Much has been achieved in pharmaceuticals in the 50 years since WHO began establishing international pharmaceutical standards and guidelines, and since the introduction 25 years ago of the essential drugs and national drug policy concepts. Nearly 160 countries now have national essential drugs lists, while over 100 countries have national drug policies in place or under development. Similarly, rational drug use concepts and teaching are spreading in all regions. Most importantly of all, though, access to essential drugs grew from 2.1 billion people in 1977 to 3.8 billion people in 1997.

The estimated number of people with access to essential drugs has doubled in only 20 years - but one-third of the world’s population still lacks such access

Source: World Health Organization, 1998. Progress of WHO Member States in Developing National Drug Policies and in Revising Essential Drug Lists.

Yet at the beginning of the 21st century inequities in terms of access to essential drugs, quality and rational use remain widespread in many parts of the world. An estimated one-third of the world population lacks regular access to essential drugs, with this figure rising to over 50% in the poorest parts of Africa and Asia. The reasons often include inadequate financing and poor health care delivery. And even if drugs are available, weak drug regulation may mean that they are substandard or counterfeit. Irrational use - for example, high rates of antibiotic prescription, very short dispensing times and incorrect drug use by patients - is of great public health concern too.