonitor and ensure the quality of medicines, particularlythose for treating HIV/AIDS, TB and malaria. This includesdeveloping greater understanding of: dossier assessmentfor new generic medicines; good manufacturing practice(GMP) adherence and GMP inspection; and how toovercome problems resulting from poor manufacturingWorkshop 5: UkraineOctober (5 days)Subject: Dossier requirements for HIV and TBproducts (pharmaceutical quality, bioequivalenceand GMP).Workshop 6: TanzaniaOctober (5 days)Subject: GMP for inspectors of Tanzania’s Food andDrug Authority.practices. For NMRA Programme participants fromdeveloped countries, the principal benefit is a greaterTraining materials initiativeunderstanding of regulatory problems in resource-poorsettings and problems encountered by pharmaceuticalmanufacturers outside their jurisdictions.The Technical Office for Studies on InternationalCooperation (Office Technique d’Etudes deCoopération Internationales 5 — OTECI) agreed totranslate training material on GMP into French (forcompletion in 2006). The translated material willbe a major contribution to training workshops to beheld in francophone Africa.ADVOCACY AND AWARENESSPrequalification team members took part in morethan 10 meetings in 2005. By presenting andexplaining the Programme’s activities they helpedto maintain awareness and understanding of theneed for and impact of prequalified medicines. Themeetings included:photo © <strong>WHO</strong>/Sophie Logez• The annual meeting of <strong>WHO</strong> MedicinesNational Professional Officers (NPOs), inNairobi, in February, which was attended byAfrica-based NPOs, as well as some of theirMinistry of Health counterparts.<strong>WHO</strong> PREQUALIFICATION PROGRAMME
PROgramme backgroundNational pharmaceutical quality control laboratories(NPQCLs): For functional developing country NPQCLs,benefits include increased capacity to assess the quality ofmedicines samples, not simply for medicines for treatingHIV/AIDS, TB and malaria, but medicines in general.Pharmaceutical manufacturers in developingcountries: The capacity of this very diverse group toproduce medicines of assured quality, efficacy and safetyis being enhanced, in turn reducing reliance on imports,and increasing opportunities for export. Manufacturershave already been assisted in improving the qualityof their dossier submission. An increased number ofgeneric medicines manufacturers now routinely submitdossiers that include sufficient detail regarding proofof safety, efficacy and quality. In short, the Programmeoffers manufacturers a tremendous opportunity to obtain• The annual Technical Briefing Seminar onEssential Medicines Policies, in September,in Geneva, for a selected group of 35 corenationals representing ministries of health,regulatory agencies, professional pharmaceuticalassociations and nongovernmental organizations(NGOs), as well as <strong>WHO</strong> field staff.• The African Medicines Regulatory AuthoritiesConference, in Addis Ababa, Ethiopia, inOctober/November.• The annual meeting organized by AFSSAPS, inParis, in November, on public health problems(especially those related to HIV/AIDS) faced bysub-Saharan French-speaking African countries.• Roundtable (Mieux s’engager dans la luttecontre le sida, le paludisme et la tuberculose)organized by ReMed (Réseau Médicaments etDéveloppement), a French NGO, in Paris, inNovember.programme activities in 2005technical guidance free of charge, that is of the highestcalibre and that might otherwise be unavailable to them.National disease control programmes and globalhealth initiatives: Prequalification not only reducesthe risk of expenditure on poor-quality, ineffective orcounterfeit medicines, but is also extending the rangeof suppliers of good-quality medicines. Given extensionof treatment to unprecedented levels, this is critical.• The Center for Drug Evaluation and ResearchForum for International Drug RegulatoryAuthorities held at US FDA offices in Rockville,USA, in September. Discussions took placeon collaboration between the PrequalificationProgramme and the US FDA, and on the FDA’stentative approval process for generic ARVs.Additionally, Programme staff briefed national andinternational journalists on medicines quality issues,helping to maintain public awareness of the neednot only to increase access to essential medicines butalso to improve medicines quality globally.TRANSPARENCY ABOUT MEDICINES QUALITYThe Programme includes a focus on transparency,especially regarding quality issues relating togeneric medicines. Information collected and resultsobtained during assessments and inspections are(subject to confidentiality requirements) madepublicly available through <strong>WHO</strong> prequalificationweb-pages and published reports.photo © International Herald Tribune<strong>WHO</strong> Public Assessment and Inspection Reportsare a major means of communication. (In 2004,the World Health Assembly requested that <strong>WHO</strong>’sprequalification activities be made more transparent,including making assessment reports and inspectionreports publicly available.) The prequalification teamhas created a standardized format for the <strong>WHO</strong>Public Assessment Report (<strong>WHO</strong>PAR). <strong>WHO</strong>PARsare posted on the prequalification website. The<strong>WHO</strong> PREQUALIFICATION PROGRAMME