Effective - but are they safe?

8 World Health • Morch-Aprill992 In assisting countries to assess their health priorities with respect to drugs, the Action Programme is undoubtedly contributing to better health and saving lives. It helps governments to focus resources where they are needed most. Estimates vary, but sound essential drugs programmes can save governments as much as 40- 50% of their budgets. Rationalizing the use of resources allows governments to save money in order to extend their health system coverage, in both quantity and quality. drugs programmes provide a unique forum to address issues that affect many, if not all, disease control or prevention activities. By working jointly with other health sectors, essential drug initiatives can contribute to strengthening the national health care infrastructure-a step towards overall country development. Improving health and promoting overall country development are completely consistent goals. One, of course, helps the other. But the field of essential drugs, as embodied in WHO's Action Programme, benefits development directly through the building of national capacities in ways that few other areas of primary health care do. The activities of essential drugs programmes are designed to address the issues of today, but they develop skills and systems that will make countries better equipped to respond to the challenges of tomorrow. • Or F. Antezana is Director of the Action Programme on Essential Drugs, World Health Organization, 1 2 1 1 Geneva 27, Switzerland. In addition, national essential In assisting countries to assess their drug needs, the Action Programme contributes to better health and saves lives. Effective - but are they safe? Taking medicines is not always without risk. Already os for back os 1937, several hundreds of children in the USA died when a manufacturer employed the wrong - toxic- solvent in preparing on anti-infective medicine. Many of us will remember the catastrophic use, in the early 1960s, by pregnant, women of a sleeping pill containing thalidomide, which resulted in the birth of thousands of malformed babies. In the wake of these disasters many countries hove established notional drug control mechanisms. Permission is only given to sell drugs that comply with requirements of pharmaceutical quality, therapeutic efficacy and safety - requirements that ore scientifically based and usually strict. The fact that, during the lost 20 years, no major cotostrophies due to drug use have occurred is on indication of the effectiveness of such regulatory systems. However, the risk that a drug is toxic con never be completely excluded during its early development phose. Such effects may only turn up when a medicine is used by thousands, or even millions, of patients in normal medical practice. This is w hy WHO is working with countries to exchange information about the side-Bffects of medicines, and is assisting its Member States to combine their forces in on internationa l programme. Notional Centres for Adverse Drug Reactions Monitoring hove been set up wh ich meet annually, and a WHO Collaborating Centre collects reports of adverse drug effects that ore received notionally in a database which currently contains over 900 000 entries. Information on safety aspects must be shored. WHO has a network of information officers within ministries of health in more than 130 countries who ore informed through a monthly newsletter. In cases of urgency on alert is sent out os a special mailing, to enable regulatory authorities to take immediate notional action if required. Properly used , drugs today ore generally safe, and pose less risk than doily rood traffic . Still , there is always a remote possibility that they might provoke severe adverse effects. lt is for this reason that WHO has to remain vigilant. Contributed by Or Martiin ten Ham, Senior Scientist with the Pharmaceuticals Unit, WHO, 1 2 1 1 Geneva 27, Switzerland