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
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.