Activity

Participants discussed the Millennium Development goals’ implementation in context of public health issues. The main challenges in public health in Moldova and other NIS countries were highlighted as priorities: 

1. 1. Lack of modern AMR surveillance system in the public health system, including lack of AMR Hospital Passport. 
   2. Low level of effectiveness of microbiology laboratory service and discordance between microbiological service and public health hospitals.
   3. Lack of coordination between human health system and veterinary / agriculture systems in AMR issues.
   4. Insufficient educational programs in medical school and lack of awareness campaign among population in AMR.
   5. Urgent need for National AMR strategic plan and National AMR Task group.

The Conference adopted the Declaration on Antimicrobial resistance that was initially developed during European AMR day – November, 18  and later widely discussed by all CoRSUM members.

1. Lack of pediatrics dosages and formulations is a barrier to effective, qualitative medical care of children as in Moldova as well in other NIS countries.  The main challenge is a absence of necessary medicines to treat HIV/AIDS and Tuberculoses. In spite of the growing rate of TB and AIDS in children during last 6 years, there is the gap in the procurement /ordering of medicines for children. 
2. In spite of the fact that the majority of anti-Tb drugs and ARVs are procure through GFTM Fund and hopefully are prequalified  by WHO Prequalification program, some of anti-Tb drugs are produced in Moldova. There is a concern about the quality of such medicines.
3. The lack of independent/ unbiased sources of literature about medicines exists in Moldova still. General practitioners and pharmacists do not have access to evidence –based information as about medicines as well about treatment protocol s.
4. There is a insufficient level of transparence in the drug registration and drug regulation in general processes.  Existing processes of the registration of medicines as well as procedures of clinical trials and decision making process about the registration are not transparent.
5. The educational programs in high school do not use the modern electonical sources of information such Pubmed, Cochrain,  NICE, BNF and others.
6. Many public health specialists do not use computer, internet , CD or other sources of information. Post -graduation education does not provide the possibility to obtain new skills in computer/internet   still.
7. In spite of the adopted National Medicine Policy (MOH RM №1352-XV from  03.10.2003: 4.4; 4,6) the  Professional  Associations and Non-for- profit, non-governmental organizations working in public health are not involved in the formulation, adaptation and discussion of the decision process about the current medicine policy.
8. Pharmaceutical and informational support to the patient with socially-significant diseases (especially diabetes) appears in incomplete volume.
9. In Moldova there is the absence of the control  system on the promotion of the food supplements to consumers   and accompanying, correct, corresponding to the law on protection of the consumer’s  rights  information.

The Conference calls to:

1. To develop concrete, detailed program on AMR with all stakeholders as from governmental organizations as well from non-governmental, professional medical, pharmaceutical organizations, agriculture/ veterinary structures and Church-related institutions.
2. In the ordering medicines to take into account the amount of pediatrics dosages and formulations for children , especially with social diseases  such as tuberculosis, HIV/AIDS.
3. International Organizations that assist countries with medicines supply such as Global fund for TB. AIDS and Malaria , UNICEF to take into account and to include in the plan of drug supply pediatrics medicines.
4. To activate the work in the computerization of the pharmaceutical service, especially in the social important diseases such as diabetes, TB and other. 
5. Standard treatment Guidelines develop and adopt with wide range of medical and pharmacy specialists.
6. To determine conceptual new ways of the collaboration between physicians, pharmacists and other specialists of public health.
7. To continue the collaboration between governmental and non-governmental organizations in the rational and safe use of medicines in the framework of partnership of CoRSUM.