The drug management cycle (Figure 1.1) illustrates the necessity for coordination of managerial and technical support with appropriate drug policies and guidelines, in order for any drug system to run smoothly (MSH 1997, part IV, section A on ‘Organization and Management’). The figure highlights the coordination between the DTC and the drug purchasing and inventory control body.

Figure 1.1 The drug management cycle

The DTC will often have to coordinate with those responsible for procurement and distribution of medicines. The DTC would not normally do the procurement itself: its role would normally be to ensure that the formulary system and other drug policies developed by the DTC are implemented by the procurement department. Every effort should be made to avoid the DTC degenerating into a forum only for making procurement decisions and complaining to the pharmacist about stock-outs. Furthermore, it is unwise to concentrate too much power over the pharmaceutical system in any one body, as this may lead to corrupt practices. The functions of selecting medicines, procurement, payments and inventory control are best kept separate (WHO/UNICEF/UNFPA/WB 1999).