MeTA - Essential medicines

The World Health Organization defines essential medicines as: '…those that satisfy the priority health care needs of the population. They are selected with due regard to public health relevance, evidence on efficacy and safety, can comparative cost-effectiveness.' MeTA is working towards equitable access to essential medicines.

We will add to this key list over time and would welcome suggestions or additions. Please send these to: sourceassistant@hi-uk.org.

Selected resources

Books, reports, etc

Effective drug regulation : a multicountry study

RATANAWIJITRASIN, Sauwakon
WONDEMAGEGNEHU, Eshetu
2002

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This publication presents a synthesis of studies on drug regulation carried out in ten countries: Australia, Cuba, Cyprus, Estonia, Malaysia, the Netherlands, Tunisia, Uganda, Venezuela, and Zimbabwe in 1998-1999. It gives an overview of the development of drug regulation in these countries as well as the resources available and the strategies applied in drug regulation implementation at the time the studies were conducted. An analysis of the strengths and weaknesses in drug regulation in these countries is also provided

Equitable access to essential medicines : a framework for collective action

WORLD HEALTH ORGANIZATION (WHO)
March 2004

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Equitable and universal access to essential medicines is a vital aspect of any health strategy in resource-limited settings. This document provides a framework of action for policy makers, highlighting the key objectives of successful essential drugs programmes: rational selection and use of essential medicines; affordable prices; sustainable financing; reliable supply systems

Factsheet : Access to medicines

DEPARTMENT FOR INTERNATIONAL DEVELOPMENT (DFID)
January 2006

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This fact sheet outlines the steps DFID is taking in response to Millennium Development Goal 8: a global partnership for development, and in co-operation with pharmaceutical companies, to create access to affordable, essential drugs in developing countries. It includes a brief case study on Ghana

Globalization and access to drugs : perspectives on the WTO/TRIPS agreement

VELASQUEZ, German
BOULET, Pascale
January 1999

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The aim of this document is to inform people working in the health sector about the impact of globalization on access to drugs, and especially about the WTO agreement on intellectual property (TRIPS). Part 1 gives an introduction to the international trade system, and part 2 analyses the section on patents of the TRIPS agreement in relation to access to essential drugs

Globalization, TRIPS and access to pharmaceuticals

WORLD HEALTH ORGANIZATION (WHO)
March 2001

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This leaflet looks at the impact on the health sector of global trade and the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). It lists the articles of the agreement that have the greatest relevance to essential medicines and to the pharmaceutical industry

Guidelines for price discounts of single-source pharmaceuticals

WORLD HEALTH ORGANIZATION (WHO). Essential Drugs and Medicines Policy
et al
2003

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These guidelines are designed to maximise the benefit of price discounts arrangements for single-source products. They are intended for policy makers and technical staff in international and bilateral agencies active in international health development support, for pharmaeutical companies and for governments and NGOs in recipient countries. It highlights a number of issues that WHO feels need to be considered when planning or negotiating offers of price discounts

Guidelines for the storage of essential medicines and other health commodities

DELIVER
2003

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Maintaining proper storage conditions for health commodities is vital to ensuring their quality. Product expiration dates are based on ideal storage conditions and protecting product quality until their expiration date is important for serving customers and conserving resources. Guidelines for the Storage of Essential Medicines and Other Health Commodities is a practical reference for those managing or involved in setting up a storeroom or warehouse. The guide contains written directions and clear illustrations on receiving and arranging commodities; special storage conditions; tracking commodities; maintaining the quality of the products; constructing and designing a medical store; waste management; and resources. It was written to meet the needs of district-level facilities; however, the guidelines and information it contains apply to any storage facility, of any size, in any type of environment

How to investigate drug use in health facilities : selected drug use indicators

WORLD HEALTH ORGANIZATION (WHO)
Action Programme on Essential Drugs
1993

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This manual defines a limited number of objective measures that can describe the drug use situation in a country, region or individual health facility. Such measures, or indicators, will allow health planners, managers and researchers to make basic comparisons between situations different areas or at different times. In addition, when an intervention is undertaken to improve aspects of drug use, the indicators can be used to measure impact. Indicators can also serve as simple supervisory tools to detect problems in performance by individual providers or health facilities

Improving management of childhood malaria in Nigeria and Uganda by improving practices of patent medicine vendors

GREER, George
et al
2004

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"A number of studies from Sub-Saharan African (SSA) have shown that between 15 and 82 per cent of the population choose to first consult private drug shops and informal providers for advice about and assistance with treatment of childhood illnesses. It has also been found for private shops that a large percentage of the drugs provided or dosages given, or both, are inappropriate, indicating the need for innovative and effective approaches to achieve rational prescribing practices. The Ministries of Health in Nigeria and Uganda, in collaboration with partners, designed approaches to utilize private providers for delivery of basic child survival strategies and products to those populations less served by the public sector. These two distinct exploratory models built on lessons from similar efforts in SSA and elsewhere to develop approaches suited to the present situations in Nigeria and Uganda. This report describes the design, implementation, and results of those interventions"

Introducing the gender perspective in national essential drug programmes

BISILLIAT, Jeanne
February 2001

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The objective of this document is to provide a conceptual framework to explain the situation of women and men with regard to health and drugs, and to encourage policy makers and programme managers to adopt a gender-sensitive approach. The document draws on and quotes theoretical anthropological literature, and the English version is a relatively poor translation of the French original

Malaria treatment in Nigeria : the role of patent medicine vendors

OLADEPO, Oladimeji
et al
March 2009

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"This scoping study provides a quick assessment of the malaria treatment markets and the role played by patent medicine vendors in Nigeria, and offers ways to improve the regulation and provision of anti-malarial drugs. It documented the sources of drugs in the three states and people’s problems in getting access to appropriate treatment for malaria"

Measuring transparency in medicines registration, selection and procurement : four country assessment studies

BAGHDADI-SABETI, Guitelle
WONDEMAGEGNEHU, Eshetu
2006

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This report summarises the findings of the transparency assessments carried out in the first four countries participating in the WHO-initiated Good Governance for Medicines Project, which offers a technical support package for tackling unethical issues in the public pharmaceutical sector. It provides a comprehensive picture of the level of transparency and potential vulnerability to corruption in three essential functions of the public pharmaceutical sector - registration, selection and procurement of medicines. The methodology provides both qualitative and quantitative information. In each country two national investigators collected data, conducting a series of interviews with carefully selected key informants

Neglected diseases : a human rights analysis

HUNT, Paul
et al
2007

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This report introduces and explores some of the connections between neglected tropical diseases (those affecting people living in developing countries, particularly in rural areas) and human rights with a view to urging all parties concerned to work collaboratively in identifying the practical implications of applying human rights to the design, implementation, monitoring and evaluation of policies, programmes and projects for neglected diseases

Prescription for healthy development : increasing access to medicines

LEACH, Beryl
PALUZZI, Joan E
MUNDERI, Paula
2005

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This resource highlights the importance of increasing the availability, affordability, and appropriate use of medicines in developing countries. Produced by the Working Group on Access to Essential Medicines or the Taskforce on AIDS, Malaria and TB and Access to Essential Medicines it offers concrete and practical steps to increase incentives for research for priority diseases of developing countries, improve procurement and distribution, strengthen primary health systems, develop more human resources, and increase health funding

Survey of the quality of selected antimalarial medicines circulating in Madagascar, Senegal, and Uganda

UNITED STATES PHARMACOPEIA DRUG AND INFORMATION PROGRAM
November 2009

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This report focuses on three of 10 sub-Saharan countries that were covered by a study examining the quality of key antimalarial medicines. A total of 491 samples of anti-malarial medicines (both artemisinin-based combination therapy and sulfadoxine-pyrimethamine products) were collected from the public sector, the regulated private sector and the informal market in these three countries. The study revealed a high failure rate among sampled antimalarials in all three countries, based both on Minilab and full-compendial or quality control laboratory testing

The push for local production, costs and benefits - a case study of Uganda’s Quality Chemicals|Africa Fighting Malaria policy paper

TAYLOR, James
et al
September 2009

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This research report considers the challenges faced by a local pharmaceutical firm - Quality Chemicals - in Uganda, which was started up as a 'solution' to reducing the high cost of medicines and improving access to medicines. "...many burdens and barriers to access continue to seriously hinder the success of such enterprises. Indirect government subsidies to exporters selling into African markets, and pressure by donors and lobbyists on innovator producers to offer developing countries subsidised prices, actually undermine the competitiveness and viability of these nascent firms. Furthermore, the focus on drug pricing and local production can actually undermine the overall aim to increase access to medicines"

The selection of essential medicines

WORLD HEALTH ORGANIZATION (WHO)
June 2002

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Essential medicines are those that satisfy the priority health care needs of the population. This leaflet looks at the policy and relevance of the concept of essential medicines, how they can be selected, and how to implement a national list of essential medicines

WHO medicines strategy : 2000-2003

WORLD HEALTH ORGANIZATION (WHO)
December 2000

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This strategy is the basis for coordinated action to bring essential medicines to where they are most urgently needed. Where public health services and insurance are inadequate, health care and medicine costs mean that serious illness is a major reason why poor populations remain trapped in poverty

WHO model list of essential medicines for children

WORLD HEALTH ORGANIZATION (WHO)
March 2009

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The medicines in this model list are intended for use for children up to the age of 12. There is a core list of minimum medicine needs for a basic health care system, listing the most efficacious, safe and cost-effective medicines for priority conditions. Priority conditions are selected on the basis of current and estimated future public health relevance, and potential for safe and cost-effective treatment. There is also a complementary list of essential medicines for priority diseases, for which specialised diagnostic or monitoring facilities, and/or specialist medical care, and/or specialist training are needed

WMF 2006 : WHO Model Formulary

MEHTA, Dinesh K. RYAN, Rachel S.M. HILL Suzanne R.
Eds
2006

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This is a resource is for countries wanting to develop a national formulary. This edition is fully compatible with the 14th WHO Model List of Essential Medicines as recommended by the WHO Expert Committee on the Selection and Use of Essential Medicines at its meeting of March 2005

Serials

Essential medicines monitor

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This publication is a re-launch of WHO's Essential Drugs Monitor. It offers on international perspective to medicines issues, focusing on developing and transitional countries. It aims to stimulate discussion and share news and experiences on core areas of work. In its new format the Monitor will be produced 10 times a year as an electronic newsletter. For readers with limited Internet access, individual articles will be available on request and a compilation of articles will be printed and distributed approximately every two years

Focus on pricing policies : EMRO ministers confront high prices

HEALTH ACTION INTERNATIONAL (HAI)
WORLD HEALTH ORGANIZATION (WHO)
2007

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The focus of this edition of HAI and WHO's bulletin for medicines prices surveys is a meeting of the regional committee of the WHO's Eastern Mediterranean region (EMRO) at which the results of 11 medicines pricing surveys carried out in the region were compared and discussed and it was decided to share information regionally

Guidelines on policies that affect medicine prices

HEALTH ACTION INTERNATIONAL (HAI)
WORLD HEALTH ORGANIZATION(WHO)
2008

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At a time when over 50 medicines pricing surveys had been completed around the world using the HAI/WHO methodology, the lead article to this edition of the medicines pricing survey bulletin considers the need for guidelines to assist in the creation of policy changes that will help to reduce the price of essential medicines

Improved availability of essential medicines needed

HEALTH ACTION INTERNATIONAL (HAI)
WORLD HEALTH ORGANIZATION (WHO)

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The lead article in this edition of the HAI and WHO medicines prices survey quarterly bulletin focuses on the need to improve the availability of essential medicines. Since 2003, medicines prices surveys have been carried out in a number of countries using a survey tool designed by WHO and HAI

Safe medicines project - phase II : the Zambian case study

AFRICA FIGHTING MALARIA
March 2009

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This bulletin reports on the results of a study in which a range of antimalarial drugs were procured from private pharmacies, shops and kiosks within the urban and peri-urban areas of Lusaka, Zambia and tested to measure the active pharmaceutical ingredient content against internationally acceptable standards

Taxing essential medicines : a sick tax that hinders access to treatment

HEALTH ACTION INTERNATIONAL (HAI)
WORLD HEALTH ORGANIZATION (WHO)
December 2009

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This issue of the bulletin includes articles about the taxes on medicines and access to medicines; a report of a survey about medicine prices and availability in Latin America and the Caribbean; and about poor access to diabetes care in the Philippines

The Lancet : essential medicines out of reach of most people

HEALTH ACTION INTERNATIONAL (HAI)
WORLD HEALTH ORGANIZATION (WHO)
December 2008

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The lead article of this edition of the WHO and HAI medicines pricing survey quarterly bulletin picks up on an article published in the Lancet which highlights the financial burden faced by many people living in low and middle income countries when having to pay for essential medicines

UN MDG gap task force report

HEALTH ACTION INTERNATIONAL (HAI)
WORLD HEALTH ORGANIZATION (WHO)
September 2008

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Making essential medicines more affordable and more widely available are essential in helping to meet the millennium development goals. The lead article of this edition of HAI and WHO's medicines pricing survey bulletin, looks at UN Secretary General Ban Ki Moon's response to a mid-term progress report from the MDG Gap Task Force

Journal articles

Access to essential medicines as a human right

HOGERZEIL, Hans
2003

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This article looks at the right to health enshrined within the Universal Declaration on Human Rights and the obligations that states have to individuals to create policies to fulfil that right, both generally and with particular with regard to essential medicines

Antimalarial drug quality in the most severely malarious parts of Africa - a six country study

BATE, Roger
et al
May 2008

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This article describes research conducted on a range of antimalarial drugs, procured from private pharmacies in urban and peri-urban areas in the major cities of six African countries which were subjected to semi-quantitative thin-layer chromatography (TLC) and dissolution testing to measure active pharmaceutical ingredient content against internationally acceptable standards

Health and the MDGs : the challenges ahead

CHAN, Margaret
2007

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Although there has been much progress towards meeting the three of the eight Millennium Development Goals relating to health, there are still considerable inequalities to be overcome if they are to be met by 2015. The Director General of the World Health Organization sees the need to improve access to essential medicines as one of major challenges

Human rights and essential medicines : what can they learn from each other?

HOGERZEIL, Hans V.
May 2006

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"This paper provides a brief overview of what the international human rights instruments mention about access to essential medicines, and proposes five assessment questions and practical recommendations for governments. These recommendations cover the selection of essential medicines, participation in programme development, mechanisms for transparency and accountability, equitable access by vulnerable groups, and redress mechanisms"

Websites

Essential medicines

WORLD HEALTH ORGANIZATION (WHO)

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This section of the WHO website provides resources, information and links relating to essential medicines. Essential medicines are those that satisfy the priority health care needs of the population. They are selected with due regard to public health relevance, evidence on efficacy and safety, and comparative cost-effectiveness; and 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 adequate information, and at a price the individual and the community can afford

GDF drugs, diagnostics and other TB supplies

GLOBAL DRUG FACILITY (GDF)

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This catalogue lists first-line anti-TB drugs, TB diagnostics equipment and other products currently supplied by the Global Drug Facility (GDF). GDF is a mechanism to expand access to, and availability of, high-quality anti-TB drugs and diagnostics to facilitate global DOTS expansion or maintenance to support the Stop TB Strategy

Malaria commodity services

ROLL BACK MALARIA

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Malaria commodities services contains background information about the different technologies available for preventing, testing for and treating malaria, as well as a database of information about the artemisinin-based combination therapies (ACTs) and insecticide treated nets (ITNs) that are available in developing country markets across the world, including procurement volume and forecasting information where this is available

PMI : President's malaria initiative

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This website highlights work in combating malaria in 15 of the worst affected countries in Africa. Some information on malaria treatment is available, primarily through recipient country case studies

SCMS [supply chain management system]

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This website includes an e-catalogue of products set out in categories including: ARVs, HIV test kits, essential drugs, and laboratory equipment and supplies, offering a brief description of each product. There is also a resource centre which includes reports of past orders through SCMS, giving data on procurement volumes

Strengthening pharmaceutical systems

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This is the website for the Strengthening Pharmaceutical Systems (SPS) project that supercedes the Rational Pharmaceutical Management (RPM) project and Rational Pharmaceutical Management Plus programme http://www.msh.org/projects/rpmplus/index.cfm . RPM’s goal was to improve the efficiency, equity, and quality of pharmaceutical management in developing countries by promoting improvements in the allocation and use of resources. The aim of SPS is to continue and expand existing work and focus good governance in the pharmaceutical sector, pharmaceutical care, pharmacovigilance, laboratory services, health financing, and innovative mechanisms to enhance access to medicines

The WHO essential medicines library

WORLD HEALTH ORGANIZATION (WHO)

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This web-based information service provides access to the latest editions of 'WHO Model List of Essential Medicines', 'Disease/Indication information' and 'WHO Model Formulary'

UNITAID : together to heal

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UNITAID’s mission is to contribute to scaling up access to treatment for HIV and AIDS, malaria and tuberculosis, primarily for people in low-income countries, by leveraging price reductions for quality diagnostics and medicines and accelerating the pace at which these are made available