E-drug: Re: description/definition of essential drugs
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Out of a curious observation that in this matter of "defining"
Essential Drugs, many e-druggers have tended to use "Description"
and "Definition" interchangeably, I decided last night to check my
concise Oxford dictionary and would like to share with you a
summary of the relevant entries for the two words, in the context
of the ongoing discussions:
Describe:
(1) Set forth in words
(2) Recite the characteristics of
Define:
(1) Make out limits
(2) Make clear
(3) Set forth the essence of
(4) Declare the exact meaning or scope of
(5) Make up total characteristics of
It seems to me, therefore, that from a semantic point of view, and
having regard to all the comments so far, the outstanding technical
issue which Agenda Item 2 is inviting the Expert Committee to
comment on should more accurately be "Definition of Essential
Drugs" and not "Description of Essential Drugs" as I understand it
to be at the moment. But, quite frankly, for me, semantics is beside
the point. I just thought that before the debate on definition gets
running too fast, I would like to use this opportunity to flag some of
the lack of clarity that have lingered on in my mind, even after
almost two years working with EDM/WHO in Geneva. First of all, to
what extent is the EDL meant to be a strategic and/or operational
document from both the WHO as well as country perspective? Such
a clarification will, I think, determine how much premium one
should really place on definitions. A related concern is "to what
extent has the EDL through its evolution over the years, contributed
to the improvement of the health and well-being of people all over
the world, particularly in the most resource- constrained countries?"
There seems to be a consensus that, without doubt, it has
immensely contributed to improving the drug, meaning medicine,
access situation. Even in cases where the EDL has been found
wanting, I doubt whether it has been principally due to a flawed
definition. So, all of you who spend time and other resources day-in
and day-out with the above goal of health status improvement in
mind, deserve a pat on your backs! - Let us guard against "throwing
the baby with the bath water" because it is an energy and
motivation "black hole". This is not meant to suggest that you
should rest on your oars because we know that a third of the world
still lacks access to the basic drugs they require to meet our goal! I
also think that we must bear in mind the need to differentiate
between the "Essential Drugs" concept per se and the "Essential
Drugs" list. I have always looked at the concept as a strategy
meant to be operationalised through a number of tools, one and
only one of which happens to be the EDL; formularies, treatment
guidelines, drug supply management manuals and indeed the much
bigger picture of National Drug Policies, all have important roles.
Anyway, I hope that the wise minds at the Expert Committee or
any e-drugger will help provide the kind of enlightenment I seek.
Murtada M Sesay
UNICEF Bangladesh
e-mail: msesay@unicef.org
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