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Essential medicines: the first generation Monday 30 May 2011, Chateau de Penthes, Geneva. Margaretha Helling Borda (former Director WHO Action Programme on Essential Drugs) . In the 1970’s - serious problems and acute situations…. Letter to WHO in 1974 :
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Essential medicines: the first generationMonday 30 May 2011, Chateau de Penthes, Geneva Margaretha Helling Borda (former Director WHO Action Programme on Essential Drugs)
In the 1970’s - serious problems and acute situations… Letter to WHO in 1974 : • -- « our latest indent is 105 % more expensive than last year’s. I need hardly say that this makes complete nonsense of our financial estimates , and my Government cannot, in the near future, double the money allocated to medicines » Ebrahim Samba, Chief Medical Offcier MOH, Gambia – later Regional Director, AFRO
Birth of Essential Drugs Concept (EDC) • Complaints in the early seventies: • No links between drugs and health needs • No access to most essential drugs • Rising costs of pharmaceuticals • Uneven rural-urban distribution • Protests against industry marketing practice • No comprehensive NDP to support PHC etc. • Against this background birth of EDC M. Helling Borda October 2002 - 25 years anniversary
Major events in the 1970’s • 1974 DPM unit established • 1975 28th World Health Assembly, - DG’s Report on drugs followed by Resolution WHA28.66 requesting advise on selection, procurement, at reasonable cost, of essential drugs of established quality corresponding to national needs • WHO entered the era of essential medicines • 1976 First consultation on the Selection of essential drugs
WHO Model List of Essential Drugs • 1976: two WHO consultants, clinical pharmacologists, prepared working document (including a preliminary draft list).Document circulated for comments • 1977: WHO Expert Committee on the Selection of Essential Drugs: WHO, Geneva, 17 – 21 Oct.1977 incl. model list and outline for a programme • TRS 615 (36 pages) became an instant WHO best seller --and a vital tool for public health
After publication of first EDL- what ? 1977: Situation analyses in Asia six countries- six-weeks 1978: WHO meetings in SEARO and WPRO 1978: 31st WHA – Technical discussions on: Drug Policies with its technical and administrative components 1978:Res. WHA 31.32 urging countries to establish ED programme; raises the issue of a WHO marketing code; and proposes establishment of an Action Programme on Essential Drugs 1978: WHO/Unicef meeting on PHC in Alma Ata
The time around the start of the Action Programme on Essential Drugs … • 1979: The Selection of Essential Drugs revised – 2nd Expert Committee (dosage forms included) • 1979: 32nd WHA calls for the establishmentof an administrative structure for the Action Programme on Essential Drugs • 1981: Establishment of an Administrative Unit for Action Programme on Essential Drugs with the acronym DAP (staff of 4)
On the way to action…and consolidation 1981: WHA-34 adopts Global Strategy on Health for All by the year 2000 – availability of essential drugs is one of eight major elements in HFA 1981: IFPMA voluntary marketing code 1981: Health Action International (HAI) founded 1982: Third Expert Cttee emphasis on «The use of EDs» 1982: WHA-35 adopts a plan of action for APED 1983: DAP placed in office of Director-General 1984: WHA-37 calls for meeting on rational use of drugs 1985: Nairobi Conference on Rational Use of Drugs broadens the scope of essential drugs policies 1986: WHA-39 accepts Revised Drug Strategy