During the Alma-Ata conference sponsored by United Nations Children’s Fund (UNICEF) and World Health Organization (WHO) in September 1978, the availability and accessibility of essential drugs were reaffirmed as basic components of primary health care. The conference recommended that governments formulate and implement national drug policies in order to improve their national pharmaceutical sectors. A year later, the thirty-second World Health Assembly requested the Director-General to establish a special programme on essential drugs that would assist Member States to develop and implement national drug policies. This request led to the creation of the Drug Action Programme now called the Essential Drugs and Medicines Policy.

The Bamako Initiative launched by UNICEF and WHO in 1987 was a further step towards assisting countries in ensuring regular access to health services in general and to essential drugs in particular in a participative manner, especially at the community level. However, available drugs need to be well managed in order to meet public health needs. The drug management cycle (i.e. selection, procurement, distribution, use) with the appropriate management support services (i.e. organization, financing, information, human resources) and within an appropriate policy and legal framework contributes significantly to getting the maximum output of limited resources available for essential drugs.

Despite the availability of numerous tools for the management of drugs, none of these specifically targets the health centre level, particularly the health workers who have had no formal training in drug management. Thus the WHO Regional Office for Africa started to develop this manual in 1996. After several reviews of the original script by outside consultants as well as staff in the Division of Health Systems and Services Development in AFRO, the first draft was ready in July 1999. The manual was field-tested in three Member States: Malawi in October 1999, the Gambia in August 2000 and Lesotho in October 2000.

The WHO Regional Office for Africa is making this manual available to Member States and is ready to provide any assistance when requested in the use of this learning tool for the training of health workers at the country level.

Dr Ebrahim Malick Samba
WHO Regional Director for Africa
Brazzaville

April 2004