Presented by: Tayari K. Jean Claude, Marie Aimee Muhimpundu
Globally, the recent growing opioid epidemic has torn the world’s eye away from a silenced, very different reality: severe shortages and, in some areas, a complete lack of access to pain medications has left millions dying in pain. To simultaneously answer this critical human rights concern and also create a crucial, accompanying protective layer to opioid production, prescription and use, developing countries must now, perhaps more than ever before, be strategic and responsible in their development of local production chains. Rwanda serves as an example of this attentive, strategic design and implementation. Prior to the 2014 development of its local morphine production program, the country’s dependence on imported morphine from foreign production and procurement chains created a extreme barrier: less than 0.1mg of morphine was given per capita and an estimated 98% of end of life pain was left untreated. Today, by locally manufacturing oral morphine and adapting procurement chains, Rwanda is challenging this barrier and reorienting its environment to equip providers to alleviate patients’ physical pain. Within the contexts of both the local, historic extreme lack of access and the current global abuse epidemic, this presentation will examine the steps Rwanda has taken and its continuous demand for equity, sustainability, and safety as it has created its high-quality, local production since 2014. A detailed picture of the stakeholders and sectors Rwanda included in its initiative will also be reviewed and discussed, including national policy, procurement, labor, law, training and clinical care, interdisciplinary disciplines, and community sensitization and partnerships.