Managing Product Entry When It Is Controversial

Location:

Introduction:

Misoprostol is a critical lifesaving postpartum hemorrhage medication. However, in many countries, misoprostol is controversial because of the perception that it is used as an abortifacient. This can cause problems when it enters the country, especially when the product is not included in the national Essential Medicines List or other national policies. Challenges can arise even when the product is included in national policies, norms, and guidance, as customs clearance procedures can depend on the directives of just a small number of powerful officials.

Project Description:

The humanitarian response agency procured misoprostol for use in their emergency response programming, but encountered challenges getting the products through customs due to the perceptions around misoprostol as an abortifacient. The SRHSexual and reproductive health Coordinator met individually with the MOHMinistry of Health official responsible for approving drug entry. She explained that it is on the WHOWorld Health Organization Essential Medicines List (EML) and that her agency procured a quality-assured product. She also discussed transparency of use in the program, explaining that its purpose is to save lives in cases of postpartum hemorrhage. The SRHSexual and reproductive health Coordinator also offered to host a field site visit for the representative at any time in the future.

Results:

Following the one-on-one meeting, the MOHMinistry of Health approved the misoprostol to enter the country and be deployed in the response. Although it is a highly regulated product, transparency, communication, and collaboration facilitated the delivery of misoprostol into this setting.

Lessons Learned:

Leveraging relationships and being transparent with national authorities about the use of controversial products can help to stem bottlenecks. Use global guidance, including the WHOWorld Health Organization EMLEssential Medicines List, to support your case. Meeting individually with receptive MOHMinistry of Health officials also helps.