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Caribbean Region

Technical Cooperation in the area of Medicines and Biologicals in the Caribbean

PAHO/WHO’s strategic goal of technical cooperation in this area is to support countries in attaining “Equitable Access to essential medical products and technologies of assured quality, safety and efficacy, cost effectiveness, and on their sound and cost-effective use”.

Caribbean countries known as Small Islands Development States (SIDS) have several commonalities, including high public and private expenditure on medicines and challenges for regulation and enforcement and guaranteeing quality and safety of medicines.  This expose the population to treats like counterfeit or falsified and/or sub-standard medicines among other problems.

In the Caribbean, the overall objective of the technical cooperation is improving availability, affordability and rational use of quality and safe medicines in the Caribbean, in order to contribute for the achievement of the Millennium Development Goals (MDG)  related to health in the Caribbean countries, namely, acute and non-communicable diseases (MDG 8); reduce child mortality (MDG 4), improve women's health (MDG 5) and lower the burden of HIV/AIDS, malaria, tuberculosis and other diseases (MDG 6).

The technical cooperation in the area of medicines and health technologies is framed by the Sub-regional Cooperation Strategy (SCS) for the Caribbean: 2010-2015 and the WHO Medicines Strategy: 2008-2013 , in line with the Caribbean mandates, such as the Caribbean Cooperation in Health, phase 3 (CCH III)  and its goal related to health systems responding effectively to the needs of the Caribbean people and the Port of Spain Declaration , that states that by 2012, 80% of people with non communicable diseases (NCDs) would receive quality care and have access to preventative education, based on regional guidelines; taking into account the implementation of the Caribbean Regional Public Health Agency (CARPHA) and the CARICOM Single Market and Economy (CSME).

The purpose is to support CARICOM Countries and Dominican Republic in improving access to safe and quality medicines and promoting rational use.

The publications Pharmaceutical Situation in the Caribbean Countries, the Regional Assessment of Drug Registration and Regulatory Systems in CARICOM Member States and the Dominican Republic  and the Assessment of Patent and Related Issues and Access to Medicines in CARICOM and Dominican Republic  contributed for identifying the gaps and were the basis for the development of the Caribbean Pharmaceutical Policy, approved by the CARICOM Council of Human and Social Development (COHSOD) in April 2011. Technical support has been provided for the development and approval of the CPP.

Currently the priority is to support the implementation of the Caribbean Pharmaceutical Policy and governing mechanisms, with special emphasis on strengthening regulatory capacity in the Caribbean region. Technical support is also  provided with the following specific objectives:

1. develop, implement and monitor National Pharmaceutical Policies, using evidence for decision making;

2. increase equitable access to essential medicines, particularly for priority health problems;

3. ensure the quality, safety and efficacy of medicines through effective drug regulation; and

4. improve rational use of medicines by health professionals and consumers.

From 2004 to 2010, PAHO/WHO technical and financial support in the area of medicines in the Caribbean was developed within the framework of the European Union/ World Health Organization (EU/WHO) Africa, Caribbean and Pacific Island (ACP) “Partnership on Pharmaceutical Policies”  . PAHO/WHO is committed to building on the successes of the EU/WHO ACP Partnership on Pharmaceutical Policies  in which CARICOM countries and Dominican Republic were beneficiaries, and is looking forward to continuing its collaboration to strengthen the pharmaceutical sector in the Caribbean region, aiming to consolidate the results achieved to date, complete the un-finished agenda and address future challenges that have been identified by Caribbean countries.

Sub-regional activities

Partners and related Agencies / Organizations


Pharmaceutical Policy: support the development, implementation and monitoring of the Caribbean and National Pharmaceutical Policies, using evidence for decision making


  • To support the development of a Caribbean Pharmaceutical Policy within the CCH III framework and to support development/updating and implementation of National Pharmaceutical Policies in selected countries as part of the steering role of the State and essential public health functions;
  • To encourage and to support Caribbean countries to participate in the pharmaceutical situation evaluation process (level I and II) and to provide feed-back about the results to national counterparts.
  • To support the strengthening of Pharmaceutical Education and to include the core elements of pharmaceutical policy into academic curricula, and 
  • To support the development of pharmaceutical services based on Primary Health Care.

Selected outcomes of technical cooperation:


Equitable Access and Innovation: support the strengthening of integrated supply systems and using of intellectual property flexibilities


  • To continue supporting OECS/PPS in the areas of prequalification, selection and rational use of medicines;
  • To continue supporting the CARIPROSUM Network of National Public Procurement Agencies:

– Harmonization of procedures
– Sub-regional mechanisms of pool negotiation mechanisms

  • To support the strengthening of comprehensive pharmaceutical supply systems and cost-containment mechanisms;
  • To facilitate the participation of Caribbean Countries in the PAHO/WHO Strategic Fund mechanism to enhance access to medicines for HIV/AIDS, tuberculosis and malaria and availability of other strategic commodities;
  • To support the development of a sub-regional strategy for Intellectual Property Rights and Public Health and a work plan with Caricom based on the results of the Survey and WHO Global Strategy aspects advocacy and training

Selected outcomes of technical cooperation:

  • CARIPROSUM: Caribbean Network of Pharmaceutical Procurement and Supply Management Authorities
  • Regional Network for Pharmaceutical Procurement and Supply Management “CARIPROSUM” 2008 Annual Meeting, Belize City, February 27 and 28th, 2008
  • Intellectual Property Rights Intellectual – Technical Cooperation Exercise in the Caribbean, Barbados, 15-17 October 2008
  • CARICOM/HERA. Assessment of Patent and Related Issues and Access to Medicines in CARICOM and Dominican Republic. Final Report. Georgetown: CARICOM, 2009 

    Quality and Regulation: To support the strengthening of core functions of NRAs and the development of a sub-regional regulatory framework


    • To support the establishment of a Network among National Regulatory Authorities in the Caribbean in order to strengthen collaboration, improve communication and promote the harmonization process, according to recommendations from the Pan American Network of Drug Regulatory Harmonization (PANDRH);
    • To support the development of a sub-regional regulatory framework based on the results of the Survey conducted within the TAG/CARICOM;
    • To continue supporting CRDTL and national laboratories of quality control; and
    • To support an inter-sectoral response for prevention and combat of counterfeit medicines

    Selected outcomes of technical cooperation:

    Improve rational use of medicines by health professionals and consumers


    • To support the development of a sub-regional strategy of rational use of medicines
    • To support the development/revision of Essential Medicines Lists, Therapeutic Formulary and Standard Treatment Guidelines in selected countries and to prepare a List of Essential Medicines for Disasters and Emergencies;
    • To support the establishment of a network among pharmacy schools for working on the harmonization and the strengthening of pharmacy education in the Caribbean;
    • To continue to support human resources training in the strategic areas related to pharmaceutical policies in the Caribbean.

    Selected outcomes of technical cooperation:


    icon December 2008  (222.58 kB)

    icon October 2008  (250.85 kB) 

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    icon June 2008  (179.13 kB)


    icon March 2007 (151.38 kB)


    icon October 2006 (73.86 kB)

  • Distance Learning Course on Rational Use of Antibiotics;
  • Distance Learning Course on HIV/AIDS and ARV (2nd edition) 

    Sub-regional activities:

    Workshop on Caribbean Pharmaceutical Policy – Barbados, July, 5th to 6th, 2010

    Partners and related Agencies / Organizations:

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    Dr. Adriana Mitsue Ivama, Medicines and Heath Technologies Sub-regional Advisor

    Adriana M. Ivama is the Sub-Regional Advisor on Medicines and Health Technologies at the PAHO/WHO Caribbean Programme Coordination Office, appointed in January 2009.   

    Dr. Ivama, a national of Brazil, is a Health Surveillance and Regulation Specialist of the National Agency of Health Surveillance (Anvisa)/Brazilian Ministry of Health (seconded to PAHO/WHO).

    Prior to assuming this position, she was a technical advisor/Technical Advisory Unity to Director President Office of Anvisa, she worked at PAHO/WHO Brazil and as Public Health professor and researcher at the University of Londrina ( Brazil).  She is a pharmacist and has obtained a PhD in Public Health, Health Legislation and History of Sciences from the University of Alcala ( Spain), as well as specializations in International Health from the University of Sao Paulo ( Brazil), Health Surveillance from the Oswaldo Cruz Foundation ( Brazil) and Teaching Methodology from the State University of Londrina ( Brazil).  Her experience in public health includes pharmaceutical policies and regulation, development of human resources, project management, planning and evaluation.


    Area of work/ Main responsibilities:

    • Provide technical support in the areas of Medicines and Health Technologies in the Caribbean; aligned with global and regional strategic orientations from PAHO/WHO and Caribbean governing bodies;
    • Assist the Caribbean countries and CARICOM Secretariat in the implementation of the Caribbean Pharmaceutical Policy and related activities;
    • Promote networks, partnerships, inter-country cooperation and commitment of stakeholders, with support of PAHO/WHO Collaborating Centres and mobilizing experts; 

    Key words: medicines supply management; medicines regulation; patent and Intellectual Property rights;  access; quality; pricing; rational use; PAHO Strategic Fund; PANDRH; CARIPROSUM network; CARICOM; Vigicarib.

  • Last Updated on Wednesday, 23 May 2012 07:07

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