Drugs and therapeutics committees (DTCs) - sometimes called pharmacy and therapeutics committees - are designated to ensure the safe and effective use of medicines in the facility or area under their jurisdiction. Such committees are well established in most industrialized countries as a successful way of promoting a more rational, cost-effective use of medicines in hospitals. WHO promotes the establishment of DTCs through its international training courses (which are run in collaboration with MSH), the preparation of a manual on DTCs and various other research projects.

The main responsibilities of a DTC are:

- developing, adapting or adopting clinical guidelines for the health institution or health facilities under its jurisdiction;

- selecting cost-effective and safe medicines (hospital/health facilities' drug formulary);

- implementing and evaluating strategies to improve medicine use (including drug use evaluations, and liaison with antibiotic and infection control committees);

- providing ongoing staff education (training and printed materials);

- controlling access to staff by the pharmaceutical industry and its promotional activities;

- monitoring and taking action to prevent adverse drug reactions and medication errors;

- providing advice about other drug management issues, such as quality and expenditure.

Governments should encourage all hospitals to set up a DTC (e.g. by making it an accreditation requirement to various professional societies) with a membership that represents all the major specialities and the administration. DTC members should be independent and declare any conflict of interest. A senior doctor would usually be the chairperson and the chief pharmacist, the secretary. Factors critical to success include: clear objectives, a firm mandate, support from the senior hospital management, transparency, wide representation, technical competence, a multidisciplinary approach and sufficient resources to implement the DTC's decisions.

The WHO manual on establishing and running a DTC will be issued in 2003 (10); international 2-week training courses are ongoing in Asia and Africa.