This paper reviews the major health and pharmaceutical developments in
developing countries for the past 25 years and suggest what may occur over the next 25 years. Major health,
social, economic and development changes have occurred during this period. The Alma Ata declaration
was pronounced in 1978 suggesting an approach to health and health services. An integral part of
this approach was the essential drugs concept which has had a global impact. The International
Dispensary Association (IDA) has been a major influence in this development. Before considering
pharmaceutical issues it is necessary to consider the underlying health and development situation of countries where
essential drugs are of critical importance...