The WHO describes Essential medicines as those that satisfy the priority health care needs of the population. Essential medicines are intended to be available within the context of functioning health systems at all times in adequate quantities, in the appropriate dosage forms, with assured quality and adequate information, and at a price the individual and the community can afford.
The concept of essential medicines is forward-looking. It incorporates the need to regularly update medicines selections to:
- reflect new therapeutic options and changing therapeutic needs;
- the need to ensure medicine quality; and
- the need for continued development of better medicines, medicines for emerging diseases, and medicines to meet changing resistance patterns.
Effective health care requires a judicious balance between preventive and curative services. A crucial and often deficient element in curative services is an adequate supply of appropriate medicines. In the health objectives of the National Drug Policy, the government of South Africa clearly outlines its commitment to ensuring availability and accessibility of medicines for all people. These are as follows:
- To ensure the availability and accessibility of essential medicines to all citizens.
- To ensure the safety, efficacy and quality of medicines.
- To ensure good prescribing and dispensing practices.
- To promote the rational use of drugs by prescribers, dispensers and patients through provision of the necessary training, education and information.
- To promote the concept of individual responsibility for health, preventive care and informed decision-making.
Achieving these objectives requires a comprehensive strategy that not only includes improved supply and distribution, but also appropriate and extensive human resource development. The implementation of an Essential Drugs Programme (EDP) forms an integral part of this strategy, with continued rationalisation of the variety of medicines available in the public sector as a first priority. The private sector is encouraged to use these guidelines and medicine list wherever appropriate.
The criteria for the selection of essential medicines for Adult Hospital level care in South Africa were based on the WHO guidelines for drawing up a national EDL. Essential medicines are selected with due regard to disease prevalence, evidence on efficacy and safety, and comparative cost.
The implementation of the concept of essential medicines is intended to be flexible and adaptable to many different situations. It remains a national responsibility to determine which medicines are regarded as essential.