Indicators selected for monitoring implementation of the WHO Medicines Strategy 2000 - 2003 reflect a pragmatic balance between those factors which are most meaningful for assessing country progress, and those which are most measurable in terms of reliability, time and cost. Table 6 lists the 26 country progress indicators - selected from among level I and level II indicators - corresponding to the target outcomes of the WHO Medicines Strategy 2000 - 2003. WHO will use them to analyse country, regional and global pharmaceutical situations and progress. They are linked to WHO's key medicines strategies to be implemented during the two biennia (2000 - 2001 and 2002 - 2003). They also represent pharmaceutical components and strategies that are key to the delivery of effective health services.

The country progress indicators provide information on structure, process and outcome:

Structure - Does a country have the necessary structures and mechanisms in place for improving its pharmaceutical sector including: a national drug policy document; a national drug policy implementation plan; a recently updated essential drugs list; computerized drug registration; national guidelines on drug donations; laws and regulations on herbal medicines; and inclusion of traditional medicine in the national drug policy and national health policy.

Process - Has a country established the necessary procedures for implementing pharmaceutical strategies including: generic substitution at private retail outlets; provision of public health insurance that reimburses drug costs; use of an essential drugs list and competitive tender for public procurement of drugs; participation in the WHO Certification Scheme on the Quality of Pharmaceutical Products Moving in International Commerce; basic drug regulation and quality assurance.

Outcome - Has a country established the necessary procedures for implementing pharmaceutical strategies including: improving the availability of essential drugs and increasing the percentage of the population with access to essential drugs.

In brief, these country progress indicators will help assess overall progress in the pharmaceutical sector that has resulted from the combined efforts of government, local NGOs, the local private sector, WHO and others. They have already been used to derive and identify a complementary set of indicators for the WHO Programme Budget 2002 - 2003. ⁷⁶ This second set of indicators will be used to monitor and evaluate WHO performance - in Regional Offices, at WHO Headquarters and within individual countries - in contributing to country progress in essential drugs and medicines work.