Chapter 16: Managing medicine selection - Key topics: the concept of essential medicines; selection of essential medicines and development of ess...ential medicines lists, formularies, and treatment guidelines. - The rationale for selecting a limited number of essential medicines is that it may lead to better supply, more rational use, and lower costs.
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The escalating antimicrobial resistance (AMR) pandemic is a global public health threat with extensive health, economic and societal implications. Resistance emerges because of selection pressure fr...om rational and indiscriminate antimicrobial use in human health as well as in the veterinary, agriculture and environmental sectors. Infections caused by resistant bacteria result in longer duration of illness, higher mortality rates and increased costs associated with alternative treatment. AMR further constrains procedures that rely on antimicrobial prophylaxis, and AMR is recognized as a threat to theworld economy.
Journal of Public Health | Vol. 39, No. 1, pp. 8–13 | doi:10.1093/pubmed/fdw015 | Advance Access Publication March 3 2016
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Using the WHO model list of essential medicines to update a national essential medicines list
Since 1977, WHO has been working with countries to design the package of essential medicines as an integral component of treatment within the continuum of care, developing ...ht medbox">and disseminating the Model List of Essential Medicines (Model List). WHO is committed to supporting Member States in sharing best practices in selecting
essential medicines, and in developing processes for the selection of medicines for national essential medicines lists (national EMLs, or NEMLs) consistent with the evidence-based methods used for updating the WHO Model List.
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23 December 2020 This document summarizes WHO recommendations for the rational use of personal protective equipment (PPE) in health care settings and...n> temporary strategies during acute supply shortages. This document also contains 2 Annex sections describing updated PPE use recommendations for health workers based on the transmission scenario, setting, and activity in the context of COVID-19 (Annex 1), and updated considerations for the decontamination or reprocessing of PPE (Annex 2). This guidance is intended for public health authorities, organizations, and focal persons involved in decisions regarding PPE distribution, management, and use by health workers.
Available in Arabic, French, English, Spanish and Russian
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Millennium Development Goal 8E aims for affordable access to essential medicines. Essential medicines, as defined by WHO, are those that “satisfy the health-care needs of the majority of the population” and that should therefore “be available ...at all times in adequate amounts”. However, there is a category of medicines that faces a unique challenge in terms of availability. These are the medicines governed by the international conventions on narcotic and psychotropic substances. “Controlled medicines” is the common definition for pharmaceuticals whose active principles are listed under the 1961 United Nations Single Convention on Narcotic Drugs as amended by the 1972 Protocol, such as morphine and methadone; the 1971 United Nations Convention on Psychotropic Substances, such as diazepam and buprenorphine; and the 1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, such as ergometrine and ephedrine. The conventions list substances in “Schedules” according to their different levels of potential for abuse and harm, and the commensurate severity of control measures to be applied by countries.
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As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is i...nappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicrobial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
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The Federal Ministry of Health (FMOH) has been coordinating sector wide reforms that aim to improve equity and quality of maternal and child health services. As part of these efforts, ... the ministry is also exerting concerted efforts to improve availability and use of quality RMNCH pharmaceuticals. Management of RMNCH pharmaceuticals has had significant challenges such as poor availability of essential pharmaceuticals and wastages of valuable resources as pharmacy professionals were not demonstrating the required knowledge, skill and attitude towards availing the pharmaceuticals and ensuring their rational medicine use.
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The "Primary Healthcare Standard Treatment Guidelines and Essential Medicines List" by the South African National Department of Health provides evidence-based guidelines for diagnosing and managing ...common medical conditions at the primary healthcare level. This document includes treatment protocols for various health issues, such as infections, chronic diseases, maternal and child health, mental health, and emergency care. It aims to standardize care, promote rational medicine use, and ensure equitable access to essential medications across South Africa. The guidelines emphasize prevention, accurate diagnosis, and efficient treatment strategies to improve patient outcomes.
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STGs are designed to assist health care professionals in making decisions about appropriate, effective patient care. However, health managers often have trouble setting and meeting the high standards required of modern, developed health care systems.... With stakeholders expressing concern over issues such as strength of evidence, transparency, conflicts of interest, and effective implementation, it is clear that many health care professionals need further guidance in developing and making use of STGs.
This manual guides health professionals through the process of establishing and implementing STGs, placing special emphasis on the low- and middle-income country (LMIC) context. By including tools, templates, and success stories as well as hyperlinks to useful resources, the manual helps health practitioners understand not only important concepts of treatment guidelines, but also how they can best be used in practice.
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Spread of resistance to antimicrobial agents (AMR) does not know national borders and has reached dimensions, which require immediate actions at the national, regional and global levels.
Antibiotic... resistance is a natural biological response to improper use of antimicrobial agents (AMA); increasing number of essential drugs, which become ineffective, contributing to selection, survival and replication of resistant strains of microorganisms. When chosen antimicrobials prove to be ineffective, the second- or third-line drugs need to be used although
in the majority of cases these drugs are more expensive, less safe and not always available.
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Last Mile delivery presents a unique challenge in making health commodities available in the developing world. This guide, designed for in-country practitioners and decisionmakers, uses a range of r...eal world examples to support selection and design of last mile distribution approaches which respond to specific challenges.
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The provision of safe and efficacious blood and blood components for transfusion or manufacturing use involves a number of processes, from the ...n class="attribute-to-highlight medbox">selection of blood donors and the collection, processing and testing of blood donations to the testing of patient samples, the issue of compatible blood and its administration to the patient. There is a risk of error in each process in this “transfusion chain” and a failure at any of these stages can have serious implications for the recipients of blood and blood products. Thus, while blood transfusion can be life-saving, there are associated risks, particularly the transmission of bloodborne infections.
Screening for transfusion-transmissible infections (TTIs) to exclude blood donations at risk of transmitting infection from donors to recipients is a critical part of the process of ensuring that transfusion is as safe as possible. Effective screening for evidence of the presence of the most common and dangerous TTIs can reduce the risk of transmission to very low levels.
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This document compiles the recommendations made by the World Health Organization (WHO) and the Pan American Health Organization (PAHO) to help professionals in charge of vector control programs in Latin America ...dbox">and the Caribbean at the national, subnational, and local level update their knowledge in order to make evidence-based decisions on the most appropriate control measures for each specific situation. IVM can be used for surveillance and control or for elimination of VBDs and can help reduce the development of insecticide resistance through the rational use of these products. This document provides instructions for fulfillment of the 2008 PAHO mandate set forth in CD 48/13 (Integrated Vector Management).
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Interagency Guidelines - This revised Interagency List of Essential Medicines for Reproductive Health presents
the current international consensus on rational selection of essential reproductive h...ealth medicines. The list is intended to support decisions regarding the production, quality assurance, national procurement and reimbursement schemes of these medicines.
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Fact Book on WHO Level I and Level II monitoring indicators - To monitor the progress of efforts to improve the global medicines situation, WHO has developed a system of indicators that measure important aspects of a country’s pharmaceutical situa...tion. Level 1 indicators measure the existence and performance of key national pharmaceutical structures and processes. Level II indicators measure key outcomes of these structures and processes in the areas of access, product quality and rational use. These indicators can be used to assess progress over time; to compare situations between countries; and to reassess and prioritize efforts based on the results.
This Fact Book gives the results of the assessment of Level I indicators conducted in 2003 and of Level II indicator surveys conducted between 2002 and 2004
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Access to safe blood and blood products is recognized as one of the key requirements for delivery of modern health care in the journey towards health for all. The foundation of safe and sustainable ...blood supplies depends on the collection of blood from voluntary non-remunerated and low-risk donors. Data from the WHO Global Database for Blood Safety (GDBS) brings out several inadequacies related to the supply and safety of blood and blood products. These inadequacies include a number of variations in safe blood practices across the world, including the quantity of blood donated (voluntary and replacement types), quality and adequate testing of the donated blood (immunohaematology [IH] and transfusion-transmitted infections [TTIs]), rational use of blood and blood components such as appropriate patient blood management protocols. These variations are very high in countries of the South-East Asian Region and most of them are either low- or middle-income countries (LMICs).
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Snakebites are well-known medical emergencies in many parts of the world, especially in rural areas. Agricultural workers and children are the most affected. The incidence of snakebite mortality is particularly high in South-East Asia. ...attribute-to-highlight medbox">Rational use of snake anti-venom can substantially reduce mortality and morbidity due to snakebites. These guidelines are a revised and updated version of Regional Guidelines for the Management of snakebites published by the WHO Regional Office in South-East Asia in 2011. These guidelines aim to promote the rational management of snakebite cases in various health facilities where trained health functionaries and quality snake antivenom are available.
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This field study to assess the pharmaceutical situation was undertaken in Ghana in May-June 2008 using a standardized methodology developed by the World Health Organization. The study assessed medicines availability and affor...dability, geographical accessibility, quality and rational use among other issues. The survey was conducted in six regions. In each region, 6 public health care facilities, 12 private pharmacies and 1 warehouse were surveyed.
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