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Chemistry International
Vol. 23, No. 6
November 2001


New Publications from the World Health Organization

The Use of Essential Drugs, 9th Report of the WHO Expert Committee (including the Revised Model List of Essential Drugs), WHO Technical Report Series No. 895, 2000, v + 61 pages (available in English; French and Spanish in preparation), ISBN 92-4-120895-3, CHF 14.-/USD 12.60; In developing countries: CHF 9.80, Order No. 1100895.

This report presents and explains the 11th model list of essential drugs issued by WHO as part of its efforts to extend the benefits of modern drugs to the world's population. Intended to guide the selection of drugs in countries where the need is great and resources are small, the list identifies a core group of prophylactic and therapeutic substances judged capable of meeting the vast majority of health needs and, thus, deserving priority in purchasing decisions and procurement schemes. The model list also serves as an information and educational tool for health professionals and consumers, and facilitates the development of treatment guidelines, national formularies, information for patients, and other measures to improve drug use. WHO model lists, the first of which was issued in 1977, are regularly updated to ensure that recommendations are in line with the latest data on the comparative safety, efficacy, and costs of specific drugs, as well as their relevance to priority health problems. Factors of stability, quality control, and international availability are also considered when validating and revising the lists.

The first part of the report provides updated information on several components of national drug policy necessary to ensure that essential drugs, corresponding to essential health needs, are available at all times in adequate amounts and in the proper dosage. Information includes guidelines for the selection of pharmaceutical dosage forms, the importance of bioavailability in assessments of drug quality, recommended use of the Anatomical Therapeutic Chemical classification system and the Defined Daily Dose as a measuring unit when conducting drug utilization studies, and the growing problem of resistance to some of the widely available and relatively cheap antimicrobials included in the list.

In view of the increasingly high levels of resistance to standard antituberculosis drugs, the report designated nine drugs and formulations as essential for the treatment of multidrug-resistant tuberculosis. The report also describes plans for a major revision of the procedures used when updating the model list.

The 11th WHO model list of essential drugs is pre-sented in the second part, together with an explanation of changes made when revising the list. Organized according to therapeutic group, the list includes information on route of administration, dosage forms, and strengths for each of 306 drugs. To qualify for inclusion, a drug must be supported by sound data demonstrating safety, efficacy, and consistent performance in a variety of medical settings.

The report concludes with an explanation of changes made in the list. These changes include the addition of nevirapine for the prevention of mother-to-child transmission of HIV, of artesunate for the treatment of malaria resistant to older drugs, and of levonorgestrel for emergency contraception.



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