E-DRUG: description/definition of essential drugs by WHO
---------------------------------------------------------
[E-drug will make some of the background papers of the upcoming WHO Expert
Committee on essential drugs/medicines available for those without email
access to the WHO/EDM website. Anybody who wants to debate the definition
of "essential drugs" is welcome to submit a message to e-drug! WB]
Agenda Item 2 : Outstanding technical issues: description of essential
drugs
Resolution WHA28.66 (1975) requests the Director-General to advise Member
States on "the selection and procurement, at reasonable cost, of essential
drugs of established quality corresponding to their national health needs".
Resolution WHA31.32 (1978) stressed "the need to provide essential drugs of
adequate quality, in sufficient quantity and at reasonable cost to meet the
health needs of countries" and endorsed the aim of "ensuring access of the
whole population to essential drugs at a cost the country can afford".
The first Expert Committee on the Selection of Essential Drugs in 1977
described essential drugs as medicines that "are of utmost importance, and
are basic, indispensable and necessary for the health needs of the
population".[1] In 1983 the Expert Committee described essential drugs as
"those that satisfy the health care needs of the majority of the
population; they should therefore be available at all times in adequate
amounts and in the appropriate dosage forms". This description has been
endorsed and used by all subsequent Committees until 1999.
To further enhance clarity the 1999 Committee combined this description
with the affordability concept from the 1978 resolution, stating that
"essential drugs are those that satisfy the health care needs of the
majority of the population; they should therefore be available at all times
in adequate amounts and in the appropriate dosage forms, and at a price
that individuals and the community can afford." [2] This same description
was used in the information paper to the Executive Board of May 2001
(EB108/INF.DOC./2).
During the consultation processes in 2001, most reviewers agreed with the
1999 Expert Committee's description. However, some reviewers questioned the
inclusion of the phrase on affordability and others wondered whether the
expression "the majority of the population" is useful. There were other
concerns that the needs for sustained financing for essential medicines,
and for essential medicines of adequate quality, were not dealt with.
In its report to the Executive Board of January 2002 (EB109/8) the
Secretariat stated that the description should include three components: a
definition, a description of the selection criteria and a description of
the purpose for which such a list is developed, as follows:
Definition: Essential medicines are those that satisfy the priority health
care needs of the population
Selection criteria: Essential medicines are selected with due regard to
disease prevalence, evidence on efficacy and safety, and comparative
cost-effectiveness
Purpose: 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 at a price the
individual and the community can afford.
This description is similar to that formulated by the first Expert
Committee on the Selection of Essential Drugs in 1977: medicines that "are
of utmost importance, and are basic, indispensable and necessary for the
health needs of the population". The purpose for which the list has been
developed was spelt out by the 1983 Expert Committee on the Use of
Essential Drugs ("they should therefore be available at all times in
adequate amounts and in the appropriate dosage forms"). A combination of
the definition and its implications has been used to describe the essential
medicines concept by all subsequent Expert Committees.
One additional element that needs to be stressed is that countries and
institutions should develop their own list of essential medicines. As
stated by the last Expert Committee in November 1999: (the concept of
essential drugs) . is intended to be flexible and adaptable to many
different situations; exactly which drugs are regarded as essential remains
a national responsibility.
The Expert Committee is invited to comment on the above description.
notes:
[1] WHO Technical Report Series, No. 615, 1977, p. 9.
[2] WHO Technical Report Series, No. 895, 2000, p. 1.
--
To send a message to E-Drug, write to: e-drug@usa.healthnet.org
To subscribe or unsubscribe, write to: majordomo@usa.healthnet.org
in the body of the message type: subscribe e-drug OR unsubscribe e-drug
To contact a person, send a message to: e-drug-help@usa.healthnet.org
Information and archives: http://www.healthnet.org/programs/edrug.html