The response to Russia’s invasion of Ukraine, the COVID-19 pandemic, and the climate crisis have proved that individuals, academic institutions, and organizations really want to help in a crisis, says Elizabeth Ashbourne, executive director of the Partnership for Quality Medical Donations.
But, she adds, it is “critically important that both the donors and the recipient countries have a mutual understanding of what the most appropriate products are and what will be of most assistance to the people everyone is trying to help.”
PQMD was founded, in part, on a demand for accepted standards to guide the highest quality delivery of medical donations to vulnerable communities around the world. There was shared recognition that donors and recipients, along with implementing partners and governmental organizations, would benefit from guidelines ensuring high standards of quality control, effective communication, and cooperation around critical needs and available resources.
That’s how the PQMD Guidelines for Quality Medical Donations came to life. Some 20 years after they were established, they still reflect the mutual commitment of over 45 corporate and nonprofit PQMD members, as well as governments all over the world. Their role is to ensure improved global access to quality health care through donations — and, in actuality, the impact stretches well beyond that remit.
“Because the work of developing and maintaining relevant guidance requires long standing relationships, we also find ourselves in a unique position to support countries’ ongoing sustainability and resilience planning. So when disaster hits, when there's a crisis or even an opportunity, health care systems are better prepared to respond.”
Speaking to Devex, Ashbourne shared examples of how guidance can help in both stable and crisis settings, and how the partnerships built in the process reinforce successes and leverage further resources championing sustainable health systems.
This conversation has been edited for length and clarity.
PQMD holds the distinction of being the first U.S. organization to contribute to and endorse the revised 2010 Guidelines for Medicine Donations. Can you tell us more about the PQMD Guidelines for Quality Medical Donations?
The guidelines reflect the deep knowledge, experience and expectations of our members. PQMD teams up global pharmaceutical, medical device and consumer product companies with leading international NGOs to provide real direction to stakeholders engaged in donations. Essentially, organizations that are often competitors come together to ensure that international protocols for the delivery of donated medical products are followed, and to continually inform the evolution of best practices while supplying vital donated products and services around the world.
While all PQMD members are committed to adhering to the standards that have been developed, the guidelines are freely available as a global public good that provides recommendations on everything from governance, finance, standard operating procedures, and partner vetting to quality controls, appropriateness, logistics, disposal, and monitoring and evaluation. The guidelines build and secure trust, so that countries and beneficiaries can be assured donations will not add unintended challenges to an already urgent situation or a protracted crisis.
In addition to printed donation guidelines, PQMD has developed an interactive training module as a ready resource for all in the donations field. The module is a step-by-step guide for practitioners, donors and local leaders alike. Through the unique expertise of our members, we have additionally developed guidelines for medical missions and will soon launch guidelines ensuring quality medicines for rare diseases.
Russia’s invasion of Ukraine has not only forced millions of people to flee their homes, but also caused a health crisis in Ukraine with a great need for medical donations. What role do the guidelines play in humanitarian crises and conflict?
Effective and accepted guidelines require partnership, and partnerships are crucial when working in countries in conflict. You have to know and trust your partners to respond quickly and responsibly, and be assured that protocols are being observed even in the direst of situations. It's also important that supply chains are left unobstructed in order to deliver products, services and resources to those most in need. PQMD members work in over 100 countries and many of our members have long-standing relationships with ministries of health, organizations and communities around the world.
While guidelines are valuable for donors and implementers, they are critical for recipient countries, as well. They provide guardrails for receiving and managing products that will contribute to the health and well-being of their citizens. When our guidelines are followed, governments dealing with a crisis can be assured quality products are coming in, and be protected in terms of quality, time, and cost of receiving the goods.
How do medical donations impact health systems and the realization of the 2030 Agenda, and how do they help advance PQMD’s mission to contribute to universal access to health and well-being?
PQMD was founded on the idea of providing quality medical donations worldwide and fostering collaborations toward that end. Trends are shifting toward a focus on sustainability and resilience, and in light of this, we have evolved our mission, which now positions PQMD as a global collaboration that promotes sustainable access to quality health care in underserved communities and populations in crisis. We work with five pillars: disaster response, humanitarian crisis, health system strengthening, knowledge and innovation, and donation guidelines.
“Partnerships are the future! … The PQMD alliance has largely been able to act humbly, be collaborative, and put competition aside.”
— Elizabeth Ashbourne, executive director, Partnership for Quality Medical DonationsOur partners and members are building mechanisms into their agendas and programs that go beyond medical donations to support and strengthen sustainability and resilience in their countries of operation. Examples include health worker training, logistics capacity, supply chain management, infrastructure, medical education, health management information systems, and health literacy programs. This is all directly related to the ultimate realization of the Sustainable Development Goals. Health touches all 17 SDGs, and while quality medical donations are not a stand-alone solution, they can serve as a pathway to a more sustainable infrastructure where all people have access to quality health care.
What are some of the challenges impacting the supply of medical equipment, pharmaceuticals, products, and services in countries not faced by conflict?
I would start by saying that the supply chain challenges for donations are no different than those for other products, and it’s a constantly changing environment. But COVID-19, in particular, caused a large number of disruptions. There were logistical challenges of moving donations, purchased medicines, personal protective equipment, medical devices, and other materials around the world. There were human capacity limitations in shipping and expediting large scale shipments of products, mostly because [COVID-19] was literally everywhere. While a company might have millions of doses of vaccines available as a donation or at no profit, they still needed to get into the country to get those doses into [the] arms of the global population. [COVID-19] exposed the large gaps in supply chain management around the world, whether a country was in conflict or not.
In addition to being a global health security issue, country capacity is another significant challenge. If health systems aren’t staffed and can’t absorb the donations, then obviously, the donations won’t have their intended impact. If health workers don’t have access to needed training, they are not able to distribute the product; and if health management information systems are insufficient, they can’t locate the people or patients in need.
Country capacity is something many PQMD members are focusing on, and that goes hand-in-hand with health system strengthening. Donations are not the only solution — they are a useful pathway. Donations are a mechanism to get the actual product to people who need it, but they absolutely have to be paired with investment, engagement, and partnership.
Do you have a call to action you’d like to share?
Partnerships are the future! Recent events underscore the need for long-term, well-developed relationships among partners working to facilitate timely, respectful and innovative responses. Collective cross-sector work for solutions is essential. Our members invest time and resources to develop deep partnerships which yield shared experience and best practices in highly complex situations and environments. They certainly provide donations, but they're also addressing systemic challenges related to equitable access to quality health care. The PQMD alliance has largely been able to act humbly, be collaborative, and put competition aside. By the example of our coalition, we recognize that phenomenal global health solutions are achieved through inclusive and trusting relationships. Access to quality health care around the world can only be achieved through active collaboration.