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Essential drugs programmes in Africa.


 The essential drugs concept encompasses national drug policy, selection, quantification, quality assurance, procurement, inventory control and distribution, financing, rational drug use, and training. People from all sectors and levels were involved in developing Tanzania's national drug policy which was approved in 1991. The process developing a policy in Kenya continues. The policy will allow Kenya's Ministry of Health to implement various operational changes (e.g., improvements in hospital drug management). 40 sub-Saharan African (SSA) countries have a national essential drug list (EDL). A synergistic effect results when EDLs are merged with standard treatment guidelines (STGs) (e.g., in Tanzania and Zimbabwe) or constructed with STGs and a national formulary. The Federal Ministry of Health in Nigeria designated 209 drugs as essential drugs, while Nigerian states determined their own EDLs based on these 209 drugs. Spreadsheet models use morbidity patterns, past consumption, and population to help countries quantify drug needs which are then used to determine drug procurement. Various problems with quality assurance in regional and national quality control laboratories in SSA include staff turnover, limited equipment maintenance, and lack of reagents and laboratory standard solutions. A database, structured, flexible drug registration system allows countries (e.g., Zimbabwe) to monitor drug suppliers and agents. Drug procurement has improved in countries with established procurement systems. Computers help control and manage drug inventories. Kenya, Mozambique, Tanzania, and Uganda distribute ration kits of prepackaged drug selections. Cash and carry in Ghana, hospital fees in Kenya, and community insurance schemes in Guinea Bissau are some financing schemes in SSA. The International Network for the Rational Use of Drugs is operating in Ghana, Nigeria, the Sudan, and Tanzania. Training courses in drug supply management are held in Ghana, Tanzania, and Zimbabwe.
