Interview: Eugène Aka-Aouélé

What are the priority health care investments to be implemented in Côte d’Ivoire?

EUGÈNE AKA-AOUÉLÉ: Every factor that contributes to maintaining the resilience of health care systems, as recommended by the World Health Organisation, is integrated into our health care policy. However, realistic planning principles must be made a priority, with preference given to the construction, rehabilitation and equipment of public hospitals, the development of human and health care resources, and the availability of medicine.

With regard to infrastructure, the various levels of the health care pyramid – primary, secondary and tertiary – are the subject of particular attention from the government. Examples of this are the special construction programme of 250 primary health care centres (PHCs) and the rehabilitation of 480 PHCs due for completion in late 2019 and early 2020.

The ministry’s goal is to raise the performance of our health care system to that of other emerging countries by 2020. The whole construction and rehabilitation programme, which has a total cost of around CFA800bn ($1.4bn), will mark the beginning of a new era for the health care system.

In what ways will objectives will be achieved under the Universal Health Coverage programme in the medium to long term?

AKA-AOUÉLÉ: In order to guarantee a high-quality health care system at a low cost for the population, the government has established Universal Health Coverage (Couverture Maladie Universelle, CMU), a compulsory health insurance system. It aims to ensure that part of the health care costs for people who have insurance are covered. The CMU will provide access to quality medicine at prices below those present in the current pharmaceutical system. In order to fully implement this programme, 725 establishments were selected to benefit from the necessary technical installations. Thus, the New Public Health Pharmacy (Nouvelle Pharmacie de la Santé Publique, NPSP) and private wholesalers will ensure the supply and distribution of 247 essential drug references needed to support the pathologies covered by the CMU health care basket.

In addition, another programme will be rolled out that is expected to provide free access to health care for the most vulnerable areas of the population, namely children and pregnant women.

How can counterfeit drugs be effectively eliminated from the market?

AKA-AOUÉLÉ: One of the biggest issues facing the pharmaceutical sector in the country today is the fight against fake drugs. Low-quality drugs are a major problem that we must overcome in order to ensure a high quality of patient care. To successfully tackle this issue, the Ivorian government has undertaken reforms that improve not only the availability but also the quality of medicines. This is the context of the reform of the NPSP, whose main goal is to ensure the availability, affordability and quality of essential drugs and strategic inputs.

Despite the ongoing efforts from the government, it is unfortunate to see the frequent use of poor-quality and illicit drugs that threaten the life of our population. Therefore, the Ministry of Health, in collaboration with security forces, has set up programmes like COTRAMED for the fight against the illicit distribution of drugs.

The development of the local pharmaceutical industry shows significant opportunity for economic growth and demonstrates an effective way to combat the illicit circulation of fake medicine. Furthermore, ongoing interventions are set to continue increasing capacity for the industrial production of quality legal drugs, but the problem of drug financing remains a notable constraint across Africa.