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Conclusion: Rationalizing drug markets in the Global South
Published in Carine Baxerres, Maurice Cassier, Understanding Drugs Markets, 2021
Maurice Cassier, Carine Baxerres
The criteria for selecting medicines for inclusion in the Essential Medicines List (EML) are crucial here to govern the pharmaceutical market to benefit public health in terms of safety, therapeutic usefulness, and product accessibility. EMLs must be formulated using International Nonproprietary Names (INNs), provoking the wrath of the International Federation of Pharmaceutical Manufacturers Associations (IFPMA), which views this as a declaration of war against its brands. The principle of a limited list of 220 products in 1977—all in the public domain due to expired patents—is also denounced by industry actors who argue for the dynamics of markets and innovation.
‘I wish one of these patients would sue us’
Published in Helen Macdonald, Ian Harper, Understanding Tuberculosis and Its Control, 2019
The above list of practices employed to provide people access to TB diagnosis and treatment should be a red flag for policymakers. The approach to drug-resistant TB has been inadequate for more than twenty years. The WHO’s (and others’) early recommendations to treat MDR-TB with the same first-line drugs as drug-susceptible TB because of the high cost of effective (second-line) treatment (Crofton et al., 1997; Alexander, 1998) have been criticized by Paul Farmer (2005) and others for creating a double standard where people in low- and middle-income countries are not entitled to the same level of medical care. One way this was accomplished is basing inclusion on the Essential Medicines List on criteria other than effectiveness, such as affordability (Nicholson et al., 2016). The WHO’s recommendations for the treatment of XDR-TB perpetuate this double standard. Cost-effectiveness and concerns over ‘irrational use’ take precedence over the public health and moral emergency to provide treatment to people who live in countries that have not adopted effective XDR-TB treatment strategies. XDR treatment is frequently determined not by what drugs a strain is susceptible to, but rather by what is available within the country. Since the WHO Global Drug Facility has only stocked drugs like linezolid and clofazimine since 2014, quality treatment for XDR-TB was unavailable in most places, with the exception of the wealthiest countries and within projects run by Partners in Health (Gelmanova et al., 2015) and Médecins Sans Frontières (Hughes et al., 2015).
Sudan
Published in Hassan Salah, Michael Kidd, Ahmed Mandil, Family Practice in the Eastern Mediterranean Region, 2019
Abdalla Sid Ahmed Osman, Eiman Hag, Hind Amin Merghani, Naeema Al Gasseer
PHC infrastructure has received great attention from the MoH in recent years. An expansion project started in 2012 and focuses mainly on infrastructure and human resources for health training. The content of the EHSP provided at PHC level is based on the burden of diseases. The finance policy ensures that the National Health Insurance Fund (NHIF) provides the EHSP and the comprehensive package for all the insured population in addition to the poor.2 The number of health facilities providing the complete EHSP has increased from 24% to 62% between 2011 and 2016.3 A recent study showed that the availability of essential medicines at public and private health facilities reached 73% and 90% respectively.4
The interpretation of China national essential medicines list 2018
Published in Expert Review of Clinical Pharmacology, 2020
Wei Zuo, Dan Mei, Wenjuan Sun, Xiaowan Tang, Ziran Niu, Daihui Gao, Bo Zhang
According to the definition of WHO, essential medicines should satisfy the priority health-care needs of member states and are selected with regard to disease prevalence, evidence of safety and efficacy, and comparative cost-effectiveness [1]. With the development of the times, the essential medicine list (EML) is no longer intended for low-income countries alone. Instead, the EML aims to create a common, global standard-a model list. Since the first edition of WHO-EML was issued in 1977, more than 156 countries have established their own EML using the WHO-EML as their basis for public procurement [2]. The 21st WHO-EML has been released in 2019. China issued the first edition of national essential medicine list (NEML) in 1982 and the current edition was updated in 2018. In the newly updated edition, the amount of medicines is expanded and the list structure is optimized. On one hand, the new list of essential medicines was brought forward on the bases of reference to the WHO-EML. On the other hand, with the development of economy and the increased requirement of medical care, the list had its own characteristics by combining with China’s national conditions. It is important to ensure that the EML is updated to reflect the contemporary worldwide medical practice as well as to adapt to the changes of the human disease spectrum.
Empirical antibiotic treatment for children suffering from dysentery, cholera, pneumonia, sepsis or severe acute malnutrition
Published in Paediatrics and International Child Health, 2018
The reviews were originally solicited by the World Health Organization (WHO) that has the mandate to support its member states through the provision of normative guidance on health promotion. There are two main tools to implement this normative support for the reduction of mortality from childhood infectious diseases: the WHO model list of essential medicines (EML) and technical guidelines about health promotion or case management of sick children. The WHO EML compiles medications considered to be most effective and safe to meet the key needs in a health system and it is frequently used by countries to help develop their own national lists of essential medicines. Technical guidelines, on the other hand, give guidance to health practitioners on the role and use of medicines in specific situations.
Assessing prescriber’s awareness of essential medicine list, hospital drug formulary and utilization of standard treatment guidelines in a tertiary healthcare facility in North-Central Nigeria
Published in Alexandria Journal of Medicine, 2018
Abdullahi Hassan, Gobir Abdulrazaq Abdullahi, Abubakar Aisha Ahmed, Adamu Sabiu, Uwaya John, Gwamna Ezekeil, Yahaya Aliyu Ibrahim
Essential Medicine List is a list of minimum medicines that are needed for a basic health-care system. The list contains the most efficacious, safe and cost–effective medicines for priority conditions.11 The List is promoted by the World Health Organization (WHO) as a means to facilitate equality in access to medicines across the globe. It has been created to satisfy the priority health care needs of societies in terms of availability and affordability of efficacious medicines.12 A study by Bazargani et al revealed that EMLs have influenced the provision of medicines and have resulted in a higher availability of essential medicines compared to non-essential medicines particularly in the public sector and in low and lower middle income countries.13 The findings revealed that the overall median availability of essential medicines for any product type was 61.5% while the availability of non-essential medicines was 27.3%. In the public sector, the median availability of essential and non-essential medicines was 40.0% and 6.6% respectively for any product type.13 Availability also differ across income groups: in upper-middle income countries the availability of originator brands was considerably higher than other income groups both for essential and non-essential medicines (40% availability in both groups). Median availability of the two groups of medicines (essential vs. non-essential) differed significantly in low and lower-middle income countries for any product type of medicines (Difference = 25% and 11.3% respectively; p, 0.05).13