Better access to medicines is a impressive challenge in the developing world, where 1,500 people die from infectious diseases every hour. Medicines to treat some of these infections are readily available but cannot be accessed, especially when regulatory requirements become too numerous among the neighbouring countries in the same sub-region, and drug manufacturers can not navigate between them. This affects the availability and price of essential medicines for the poor who need them the most.

On October 11th, 2012 the World Bank’s China Office hosted a discussion on global medicines regulatory harmonization. Participants included government officials from the State Food and Drugs Administration (SFDA), international development partners, academics, donors, embassy representatives and industry associations representing both the local and multi-national pharmaceutical companies.

The main objectives of the session were to share information on the Bank’s Global Medicines Regulatory Harmonization (GMRH) Multi-Donor Trust Fund (MDTF) and African Medicines Regulatory Harmonization project; and to understand how the Bank could play a role in regional efforts.

Participants also discussed a potential role for China in global and regional harmonization efforts, in particular contributions to the African regional projects. It was agreed that there is a role for the Chinese SFDA, the development community and the Chinese-based pharmaceutical industry in harmonization efforts in Africa. Participants agreed to further discussions within their institutions and with other partners on how best to harness the relevant contributions.

The GMRH MDTF was established in 2011 with an initial contribution of USD 12.5 million from the Bill and Melinda Gates Foundation. The overall project goal for GMRH is to promote the harmonization of medicines regulation as a means to increase patients’ access to safe, effective, and good-quality essential medicines.

The first project to be funded from the GMRH MDTF is the African Medicines Regulatory Harmonization project which focuses on the harmonization of medicines registration in the East African Community (EAC) including Burundi, Kenya, Rwanda, Tanzania, Uganda and Zanzibar. Partners in the project include WHO, World Health Organization, the New Partnership for African Development, the EAC secretariat and national regulators.

“The recent escalation of clashes had resulted in substantial damages to the pharmaceutical plants located in rural Aleppo, Homs and Rural Damascus, where 90 per cent of the country’s plants were located,” a WHO spokesperson, Tarik Jasarevic, told reporters in Geneva today. “Many of these plants had now closed down, thus resulting in a critical shortage of medicines.”

Prior to the violence which has wracked the Middle Eastern country, Syria produced 90 per cent of its medicines and drugs locally.

However, this production has slowed down due to insecurity, the decreased availability of raw materials, sanctions and increased fuel costs stemming from the violence that has killed an estimated 17,000 people, mostly civilians, since the uprising against President Bashar al-Assad began some 17 months ago.

Over recent days, there have been reports of an escalation in violence in many towns and villages, as well as the country’s two biggest cities, Damascus and Aleppo, with the latter reportedly the centre of intense combat between Government and opposition forces, involving both aerial bombardments and heavy weaponry.

Among the most urgently needed medicines are drugs to treat tuberculosis, hepatitis, hypertension, diabetes and cancer, as well as haemodialysis for kidney diseases, according to WHO. Chemical reagents for blood screening tests are also urgently needed to ensure the safety and quality of blood used in surgical and trauma cases.

“The health sector had been heavily affected in conflict areas as hospitals and health centres had been closed, damaged or controlled by parties to the conflict,” Jasarevic said. “Public health facilities were often inaccessible due to ongoing violence and lack of public transportation.”

The spokesperson added that the main challenge faced by WHO staff remained unhindered access to those in need. The health agency has been working with Syria’s Ministry of Health, the Syrian Arab Red Crescent and partners since the beginning of the conflict to address the health needs of crisis-affected populations.

“This [includes] the provision of ambulances, the refurbishing and equipping of mobile health clinics, and providing medicines and medical supplies for 700,000 people,” Jasarevic said, noting that the Ministry of Health had reported having lost 200 ambulances over the last few weeks.

To ensure access to essential health services – including life-saving medical and surgical services in directly and indirectly affected areas – WHO and its health sector partners are supporting trauma management at primary health care centres and hospitals.

This includes providing support to mobile medical clinics and outreach services, as well as supporting the procurement and provision of hygiene kits, medicines, medical equipment and supplies, among other things.

Addressing reporters at the same media encounter in Geneva, a spokesperson for the UN World Food Programme (WFP), Elisabeth Byrs, said that the food relief agency has sent assistance for distribution to 28,000 people in Aleppo over the next few days to address food shortages there.

Since the intensification of clashes in Aleppo in July, WFP has reached close to 46,000 people in the city with urgent food assistance. Overall, during the month of July, WFP’s food assistance reached 541,575 people in most of Syria’s governorates – the agency had aimed to reach 850,000 people, but was prevented from doing so by the violence.

“Following the recent escalation in Damascus on 18 July, it has become extremely difficult to secure trucks for deliveries and labour for packaging,” Byrs said. “Nevertheless, since that date, WFP has managed to dispatch food to close to 228,000 beneficiaries to Aleppo, Damascus, Rural Damascus, Deir Ezzor, Idlib, Quneitra and Tartous, amid increased challenges.”

In line with the target established by the Syrian Humanitarian Assistance Response Plan and following a request from the Syrian Arab Red Crescent, WFP aims to reach 850,000 people inside Syria in August.

According to the UN Office for the Coordination of Humanitarian Affairs (OCHA), the Syrian Humanitarian Assistance Response Plan seeks $180 million to cover humanitarian relief activities in Syria. So far, it has received $69 million, or just over 38 per cent of the amount sought.