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Southern Med Review. 2011 Dec; 4(2):15-21.Objectives: Although poor reproductive health constitutes a significant proportion of the disease burden in developing countries, essential medicines for reproductive health are often not available to the population. The objective was to analyze the guiding principles for developing national Essential Medicines Lists (EML). The second objective was to compare the reproductive health medicines included on these EMLs to the 2002 WHO/UNFPA list of essential drugs and commodities for reproductive health. Another objective was to compare the medicines included in existing international lists of medicines for reproductive health. Methods: The authors calculated the average number of medicines per clinical groups included in 112 national EMLs and compared these average numbers with the number of medicines per clinical group included on the WHO/UNFPA List. Additionally, they compared the content of the lists of medicines for reproductive health developed by various international agencies. Results: In 2003, the review of the 112 EMLs highlighted that medicines for reproductive health were not consistently included. The review of the international lists identified inconsistencies in their recommendations. The reviews' outcomes became the catalyst for collaboration among international agencies in the development of the first harmonized Interagency List of Essential Medicines for Reproductive Health. Additionally, WHO, UNFPA and PATH published guidelines to support the inclusion of essential medicines for reproductive health in national medicine policies and EMLs. The Interagency List became a key advocacy tool for countries to review their EMLs. In 2009, a UNFPA/WHO assessment on access to reproductive health medicines in six countries demonstrated that the major challenge was that the Interagency List had not been updated recently and was inconsistently used. Conclusion: The addition of cost-effective medicines for reproductive health to EMLs can result in enhanced equity in access to and cost containment of these medicines, and improve quality of care. Action is required to ensure their inclusion in national budget lines, supply chains, policies and programmatic guidance.
Research Triangle Park, North Carolina, FHI, 2008.  p.In order to help nonmenstruating clients safely initiate their method of choice, Family Health International (FHI) developed a simple checklist for use by family planning providers. Although originally the Pregnancy Checklist was developed for use by family planning providers, it can also be used by other health care providers who need to determine whether a client is not pregnant. For example, pharmacists may use this checklist when prescribing certain medications that should be avoided during pregnancy (e.g., certain antibiotics or anti-seizure drugs). The checklist is endorsed by the World Health Organization (WHO) and is based on criteria established by WHO for determining with reasonable certainty that a woman is not pregnant. Evaluation of the checklist in family planning clinics has demonstrated that the tool is very effective in correctly identifying women who are not pregnant. Furthermore, recent studies in Guatemala, Mali, and Senegal have shown that use of the checklist by family planning providers significantly reduced the proportion of clients being turned away due to menstrual status and improved women's access to contraceptive services.
Bulletin of the World Health Organization. 2007 Sep; 85(9):650.The WHO Model List of Essential Medicines, used by many countries to guide drug procurement and supply, has been a global standard for 30 years. Although this list has included some paediatric medicines, a children's list has not been systematically developed until now. To address this shortcoming, a subcommittee of the WHO Expert Committee on Selection and Use of Essential Medicines met in July 2007, to develop a list of essential medicines for children. In May 2007, the 60th World Health Assembly passed a resolution on Better Medicines for Children (WHA60.20) that described several strategies to improve access to essential medicines of adequate quality for children. As has been described in several reviews, the main causes of mortality in children can be treated by essential medicines such as antibiotics for infections or oral rehydration solution and zinc for diarrhoea. To apply this knowledge effectively requires that these medicines be available; yet suitable zinc tablets, for example, are still not included in many national essential medicines lists. (excerpt)
Bulletin of the World Health Organization. 2003 Oct; 81(10):774-775.A landmark deal that waives international trade rules may work if implemented in good faith, experts say. Poor countries with no manufacturing capability of their own will be allowed to import cheap copies of patented essential drugs under a complex procedure. (excerpt)
Report to the Prime Minister. UK Working Group on Increasing Access to Essential Medicines in the Developing World. Policy recommendations and strategy.
London, England, Department for International Development [DFID], 2002 Nov 28.  p.This report outlines the discussions and conclusions of the Working Group. It supports specific action on the R&D agenda, and outlines an ambitious international agenda to facilitate a framework for voluntary, widespread, sustainable, and predictable differential pricing as the operational norm1. It proposes, as a short-term goal, to have significant international commitment to an overarching framework for differential pricing in place in time for the 2003 G8 Summit in France. (excerpt)
WORLD HEALTH FORUM. 1993; 14(4):390-5.About 80% of the world's people depend largely on traditional plant-derived drugs for their primary health care (PHC). Medicinal plants serve as sources of direct therapeutic agents and raw materials for the manufacture of more complex compounds, as models for new synthetic products, and as taxonomic markers. Some essential plant-derived drugs are atropine, codeine, morphine, digitoxin/digoxin, and quinine/artemisinin. Use of indigenous medicinal plants reduces developing countries' reliance on drug imports. Costa Rica has set aside 25% of its land to preserve the forests, in part to provide plants and other materials for possible pharmaceutical and agricultural applications. The Napralert database at the University of Illinois establishes ethnomedical uses for about 9200 of 33,000 species of monocotyledons, dicotyledons, gymnosperms, lichens, pteridophytes, and bryophytes. Sales of crude plant drugs during 1985 in China equaled US$1400 million. Even though many people use medicinal plants, pharmaceutical firms in industrialized nations do not want to explore plants as sources of new drugs. Scientists in China, Germany, and Japan are doing so, however. Screening, chemical analysis, clinical trials, and regulatory measures are needed to ensure safety of herbal medicines. WHO has hosted interregional workshops to address methodologies for the selection and use of traditional medicines in national PHC programs. WHO, the International Union for the Conservation of Nature and Natural Resources, and the World Wide Fund for Nature developed guidelines for conservation of medicinal plants. Their 2-pronged strategy includes prevention of the disappearance of forests and associated species and the establishment of botanical gardens. WHO's Traditional Medicine Programme hopes that people will apply known and effective agroindustrial technologies to the cultivation and processing of medicinal plants and the production of herbal medicines and the creation of large-scale networks for the distribution of seeds and plants.
CONTRACEPTIVE TECHNOLOGY UPDATE. 1989 Jun; 10(6):77-81.Although generic oral contraceptives (OCs) are bioequivalent to brand-name formulations, many family planning professionals do not prescribe the significantly lower-priced generics. The Planned Parenthood Federation of America, for example, has refused to approve generic OCs for use in the organization's clinics, presumably because of concerns about their equivalent efficacy and safety. However, much of this skepticism may be fueled by misleading marketing by brand-name OC manufacturers. Sales representatives have reportedly told clinicians that generic OCs can be as much as 20% different from brand-name formulations, despite evidence collected by the US Food and Drug Administration confirming that there is virtually no difference except in terms of inert ingredients. In the case of many formulations, the variability between the generic and brand-name products is no different than the variability found between different lots of the same brand-name drug. Another obstacle to wider use of generic OCs is that discounts for large volume purchases make brand-name OCs the best buy for family planning clinics. Clinicians also note that clients complain of minor side effects whenever OC brands are changed, even if the compounds are the same. As the price of medication continues to rise, the more widespread availability of generic OCs will be especially important for teenagers and other low-income clients.
World Health. 1984 Jul; 3-5.In 1977 the World Health Organization (WHO) began a peaceful revolution in international public health by asking a group of experts which drugs were really necessary to take care of most health problems. The conclusion was that about 200 drugs and vaccines could be considered essential in good medical practice. Most of them were of proven efficacy, with well-known therapeutic properties, and most were no longer protected by patent rights and could be mass produced at a reasonable cost to patients. The Model List of Essential Drugs, although revised twice since 1977, has needed only minor adjustments and is still limited to about 220 essential drugs and vaccines. More than 80 countries in the 3rd world have adapted the model list to their requirements. Country experience demonstrates that using a limited number of essential drugs poses no threat to public health. In response to problems of drug supply and drug use in developing countries, country application of the philosophy of essential drugs has become the centerpiece of a global program designed to make sure that a limited number of essential drugs of good quality are available at prices that poorer patients can afford. A strategy, drawn up toward the end of the 1970s and which eventually became the Action Program on Essential Drugs and Vaccines, addresses the complexity of the world of pharmaceutical products and their utilization. It focuses on essential drug availability in primary health care. If a limited number of essential drugs cannot be delivered on a regular basis to rural areas and the poorer sections of cities, the whole strategy of health for all by the year 2000 will face a partial or even total failure. The Action Program on Essential Drugs and Vaccines is becoming a worldwide effort, with many partners involved. Countries decide for themselves on the pharmaceutical policy they want to follow. Many have chosen an essential drug policy and some have accelerated their programs with external technical and financial collaboration. Physicians and other health workers who prescribe, and dispensing pharmacists, are obvious partners for the Action Program. New information and training must be provided for students of medicine, pharmacy, and pharmacology before an improvement in the fine art of prescribing medicine can be expected. Patients, supported by better information and follow-up, should also accept more responsibility for their own use of drugs.
Who Chronicle. 1984; 38(2):47-59.The 73rd session of the World Health Organization's (WHO) Executive Board met in January 1984 to review progress in implementing strategies for health for all by the year 2000, based on information emanating from the countries themselves. This monitoring function was assigned to the Board by the World Health Assembly in 1981 and calls for the Board to evaluate progress towards health for all at regular intervals and to report back to the Health Assembly. The 1st country reports together with comments of the regional committees and relevant information provided by theSecretariat were examined in November 1983 by the Board's Program Committee. Emphasis at this stage was placed on reviewing the relevance of national health policies to the attainment of health for all and the progress being made in implementing national strategies. Actual evaluation of the strategies will begin in 1985. As many of the country reports submitted were not as complete or as accurate as they could have been, the overall progress report submitted were not as complete or as accurate as they could have been, the overall progress report suffered from a lack of detailed and precise informattion on many important aspects that were crucial to national health for all strategies. Dr. Brandt, presenting the Program Committee's views, told the board that the report did indicate that a high level of political sensitization had occurred and that the political will to attain the goal of health for all existed in a large majorithy of the countries that had reported. The report indicated that to a large extent the Secretariat had met its responsibilities. It was the Member States that had to shoulder the responsibility and reaffirm their commitment by action. The Program Committee's progress report points to the existence of specific technical needs, particularly in national capability to carry out health policies. Among the areas requiring strengthening are information analysis and management, financial analysis, assessment of status of public information, competence in planning and management, effective involvement of relevant sectors in health, and measurement of intersectoral action for health. The Board urged Member States to give highest priority to the continuing monitoring and evaluation of their health for all strategies and to assume full responsibility for this process. In regard to the action program on essential drugs and vaccines, priority in the last 2 years has gone to training and manpower development, the dissemination of experience and information, cooperation in the procurement and production of essential drugs, technical cooperation among developing countries, and contracts with nongovernmental organizations and the pharmaceutical industry. During the far ranging discussion that ensued in the Executive Board, members addressed themselves in considerable detail to numerous aspects of the action program. The Board approved a new and carefully phased procedure for the review of substances to be recommended for international drug control.
In: Bannerman RH, Burton J, Ch'en Wen-Chieh. Traditional medicine and health care coverage: a reader for health administrators and practitioners. Geneva, Switzerland, World Health Organization, 1983. 194-206.There is a genuine interest now being taken in phytotherapy and medicinal plants throughout the world. In industrialized countries there is a trend of going back to nature or wanting to combat the chemical pollution of the body provoked by inopportune chemotherapy or by the misuse of convenience drugs of chemical origin; third world countries are primarily concerned with providing their peoples with adequate coverage of their essential drug needs. A new type phytotherapy is proposed, to produce phytotherapeutic preparations for use in modern medical practice from the resources of traditional medication. In view of difficulties experienced by developing countries in meeting their needs for essential drugs, 4 measures might be taken to encourage utilization for primary health care of their vast local resources: 1) a real health policy option at national and regional level; 2) determination of priorities regarding health problems and definition of possible solutions; 3) goal-oriented applied scientific research on medicinal plants, incorporating properly planned programs; 4) effective implementation of these programs with regard to technical and financial resources and appropriate personnel. Cooperation among developing countries, with the industrialized countries and with organizations of the United Nations system is recommended. A table illustrates integrated overall organization.
[Geneva, Switzerland], WHO, 1982. 17 p. (HRG/CRU.1/Rev.1/Mtg.1)In 1979, a WHO team collaborated with national personnel in The Gambia in developing a comprehensive primary health care (PHC) plan of action for the period 1980/81 - 1985/86. In his address to the legislature in August, 1980, the president declared that the plan involved the active participation of local communities and emphasized programs for health promotion and disease prevention. This monograph reports on a meeting of the Gambian Ministries of Economic Planning and Industrial Development and of Health, Labor and Social Welfare in June 1982. Improvements in rural health are a basic need. In order to provide PHC, it was fully realized that a strong supportive infrastructure was essential. The village sensitization program was considered as vital for success. Not 1 village has rejected PHC or its responsibilities. The training program for community health nurses, village health workers and traditional birth attendants was proceeding according to plan for the various levels. Recognizaing that an efficient drug supply was essential, concomitant action had been taken to reorganize the central store. Another essential element without which success could not be achieved related to provision of transport and facilities for their maintenance, so that communications could be assured with rural areas. The need for a radio network to link 6 staions and 26 sub-stations was stresses. The list of participants and the agenda are attached as are the requirements for external support for the planned provision of PHC which were considered by the participants of the meeting.