WHO Drug Information Vol. 25, No. 2, 2011

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Recent Publications, Information and EventsWHO Drug Information Vol. 25, No. 2, 2011antiretrovirals, inclusion in the EML mayhelp to contribute to a reduction inprices.• Section 22.1: addition of misoprostoltablet, 200 micrograms for the preventionof post-partum haemorrhage, whereoxytocin is not available or cannot besafely used. WHO guidelines currentlyrecommend that in situations wereoxytocin is not available, misoprostolcan be used to prevent and treat postpartum haemorrhage due to uterineatony.Based on the evidence provided, theCommittee considered that misoprostolcan be safely administered to women toprevent post-partum haemorrhage byhealth workers trained in its use in thethird stage of labour. The addition ofmisoprostol for the treatment of postpartumhaemorrhage was not approved.The clinical trials that compare misoprostolto oxytocin in women who needtreatment for post-partum haemorrhageshow that misoprostol is not as effectiveas oxytocin. In addition, there is noevidence to support the safety andefficacy of the 800-microgram dose fortreatment of post partum haemorrhagewhen given to women who have alreadyreceived prophylactic misoprostol 600micrograms orally. Countries need towork to make oxytocin available fortreatment of women who are bleedingafter delivery and misoprostol shouldonly be used if there is no other option.Other medicines that were added to theEML are: isoflurane, propofol, midazolam,clarithromycin, miltefosine, paclitaxel anddocetaxel, bisoprolol, terbinafine cream/ointment, mupirocin cream/ointment, andatracurium.A summary of reasons for all changes tothe EML is in Section 1 of the report. Allapplications and documents consideredby the Committee will remain availableon the web site for the meeting at http://www.who.int/selection_medicines/committees/expert/18/en/index.html.The next update of the WHO Model Listof Essential Medicines will take place in2013.Reference: Unedited report of the 18thmeeting of the WHO Expert Committee on theSelection and Use of Essential Medicines athttp://www.who.int/medicines/publications/unedited_trs/en/index.htmlPolicy guidelines oncontrolled substancesWorld Health Organization — The WHOAccess to Controlled Medicines Team haspublished “Ensuring balance in nationalpolicies on controlled substances: guidancefor availability and accessibility forcontrolled medicines”. This book providesguidance on policies and legislation withregards to availability, accessibility,affordability and regulation of controlledmedicines.It includes 21 guidelines on varioustopics: content of drug control legislationand policy; authorities and their role in thesystem; policy planning for availabilityand accessibility; healthcare professionals;estimates and statistics; procurement,and nationally listed drugs. Eachguideline is followed by an explanationand a description of the legal context. TheCountry Assessment Checklist enablesthe user to determine which guidelinesstill need to be worked on. A CD-ROMprovides additional information.The guidelines are currently available inEnglish. Other on-line language versionswill follow, some of them very soon(Armenian, Bulgarian, French, Georgian,Greek, Hungarian, Khmer, Polish, Russian,Serbian, Slovakian, Slovenian andTurkish). The publication will also becomeavailable in print in English and French.132
WHO Drug Information Vol. 25, No. 2, 2011Recent Publications, Information and EventsReference: Ensuring Balance in NationalPolicies on Controlled Substances, Guidancefor Availability and Accessibility of ControlledMedicines at: http://www.who.int/medicines/areas/quality_safety/guide_nocp_sanend/en/index.List of medicines to savemothers and childrenWorld Health Organization — The newdocument, “Priority medicines for mothersand children” contains a list of 30 medicinesdeveloped to advocate for bettersupply and use of the most importantessential medicines. The vast majority ofmaternal and child deaths can be preventedwhen these 30 medicines areavailable in the right formulations andprescribed and used correctly.Medicines on this new priority list wereselected based on burden of diseasedata and their potential for impact onmaternal and child mortality and morbidity.All medicines on the list are already inthe WHO Model List of Essential Medicinesand the latest WHO treatmentguidelines. The list was developed by theDepartment of Essential Medicines andPharmaceutical Policies (EMP) in collaborationwith the Departments of Child andAdolescent Health and Development(CAH) and Making Pregnancy Safer(MPS), UNICEF and UNFPA.Reference: Priority medicines for mothers andchildren, WHO/EMP/MAR/2011.1 at http://www.who.int/mediacentre/news/notes/2011/mother_child_ medicine_20110321. The listcan be downloaded at http://www.who.int/medicines/publications/emp_mar2011.1/en/index.htmlWorld medicines situationWorld Health Organization — The thirdedition of the “World Medicines SituationReport 2011” brings together new data on24 key topics relating to pharmaceuticalproduction and consumption, innovation,regulation and safety.Topics include selection, procurement,supply management, rational use,financing and pricing. Cross-cuttingchapters cover household medicines use,access and human rights, good governance,human resources and nationalmedicines policies.The chapters released in April 2011 are:• Background on past and present effortsto document and improve sharing ofinformation.• Medicines prices, availability andaffordability featuring data and informationfrom surveys using WHO standardmethodology.• Rational use of medicines describes theproblem of bad practices in medicinesprescribing and the harmful consequencesin terms of morbidity, mortalityand impact to health cost. This chapterlooks at global data, and draws attentionto trends in developing and transitionalcountries, in both public andprivate sectors.• Traditional medicines: global situationissues and challenges describes use oftraditional and herbal medicines aroundthe world.• Access to controlled medicines. Internationaldrug treaties stress that psychotropicand narcotic substances must beavailable for medical and scientific use,even if they are classified as controlledmedicines.• Good governance reviews the findingsof country studies, highlighting weaknessesand strengths in pharmaceuticalsystems that can help policy-makersbetter understand problems and identifysolutions.133
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WHO Drug Information Vol. 25, No. 2, 2011

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