I was engaging my followers on the need for constructive methods of essential medicine financing when Pharmacist Bukola Fabiyi mentioned “Drug Revolving Funds” as a potent and strategic means of ensuring people do not die due to live saving medications like insulin.
So i pleaded with her to submit an article about this which she did and i hope our readers can begin to task the government at local, state and federal level into making sure the right things are done towards ensuring essential medicines are made available, affordable and accessible to everyone irrespective of the social status.
Drug Revolving Fund (DRF)
The Bamako Initiative (BI) was introduced by WHO/UNICEF in the late 1980’s to improve access to essential drugs for the most vulnerable in the society and thus improve the health outcomes (Chukwuani et al., 2006).
Essential medicines, as defined by the World Health Organization (WHO), are the medicines that “satisfy the priority health care needs of the population”. These are the medications to which people should have access at all times in sufficient amounts.
Essential medicines selected for diabetes are “Insulins and analogues” and “Oral blood glucose lowering medicines”
The DRF is a method of financing medicine in which, after an initial capital investment, drug supplies are replenished with monies collected from the sales of drugs according to the world health organization. It is an effective strategy for ensuring regular drug supply in the healthcare delivery system.
This scheme according to the research conducted by ogbonna however has not been successful due to the following reasons:
- Poor management
- Mis-application of the Fund
- Purchasing of drugs at exorbitant prices
- Lumping of the proceeds of the fund into a general account
- Non-reimbursement of the cost of drugs for exempted patients.
According to Gazelle News, May 14, 2013, it stated that 17 states went to understudy and adopt Ekiti’s unified DRF.
A case study was also carried out and evaluated on the efficiency in the drug supply system in Kano state in 2013. Kano state was able to increase their procurement significantly from N133 million in 2008 to N1 billion in 2013 without additional financial support. This was managed and supported by key institutions.
To ensure the success of DRF, quality medicines must be identified, the medicine must be affordable and the monitoring and evaluation of the DRF facility must be achieved in accordance to the set performance targets (Ogbonna and Nwako, 2016).
The Central medical stores in Lagos was renovated in 2013 through funding from Non-Governmental Organisation and Federal Ministry of Health (NGO/FMOH). The Lagos state ministry of health has gone into collaboration with PATHS (Partnership for Transforming Health Systems) and private suppliers of medicines to enhance the operation of sustainable DRF system.
Ogbonna, B. O., and Nwako, C. N. (2016) Essential Drug Revolving Fund Scheme in Nigeria, from the Edge of a Precipice towards Sustainability. Journal of Advances in medical and Pharmaceutical Sciences. Vol 8(2), Pp1-8.
WHO (2009) How to establish a successful revolving drug fund: the experience of Khartoum state in the Sudan. Available [online] from here