This paper reports the experience of the Ghana National Drugs Programme
as they reviewed the international evidence base for five priority
paediatric medicines: oral zinc sulphate for acute diarrhoea, injectable
artesunate for severe malaria, topical chlorhexidine for preventing
neonatal cord sepsis, dispersible oral amoxicillin for community
acquired pneumonia, and oral and injectable caffeine citrate for
Applying the global recommendations to Ghana was not straightforward for
any of the five medicines, regardless of the presence of high quality
evidence of important clinical benefits.
Four main factors generated debate and uncertainty in the committee: (1)
effect unproven in African settings; (2) control group in trials not
consistent with current practice; (3) little evidence on cost and cost
effectiveness; and (4) limited supply chain.
This project demonstrates why global recommendations should be presented
alongside transparent descriptions of the evidence base, allowing policy
groups to identify where, when, and how the interventions have been
evaluated, and any factors limiting applicability.
As many policy questions are relevant across sub-Saharan Africa, and
policy makers are likely to encounter similar problems, we encourage
regional collaboration on health technology assessment, and sharing of
information and resources.
Sinclair, D.; Gyansa-Lutterodt, M.; Asare, B.; Koduah, A.; Andrews, E.; Garner, P. Integrating Global and National Knowledge to Select Medicines for Children: The Ghana National Drugs Programme. PLoS Medicine (2013) 10 (5) e1001449. [DOI: 10.1371/journal.pmed.1001449]
Integrating Global and National Knowledge to Select Medicines for Children: The Ghana National Drugs Programme