Low and middle income countries (LMICs) continue strive to achieve universal health coverage (UHC), but these efforts are sometimes constrained by insufficient resources. As the need for health systems increases, lowering costs can threaten the quality of health, including the quality of medicines on which the health system relies. Meanwhile, WHO states that substandard and falsified medicines (S&F meds) are increasingly circulating at this time. There is no agreed method of measuring the problem, thus there is no way to ensure that the medicines available to the very poor are safe and effective according to universal health coverage (UHC). Because of this, the Faculty of Pharmacy, Universitas Pancasila, Imperial College and Erasmus University through funding from the United Kingdom National Institute for Health Research conducted a collaborative project called the STARmeds program (Systematic Tracking of At-Risk Medicines). Through the STARmeds Program We want to help countries understand and measure problems, so they can plan effective action and track change over time. We also wanted to develop a simple tool for estimating the overall size of the problem with substandard and falsified medicines in a country, and their impact on health and the economy. In collaboration with regulators, we plan to sample medicines from our model categories that we predict are substandard and falsified medicines (S&F meds) and test them. We will collect samples from several large regions and use the results together with assumptions based on market volume, insurance claims and discussions with our policy partners to estimate the prevalence, impact and cost of low quality medicines in Indonesia. We conduct Policy discussions with the various sectors concerned to be able to provide a springboard for the actions needed to ensure that quality is built into the medicines procurement process, while the methods we have developed will provide a blueprint for other countries that facing similar challenges.
1. Trial risk-based sentinel surveillance for substandard and falsified medicines
2. Develop methods for estimation of substandard and falsified medicines prevalence
3. Develop methods for estimation of substandard and falsified medicines impact
4. Estimate prevalence and impact of substandard and falsified medicines in Indonesia
5. Integrate policy influence, and learning
6. Expand sustainable capacity for medicine policy research in Indonesia