Essential Medicines

The Concept of Essential Medicines

SHARED is committed to improving global health for the world's poorest by increasing the availability of essential medicines and vaccines. How was the concept of "essential medicines" developed? What are "essential medicines"? And who decides what medicines are available within various countries?

The Role of the World Health Organization

The World Health Organization (WHO) is based in Geneva, Switzerland with satellite offices around the world. Established in 1948 as a United Nations agency for health, WHO's constitutional objective is to ensure that "all people attain the highest possible level of health". As set out in the WHO's constitution, health is defined as "a state of complete physical, mental and social well-being and not merely the absence of disease".

The governing body of the WHO is the World Health Assembly that is made up of representatives from the 191 nations who are members of the United Nations. The World Health Assembly sets the WHO's budget as well as directing and deciding major health policy questions. To learn more about the World Health Organization, please visit their website at http://www.who.int/en/

For every one of the UN member nations, a major issue is providing health care to its citizens. Whether rich or poor, every country deals with problems such as: Which medicines and vaccines should be made available to the citizens of our country? Who should pay for those medicines, the government or individuals? How will these drugs be distributed within our country? How should the government provide for those people who are too poor to pay for medical care?

The answers to these questions are most difficult for countries that are the poorest. With few resources, people living in developing countries face multiple problems including lack of food, clean water, sanitation, and roads which compounds the lack of money needed to buy living saving medicine. Millions of people die each year because they did not have a few cents to buy the life saving medicine that their governments are too poor to provide to them for free.

Essential Medicines and Health Priorities

To assist its nation members budget and set priorities for their health care needs, the WHO supports the concept of "essential medicines". The term "essential medicines" is defined by WHO as the medicines "that satisfy the needs of the majority of the population and therefore should be available at all times, in adequate amounts in appropriate dosage forms and at a price the individual and community can afford". Most countries have taken this definition and used it as a basis to develop a national essential medicine list to ensure that the limited resources are allocated to serve as many people as possible.

A national essential medicine list reflects the medicines and vaccines that are needed to serve that country's population. For example, a country whose citizens suffer from diseases such as malaria or cholera will prioritize access to medicines for those diseases. In other countries where cancer and heart disease afflict the majority of the population, the essential medicine list will emphasize medicines to treat those illnesses.

Many countries, excluding the United States, have developed an essential medicine list that is used for purchasing medicines using national funds. These medicines and vaccines are typically distributed through hospitals and clinics that are operated by the Ministry of Health.

While the essential medicine concept is quite simple to understand, its implementation is complicated. Universally, there is more demand for health care services in every country than there is money available to meet that demand. In poverty stricken countries, people die without access to medicines that often cost a few cents. These diseases are often unknown in developed countries. The medicines exist to cure or treat many of these diseases but, for many reasons, the essential medicines do not reach the hands of those whose lives could be saved.

Essential medicines can range from medication designed to manage the effects of diabetes to Vitamin A (retinol) administered to prevent blindness from nutritional deficiency. The WHO Model List of Essential Medicines can be viewed at http://www.who.int/medicines/organization/par/edl/eml.shtml.

Much work is being done by many organizations, particularly in private-public partnerships, to ensure that lives are saved and health improved worldwide. Please read about one topic, nutritional blindness due to Vitamin A deficiency, in our Hot Topics section. Information about some of the essential medicine donation programs is found in our Donation Programs section.

Working together, in partnership, access to essential medicines can be improved worldwide.