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96 Andrea Gardellin, Abraham Gebre GiorgisTable 12. Status of essential medicines lists (EMLs), standard treatment guidelines(STGs) and national medicines formularies• Almost all low- and middle-income countries have an EML, and most limit∞ Almost all low- and middle-income countries have an EML, and most limit procurement tomedicinesprocurementon thetolist.medicines on the list.∞ The • The number number of of medicines medicines included included on on EMLs tends to toincrease increasewith withincreasingincreasing countryincome. country income.∞ Only • Only a few a few countries countries reported reported that that public public or private or private sector sector insurance reimbursement reimbursementto the EML. was linked to the EML.waslinked∞ Standard • Standard treatment treatment guidelines are are available for for primary health carein inoverover 70% ofcountries. 70% of countries.∞ National • National formularies formularies exist exist in over in over two thirds two thirds of countries, of countries, and over and half over ofhalf low-ofand middleincomelow- countries and middle-income limit the formulary countries to limit medicines the formulary on the EML. to medicines on theEML.Key policies and regulations to promote rational useKey policies and regulations to promote rational use5.4 Why is this important?The role of a drug and therapeutics committee (DTC) is to ensure the safe and5.4 Why is this important?effective use of medicines in a health facility or the area under its jurisdiction. TheDTCThe must role have of a clear drug objectives, and therapeutics a firm mandate, committee the (DTC) support is to ofensure senior the hospital safe staff,transparency, and effective wide use representation, of medicines in technical a health competence, facility or the a multidisciplinary area under its jurisdiction.The resources DTC must to implement have clear its objectives, decisions. a firm mandate, the supportapproachand sufficient ofOver-the-counter (OTC) sale of antibiotics is a concern worldwide. This can be due tolack of enforcement of regulations or lack of information on the part of consumersabout the potential negative impacts of antibiotic misuse. Irrational use of antibiotics