2005-12-31-世界卫生组织-Essential_Medicines_for_Reproductive_Health_110页_1mb

Summary of Essential Medicines for Reproductive Health: Guiding Principles for Their Inclusion on National Medicines Lists

Core Content

This document outlines the importance of including reproductive health medicines in national essential medicines lists (EMLs) and provides guidance on how to do so effectively. It is a collaborative effort by PATH, the World Health Organization (WHO), and the United Nations Population Fund (UNFPA), aiming to improve access to essential medicines for reproductive health in developing countries.

Main Objectives

• To provide background on the EML process and the rationale for including reproductive health medicines.
• To offer practical guidance for incorporating these medicines into national EMLs.
• To support reproductive health programme managers, national EML committees, and policymakers in their decision-making.

Key Points

Importance of Reproductive Health

• Reproductive health is a fundamental aspect of human well-being and is recognized as a priority in global health policy.
• The ICPD Programme of Action (1994) emphasized the importance of reproductive health and sexual rights.
• Poor reproductive health contributes significantly to the global disease burden, particularly among women and adolescents.
• Reproductive health issues, such as maternal mortality, HIV/AIDS, and STIs, have a major impact on health outcomes and economic stability.

Role of Essential Medicines

• Essential medicines are selected based on public health relevance, efficacy, safety, and cost-effectiveness.
• Their availability is crucial for improving access to health care and managing health costs.
• The absence of reproductive health medicines in many national EMLs is a significant barrier to achieving better health outcomes.

WHO Model List of Essential Medicines

• The WHO model list is a global reference for essential medicines, reviewed every two years.
• It serves as a guide for national EMLs and helps countries make informed decisions about which medicines to prioritize.
• The selection process has evolved to be more evidence-based, transparent, and focused on public health impact.

Main Views

• Reproductive health is a public health priority, and its improvement requires a strong focus on essential medicines.
• National EMLs are critical tools for ensuring access to medicines, but many countries fail to include reproductive health medicines.
• Political commitment and evidence-based decision-making are essential for the inclusion of reproductive health medicines in EMLs.
• User preference and perception of reproductive health medicines (e.g., contraceptives) as non-therapeutic can hinder their inclusion.

Key Information

• The Interagency List of Essential Medicines for Reproductive Health includes 16 essential medicines covering contraception, STI treatment, and maternal health.
• The WHO Model List includes 312 medicines, with the 14th edition published in 2005.
• A review of 112 countries in 2002 showed that only 40% included magnesium sulfate for eclampsia and preeclampsia, and only 33% included family planning methods.
• The guide provides a checklist for inclusion and policy briefs for each of the 16 essential medicines.
• Barriers to inclusion include lack of awareness, political neglect, and the perception of contraceptives as preventative rather than therapeutic.

Structure of the Guide

1. Introduction

   • Highlights the importance of reproductive health medicines in public health.
   • Outlines the objective of the guide and its target audience.

2. Reproductive Health: A Public Health Priority

   • Discusses the global perspective and burden of poor reproductive health.
   • Emphasizes the role of essential medicines in reducing health disparities.

3. EMLs: Application of a Global Concept

   • Explains the concept of EMLs and their role in improving access to medicines.
   • Describes the WHO model list and its influence on national EMLs.

4. Adding Reproductive Health Medicines to EMLs

   • Provides a step-by-step approach for including reproductive health medicines in national EMLs.
   • Includes contact information, expert identification, and application procedures for WHO model list updates.

Appendices

• Appendix 1: Interagency List of Essential Medicines for Reproductive Health (16 medicines).
• Appendix 2: Checklist of activities to ensure inclusion of reproductive health medicines in national EMLs.
• Appendix 3: Information required for applying to include, change, or delete a medicine from the WHO model list.
• Appendix 4: Policy briefs for each of the 16 essential reproductive health medicines, including clinical evidence and cost-effectiveness data.

Conclusion

• The inclusion of reproductive health medicines in EMLs is vital for improving public health outcomes.
• A comprehensive, evidence-based approach is necessary to ensure these medicines are prioritized and accessible.
• Collaboration between agencies and commitment at the national level are essential for successful implementation.

References

• The document cites several key sources, including the ICPD Programme of Action, WHO reports, and studies from the Alan Guttmacher Institute and the World Bank, to support its arguments and recommendations.

Additional Resources

• The guide includes links to various organizations and reports, such as the Cairo Conference, the Global Health Council, and the United Nations Millennium Project, to provide further reading and context.