Table 2 Stakeholder Perspectives about child-appropriate medicines

MOH (child health division, pharmacy division and procurement)

Preference for solid oral dosage formulations for adults because they are cheaper than the liquid oral dosage formulations that are too expensive, bulky and have short shelf life.

MOH (National Medical Stores)

Supports the efficiency view. The choice of medicines to be procured should address wider public interest needs. Liquid oral formulations do not meet this requirement. Prefer solid oral dosage formulations for adults that are cheap and easy to handle.

MOH (National Drug Authority)

The mission of NDA is to ensure access to quality, safe and efficacious medicines through the regulation and control of their production, importation, distribution and use of the medicines. NDA has registered varieties of medicines including child-appropriate dosage formulations and liquid oral dosage formulations some of which are not included in the EMHSLU but are registered for the private sector.

Joint Medical Stores

Support for the effectiveness view. Liquid oral dosage formulations are most appropriate for administering to children. Dividing adult tablets leads to inaccurate doses and interference in chemical properties. Holds a view that the UCG are not consistent with EMHSLU.

Development Partners

Support the efficiency view since Uganda is a poor country that cannot afford liquid oral dosage formulations and dispersible tablets. Supported the removal of liquid oral dosage forms from the EMHSLU 2012.

Paediatricians

Support the effectiveness view and argue that liquid oral dosage formulations are easy to administer and are best for infants. Fear of adverse events that might arise due to inaccurate dosing when solid oral dosage formulations for adults are split. They have no trust in the UCG which do not adequately address children’s needs.

UNICEF

The child size medicine concept would be the ideal and if not adult medicines should be scored to make them easy to break for children. Supports distribution of child-appropriate medicines at the community level.

Pharmacists outside government

Dividing of adult medicines interferes with chemical properties which affects the effectiveness of the medicines and might lead to adverse events. Highlight the role the Trade-Related Intellectual Property Rights (TRIP) agreements which keep the medicine prices high and hence impossible for low income countries to purchase such medicines using their own budget.