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...