[A drug revolving fund program for rural villages in the Philippines]

In 1994, a community-based drug revolving fund program was introduced in 10 pilot villages in the province of Tarlac, Philippines, as a component of a health project by the provincial health office and Japan International Cooperation Agency (JICA). The purpose of the program was to set up a cooperative drug store in each community in order to regularly provide rural residents with essential drugs at affordable prices. The following are the results and findings during the first two years of operation. 1. Collaboration with a local NGO facilitated implementation and management of the program, when socio-cultural consideration was necessary. Stable and prompt procurement of drugs was secured on a contract with a commercial wholesaler in Manila. 2. Out of the 105 kinds of pharmaceuticals that were sold both in the cooperative and commercial drug stores, 83% were less expensive than the average market price, and 51% were discounted more than 25% of the market price. 3. The levy of premiums was introduced to increase the cooperative fund with the consent of each community. The amount was 0.1-0.2% of the average family income. However, regular collection of premiums was difficult due to various reasons. The practice of the sales on credit was common in all pilot villages. 4. While the knowledge of community health workers, who were in charge drug sales, was improved after training sessions on rational drug use, it was not at a sufficient level yet. 5. When assisting a community-oriented health program, an exterior organization should try to encourage the community to generate its own solutions to operational difficulties, based on the socio-cultural context in the community.