Stop Stock-outs Campaign Statement

Access to essential medicines is a human right and a cornerstone of an effective primary health care system. Access to free essential medicines determines whether people live or die, suffer pain and discomfort, or have their ailments cured, recover from illness or endure life-long disease.
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Factsheet: Essential Medicines Crisis In Kenya – Killer Facts

Download the Factsheet: Essential Medicines Crisis In Kenya – Killer Facts here.

Factsheet: African Union commitments to essential medicines

Download the African Union commitments to essential medicines factsheet here.

Stop Stock-outs Campaign statement

Download the Stop Stock-outs Campaign statement here.

Factsheet:Essential medicines factsheet

Download the Essential medicines factsheet here

Factsheet:Prices and availability affect access to medicines

Download the “Prices and availability affect access to Medicines” factsheet here.

Factsheet: Stockouts Factsheet 2009

Download the Stop Stockouts Factsheet (2009) here.

What are Essential Medicines

Original definition

Essential medicines were originally defined by the World Health Organization (WHO) as those which:

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.

Development of the concept

The idea of defining essential medicines – and establishing a list of them – was developed from a report made to the 1975 World Health Assembly. These efforts were aimed to increase the range and availability of medicines for populations with poor access.

The Expert Committee on the Use of Essential Medicines was established to assist member states to select and procure essential medicines. In 1977, the first report of the Expert Committee included (a) criteria for determining if a medicine fit the definition of an essential medicines and (b) the first model essential medicines list (EML) as two examples of how the concept of essential medicines could be implemented.

Since then WHO has updated the model EML every two years. In 2007, thirty years after introduction of the essential medicines concept, a model EML for children was also introduced.

Adapting the concept at national level

There should be clear links between the national EML, standard treatment guidelines, national expenditure on essential medicines, and procurement practices within the country.

The model EML is expected to be adapted at national level based on the local public health context of the country. Most countries have published a national EML. Most lists have been updated in the past five years; this exercise is crucial to reflect new therapeutic options and changing therapeutic needs.

Selection of medicines for the national EML

Within a country, the selection of essential medicines is usually a two-step process. The first involves regulatory approval, which is based on a review of efficacy, safety, and quality of medicines (without comparison between medicines). From these registered products, essential medicines within a therapeutic class are then selected on the basis of comparative efficacy, safety, and cost. To best ensure the widest acceptance of the list, the selection process for essential medicines needs the involvement of a number of stakeholders, including prescribers, dispensers, academics, health facilities, civil society, professional organizations, and others.

Before 2002, relatively expensive medicines were basically not found on the WHO model EML. This was successfully challenged by public health advocates and treatment activists. With the issue abolished, traditionally more expensive medicines (such as antiretrovirals) were quickly included on the WHO model EML and the official definition of essential medicines was updated to:

Essential medicines are those that satisfy the priority health care needs of the population. They are selected with due regard to disease prevalence, evidence on efficacy and safety, and comparative cost effectiveness. Essential medicines are intended to be available within the context of functioning health systems at all times, in adequate amounts, in the appropriate dosage forms, with assured quality, and at a price the individual and the community can afford. The implementation of the concept of essential medicines is intended to be flexible and adaptable to many different situations; exactly which medicines are regarded as essential remains a national responsibility.

It is also important to stress that essential medicines are not second rate medicines for poor people, but that they represent the most cost effective treatments for a given condition
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What Are Stock-outs?

When a pharmacy (in a medical store or health facility) temporarily has no medicine on the shelf, it is known as a “stock-out”. It may affect one medicine or many medicines, or in the worst case, all medicines. A stock-out can be documented at one point-in-time or over a period of days, weeks or months. When there is good stock management systems in place, the stock-out duration will be minimal or, ideally, never. Read more