The Psychological Antecedents to COVID-19 Vaccination among Community Pharmacists in Khartoum State, Sudan.

Background and Objectives: Little is known regarding the 5C psychological antecedents to COVID-19 vaccination among pharmacists in low- and middle-income countries. This study aimed to assess the acceptance of COVID-19 vaccination and its psychological antecedents among community pharmacists in Khartoum State, Sudan. Materials and Methods: A cross-sectional study was conducted from July to September 2022. A self-administered questionnaire was used to collect data about sociodemographic and health status characteristics, vaccine acceptance, and the 5C psychological antecedents to vaccination. Stepwise logistic regression analysis was conducted, and results were presented using odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Results: A total of 382 community pharmacists participated in the current study, with a mean age of 30.4 ± 5.6 years. Nearly two-thirds of the participants (65.4%) were females, and the majority (74.9%) have received or intended to receive the COVID-19 vaccination. Vaccine acceptance was significantly associated with the following psychological antecedents to vaccination: confidence, complacency, constraints, and calculation (p < 0.001). Results of the logistic regression showed that confidence in vaccines [OR = 6.82 (95% CI = 3.14-14.80)], conspiracy beliefs [OR = 0.44 (95% CI = 0.23-0.85)], and constraints to vaccination [OR = 0.18 (95% CI = 0.06-0.56)] were the significant determinants of vaccine acceptance. Conclusion: The study revealed important predictors of COVID-19 vaccine acceptance that can be used to guide policymakers in designing target-oriented interventions that can improve the vaccine acceptance rate among community pharmacists in Sudan. These findings suggest that interventions to promote vaccine acceptance among pharmacists should focus on building confidence in vaccines and providing accurate information about the safety and efficacy of the COVID-19 vaccine, and reducing constraints to vaccination.

A Meta-Analysis on the Safety and Immunogenicity of Covid-19 Vaccines.

OBJECTIVE: The presented meta-analysis (MA) aims at identifying the vaccine safety and immunogenicity in published trials about SARS-CoV-2 vaccines. METHODS: All relevant publications were systematically searched and collected from different databases (Embase, Scopus, EBSCO, MEDLINE central/PubMed, Science Direct, Cochrane Central Register for Clinical Trials (CENTRAL), Clinical Trials.gov, WHO International Clinical Trials Registry Platform (ICTRP), COVID Trial, COVID Inato, Web of Science, ProQuest Thesis, ProQuest Coronavirus Database, SAGE Thesis, Google Scholar, Research Square, and Medxriv) up to January 10, 2021. The pooled vaccine safety and immunogenicity following vaccination in phase 1 and 2 vaccine clinical trials, as well as their 95% confidence intervals (CI), were estimated using the random-effects model. RESULTS: The predefined inclusion criteria were met in 22 out of 8592 articles. The proportion of anti-severe acute respiratory distress coronavirus 2 (SARS-CoV-2) antibody responses after 7 days among 72 vaccinated persons included in 1 study was 81% (95% CI: 70-89), after 14 days among 888 vaccinated persons included in 6 studies was 80% (95% CI: 58-92), after 28 days among 1589 vaccinated persons included in 6 studies was 63% (95% CI: 59-67), after 42 days among 478 vaccinated persons included in 5 studies was 93% (95% CI: 80-98), and after 56 days among 432 vaccinated persons included in 2 studies was 93% (95% CI: 83-97). Meta regression explains more than 80% of this heterogeneity, where the main predictors were; the inactivated vaccine type (ß = 2.027, P = 0.0007), measurement of antibodies at week 1 (ß = -4.327, P < 0.0001) and at week 3 of the first dose (ß = -2.02, P = 0.0025). Furthermore, the pooled proportion adverse effects 7 days after vaccination was 0.01 (0.08-0.14) for fever, headache 0.23 (0.19-0.27), fatigue 0.10 (0.07-0.13), and 0.18 (0.14-0.23) for muscle pain. CONCLUSION: Immunogenicity following vaccination ranged from 63% to 93% depending on the time at which the antibody levels were measured.

High levels of burnout among health professionals treating COVID-19 patients in two Nile basin countries with limited resources.

Burnout syndrome is a real cause for concern in African health facilities. Healthcare professionals (HCPs) burnout is considered a great public health problem and especially during pandemics as several physical and emotional stressors on this population can lead to increased burnout. This study aimed to investigate the frequency and associated factors of occupational burnout among HCPs working at COVID-19 isolation facilities in Egypt and Sudan. This is important to summarize lessons learned and inform relevant interventions for future pandemic responses. A cross-sectional survey was conducted among frontline HCPs from May 2021 to July 2021. An online, anonymous, self-administered questionnaire was used for data collection. Occupational burnout was estimated using  the Oldenburg Burnout Inventory. A total of 362 HCPs participated in the study and were equally recruited from Egypt (181) and Sudan (181) with a mean age of (31.84 ± 8.32) years. More than half of HCPs were females (60%) and physicians (58.3%). Most HCPs included in the study had high levels of work disengagement (75.4%) and emotional exhaustion (98.6%). Burnout syndrome was present in 75% of the HCPs with 77% among Egyptian HCPs and 71% among Sudanese HCPs. Multivariate logistic regression was used to determine predictors of burnout, working hours per week were the parameters associated with burnout syndrome among Egyptian HCPs; while for Sudanese HCPs, these were age and number of days off. The study revealed a high level of burnout syndrome among HCPs working at COVID-19 isolation facilities in both Egypt and Sudan. Appropriate actions should be taken to preserve the mental health status of HCPs through the establishment of effective and efficient coping strategies.

Workplace violence against healthcare workers during the COVID‐19 pandemic in Sudan: A cross‐sectional study

Background Workplace violence (WPV) against healthcare workers (HCWs) is a growing global issue. During the coronavirus diseases‐2019 (COVID‐19) pandemic, violent attacks on HCWs have been documented worldwide. This study aimed to investigate the magnitude and pattern of WPV among HCWs in Sudan during the COVID‐19 pandemic. Methods A web‐based cross‐sectional study of WPV was conducted among registered medical and health workers (pharmacists, physicians, dentists, nurses, laboratory technicians, and administrative and paramedical staff) during the COVID‐19 pandemic in Sudan. Data were collected from August to December 2021 using a self‐administered questionnaire distributed through social media platforms. Results A total of 792 HCWs returned the online questionnaire. The mean age was 33.5 ± 8.6 years, where more than half were females (54.9%) and working during the day shift (58.8%). During the COVID‐19 pandemic, three out of every four participants (78.3%) reported experiencing violence, with 65.8 % experiencing it more than three times. The common types of violence experienced were verbal (91.6%), physical (50.0%), and sexual abuse (11.0%). The emergency department reported the highest number of violent incidents (46.9%). Half of these violent events were not reported (50.3%), primarily due to a lack of a reporting system. The demographic factors that were significantly associated with exposure to violence were participants' occupation (p < 0.001), age (p = 0.001), marital status (p = 0.002), and years of working experience (p = 0.020). Conclusion WPV was rampant among the HCWs in Sudan during the COVID‐19 pandemic. The current findings are presented to draw the attention of policy leaders and stakeholders in Sudan to this alarming problem prompting the pressing need for policy and system interventions.

Quality of life among health care workers in Arab countries 2 years after COVID-19 pandemic.

Background: Assessment of the quality of life (QoL) among healthcare workers (HCWs) is vital for better healthcare and is an essential indicator for competent health service delivery. Since the coronavirus disease 2019 (COVID-19) pandemic strike, the frontline position of HCWs subjected them to tremendous mental and psychological burden with a high risk of virus acquisition. Aim: This study evaluated the QoL and its influencing factors among HCWs residing in the Arab countries. Methods: This was a cross-sectional study using a self-administered online questionnaire based on the World Health Organization QoL-BREF instrument with additional questions related to COVID-19. The study was conducted in three different languages (Arabic, English, and French) across 19 Arab countries between February 22 and March 24, 2022. Results: A total of 3,170 HCWs were included in the survey. The majority were females (75.3%), aged 18-40 years (76.4%), urban residents (90.4%), married (54.5%), and were living in middle-income countries (72.0%). The mean scores of general health and general QoL were 3.7 ± 1.0 and 3.7 ± 0.9, respectively. Those who attained average physical, psychological, social, and environmental QoL were 40.8, 15.4, 26.2, and 22.3%, respectively. The income per capita and country income affected the mean scores of all QoL domains. Previous COVID-19 infection, having relatives who died of COVID-19, and being vaccinated against COVID-19 significantly affected the mean scores of different domains. Conclusion: A large proportion of the Arab HCWs evaluated in this study had an overall poor QoL. More attention should be directed to this vulnerable group to ensure their productivity and service provision.

Exploring enablers and barriers toward COVID-19 vaccine acceptance among Arabs: A qualitative study.

Background: With the emergence of the coronavirus disease 2019 (COVID-19) and rapid vaccine development, research interest in vaccine hesitancy (VH) has increased. Research usually focuses on quantitative estimates which largely neglected the qualitative underpinnings of this phenomenon. This study aimed to explore the beliefs and views towards COVID-19 vaccination among Arabs in different countries. Furthermore, we explored the effect of confidence in the healthcare system, misinformation, and scientific approaches adopted to mitigate COVID-19 on how individuals are following the recommended preventative actions including vaccination. Methods: This study was based on the Strategic Advisory Group of Experts (SAGE)-VH Model: A qualitative design that utilized in-depth, online interviews. The study was conducted in seven Arab countries (Egypt, Qatar, Kingdom of Saudi Arabia, Libya, Sudan, United Arab Emirates and Jordan) from June 2020 to December 2021. Transcripts were analyzed using NVivo 12 Software. Results: A total of 100 participants, 44 males and 56 females, of different age groups (37.1 ± 11.56 years) were interviewed. Findings revealed six themes as enablers and barriers to COVID-19 vaccination. Many participants indicated trusting the vaccines, the healthcare systems, and the vaccination policies were the main driver to get the vaccine. Participants showed concerns towards potential long-term vaccine effects. A consistent inclination towards collective responsibility, which is the willingness to protect others by own vaccination, was also reported. Conclusion: Enablers and barriers of COVID-19 vaccination acceptance in the Arab region, from sociocultural and political perspectives, are critical to guide policymakers in designing target-oriented interventions that can improve vaccine acceptance.

Self-reported adherence to preventive practices during the third wave of COVID-19 in Afghanistan.

Objective: The study objectives were aimed to highlight the areas where public awareness is needed to enhance preventive practices among the public. Hence, to avoid the spread of virus in public settings. In addition, the study has provided compelling data and evidence on the coronavirus disease-2019 trend for health policymakers to make strategic decisions. Introduction: The coronavirus disease-2019 is a highly contagious respiratory disease caused by severe acute respiratory syndrome coronavirus type-2. The disease has spread across the globe. In Afghanistan, thousands of confirmed cases with hundreds of deaths have been reported. In addition, due to insufficient healthcare workforce, insecurity, fragile healthcare infrastructure, low coronavirus disease-2019 vaccination and low testing capacity, the true nature of the pandemic is unlcear. Method: An online survey of the general population in Afghanistan was conducted from April-May 2021. Convenience sampling technique was used to recruit the respondents. Social media platforms were used (WhatsApp, Twitter and Facebook Messenger) to disseminate the electronic survey instrument. Written informed consent was taken from the participants before the filling questionnaires. Data collection was guided through a self-administered questionnaire developed by the researchers according to the World Health Organization guidelines. The sample size was calculated using EPI software. The inclusion criteria were being 18 years or older and having access to the Internet to fill out the online questionnaire. IBM SPSS Statistics version 25.0 was used for analysis. Descriptive statistics (frequencies, percentages) and bi-variable (chi-square) analyses were done. A p value of <0.05 was considered significant at a 95% confidence interval. Results: From 1094 respondents, 78% were male. The majority of respondents were aged ⩽30 years and had an undergraduate education. Nearly 1 in 3 participants were healthcare workers, and 70% lived in households with five or more family members. Overall, 70% of the respondents reported good preventive practices. The majority of the participants reported covering their mouth and nose while coughing and sneezing and cleaning their hands regularly and using alcohol. Meanwhile, 80% of the participants wore a mask when going outside. Moreover, people with post-graduate education had a higher level of preventive practices than those with an undergraduate education.The results of logistic regression revealed participants residence in Kabul, healthcare workers, family size less than 5, avoid meeting people outside, gender, and avoiding 3Cs, were the significant determinants of adhering to good preventive practices. Conclusion: Generally, the public in Afghanistan followed infection prevention rules. However, certain areas require further improvement, such as observing social distance and avoiding shaking hands when meeting others. Negligence of these prevention practices can lead to an increase in infection transmission among people. Public awareness should be continued to keep the people supportive of the government policies.

COVID-19 Vaccine Acceptance among Social Media Users: A Content Analysis, Multi-Continent Study.

Vaccine hesitancy (VH) is defined as a delayed in acceptance or refusal of vaccines despite availability of vaccination services. This multinational study examined user interaction with social media about COVID-19 vaccination. The study analyzed social media comments in 24 countries from five continents. In total, 5856 responses were analyzed; 83.5% of comments were from Facebook, while 16.5% were from Twitter. In Facebook, the overall vaccine acceptance was 40.3%; the lowest acceptance rates were evident in Jordan (8.5%), Oman (15.0%), Senegal (20.0%) and Morocco (20.7%) and the continental acceptance rate was the lowest in North America 22.6%. In Twitter, the overall acceptance rate was (41.5%); the lowest acceptance rate was found in Oman (14.3%), followed by USA (20.5%), and UK (23.3%) and the continental acceptance rate was the lowest in North America (20.5%), and Europe (29.7%). The differences in vaccine acceptance across countries and continents in Facebook and Twitter were statistically significant. Regarding the tone of the comments, in Facebook, countries that had the highest number of serious tone comments were Sweden (90.9%), USA (61.3%), and Thailand (58.8%). At continent level, serious comments were the highest in Asia (58.4%), followed by Africa (46.2%) and South America (46.2%). In Twitter, the highest serious tone was reported in Egypt (72.2%) while at continental level, the highest proportion of serious comments was observed in Asia (59.7%), followed by Europe (46.5%). The differences in tone across countries and continents in Facebook and Twitter and were statistically significant. There was a significant association between the tone and the position of comments. We concluded that the overall vaccine acceptance in social media was relatively low and varied across the studied countries and continents. Consequently, more in-depth studies are required to address causes of such VH and combat infodemics.

Oral health in Sudan: the current situation during COVID-19 pandemic.

The coronavirus pandemic (COVID-19) has affected the delivery of healthcare services and posed enormous challenges to medical and dental care across the world. This article sought to explore various challenges implicated in the provision, access, and utilization of oral healthcare services in Sudan and to describe the current situation amid COVID-19. The oral health sector in Sudan has been experiencing multiple challenges in the delivery of dental care, and the current pandemic of COVID-19 has aggravated and multiplied the existing challenges. Conflict, economic meltdown, and political instability have disrupted all medical and dental services in many parts of Sudan. Furthermore, the oral health sector in Sudan suffers a lack of essential instruments, materials, and supplies, a shortage of health workers, and poor infection control practices, which present major threats to dental care in the region. The COVID-19 pandemic has contributed to further scarcity of essential materials and supplies. Moreover, the frequent closure of dental hospitals and clinics either due to civil disobedience or COVID-19 lockdown has limited accessibility and utilization of oral services. There is an urgent need to address challenges identified to ensure adequate provision of oral healthcare in Sudan.

Efficacy and Effectiveness of SARS-CoV-2 Vaccines: A Systematic Review and Meta-Analysis.

The coronavirus disease 2019 (COVID-19) pandemic has threatened global health and prompted the need for mass vaccination. We aimed to assess the efficacy and effectiveness of COVID-19 vaccines to prevent mortality and reduce the risk of developing severe disease after the 1st and 2nd doses. From conception to 28 June 2021, we searched PubMed, Cochrane, EBSCO, Scopus, ProQuest, Web of Science, WHO-ICTRP, and Google Scholar. We included both observational and randomized controlled trials. The pooled vaccine efficacy and effectiveness following vaccination, as well as their 95 percent confidence intervals (CI), were estimated using the random-effects model. In total, 22 of the 21,567 screened articles were eligible for quantitative analysis. Mortality 7 and 14 days after full vaccination decreased significantly among the vaccinated group compared to the unvaccinated group (OR = 0.10, ([95% CI, 0.04-0.27], I2 = 54%) and (OR = 0.46, [95% CI, 0.35-0.61], I2 = 0%), respectively. The probability of having severe disease one or two weeks after 2nd dose decreased significantly (OR = 0.29 [95% CI, 0.19-0.46], I2 = 25%) and (OR = 0.08 [95% CI, 0.03-0.25], I2 = 74%), respectively. The incidence of infection any time after the 1st and 2nd doses diminished significantly (OR = 0.14 [95% CI, 0.07-0.4], I2 = 100%) and (OR = 0.179 [95% CI, 0.15-0.19], I2 = 98%), respectively. Also, incidence of infection one week after 2nd dose decreased significantly, (OR = 0.04, [95% CI (0.01-0.2], I2 = 100%). After meta-regression, the type of vaccine and country were the main predictors of outcome [non-mRNA type, ß = 2.99, p = 0.0001; country UK, ß = -0.75, p = 0.038; country USA, ß = 0.8, p = 0.02]. This study showed that most vaccines have comparable effectiveness, and it is purported that mass vaccination may help to end this pandemic.

Exploring Challenges to COVID-19 Vaccination in the Darfur Region of Sudan.

The current COVID-19 pandemic has affected the ability of health systems to provide essential services globally. The Darfur region, located in the western part of Sudan, has been largely devastated by the war that began in 2003 and has been drawing considerable attention from the international community. The war, which erupted as a result of environmental, political, and economic factors, has led to tragic outcomes. Collapsing health-care infrastructures, health workforce shortages, lack of storage facilities for medicines and medical products, and inadequate access to health services are some of the effects of the war. After Sudan received the AstraZeneca COVID-19 vaccine through the COVID-19 Vaccines Global Access facility, significant challenges have been implicated in the delivery, storage, and use of the vaccine in the Darfur region. Lack of vaccine storage and transportation facilities, vaccination hesitancy, inequity in the distribution to health facilities, and shortage of health-care professionals resulting from insecurity and instability have added an extra layer of burden on local authorities and their ability to manage COVID-19 vaccinations in the region adequately. Addressing the impact of COVID-19 requires an effectively managed vaccination program. In the face of current challenges in Darfur, ensuring a fully vaccinated population might remain far-fetched and improbable if meaningful efforts are not put in place by all stakeholders and actors to address some of the challenges identified.

The coronavirus disease 2019 (COVID-19) vaccination psychological antecedent assessment using the Arabic 5c validated tool: An online survey in 13 Arab countries.

BACKGROUND: Following the emergency approval of the coronavirus disease 2019 (COVID-19) vaccines, research into its vaccination hesitancy saw a substantial increase. However, the psychological behaviors associated with this hesitancy are still not completely understood. This study assessed the psychological antecedents associated with COVID-19 vaccination in the Arab population. METHODOLOGY: The validated Arabic version of the 5C questionnaire was distributed online across various social media platforms in Arabic-speaking countries. The questionnaire had three sections, namely, socio-demographics, COVID-19 related infection and vaccination, and the 5C scale of vaccine psychological antecedents of confidence, complacency, constraints, calculation, and collective responsibility. RESULTS: In total, 4,474 participants with a mean age of 32.48 ± 10.76 from 13 Arab countries made up the final sample, 40.8% of whom were male. Around 26.7% of the participants were found to be confident about the COVID-19 vaccination, 10.7% indicated complacency, 96.5% indicated they had no constraints, 48.8% had a preference for calculation and 40.4% indicated they had collective responsibility. The 5C antecedents varied across the studied countries with the confidence and collective responsibility being the highest in the United Arab Emirates (59.0% and 58.0%, respectively), complacency and constraints in Morocco (21.0% and 7.0%, respectively) and calculation in Sudan (60.0%). The regression analyses revealed that sex, age, educational degrees, being a health care professional, history of COVID-19 infection and having a relative infected or died from COVID-19 significantly predicted the 5C psychological antecedents by different degrees. CONCLUSION: There are wide psychological antecedent variations between Arab countries, and different determinants can have a profound effect on the COVID-19 vaccine's psychological antecedents.

UAE efforts in promoting COVID-19 vaccination and building vaccine confidence.

The United Arab Emirates (UAE) is leading globally in many indicators for tackling the COVID-19 pandemic. This ranges from taking adequate preventive measures to the free vaccination drive and viable public health strategy. As of 18 August 2021, the UAE has significantly reduced the number of cases and successfully administered 17,454,250 doses. Furthermore, efforts and plans are underway to provide the third dose to high-risk people three months after completing the second dose and six months later to others. The UAE is considered one of the leaders globally for vaccinating "medically eligible" residents against COVID-19, with over 70% of the population currently fully vaccinated in the drive towards achieving herd immunity. The UAE's vaccination program is on track, covering a significant part of the population. The massive efforts of the National Vaccination Program's roll-out made by the UAE government and the various health authorities and stakeholders were vital for the general public's active participation in its success.

Food security and COVID-19 in Afghanistan: a two-sided battlefront.

Food security is a major element for the sustainability, stability and development of a country. However, despite fundamental efforts in fighting poverty, Afghanistan continues to struggle with food insecurity with a large proportion of its population living below the poverty line. With extreme climates, protracted conflict, and now COVID-19, food insecurity has become rampant and is on the rise in the country. Efforts have been reinforced to mitigate this issue, but a spate of obstacles which seems not to come to an end, has contributed to the deterioration of the situation. With the collaboration and efforts of international organizations, there remains a glimmer of hope to potentially reduce the gravity of the food insecurity in the country. This paper aims to highlight the efforts of Afghanistan in alleviating food insecurity with a focus on the impact of COVID-19 on this issue. It also presents recommendations that may help ameliorate the country's food security status during and after the pandemic.

Public willingness to adhere to COVID-19 precautionary measures in Sudan: an application of the Health Belief Model.

INTRODUCTION: coronavirus disease (COVID-19) is a highly infectious disease caused by the novel coronavirus (SARS-CoV-2). Several public health and social protective measures that may prevent or slow down the transmission of COVID-19 were introduced. However, these measures are unfortunately being neglected or deliberately ignored by some individuals. METHODS: a cross sectional online based survey was conducted to identify possible factors influencing public willingness to adhere to precautionary measures and preventive guidelines against COVID-19 during the lockdown periods in Sudan. The questionnaire was used to collect socio-demographic data of study participants, their health beliefs and willingness regarding adherence to precautionary measures against COVID-19 based on the constructs of the Health Belief Model. RESULTS: a total of 680 respondents completed and returned the online questionnaire. Significant predictors of the willingness to adhere to the precautionary measures against COVID-19 were gender (ß= 3.34, P<0.001), self-efficacy (ß= 0.476, P<0.001), perceived benefits (ß= 0.349, P<0.001) and perceived severity (ß= 0.113, P=0.005). These factors explained 43% of the variance in respondents' willingness to adhere to COVID-19 precautionary measures. Participants who were female, confident in their ability to adhere to the protective measures when available, believing in the benefits of the protective measures against COVID-19 and perceiving that the disease could have serious consequences were more likely to be willing to adhere to the protective measures. CONCLUSION: female respondents and respondents having higher self-efficacy, higher perceived benefits and higher perceived severity were more likely to be willing to adhere to the protective measures against COVID-19 in Sudan.

The formidable task of fighting COVID-19 in Sudan.

Sudan is facing a formidable task of fighting COVID-19. The country is suddenly challenged by this health issue that will test its path towards peace, stability, and development. The fragile task of handling COVID-19 epidemic in Sudan is brought about by several factors such as the weak healthcare system and political conflicts, that have been intertwined with the recent regime. Even before the COVID-19 pandemic, there was already high unemployment, soaring inflation and lack of social protection and safety nets for its populace. The government has been trying its best to address the pandemic, however, much still needs to be done. Neglecting Sudan by the international community in terms of support towards containment of COVID-19 has grievous implications for transition out of military dictatorship and efforts to curb the pandemic globally. As no country is safe if all is not safe. It is essential that Sudan should leverage on innovations, country-compatible measures, and other tailor-made strategies for effective responses.

Drug shortage crisis in Sudan in times of COVID-19.

Sudan is witnessing severe drugs, medicines, and medical supplies shortages, which present a major impediment to the provision of emergency healthcare services. Drug insecurity in Sudan is as a result of several accumulated factors, primarily due to worsening economic condition, inappropriate pricing policy, privatization of the pharmaceutical sector, poor manufacturing and weak weak weregulatory system. These could threaten patient health through replacement of highly efficacious medicines with less effective alternatives and by impacting the scheduling of urgent medical operations and procedures. Drug and medicine shortages are of catastrophic impact especially amid the current epidemic of COVID-19 where these are salient needs. Efforts should be quickly directed to ensure immediate access to pharmaceutical products and other essential health commodities. Effective policies on drug importation, production, pricing, and distribution should be established to avoid the consequences of an impending crisis.