WHO expanded its support to the WHO-India Essential Drugs Programme in 1997. This was to enable the Programme to extend the success of its Delhi Capital Territory Essential Medicines Programme, largely implemented by the Delhi Society for Promotion of Rational Use of Drugs (DSPRUD). DSPRUD's activities during 1997- 2002 were externally evaluated in October 2002.
The hallmark of DSPRUD activities has been close cooperation with the Delhi State Government. DSPRUD has also assisted nongovernmental organizations (NGOs) in other states, such as Rajasthan, and large institutions such as the Municipal Corporation of Mumbai, with activities to promote rational use of medicines. The evaluation found that DSPRUD's design and implementation of a transparent pooled procurement and distribution system had resulted in a consistent supply of good-quality essential medicines for Delhi State's public health facilities. It also noted that execution of the programme through an NGO had minimized bureaucracy and encouraged flexibility for developing linkages with medical schools, universities and other institutions.
By the end of 2001, the WHO-India Essential Drugs Programme was operating comprehensive essential drugs programmes in 6 states and partial programmes in a further 8 states. In 2002, partial programmes were introduced in Bihar, Chattisgarh, Kerala, Orissa and Uttar Pradesh, and significant progress made in developing standard treatment guidelines (STGs). STGs were developed as follows:
• Delhi State: STGs were prepared by DSPRUD, for treating patients with specific clinical conditions, following an extensive consultative process involving 70 clinicians, from all levels of health care, and including some private practitioners.
• Karnataka State: STGs for primary health care facilities were prepared and distributed to district health officers.
• Madya Pradesh State: STGs were developed for reproductive and child health.
• Maharashtra State: STGs for treating in-patients of secondary and tertiary health-care facilities in the Municipal Corporation of Greater Mumbai were prepared and published by the Department of Clinical Pharmacology, BYL Nair Charitable Hospital.
• Uttar Pradesh State: STGs were prepared with technical support from DSPRUD and will be distributed by the Government of Uttar Pradesh to doctors in hospitals and primary health centres.