It is my pleasure to present this revised and updated Essential Drugs list for Uganda (EDLU) 2001 to all prescribing and dispensing staff, and to other health professionals handling medicines in Uganda.
This 3rd edition of EDLU has been produced in order to take account of the various changes which have taken place in therapeutic practice over the 5 year period since the last edition.
Essential drugs are those which satisfy the needs of the majority of the population and should therefore always be available in adequate amounts and appropriate dose forms. EDLU lists those essential drugs considered to be the most appropriate for use in the Uganda public health system. It is also strongly recommended as a rational basis for private sector prescribing.
In order to ensure that the correct decision is taken on whether to include a particular item or not, consideration must be made of a number of key criteria including:
Efficacy: the capacity of the medicine effectively to treat the diagnosed condition
Safety: the therapeutic index of the drug (ratio of treatment dose to toxic dose) and the nature, frequency and severity of expected side-effects
Quality: compliance of the drug presentation with internationally accepted standards of purity, composition, and consistency
Cost-effectiveness: considered in terms of available and effective alternative medicines or dose-forms
Appropriateness: the overall suitability of the medicine within the local context taking account of various factors including:
• Changing morbidity patterns
• Stability in storage
• Likely compliance with dose regime
• Development of resistance
• Type of dose form/method of administration
• Socio-economic factors
In preparing the new EDLU, these criteria have been carefully considered by the Committee on Essential Drugs (CED), assisted as required by experts in the various medical specialities.
Drug lists by their very nature are subject to rapid obsolescence due to ever-changing therapeutic requirements for the treatment of conditions found in Uganda. A good example of this is the treatment of malaria which has had to be revised recently to take account of rapidly developing resistance to previous first-line medication.
Thus the list should be subject to constant scrutiny and updated accordingly. This process is highly dependent on the input of clinicians in the field who should therefore continuously assess the appropriateness of the selected medicines for treating the conditions encountered. Clinicians are encouraged to submit proposals for amendments to EDLU following the procedures given in the Preface.
The EDLU is a guide for drug selection and level of distribution and is meant to be used together with the National Standard Clinical Guidelines (NSCG) which give practical guidance on diagnosis and appropriate therapeutic approaches. Both publications are also useful resource materials for training in all aspects of rational drug use.
I wish to thank the Chairman and members of the National Drug Authority Committee on Essential Drugs for the time and effort they have put into the production of this excellent and vital document.
It is my sincere hope that routine use of the EDLU in combination with the NSCG by all levels of prescriber in their daily work will greatly assist in ensuring that patients receive optimum treatment of their health problems at all times.
However this will only be possible if adequate quantities of the recommended drugs are constantly available for utilisation at the appropriate level of health unit.
The Ministry of Health is therefore committed to improving accessibility to required essential drugs through active implementation of the new National Drug Policy which aims inter alia at securing adequate funding of essential drugs procurement and improved management of the drug supply system at all levels.
Dr C W C B Kiyonga MP
Hon. Minister of Health
