EDCTP Alumni Network

Fostering excellence and collaboration in the next generation of researchers

Call Career Development Fellowship (CDF)
Programme EDCTP2
Start Date 2021-02-01
End Date 2023-01-31
Project Code TMA2019CDF-2768
Status Active

Title

Countering the prevalence of substandard and falsified medicines in Malawi (COPSMEDS)

Objectives

Overall Objective; To investigate the prevalence of SF medicines and its linkage with the pharmaceutical price, logistics and supply, and country of origin Specific Objectives • To quantify the prevalence of SF medicines in the public, CHAM and private sectors in Malawi • To assess temperature variation in various storage sites for medicines and medical supplies • To assess the impact of pharmaceutical storage (temperature, humidity) in the deterioration of pharmaceutical quality in various storage sites for medicines in Malawi • To assess the impact of distribution (pharmaceutical supply chain and logistics) on quality of medicines • To assess the influence of economic incentives (including pricing) has on the proliferation of SF medicines

Host Organisation

Institution Country
University of Malawi Malawi
Kamuzu University of Health Sciences Malawi

Study Design

For this conceptual framework, analysis of quality of selected medicines will be done to explain the model. This approach for investigation is explanatory and comprises cross-sectional and longitudinal sample collection. These will be followed by laboratory analysis and techniques leading to quantitative data for the study. The quantitative data for this study is both descriptive and analytical. Descriptive because it is describing the pattern of prevalence of poor quality medicines in Malawi, while analytical because it tries to infer the possible contributing factors of poor quality medicines in Malawi by looking at country of origin, storage and logistic factors, and price as predictor of substandard and falsified medicines. Eighteen various medicines have been selected which includes antimalarial, antibiotic, antihypertensive and antidiabetic medicines. The selection of the medicines has been done using: Malawi Standard Treatment Guideline 2015 and Malawi Essential Medicines List 2015; WHO Model Lists of Essential Medicines 2019; WHO Model Lists of Essential Medicines for Children 2019

Students Supervised

Type Name Title University Start Date End Date
Masters in Antimicrobial stewardship Enock Forster Assessment of Knowledge, Attitude and Practices of individuals who drink alcohol compared to non-alcohol consuming individuals on Human Immunodeficiency Virus Post Exposure Prophylaxis Medicines in Lilongwe city of Malawi Kamuzu University of Health Sciences 2020 2022
PhD in Pharmacy Francis K. Chiumia Assessing the quality and antibiotics and associated clinical outcomes in southern Malawi Kamuzu University of Health Sciences 2020 2023

Current Organisation

College of Medicine

Current Job Title

Senior Lecturer

Students Supervised

Type Name Title University Start Date End Date
Davie Kondowe University of Malawi 2020

Memberships

Role Committee/board Start Date End Date
Vice Chairperson Board 2018 2020

Education

Institution Degree Year
College of Medicine-University of Malawi, Malawi PhD 2019-01-26

Areas Of Specialisation

Pharmacy

Publications

Authors:
Etando A, Amu AA, Haque M, Schellack N, Kurdi A, Alrasheedy AA, Timoney A, Mwita JC, Rwegerera GM, Patrick O, Niba LL, Boahen-Boaten BB, Tabi FB, Amu OY, Acolatse J, Incoom R, Sefah IA, Guantai AN, Opanga S, Chikowe I, Khuluza F, Kibuule D, Kalemeera F, Hango E, Lates J, Fadare J, Ogunleye OO, Saleem Z, Oosthuizen F, Cordier W, Matlala M, Meyer JC, Schellack G, Massele A, Malande OO, Kalungia AC, Sichone J, Banda SS, Zaranyika T, Campbell S, Godman B. , Etando A, Amu AA, Haque M, Schellack N, Kurdi A, Alrasheedy AA, Timoney A, Mwita JC, Rwegerera GM, Patrick O, Niba LL, Boahen-Boaten BB, Tabi FB, Amu OY, Acolatse J, Incoom R, Sefah IA, Guantai AN, Opanga S, Chikowe I, Khuluza F, Kibuule D, Kalemeera F, Hango E, Lates J, Fadare J, Ogunleye OO, Saleem Z, Oosthuizen F, Cordier W, Matlala M, Meyer JC, Schellack G, Massele A, Malande OO, Kalungia AC, Sichone J, Banda SS, Zaranyika T, Campbell S, Godman B. Challenges and Innovations Brought about by the COVID-19 Pandemic Regarding Medical and Pharmacy Education Especially in Africa and Implications for the Future. Healthcare (Basel). 2021 Dec 13;9(12):1722. doi: 10.3390/healthcare9121722. PMID: 34946448; PMCID: PMC8701006.
Date:
2021-12-13
Journal:
Healthcare
Content:

Background: Multiple measures introduced early to restrict COVID-19 have dramatically impacted the teaching of medical and pharmacy students, exacerbated by the lack of infrastructure and experience with e-learning at the start of the pandemic. In addition, the costs and reliability of the Internet across Africa pose challenges alongside undertaking clinical teaching and practical programmes. Consequently, there is a need to understand the many challenges and how these were addressed, given increasingly complex patients, to provide future direction.

Method: An exploratory study was conducted among senior-level medical and pharmacy educators across Africa, addressing four key questions, including the challenges resulting from the pandemic and how these were dealt with.

Results: Staff and student members faced multiple challenges initially, including adapting to online learning. In addition, concerns with the lack of equipment (especially among disadvantaged students), the costs of Internet bundles, and how to conduct practicals and clinical teaching. Multiple activities were undertaken to address these challenges. These included training sessions, developing innovative approaches to teaching, and seeking ways to reduce Internet costs. Robust approaches to practicals, clinical teaching, and assessments have been developed.

Conclusions: Appreciable difficulties to teaching arising from the pandemic are being addressed across Africa. Research is ongoing to improve education and assessments.

Identifiers:
34946448: not informed
Authors:
Newton PN , author
Bond KC , author
53 signatories from 20 countries , author
Date:
2020-04-01
Journal:
The Lancet. Global health
Content:
Identifiers:
Authors:
Felix Khuluza , author
Stephen Kigera , author
Richard W. O. Jähnke , author
Lutz Heide , author
Date:
2016-04-01
Journal:
Malaria Journal
Content:
Identifiers:
Authors:
Ogunleye O , author
Basu D , author
Mueller D , author
Sneddon J , author
Seaton R , author
Yinka-Ogunleye A , author
Wamboga J , author
Miljković N , author
Mwita J , author
Rwegerera G , author
Massele A , author
Patrick O , author
Niba L , author
Godman B , author
Date:
2020-01-01
Journal:
Frontiers in pharmacology
Content:
Identifiers:
PMC: PMC7533592
Authors:
Felix Khuluza , author
Lutz Heide , author
Maarten Postma , editor
Date:
2017-04-01
Journal:
PLOS ONE
Content:
Identifiers:
Authors:
Nhomsai Hagen , author
Girish Sailor , editor
Thomas Bizimana , author
P. Claver Kayumba , author
Felix Khuluza , author
Lutz Heide , author
Date:
2020-09-02
Journal:
PLOS ONE
Content:
Identifiers:
Authors:
Date:
2019-05-15
Journal:
BMC health services research
Content:
BACKGROUND:Despite the increasing frequency of ARV medicines stock-outs in Sub-Saharan Africa, there is little research inquiring into the mitigation strategies devised by frontline health facilities. Many previous studies have focused on 'upstream' or national-level drivers of ARVs stock-outs with less empirical attention devoted 'down-stream' or at the facility-level. The objective of this study was to examine the strategies devised by health facilities in Uganda to respond to the chronic stock-outs of ARVs. METHODS:This was a qualitative research design nested within a larger mixed-methods study. We purposively selected 16 health facilities from across Uganda (to achieve diversity with regard to; level of care (primary/ tertiary), setting (rural/urban) and geographic sub-region (northern/ central/western). We conducted 76 Semi-structured interviews with ART clinic managers, clinicians and pharmacists in the selected health facilities supplemented by on-site observations and documentary reviews. Data were analyzed by coding and thematic analyses. RESULTS:Participants reported that facility-level contributors to stock-outs include untimely orders of drugs from suppliers and inaccurate quantification of ARV medicine needs due to a paucity of ART program data. Internal stock management solutions for mitigating stock-outs which emerged include the substitution of ARV medicines which were out of stock, overstocking selected medicines and the use of recently expired drugs. The external solutions for mitigating stock-outs which were identified include 'borrowing' of ARVs from peer-providers, re-distributing stock across regions and upward referrals of patients. Systemic drivers of stock-outs were identified. These include the supply of drugs with a short shelf life, oversupply and undersupply of ARV medicines and migration pressures on the available ARVs stock at case-study facilities. CONCLUSION:Health facilities devised internal stock management strategies and relied on peer-provider networks for ARV medicines during stock-out events. Our study underscores the importance of devising interventions aimed at improving Uganda's medicines supply chain systems in the quest to reduce the frequency of ARV medicines stock-outs at the front-line level of service delivery. Further research is recommended on the effect of substituting ARV medicines on patient outcomes.
Identifiers:
Authors:
Nhomsai Hagen , author
Felix Khuluza , author
Lutz Heide , author
Date:
2020-03-01
Journal:
BMC Pregnancy and Childbirth
Content:
Identifiers:
Authors:
Nhomsai Hagen , author
Thomas Bizimana , author
P. Claver Kayumba , author
Felix Khuluza , author
Lutz Heide , author
Date:
2020-08-03
Journal:
The American Journal of Tropical Medicine and Hygiene
Content:
Identifiers:
DOI: 10.4269/ajtmh.20-0255
Part of ISSN: 0002-9637
Authors:
Newton PN , author
Bond KC , author
Oxford Statement signatories , author
Date:
2019-12-01
Journal:
The Lancet. Global Health
Content:
Identifiers:
Authors:
Godman, Brian and Leong, Trudy and Abubakar, Abdullahi Rabiu and Kurdi, Amanj and Kalemeera, Francis and Rwegerera, Godfrey Mutashambara and Patrick, Okwen and Lum Niba, Loveline and Ibrahim, Kamilou and Amu, Adefolarin A and Matowa, Patrick and Acolatse, Joseph and Incoom, Robert and Sefah, Israel and Opanga, Sylvia and Njeri, Lisper Wangeci and Kimonge, David and Oluka, Margaret and Chikowe, Ibrahim and Khuluza, Felix and Phiri, Henry and Kibuule, Dan and Hango, Ester and Sani, Ibrahim Haruna and Malande, Oliver Ombeva and Piloya-Were, Thereza and Alutuli, Luke and Kalungia, Aubrey Chichonyi and Chaibva, Blessmore Vimbai and Zaranyika, Trust and Haque, Mainul and Allocati, Eleonora and Campbell, Stephen and Adwubi, Eunice Twumwaa and Ogunleye, Olayinka
Date:
2021-09-15
Journal:
Internal Medicine: Open Access
Content:

Background: Prevalence rates of diabetes mellitus are growing across Africa with an appreciable number likely to be on insulin to manage their condition. This has significant implications on future morbidity and mortality exacerbated by high complication rates. Complication rates in patients requiring insulins are enhanced by hypoglycaemia. Long acting insulin analogues were developed to reduce hypoglycaemia and improve patient compliance. However, they are typically appreciably more expensive than human and other insulins in Africa, and continuing controversies surrounding their benefits limits their listing on national Essential Medicine Lists (EMLs). Biosimilars can reduce the prices long-acting insulin analogues. This needs assessing.

Methods: Mixed methods approach including documentation of insulin utilisation patterns and prices among a range of African countries. In addition, input from senior level government, academic, and healthcare professionals from across Africa on the current situation with long-acting insulin analogues as well as potential changes needed to enhance future funding of long-acting analogue biosimilars.

Results: There is variable listing of long-acting insulin analogues on national EMLs across Africa due to their high prices and issues of affordability. Even when listed, utilisation of long-acting insulin analogues is limited by similar issues including affordability. Appreciably lowering the prices of long-acting insulin analogues via biosimilars should enhance future listing on EMLs and use accompanied by educational and other initiatives. However, this will require increased competition to lower prices.

Conclusion: There are concerns with value and funding of long-acting insulin analogues across Africa including biosimilars. A number of activities have been identified to improve future funding and listing on EMLs.

Identifiers:
Not Informed: not informed
Authors:
Khuluza F , author
Date:
2014-06-01
Journal:
Malawi Medical Journal
Content:
Identifiers:
PMID: 25157315
PMC: PMC4141240
Authors:
Felix Khuluza , author
Christine Haefele-Abah , author
Khin Thet Wai , editor
Date:
2019-02-01
Journal:
PLOS ONE
Content:
Identifiers:
Authors:
Date:
2021-06-07
Journal:
LIFE
Content:

Antimicrobial resistance (AMR) is a high priority across countries as it increases morbidity, mortality and costs. Concerns with AMR have resulted in multiple initiatives internationally, nationally and regionally to enhance appropriate antibiotic utilization across sectors to reduce AMR, with the overuse of antibiotics exacerbated by the COVID-19 pandemic. Effectively tackling AMR is crucial for all countries. Principally a narrative review of ongoing activities across sectors was undertaken to improve antimicrobial use and address issues with vaccines including COVID-19. Point prevalence surveys have been successful in hospitals to identify areas for quality improvement programs, principally centering on antimicrobial stewardship programs. These include reducing prolonged antibiotic use to prevent surgical site infections. Multiple activities centering on education have been successful in reducing inappropriate prescribing and dispensing of antimicrobials in ambulatory care for essentially viral infections such as acute respiratory infections. It is imperative to develop new quality indicators for ambulatory care given current concerns, and instigate programs with clear public health messaging to reduce misinformation, essential for pandemics. Regular access to effective treatments is needed to reduce resistance to treatments for HIV, malaria and tuberculosis. Key stakeholder groups can instigate multiple initiatives to reduce AMR. These need to be followed up.

Identifiers:
34200116: not informed
Authors:
Olayinka O. Ogunleye, Debashis Basu, Debjani Mueller, Jacqueline Sneddon, R. Andrew Seaton, Adesola F. Yinka-Ogunleye, Joshua Wamboga, Nenad Miljković, Julius C. Mwita, Godfrey Mutashambara Rwegerera, Amos Massele, Okwen Patrick, Loveline Lum Niba, Melaine Nsaikila, Wafaa M. Rashed, Mohamed Ali Hussein, Rehab Hegazy, Adefolarin A. Amu, Baffour Boaten Boahen-Boaten, Zinhle Matsebula, Prudence Gwebu, Bongani Chirigo, Nongabisa Mkhabela, Tenelisiwe Dlamini, Siphiwe Sithole, Sandile Malaza, Sikhumbuzo Dlamini, Daniel Afriyie, George Awuku Asare, Seth Kwabena Amponsah, Israel Sefah, Margaret Oluka, Anastasia N. Guantai, Sylvia A. Opanga, Tebello Violet Sarele, Refeletse Keabetsoe Mafisa, Ibrahim Chikowe, Felix Khuluza, Dan Kibuule, Francis Kalemeera, Mwangana Mubita, Joseph Fadare, Laurien Sibomana, Gwendoline Malegwale Ramokgopa, Carmen Whyte, Tshegofatso Maimela, Johannes Hugo, Johanna C. Meyer, Natalie Schellack, Enos M. Rampamba, Adel Visser, Abubakr Alfadl, Elfatih M. Malik, Oliver Ombeva Malande, Aubrey C. Kalungia, Chiluba Mwila, Trust Zaranyika, Blessmore Vimbai Chaibva, Ioana D. Olaru, Nyasha Masuka, Janney Wale, Lenias Hwenda, Regina Kamoga, Ruaraidh Hill, Corrado Barbui, Tomasz Bochenek, Amanj Kurdi, Stephen Campbell, Antony P. Martin, Thuy Nguyen Thi Phuong, Binh Nguyen Thanh and Brian Godman
Date:
2021-01-14
Journal:
Frontiers in Pharmacology
Content:
Identifiers:
HTTPS://DOI.ORG/10.3389/FPHAR.2020.588106: not informed
Authors:
Felix Khuluza , author
Stephen Kigera , author
Lutz Heide , author
Date:
2017-02-01
Journal:
The American Journal of Tropical Medicine and Hygiene
Content:
Identifiers:
Authors:
Ogunleye OO , author
Basu D , author
Mueller D , author
Sneddon J , author
Seaton RA , author
Yinka-Ogunleye AF , author
Wamboga J , author
Miljković N , author
Mwita JC , author
Rwegerera GM , author
Massele A , author
Patrick O , author
Godman B , author
Date:
2020-09-01
Journal:
Frontiers in pharmacology
Content:
Identifiers:

Projects

Fellow:
Felix Khuluza
Collaborators:
Name Country Institution
Dr. Felix Khuluza Malawi Kamuzu University of Health Sciences (formerly University of Malawi-College of Medicine)
Objectives:
1. To quantify the prevalence of SF medicines in the public, CHAM and private sectors in Malawi. 2. To assess temperature variation in various storage sites for medicines and medical supplies 3. To assess the impact of pharmaceutical storage (temperature, humidity) in the deterioration of pharmaceutical quality in various storage sites for medicines in Malawi 4. To assess the impact of distribution (pharmaceutical supply chain and logistics) on quality of medicines 5. To assess the influence of economic incentives (including pricing) has on the proliferation of SF medicines
Sites:
Nsanje (Malawi) Zomba (Malawi) Machinga (Malawi)
Study Design:
The COPSMEDS is a two-year and a half (30 months) project that is aimed at assessing the prevalence of SF medicines and its linkage to pharmaceutical prices, logistics and supply, and the country of origin. The project is being conducted at the pharmacy department of the Kamuzu University of Health Sciences ((KUHES), formerly the College of Medicine of the University of Malawi). The research team is led by Dr Felix Khuluza who is also the Head of the department. Currently, the project has completed its first year of implementation and is expected to end by August 2023. In total, data is being collected across 29 randomly selected health care facilities which include government, private and CHAM hospitals and health centres in Zomba, Nsanje, and Machinga districts in the southern region of Malawi. Almost 50% of the health centres that are participating in the project are remote, hard-to-reach and with limited resources where the medicines are most likely to be exposed to harsh conditions during both transportation and storage. Medicine samples are collected from the facilities at 3-months intervals and tested for various quality aspects including dissolution and content of active ingredients by performing HPLC and other pharmacopeial assays at the KUHES Pharmacy department laboratory. Simultaneously, storage conditions are being recorded for the whole duration at a 15-minute interval using automated temperature loggers to establish if the storage conditions are contributing to the deterioration of medicine quality.
Subjects:
Pharmacy
Start Date:
2021-02-01
End Date:
2023-08-31
Fellow:
Felix Khuluza
Collaborators:
Name Country Institution
Dr. Felix Khuluza Malawi Kamuzu University of Health Sciences (formerly University of Malawi-College of Medicine)
Objectives:
1. To quantify the prevalence of SF medicines in the public, CHAM and private sectors in Malawi. 2. To assess temperature variation in various storage sites for medicines and medical supplies 3. To assess the impact of pharmaceutical storage (temperature, humidity) in the deterioration of pharmaceutical quality in various storage sites for medicines in Malawi 4. To assess the impact of distribution (pharmaceutical supply chain and logistics) on quality of medicines 5. To assess the influence of economic incentives (including pricing) has on the proliferation of SF medicines
Sites:
Nsanje (Malawi) Zomba (Malawi) Machinga (Malawi)
Study Design:
The COPSMEDS is a two-year and a half (30 months) project that is aimed at assessing the prevalence of SF medicines and its linkage to pharmaceutical prices, logistics and supply, and the country of origin. The project is being conducted at the pharmacy department of the Kamuzu University of Health Sciences ((KUHES), formerly the College of Medicine of the University of Malawi). The research team is led by Dr Felix Khuluza who is also the Head of the department. Currently, the project has completed its first year of implementation and is expected to end by August 2023. In total, data is being collected across 29 randomly selected health care facilities which include government, private and CHAM hospitals and health centres in Zomba, Nsanje, and Machinga districts in the southern region of Malawi. Almost 50% of the health centres that are participating in the project are remote, hard-to-reach and with limited resources where the medicines are most likely to be exposed to harsh conditions during both transportation and storage. Medicine samples are collected from the facilities at 3-months intervals and tested for various quality aspects including dissolution and content of active ingredients by performing HPLC and other pharmacopeial assays at the KUHES Pharmacy department laboratory. Simultaneously, storage conditions are being recorded for the whole duration at a 15-minute interval using automated temperature loggers to establish if the storage conditions are contributing to the deterioration of medicine quality.
Subjects:
Pharmacy
Start Date:
2021-02-01
End Date:
2023-08-31

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