who medicines strategy - libdoc.who.int - World Health Organization

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WHO MEDICINES STRATEGY 2004-2007 | 128EO 7.9Identification and promotion ofcost-effective strategies to promoterational use of medicinesRationaleSince irrational use of medicines is not limitedto one area of the health sector, strategiesshould be designed to cover the public andprivate sectors and to target self-medication andprescribing habits. What is needed is a majorshift in the knowledge and behavioural patternsof both individuals and social groups, includinghouseholds, communities, health professionals,educational institutions, and industry. In view ofthe financial constraints, there is a need to identifyand target priority areas. From a health economicsperspective, these areas should be those whichare expected to yield the largest improvement insocial benefit (or reduction of unnecessary socialcosts) for the money invested. 68ProgressWHO, in collaboration with partners includingMSH and the Universities of Harvard and Bostonin the United States, has supported more than20 intervention research projects in developingcountries, aimed at providers and consumers,hospitals, primary health care and the community,and private and public sectors. Technical supportfor these has included supervisory visits as wellas workshops for proposal development and dataanalysis. A policy perspective paper outlining corecomponents of a national strategy to promoterational use of medicines was published in2002. 69 WHO is also developing a quantitativedatabase of all medicine use studies from 1993onwards in order to assess global progress inpromoting rational use of medicines. In addition,WHO has supported INRUD and associatedtraining programmes. A major advance was thefirst francophone course on promoting rationaluse of medicine, conducted in Rwanda in 2003.This will be replicated in 2004 and followed upwith field activities.
COMPONENTS OF THE STRATEGY | 129Challenges remainingIrrational prescribing, dispensing, andconsumption of medicines exist even in thepresence of agreed strategies and policies forrational use, especially in developing countries.Although past research has identified theeffectiveness of many interventions, particularlywhen used in combination, many countries havenot implemented or scaled up such strategies,possibly because of the expense involved. Thechallenge for WHO is to evaluate the costeffectivenessof various strategies and to advocatea package of priority cost-effective interventions tobe adopted by countries. An additional challengeis the need to identify effective interventions toimprove medicines use in hospitals and in thetreatment of chronic diseases such as HIV/AIDS indeveloping countries.Meeting the challenges 2004-2007Over the next four years WHO will:> continue to support intervention researchprojects to evaluate the cost-effectiveness ofinterventions to improve the rational use ofmedicines. The results of projects supportedin the last four years and the WHO rationalmedicine use database will be presented atthe 2 nd International Conference for Improvingthe Use of Medicines in April 2004 inThailand. The global agenda for the next fiveyears, to be decided at this conference, willinclude evaluation of the impact of nationalpolices on medicines use and the costeffectivenessof interventions.> continue to work with INRUD to supporttraining programmes on promoting rationaluse of medicines, running fewer coursesbut with greater follow-up of participants’activities at country level.> increase efforts to improve the rational use ofmedicines for chronic diseases.OUTCOME INDICATORS1999 2003 2007No. of countries that have undertaken a nationalassessment / study of the rational use of medicines#REPORTING % TARGET#REPORTING % TARGETna na na 57/97 59% 60%
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