6.4 KiB
| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Evidence-based pharmacy in developing countries | 3/4 | https://en.wikipedia.org/wiki/Evidence-based_pharmacy_in_developing_countries | reference | science, encyclopedia | 2026-05-05T04:25:38.590092+00:00 | kb-cron |
== Drug donations == It is a natural human reaction to want to help in whatever way possible when face with human disaster, either as a result of some catastrophe or because of extreme poverty. Sympathetic individuals want to take action to help in a situation in which they would otherwise be helpless, and workers in difficult circumstances, only too aware of waste and excess at home, want to make use of otherwise worthless materials. The problem is that these situations do not lend themselves to objectivity. There are numerous accounts of tons of useless drugs being air-freighted into disaster areas. It the requires huge resources to sort out these charitable acts and often the drugs cannot be identified because the labels are not in a familiar language. In many cases, huge quantities have to be destroyed simply because the drugs are out of date, spoiled, unidentifiable, or totally irrelevant to local needs. Generally, had the cost of shipping been donated instead, then many more people would have benefited. In response to this, the WHO has generated guidelines for drug donations from a consensus of major international agencies involved in emergency relief. If these are followed, a significant improvement in terms of patient benefit and use of human resources will result.
=== WHO guidelines for drug donations 2005 ===
==== Selection of drugs ==== Drugs should be based on expressed need, be relevant to disease pattern and be agreed with the recipient. Medicines should be listed on the country's essential drugs list or WHO model list. Formulations and presentations should be similar to those used in the recipient country.
==== Quality assurance (QA) and shelf life ==== Drugs should be from a reliable source and WHO certification for quality of pharmaceuticals should be used. No returned drugs from patients should be used. All drugs should have a shelf life of at least 12 months after arrival in the recipient country.
==== Presentation, packing and labelling ==== All drugs must be labelled in a language that is easily understood in the recipient country and contain details of generic name, batch number, dosage form, strength, quantity, name of manufacturer, storage conditions and expiry date. Drugs should be presented in reasonable pack sizes (e.g. no sample or patient starter packs). Material should be sent according to international shipping regulations with detailed packing lists. Any storage conditions must be clearly stated on the containers, which should not weigh more than 50 kg. Drugs should not be mixed with other supplies.
==== Information and management ==== Recipients should be informed of all drug donations that are being considered or under way. Declared value should be based on the wholesale price in the recipient country or on the wholesale world market price. Cost of international and local transport, warehousing, etc., should be paid by the donor agency unless otherwise agreed with the recipient in advance.
== Evidence-based pharmacy practice == While modern practices, including the development of clinical pharmacy, are important, many basic issues await significant change in developing countries.
Medicines can often be found stored together in pharmacological groups rather than in alphabetical order by type. Refrigerator space is often inadequate and refrigerators unreliable. There are different challenges, such as ensuring that termites do not consume the outer packages and labels or that storage is free of other vermin such as rats. Dispensary packaging and labelling can be woefully inadequate and patients leave with little or no understanding of how to take medicines which may have cost them at least one week's earnings. Medicines are often out of stock, not just for a few hours but for days or even weeks, particularly at the end of the financial year. Protocols and standard operating procedures are rarely found. Even when graduate pharmacists are employed, they often have little opportunity to perform above the level of salesperson, simply issuing medicines and collecting payment. For example, several hospital pharmacies in Mumbai, India, are open 24 hours per day for 365 days per year but only to function as retail outlets selling medicines to outpatients or to relatives of inpatients who then hand over the medicines to the nursing staff for administration.
== Conclusions == Evidence is as important in the developing world as it is in the developed world. Poverty comes in many forms. While the most noticed are famine and poor housing, both potent killers, medical and knowledge poverty are also significant. Evidence-based practice is one of the ways in which these problems can be minimized. Potentially, one of the greatest benefits of the internet is the possibility of ending knowledge poverty and in turn influencing the factors that undermine wellbeing. Essential drugs programs have been a major step in ensuring that the maximum number benefit from effective drug therapy for disease.
== See also == Essential medicines WHO Model List of Essential Medicines Department of Essential Drugs and Medicines Campaign for Access to Essential Medicines Evidence-based practice Universities Allied for Essential Medicines
== References ==
== Useful sources of information == The following is a list of useful publications from the WHO Department of Essential Drugs and Medicines Policy about essential drugs programs.
=== General publications === Essential Drugs Monitor - periodical issued twice a year, covering drug policy, research, rational drug use and recent publications. WHO Action Programme on Essential Drugs in the South-East Asia Region - report on an Intercountry Consultative Meeting, New Delhi, 4–8 March 1991. 49 pages, ref no SEA/Drugs/83 Rev.1.
=== National drug policy === Report of the WHO Expert Committee on National Drug Policies - contribution to updating the WHO Guidelines for Developing Drug Policies. Geneva. 19–23 June 1995. 78 pages, ref no WHO/DAP/95.9. Guidelines for Developing National Drug Policies - 1988, 52 pages, ISBN 92-4-154230-6. Indicators for Monitoring National Drug Policies - P Brudon-Jakobowicz, JD Rainhorn, MR Reich, 1994, 205 pages, order no 1930066.