Role of Essential Medicines in framing National Medicine Policy – An Approach from Concept to Clinic

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About Authors: Ashish Chauhan.
Department of Pharmaceutical Sciences,
Lovely Professional University,
Jalandhar, Punjab.

The essence of essential medicines underlies in satisfying the priority health care needs of the population. The selection of essential medicines is one of the core principles of a national medicine policy as it helps to set primacies for all the aspects of the pharmaceutical system and helps in the maintenance of a proficient healthcare system globally. Devising of essential medicines and national medicine policy is fast emerging as global concept of high relevance to the public irrespective of their nationalities. The prevalence of dreaded diseases like HIV, cancer, and a worldwide upsurge in case of malaria, tuberculosis and other infectious diseases with an addendum problem of multidrug resistance has further augmented the relevance of essential medicines and formulation of a rigid comprehensive national drug policy under the endorsement of WHO medicine strategy andimplementing the same under a complete implementation plan or master plan. This review emphasis the development and selection of essential medicines along with Indian scenario. This review also emphasis the mission, objectives, components, devising and implementation of essential medicine policy along with WHO tenets and regulations.


1.1  Definition
In accordance to World Health Organisation, essential drugs are the "drugs that satisfy the primary health care needs of the population."1They are selected with due respect to public health relevance, confirmation on efficacy and safety and comparative cost effectiveness.2

1.2  Development
The concept of Essential drugs was launched in 1977, and regarded among one of the eight pillars of WHO's "Primary Health Care" strategy. The WHO List of Essential drugs is updated every two years by an expert committee. The current list is the 16th model list released in 2009. This list is regarded as “WHO Model List of Essential Medicines” which is designed in accordance to set a model list for countries to adapt to their needs. SATELLIFE and a group of volunteer moderators in 1995 started E-Drug, the English language discussion group of E-Drug promotes an idea to support the concept of essential drugs by improving and speeding up communications among all health professionals of the world. This concept was applied in all the countries at national, provincial, district and hospital level. This concept of essential drugs proves valuable in poor-resource settings by allowing one to get the best medicines. The website was launched in 2002 on the eve of 25th anniversary of the essential drug concept and in the same year WHO amended the name of "essential drugs" into "essential medicines." 1

1.3  Selection of Essential Medicine List
The selection process of medicines is precarious. The process should be consultative, transparent, unambiguous, and concomitant to evidence-based standard clinical guidelines. The list is divided into levels of care, and are regularly reviewed and updated. The review of clinical guidelines and the list should be revised out at least every second year, and their use and the impact should be supervised.3

1.4  Indian Scenario
The overall budget of medicines contrasts widely in different states in India. The expenditure outline on medicines of the State Government demonstrates that there are widespread differences across states, from as little as less than 2% in Punjab to as much as 17% in Kerala during 2001-02. Assam, Bihar, U.P., and Orissa spent about 5% or less of their health budget on medicines. The Central Government's stake of medicines in its total health budget is around 12%., roughly 10% of the health budget goes into procurement of   medicines in India. Even then, availability of medicines often is a big concern. The non-availability of essential medicines endangers the trustworthiness of the public health system.

The availability of medicines is destabilised by several factors:

*  Deprived medicine supply

*  Dispersal systems

*  Inadequate health facilities and staff

*  Low outlay in health

*  High cost of medicines

The Essential Medicine can help countries rationalize the purchasing and distribution of medicines, thereby reducing costs to the health system.3


2.1 Mission
The mission of the country Essential Drugs and Medicines Policy (EDM) program is entrenched in the WHO mission in medicines which is “to aid and save lives and improve health by making it available to the underprivileged society of the world.” The country EDM program follows the WHO medicine strategy. It works in alliance with the Ministry of Health and other partners to recognise the needs and priorities; plan, implement and monitor action in the pharmaceutical zone including traditional medicines.2

2.2  National Medicine Policy (NMP)
A national medicine policy (NMP) is an obligation to goals and to monitor action. Irrespective of a nation’s specific settings, a complete national medicine policy consider all the components of the pharmaceutical segment and all relevant shareholders. The NMP of   any country varies. WHO endorses all the countries to frame and implement a comprehensive national medicine policy. A national medicines policy provides a mutual framework to resolve problems in pharmaceuticals. The process of developing an NMP is as important as the final product. A national medicine policy, presented and printed as an official government proclamation, is imperative because it acts as a formal record of ambitions, aims, decisions and promises.4



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