The world entered into 20th century with only one drug “aspirin”. Then there were discoveries and development of drugs like chloroquine, streptomycin, isoniazid, oral contraceptive pills (OCPs), anti-diabetics, cardiovascular drugs (CSVs), etc. The concept of Essential Medicines arose from countries like Sri Lanka, Tanzania and Cuba. Essential medicines are simply drugs used for treating widespread health problems.
WHO Definition of Essential Medicines
According to World Health Organization (WHO), “Essential medicines are those that satisfy the priority health care needs of the population. They are selected with due regard to public health relevance, evidence on efficacy and safety, and comparative cost-effectiveness. Essential medicines are intended to be available within the context of functioning health systems at all times in adequate amounts, in the appropriate dosage forms, with assured quality and adequate information, and at a price the individual and the community can afford.”
The implementation of the concept of essential medicines is intended to be flexible and adaptable to many different situations; exactly which medicines are regarded as essential remains a national responsibility.
The first WHO list of essential drugs was published in 1977 with 205 items. At present there are over 300 items in the list.
Each country is encouraged to prepare their own lists taking into consideration local priorities. At present over 150 countries have published an official essential medicines list. The WHO List contains a core list and a complementary list. The criteria for selection of essential medicines are:
- Adequate data on its efficacy and safety
- Availability in a form in which quality, including bioavailability and stability on storage
- Based on pattern of prevalent disease
- Based on availability of facilities, trained personnel and financial resources
- Cost-benefit ratio should be a major consideration
- Most essential medicines should be single compounds
- Selection of essential medicines should be a continuous process which should take into account the changing priorities
Advantages of Essential Medicines
- Maximum benefit from limited resources: Essential medicine concept forms the key component of primary health care (PHC). It protects the end users from financial exploitation and misuse of scarce resources.
- Promotes rational drug use messages: Development and use of national essential medicines list is one of the 12 key interventions to promote rational drug use. The rational use of medicines implies that patients receive medicines appropriate to their clinical needs, in doses that meet their individual requirements, for an adequate period of time, and at the lowest cost to them and their community.
- Assists the development of standards: It helps to encourage the use of standard treatment protocols and rational prescribing policies.
- Economic Advantages:
- To lower costs through economies of scale
- To simplified systems of procurement, supply, distribution and reimbursement
- Medical Advantages:
- Better quality of care and better health outcomes
- Helps focus quality control, drug information, prescriber training and medical audit
- Helps to make sound financial decisions and appropriate funding activities for NGOs
Essential Medicines as a human right
In 1999, over 1.7 billion people were deprived of access to the Essential Medicines. Such problems are still seen majorly in many parts of Asia and Africa. Now, the access to essential medicines have been declared as a fundamental human right.
Essential Medicines In Context to Nepal
The 1st national list of essential drugs was published in the year 1986. The list was revised in the year 1992, 1997 and 2002. The list is expected to be revised again by next year. Separate lists are provided for sub health post, health post and primary health care centers.
- WHO List of Essential Medicines Nepal
- Availability of Essential Drugs in Nepal