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Geneva, Switzerland, UNAIDS, 1998 Oct.  p. (UNAIDS Best Practice Collection)The World Health Organization (WHO) estimates that over one-third of the world's population has no guaranteed access to essential drugs. There are various reasons for this lack of access. Worldwide, the most important is affordability (drugs cost more money than is available to pay for them) but legal, infrastructural, distribution and cultural factors are also serious obstacles. The influence of each of these factors is different from country to country, just as frequencies of diseases also vary greatly. Among its activities aimed at improving drug access in developing countries (including technical services such as help in drug procurement and performance of needs estimates), WHO has drawn up a Model List of Essential Drugs, which is updated every two years. The tenth list (1997) has 308 priority drugs that provide safe, effective treatment for the infectious and chronic diseases which affect the vast majority of the world's population. The drugs are selected on the basis of cost-effectiveness within each drug class (e.g. of the dozens of penicillins only eight appear on the Essential Drugs list). With WHO's encouragement, more than 140 countries have developed their own national essential drug lists taking into account local needs, costs and available resources. (excerpt)
[Unpublished], 1993. Background paper for the WHO Advisory Group Meeting on STD Treatments, Geneva, Switzerland, February 18-19, 1993. 14 p.The introduction for this core list of essential drugs recommended for the treatment of sexually transmitted diseases (STDs) notes that STD drug selection for individual countries should be based on ongoing epidemiological studies of the population to be served and that STD treatment should afford a minimum 95% cure rate. Programs that use a cost justification to settle for a 85-95% cure rate may increase drug resistance and unrealistically depend upon the patient presenting for a second course of treatment. While the newer, effective drugs are expensive, they are less expensive than the alternative, which includes increased HIV transmission. The criteria used for the choice of drugs presented here were: high efficacy, lowest cost, availability, acceptable toxicity, and delayed or unlikely resistance development. Additional criteria seek, when possible, single dose, oral administration, and same treatment for pregnant women. The effect of concurrent HIV infection was not taken into consideration for the development of this list of drugs. Presumptive, syndrome-oriented treatment is recommended as more cost effective than even the most inexpensive diagnostic tests. The objectives of STD service provision can be met through appropriate case management, and STD services should be integrated in the primary health care system. Three tables in this report list 1) the selected drugs to be used in cases diagnosed etiologically, 2) those recommended in cases diagnosed syndromically, and 3) those recommended as alternative for some etiologies (with advantages and disadvantages noted). A table shows the ratios of the costs of World Health Organization (WHO) treatments as compared to treatments recommended in Gambia, Papua New Guinea, Honduras, Sri Lanka, Jamaica, and Zimbabwe. In all cases, the WHO recommended treatments are more expensive.