Delivering medicines in a challenging environment: the pharmaceutical sector in East Timor (a descriptive study)

BACKGROUND: The health status of the East Timorese population is very poor and much of the health system was destroyed during the violence of 1999. As in other developing countries, the lack of appropriate and high quality medicines significantly compromises patient care throughout the health system. The aim of this study was to examine the purchase, distribution and supply of pharmaceuticals in East Timor, and to identify the challenges faced by the pharmaceutical sector. METHODS: Key informant interviews were held with health professionals and others involved in health care and the pharmaceutical sector in East Timor; documents (including regulations and rules) were reviewed; and daily activities observed at the Central Store, health centers, pharmacies and retail shops. RESULTS: Some of the major challenges facing the pharmaceutical sector include lack of trained staff, sub-optimal facilities and lack of basic equipment. These lead to unsafe practices, and reliance on outside agencies. CONCLUSIONS: There are significant threats to the supply and quality of medicines in East Timor. There is currently a high level of dependence on foreign expertise, which is unsustainable in the long term.