Evidence-based Pharmacy in Developing Countries - The Essential Drugs Concept

The Essential Drugs Concept

The essential drugs list concept was developed from a report to the 28th World Health Assembly in 1975 as a scheme to extend the range of necessary drugs to populations who had poor access because of the existing supply structure. The plan was to develop essential drugs lists based on the local health needs of each country and to periodically update these with the advice of experts in public health, medicine, pharmacology, pharmacy and drug management. Resolution number 28.66 at the Assembly requested the WHO Director-General to implement the proposal, which led subsequently to an initial model list of essential drugs (WHO Technical Series no 615, 1977). This model list has undergone regular review at approximately two-yearly intervals and the current 14th list was published in March 2005. The model list is perceived by the WHO to be an indication of a common core of medicines to cover most common needs. There is a strong emphasis on the need for national policy decisions and local ownership and implementation. In addition, a number of guiding principles for essential drug programs have emerged.

• The initial essential drugs list should be seen as a starting point.
• Generic names should be used where possible, with a cross-index to proprietary names.
• Concise and accurate drug information should accompany the list.
• Quality, including drug content stability and bioavailability, should be regularly assessed for essential drug supplies.
• Decisions should be made about the level of expertise required for drugs. Some countries make all the drugs on the list available to teaching hospitals and have smaller lists for district hospitals and a very short list for health centers.
• Success depends on the efficient supply, storage and distribution at every point.
• Research is sometimes required to settle the choice of a particular product in the local situation.