The medicines listed in this document are derived from the revised Standard Treatment Guidelines (2004) of the Ministry of Health. The criteria used to guide the selection of medicines were dependent on those used for the selection of medicines for the World Health Organisation Model List of Essential Medicines

The revision of the Standard Treatment Guidelines was based on published evidence or expert opinion. The final document was then field-tested among all categories of health professionals. As a consequence, medicines mentioned for the treatment of health problems in the Standard Treatment Guidelines have been included in this edition of the Essential Medicines List. In addition, comments on the 2000 Essential Medicines List collected from health professionals were considered on the basis of the WHO criteria by an expert panel. The criteria are:

• drug selection should be based on the results of efficacy and safety evaluations obtained in controlled clinical trials and epidemiological studies, and on the performance in general use in a variety of medical settings;

• when several drugs are available for the same indication, only the drug and the pharmaceutical form that provides the more convenient benefit/risk ratio should be selected;

• when two or more drugs are therapeutically equivalent, the selection should fall on:

- the drug that has been more thoroughly investigated,

- the drug with the most favourable pharmacokinetic properties,

- the drug with the lowest cost, calculated on the basis of the whole course of treatment,

- the drug with which health workers are already familiar,

- the drug for which economically convenient manufacturing is available in the country,

- the drug which shows better stability at the available storage conditions;

A fixed dose combination should be accepted only if clinical documentation justifies the concomitant use of more than one drug, and the combination provides a proven advantage over single compounds administered separately in therapeutic effect, safety, patients' compliance or cost.

Furthermore, guidelines are proposed to confine the circulation of essential drugs to specific and appropriate settings and levels of health care delivery. For this, drugs have been grouped into the following categories:

Specialist Drugs are restricted for use by qualified specialists who may request for them. Programme Drugs are those drugs used in public health programmes of the Ministry of Health and as such used within the guidelines of the specific programmes.

In previous editions, the British Appoved Name (BAN) was adopted for all medicines in the Essential Medicines List (EML). This current issue uses only the Recommended International Non-Proprietary Name (rINN) in line with WHO recommendations and practice.

It is the hope of the Ministry that health professionals will support this document by providing comments and suggestions towards to inform the next review

Comments and suggestions should be sent to:

The Programme Manager
Ghana National Drugs Programme
Ministry of Health
P.O. Box MB-582
Accra, Ghana
Tel +233 (0) 21 661 670/1
Fax: +233 (0) 21 664309
E-mail: gndp@ighmail.com