After the second World War the development and emergence of miracle medicines
like antibiotics brought a revolution in the medical care. The obvious
effectiveness of these new pharmaceuticals and intensive marketing efforts
combined to catalyze wide spread use of modern medicine. A rapidly growing and
profitable industry, together with an enthusiastic but largely uninformed
audience and an unregulated market, resulted in excess of promotion and
consumption alowgwith inflated level of expenditure. However, by 1970s it had
become clear that least advantageous nations were not even meeting the basic
needs of their people for essential life saving and health promoting medicines.
As a result gradually a number of countries started concentrating on the
development of a basic list of reliable medicines to meet the most vital basic
needs of their people.
A World Health Organization (WHO) Committee of Experts met in 1977 to determine
the number of medicines, which were actually needed to ensure a reasonable level
of health care for as many people as possible. Consequently, the first Model
List of Essential medicines was finalized in the same year. This list is being
updated regularly by the WHO and is intended to be used as a guideline and
provide basis for member countries to identify their own priorities and make
their own selection. Through 1970s and 1980s the WHO started promotion of the
concept of Essential medicines Program in order to redress this imbalance. The
program aimed at reduction in the number of medicines purchased/used by the
hospitals/institutions to a minimum possible level in order to make best use of
limited public funds.
Essential medicines as defined by WHO are those that satisfy the health care
needs of majority of the population. They should therefore be available at all
times in adequate amounts and in the appropriate dosage forms.
The National Essential medicines List (NEML) of Pakistan was first prepared in
1994 in consultation with relevant experts. The list was previously reviewed in
1995, 2000 and 2003. The present list is the fourth revision containing 335
medicines of different pharmacological classes.
The health sector in general and public health sector in particular is expected
to seriously consider adopting this list. The provincial health departments can
play a pivotal role to encourage the hospitals/institutions for making bulk
purchases from within this list. We hope that this list will find more
acceptance among health care professionals...