African Traditional Medicine: A Dictionary of Plant Use and Applications, H.D. Neuwinger, 2000, 590 p.

This comprehensive book documents the traditional knowledge and use of African medicinal plants. In total more than 5,400 plants from the sub-Sahara region are listed, together with over 16,300 medicinal applications, giving the plant part used, preparation method and dosage.

Plants are arranged alphabetically by their scientific names. A supplement to the book gives an alphabetical list of diseases and ailments, with a numbered search system for the relevant plants. The publication is primarily intended for scientists looking for medicinally active plants for further research, and will also be of interest to botanists, biologists and ethnologists.

Available from: Medpharm GmbH Scientific Publishers, Birkenwaldstr. 44, 70191 Stuttgart, Germany. Price: Fr.fr. 720; Euro 109.

Management of the Child with a Serious Infection or Severe Malnutrition, Guidelines for Care at the First-referral Level in Developing Countries, World Health Organization, 2000, 162 p.

Intended for doctors and senior nurses in small hospitals, the manual aims to provide all the practical and technical guidance needed to facilitate quick decisions and life-saving interventions. Although advice on outpatient care is included, the manual concentrates on the inpatient management of diseases known to be the major killers of children in the developing world. Conditions covered range from pneumonia, diarrhoea, and severe malnutrition to malaria, meningitis and measles.

The manual follows a logical, sequential approach to management that relies on a limited number of drugs, laboratory investigations and practical procedures. Recommended lines of action combine the latest clinical knowledge with extensive practical experience concerning what works best when resources, drugs, and equipment are limited. Throughout, charts, tables, model forms, alerts to common errors and step-by-step instructions enhance the manual’s value as a practical tool.

The core of the manual provides detailed treatment instructions for individual clinical conditions. Separate chapters cover the management of over twenty diseases in children presenting with cough or difficult breathing, diarrhoea and fever. Other chapters cover the management of common problems in young infants, of children suffering from severe malnutrition and of children with HIV/AIDS.

Five appendices offer an illustrated guide to the performance of practical procedures, list recommended dosages and regimens for some 57 drugs, give formulas and recipes for treating severely malnourished children, and provide tables and charts for assessing nutritional status and recovery.

Available in English (Arabic, French, Portuguese, Russian, and Spanish in preparation), from: World Health Organization, Marketing and Dissemination, 1211 Geneva 27, Switzerland. Price: Sw.fr. 15/US$13.50, and in developing countries Sw.fr. 10.50.

International Nonproprietary Names (INN) for Pharmaceutical Substances: Names for Radicals and Groups. Comprehensive List: April 2000, World Health Organization, WHO/EDM/QSM/99.7, 2000, 49 p.

The book contains a comprehensive list of names for radicals and groups used in the WHO system for assigning international nonproprietary names (INNs) for pharmaceutical substances. Names for radicals and groups arise from the need to provide modified names for the salts or esters of substances already identified by an INN. In view of the complex composition of many radicals and groups, use of the chemical nomenclature is inconvenient and shorter nonproprietary names are therefore selected. The list also includes reference to two-word INN, and to British, Japanese and United States Accepted Names for the radicals, groups, and adducts published or accepted for use by the national nomenclature committees.

Available from: World Health Organization, Marketing and Dissemination, 1211 Geneva 27, Switzerland. Price: Sw.fr. 15/US$ 13.50, and in developing countries: Sw.fr. 10.50.

Bhutan Essential Drugs Programme: A Case History, M. Stapleton, World Health Organization, WHO/EDM/DAP/2000.2, 2000, 110 p.

This case history describes the development of the Bhutan Essential Drugs Programme - one of the best in the region -from 1984 to 1998. The approaches taken and lessons learnt during this period are described in detail for areas such as drug selection and rational use, store management, inventory management, drug procurement and quality assurance.

Available, free of charge, from: Department of Essential Drugs and Medicines Policy, World Health Organization, 1211 Geneva 27, Switzerland.

Management of Severe Malaria, A Practical Handbook, 2nd ed., World Health Organization, 2000, 70 p.

This is the second revised edition of a pocket-sized guide to the rapid diagnosis and management of severe P. falciparum malaria. In view of the complexities of management, the need for speed, and the severe consequences of errors, the book adopts a highly didactic approach. It offers an at-a-glance reference to the signs to look for, the tests to perform, the actions to take immediately and later, and the nursing care required. Special problems addressed throughout the book include the tendency of malaria to mimic many other diseases, the difficulty of diagnosis in cases of self-medication, the spread of parasite resistance to chloroquine and other drugs, and the need for special precautions in areas where blood may be contaminated with the human immunodeficiency virus (HIV).

Addressed to doctors and other medical staff, the book is designed to facilitate rapid decisions and immediate action. Fold-out flaps on the inside and back covers guide the correct selection, dosage, and administration of antimalarial drugs, provide a map showing the global status of chloroquine resistance, and summarise the immediate steps to follow when confronted with 13 specific complications. Coloured tab dividers make it possible to flip to the appropriate section containing full details on the clinical features and management of a given complication, the general principles of management and nursing care that apply to all patients, and the special protocols to follow when treating children and pregnant women.

Available in English, (French and Spanish in preparation), from: World Health Organization, Marketing and Dissemination, 1211 Geneva 27, Switzerland. Price: Sw.fr. 15/US$ 13.50, and in developing countries Sw.fr. 10.50.

The Use of Common Stems in the Selection of International Nonproprietary Names (INN) for Pharmaceutical Substances, World Health Organization, WHO/EDM/QSM/99.6, 2000, 137 p.

This is a list of common stems for international nonproprietary names (INNs) for pharmaceutical substances for which chemical or pharmacological categories have been established. These stems and their definitions are intended to guide the selection of new INNs (generic names) for substances that belong to an established series of related compounds. The list aims to encourage consistency in the designation of generic drug names while also protecting the principle that INNs are public property.

In two main parts, the publication first gives common stems and their definitions for 23 categories of drugs, the second part provides an alphabetical list of recommended stems and the corresponding family of INN. The publication is intended for manufacturers engaged in research and development, trademark officers and national regulatory authorities, and teachers of medicinal chemistry and pharmacology.

Available from: World Health Organization, Marketing and Dissemination, 1211 Geneva 27, Switzerland. Price: Sw.fr. 18./US$ 16.20, and in developing countries Sw.fr. 12.60.

WHO Model Prescribing Information: Drugs used in Bacterial Infections, World Health Organization, 2001, 126 p.

WHO Model Prescribing Information provides up-to-date, independent clinical information on essential drugs, including details of dosages, uses, contraindications and adverse effects. It is intended as source material for adaptation by national authorities, in particular in developing countries, that wish to produce drug formularies, data sheets and teaching materials.

Although many communicable diseases have been effectively contained, bacterial infections remain a major cause of morbidity and mortality, particularly in developing countries. This new volume of Model Prescribing Information includes drugs used for treating respiratory, gastrointestinal, urinary, perioral, dental and cardiovascular infections. It also covers scepticaemia and infections of the skin, soft tissues, bones and joints, sexually transmitted diseases and other commonly encountered infections. As the increasing prevalence of strains of common pathogenic bacteria resistant to widely available, affordable antimicrobials is, in many cases, dangerously eroding their effectiveness, general principles of antimicrobial prescribing are discussed.

Available from: World Health Organization, Marketing and Dissemination, 1211 Geneva 27, Switzerland. Price: Sw.fr. 35/US$ 31.50, and in developing countries Sw.fr. 24.50.

Drug Situation Analysis for the West Bank and Gaza Strip, World Health Organization, WHO/EDM/DAP/2000.1, 2000, 41 p.

This report of a situation analysis on drug availability and drug quality in the West Bank and Gaza Strip concludes that both are generally satisfactory, with major disruptions of supply only occurring as a result of political turbulence. The document provides demographic, socioeconomic and epidemiological background, followed by an overview of the health care system. It then focuses on pharmaceutical issues, with a series of recommendations on improving drug policy.

Available, free of charge, from: Department of Essential Drugs and Medicines Policy, World Health Organization, 1211 Geneva 27, Switzerland.

Ensuring Equal Access to Health Services: User Fee Systems and the Poor, W. Newbrander, D. Collins, L. Gilson, Management Sciences for Health, 2000, 188 p.

Health programmes in which patients pay fees for services generate much-needed revenue but also raise important concerns. For example, do user fees limit access to health services by the poor? How can people receive the health services they need even if they cannot pay for them? Some countries have developed mechanisms to protect the poor from the negative effects of user charges; do these protection mechanisms work?

This book examines user fee systems in five countries: Ecuador, Guinea, Indonesia, Kenya and Tanzania, to answer these questions and to make recommendations for policy experts and decision-makers. In many instances, user fees have reduced the access of the poor to health services, often because exemption mechanisms are poorly designed or implemented. In other cases, fees have resulted in improved access to and quality of services. The book synthesises lessons from these five countries and other studies, and the authors identify issues that must be addressed to protect the poor, and provide guidelines for designing and managing user fee systems.

User Fees for Health Services: Guidelines for Protecting the Poor, W. Newbrander, D. Collins, L. Gilson, Management Sciences for Health, 2001, 60 p.

Declining government resources for health and increasing demand have led many countries to seek funding for health services by charging users. Although these user fee systems usually incorporate mechanisms to protect the poor, the mechanisms often do not work well. This guide offers suggestions for making new or existing user fee systems more equitable. It helps policy-makers and programme managers decide what information they need before introducing fees, and advises on the types of mechanisms available to protect the poor, their effectiveness and cost.

Available from: Management Sciences for Health, 165 Allendale Road, Boston, MA 02130, USA. Tel: + 1-617-524-7799, fax: + 1-617-524-2825, e-mail: bookstore@msh.org

Publications are free of charge to people in Africa, Asia and Latin America. Contact MSH for details of prices elsewhere.

General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine, World Health Organization, WHO/EDM/TRM/ 2000.1, 2001, 71 p.

WHO has developed these general guidelines to respond to the question of what types of academic research approaches and methods can be used to evaluate the safety and efficacy of traditional medicine. The guidelines consist of sections on herbal medicines, on traditional procedure-based therapies, on clinical research, and related issues including ethics, education and training, and surveillance systems.

The specific objectives of the guidelines are to: harmonise the use of certain accepted and important terms in traditional medicine; summarise key issues for developing methodologies for research and evaluation of traditional medicine; improve the quality and value of research in traditional medicine; and provide appropriate evaluation methods to facilitate the development of regulation and registration in traditional medicine.

Available, free of charge, from: Department of Essential Drugs and Medicines Policy, World Health Organization, 1211 Geneva 27, Switzerland.

Reporting with Pictures, A. Haaland, P.B. Akogun, O. Oladepo, with contributions by O.O. Kale, UNDP, World Bank, WHO/TDR. TDR/IDE/RP/00.1, 2000, 80 p.

This document is a product of an operational field research project on community-directed treatment of onchocerciasis with ivermectin, which explains how record-keeping and reporting of events at the community level can be undertaken without illiteracy being a constraint. Such a simple method can be useful for non-professional community health workers. This publication is a succinct yet comprehensive exposition of how policy-makers and health planners, among others, can purposefully extend the frontiers of health care at the grass roots, thus providing a substantial window of opportunity beyond drug delivery.

The manual describes the conceptualisation, development, testing and adaptation of the pictorial reporting form to distribute ivermectin, summarises the lessons learnt in the process, and relates these lessons and experiences to other research questions and topics. It also summarises the principles of visual perception among illiterates which the form builds on, and which were confirmed by testing in different countries.

Available from: World Health Organization, Communications Unit, Special Programme for Research and Training in Tropical Diseases (TDR), 1211 Geneva 27, Switzerland. Fax: + 41 22 791 4854, e-mail: tdr@who.int

Pharmaceuticals: Restrictions in Use and Availability, World Health Organization, EDM/QSM/2001.3, 2001, 40 p.

This document presents information on new national regulatory decisions and on voluntary withdrawal of products by manufacturers on grounds of safety, that were reported to WHO up to December 2000.

Products are listed alphabetically within sections, with international nonproprietary names used wherever possible. Each product entry includes, where available, the Chemical Abstracts Service registry number; synonyms including other generic names and chemical name; the effective date on which the regulation came into force; a summary of regulatory measures taken by governments; brief explanatory comments where necessary; and legal and bibliographic references. While the information given is not exhaustive, either in terms of products or regulatory measures, the document covers regulatory actions taken by a total of 41 governments on 76 products.

This text is the second update to the Sixth Issue of the United Nations Consolidated List of Products whose Consumption and/or Sale have been Banned, Withdrawn, Severely Restricted or Not Approved by Governments -Pharmaceuticals. It is intended for drug regulators, the pharmaceutical industry, and everyone interested in assuring the safe and rational use of drugs.

Available, free of charge, from: Department of Essential Drugs and Medicines Policy, World Health Organization, 1211 Geneva 27, Switzerland.

World Health Report 2001. Mental Health, New Understanding, New Hope, World Health Organization, 2001, 178 p.

One in four people in the world will be affected by mental or neurological disorders at some point in their lives. Around 450 million people currently suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide. Treatments are available, but nearly two-thirds of people with a known mental disorder never seek help from a health professional. Stigma, discrimination and neglect prevent care and treatment from reaching people with mental disorders, says WHO’s World Health Report 2001.

With the Report WHO seeks to break this vicious cycle and urges governments to find solutions for mental health that are already available and affordable. Policy-makers should move away from large mental institutions and towards community health care, integrating mental health care into primary health care and the general health care system, the Report states.

The Report invites governments to make strategic decisions and choices in order to bring about positive change in the acceptance and treatment of mental disorders. It states that some mental disorders can be prevented; most mental and behavioural disorders can be successfully treated; and that much of this prevention, cure and treatment is affordable. Over 80% of people with schizophrenia can be free of relapses at the end of one year of treatment with antipsychotic drugs combined with family intervention. Up to 60% of people with depression can recover with a proper combination of antidepressant drugs and psychotherapy. Up to 70% of people with epilepsy can be seizure free when treated with simple, inexpensive anticonvulsants.

According to the Report the responsibility for action lies with governments. Currently, more than 40% of countries have no mental health policy and over 30% have no mental health programme. More than 33% of countries allocate less than 1% of their total health budgets to mental health, with another 33% spending just 1% of their budgets on it. A limited range of medicines is sufficient to treat the majority of mental disorders. But about 25% of countries do not have the three most commonly prescribed drugs used to treat schizophrenia, depression and epilepsy at the primary health care level.

The poor often bear the greater burden of mental disorders, both in terms of the risk in having a mental disorder and the lack of access to treatment. Constant exposure to severely stressful events, dangerous living conditions, exploitation, and general ill health all contribute to greater vulnerability. Lack of access to affordable treatment makes the course of the illness more severe and debilitating, leading to a vicious circle of poverty and mental health disorders that is rarely broken.

WHO’s message in the Report is that every country, no matter what its resource constraints, can do something to improve the mental health of its people. What it requires is the courage and the commitment to take the necessary steps.

Available from: World Health Organization, Marketing and Dissemination, 1211 Geneva 27, Switzerland. Price: Sw.fr. 15/US$ 13.50, and in developing countries Sw.fr. 10.50.

Guidelines for the WHO Review of Dependence-producing Psychoactive Substances for International Control. World Health Organization, WHO/EDM/QSM/2000.5, 2000, 17 p.

WHO is the agency designated for the evaluation of the medical, scientific and public health aspects of psychoactive substances under the Single Convention on Narcotic Drugs, 1961 (amended by the 1972 Protocol), and the Convention on Psychotropic Substances, 1971.

An assessment procedure has been developed following resolutions of the World Health Assembly and the United Nations Commission on Narcotic Drugs. This document sets out guidelines dealing with the underlying principles of the review procedure, working arrangements within the WHO Secretariat and with external bodies, and the nature of the documentation to be prepared. The guidelines cover WHO’s responsibilities on whether or not to recommend international control of substances, as well as the assessment of exempted preparations.

Available, free of charge, from: Department of Essential Drugs and Medicines Policy, World Health Organization, 1211 Geneva 27, Switzerland.

Attention Deficit/Hyperkinetic Disorders: Their Diagnosis and Treatment with Stimulants, Cooperation Group to Combat Drug Abuse and Illicit Trafficking in Drugs (Pompidou Group), Council of Europe, 2000, 113 p.

The rise in the number of stimulants being prescribed to treat attention deficit/ hyperactivity disorders has led to increasing debate over the use of drugs to treat child sufferers. In December 1999 the Pompidou Group (an intergovernmental body) and WHO organized a meeting to exchange information on the situation in Europe.

This report of the meeting focuses on two European studies presented to participants: one on sociocultural factors and treatment, and the second on diagnosis and treatment practices in Europe. It also includes the meeting’s recommendations on improving the availability of proven medication and the quality of service delivery, whilst avoiding stimulant abuse and diversion of drugs to the illicit market.

Available, in English and French, from: Council of Europe Publishing, F-67075 Strasbourg Cedex, France. Tel: + 33 (0) 3 88 41 25 81, fax: + 33 (0) 3 88 41 39 10, e-mail: publishing@coe.int Web site: http://book.coe.fr Price: Fr.fr. 85/US$ 21.

Review of the TRIPS Agreement under Article 71.1, M. Stilwell, C. Monagle, South Centre, Occasional Papers No. 3, 2000, 15 p.

This paper provides some reflections on the review of the TRIPS Agreement required under Article 71.1, noting the need for a full review of the Agreement from a development standpoint. This is in line with the decision of WTO Members at the General Council Meeting of 7 February 2000, which provides that “the General Council also agreed that mandated reviews should address the impact of the agreements concerned on the trade and development prospects of developing countries.” The paper suggests that the review should carefully examine the impact implementing the Agreement will have on developing countries. The authors also urge that it should be acknowledged that intellectual property protection is not an objective in itself, and should be viewed in the context of the trade and development conditions in these countries.

In the second section, the document discusses the scope of the review, while part three explores a number of issues that developing countries have identified as relevant. It begins by examining the TRIPS Agreement’s objectives and principles, including the need to maintain a balance of rights and obligations. The authors then look at why it is important for WTO Members to gain understanding of the potential impacts of implementing the Agreement on the transfer and dissemination of technology, and competitive markets. They also stress the need for Member countries to be aware of their capacity to maintain a balance of rights and obligations by establishing exceptions to the rights of, and applying obligations to, title-holders.

Non-violation Complaints and the TRIPS Agreement: Some Considerations for WTO Members, M. Stilwell, E. Tuerk, South Centre, Occasional Papers No. 1, 2000, 15 p.

This paper builds on the analysis of non-violation complaints included in Occasional Papers No. 3 in this series that examined the Article 71.1 review of the TRIPS Agreement (see above). It explores in more detail the concerns raised by non-violation complaints, and concludes that WTO Members should not apply these complaints to TRIPS. As a step towards this goal, it recommends that WTO Members extend the moratorium on the application of the non-violation remedy until further experience is gained with the Agreement’s implementation.

Technical Issues on Protecting Plant Varieties by Effective Sui Generis Systems, Francis Mangeni, South Centre, Occasional Papers No. 2, 2000, 13 p.

From the developing country perspective, protection of plant varieties raises fundamental political, economic, social, biodiversity and other questions. The rights of plant breeders to be protected include authorising the use of their varieties as well as their propagating material. This affects access to propagating material (seeds) by local or rural communities that in developing countries make up to 90% of the population, who meet their agricultural, food and financial needs from (subsistence) farming.

The author argues that farming communities have a well established practice of saving, sharing and replanting seed (farmers’ rights) which may be threatened if plant breeders’ rights are protected in a way that restricts or even destroys this practice. As well as equity concerns, the issue of food security is also involved. Plus, over the years these communities have identified, selected and bred plant varieties of food or medicinal value, conserving and sustaining biodiversity: a contribution that requires due recognition.

The author looks at the debate on the form of sui generis systems, and makes specific recommendations on the minimum proposals developing countries should make in negotiations.

The Occasional Papers are available, free of charge, from: South Centre, Chemin du Champ d’Anier 17, Case postale 228, 1211 Geneva 19, Switzerland. Fax: + 41 22 798 85 31, e-mail: south@southcentre.org and on the Web at: www.southcentre.org

Gesundheit für Alle oder nur für die Pharmaindustrie? (Health For All or Only For the Pharmaceutical Industry), BUKO Pharma-Kampagne, 2000, 28 p.

This series of articles expresses the authors’ concerns at what they believe are current problems created by the pharmaceutical industry. The major issues covered are direct to consumer advertising, with examples from Germany and India, the dangers of drugs being sold on the Internet, and difficulties which can arise from public-private partnerships and inappropriate drug donations.

Available, in German only, from: BUKO Pharma-Kampagne, August-Bebel Str. 62, 33602 Bielefeld, Germany. Fax: +49 521 63789, e-mail: bukopharma@compuserve.com Price: DM14, including postage.

Diagnosis and Treatment - A Training Manual for Primary Health Care Workers, K. Birrell, G. Birrell, 2000, 272 p.

This manual teaches primary health care workers how to diagnose and treat the most common illnesses that present at rural and urban health centres: prescribe rationally in line with WHO and national guidelines; and deliver good patient care with scarce resources.

Lesson plans are based on successful training courses developed by VSO (Voluntary Service Overseas) doctors, national doctors and health workers. The manual also incorporates information from over 30 health experts and practitioners worldwide. It can be used as a self-study guide and as a reference manual.

Twenty-three appendices give more detailed practical information about diagnosis, treatment and procedures, and include reference charts, a glossary, progress checklists for trainers and students, and a list of medicines and their uses.

Available from: VSO Books, 317 Putney Bridge Road, London SW15 2PN, UK. Tel: +44 20 8780 7200, fax: +44 20 8780 7300. Price: £9.90, excluding postage and packing.

Tales from the Other Drug Wars, M.L. Barer, K.M. McGrail, K. Cardiff, L. Wood, C.J. Green, eds., 2000, 39 p.

A new publication from the University of British Columbia’s Centre for Health Services and Policy Research points to what it sees as some disquieting realities in the modern pharmaceutical sector. Tales from the Other Drug Wars is assembled from papers presented at the 12th Annual Health Policy Conference in Vancouver. Its contributors examine what they view as pharmaceutical manufacturers’ successful infiltration and “skewing” of the research and drug approval process, to improve not patient health but profit. The authors argue that a coherent industry strategy is emerging, aiming to pressure or co-opt researchers, regulators, providers and consumers.

The publication notes that critical voices in research have been singled out for oppressive silencing tactics in Canada and internationally. It concludes that the aim is to leave industry-sympathetic research free to develop drugs which often only provide minor therapeutic advantage, but which can be exaggerated into major marketing promotions for the “management” of industry-defined “conditions”.

Available from: Centre for Health Services and Policy Research, University of British Colombia, 429-2194 Health Services Mall, Vancouver, BC, V6T 1Z3, Canada. Price: Canadian $10 plus postage and handling. Also available on the Web at: www.chspr.ubc.ca