It is my honour and privilege to write the preface to this fourth revision of the Essential Drugs List for the Nigerian public health care system. This fourth revision is much delayed due to several constraints. The National Drug Formulary and Essential Drugs List Review Committee has been working constantly on this revision since 2000. This fourth revision is the product of several reviews. This edition has also taken care of the current concerns in the management of HIV/AIDS, tuberculosis, Integrated Management of Childhood Illnesses (IMCI) and malaria. The reader may also discover that new internationally accepted names of some drugs, formulations and dosage forms have been adopted.
Essential Drugs have been defined as those drugs that satisfy the health care needs of the majority of the population. They should therefore be available at all times in adequate amounts and in appropriate dosage forms at all levels of the health care delivery system of the country.
The Essential Drugs Programme of the Federal Republic of Nigeria came on stream in 1988 and received legal backing when in 1989 Decree 43 was promulgated. That same year the first Revision was published. The second revision soon followed in 1991 and the third in 1996. The programme and its legal instrument came under severe criticism by the Drug Manufacturing/Distribution concerns as well as several health practitioners for obvious reasons as the impression was created that whatever drug was not included in the list could neither be imported nor used legally. The amendment to this decree that appeared in 1992, limiting the provision of the earlier decree to the Public Sector only, had the salutary effect of removing the pressure on the programme as well as on those who implemented it.
The expected advantages of an Essential Drugs Programme include:
- Limiting the number of drugs deployed in the health care system,
- Creating opportunity for the provision of concise, accurate and comprehensive information in the form of a National Drug Formulary on all the drugs in the essential drugs list,
- Improving the knowledge of prescribers regarding the pharmacological properties of the prescribed drugs thus improving the quality of drug
- Improving drug utilisation by the various sectors of the health care system through better monitoring.
Sound policy, legislation and en essential drugs programme that includes education of health professionals and patients in rational use of drugs are measures that should ensure better health care in all countries. The National Drug Formulary and Essential Drugs Review Committee working with the Food and Drugs Services in collaboration with the World Health Organisation have worked out the modalities of ensuring that this fourth revised edition gets to the authorities and individuals that the programme is intended for and ensuring maximum derivation of the advantages of the essential drugs programme.
In this revision there are no drugs marked for deletion as all drugs so labelled in the third revision have been appropriately taken care of. There are fewer drugs in this list than in the third revision. About one hundred and fifty drugs and dosage forms have been deleted. The newly added drugs or dosage forms number about fifty. A new restricted list has been appended. These drugs are considered essential for specialist and tertiary health care facilities and need to be available for the Public Health Care system. A reviewed list for Primary Health Care is included as well as the list of products suggested to be stocked and sold by Patent Medicine Dealers/Vendors.
The current National Drug Formulary and Essential Drugs List (NDF/EDL) Review committee inherited a revised but unpublished National Drug Formulary which needs to be reviewed in line with this fourth revision of the Essential Drugs List. It is hoped that this exercise will soon take place to ensure that this important component of the Essential Drugs Programme is fully achieved in Nigeria. We are encouraged by the support given to the Federal Ministry of Health in the area of Essential Medicines. We hope that the proposed interest in the development of the Standard Treatment Guidelines proposed by the immediate past chairman of the NDF/EDL Review Committee shall be followed by the necessary motions to put Nigeria in line with countries with a viable Health Care delivery system for their peoples.
Professor Ibrahim Abdu-Aguye,
Chairman,
National Drug Formulary and Essential Drugs Review Committee,
January 2003
