Health in Northern Caucasus: March 2000
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RATIONAL DRUG USE WOULD REDUCE THE NEEDS
Medécins sans Frontières -Holland (MSF-H) has recently conducted interviews on randomly selected patients on medical and surgical wards and polyclinics in Ingushetia. Based on this, they conclude that the majority of patients receive the MSF medical supplies for free. The prescribing practices of doctors and the expectations of patients result in general overuse of drugs. The average number of drugs prescribed per patient is 6.6, and must be said to be very high.
Less than half of the drugs prescribed were included on the MSF list. The MSF list includes drugs on the WHO essential drugs list and covers the main morbidities related to this emergency as well as limited coverage of chronic diseases. The most common drugs not on the MSF list and most commonly requiing procurement by the patients were: Analgin (metamizole sodium), Dimedrol (diphenhydramine), Procaine, Vitamin B1, B6 and B12 injections, Heparin, Potassium and magnesium asparate injections, and Captopril.
Many of the prescribed drugs that patients buy are not essential drugs. Rational drug use by the doctors and patients would reduce the amount of drugs prescribed as well as the amount needed to be bought by the patients.
The question of purchasing locally produced drugs has repeatedly been discussed at the health coordination meetings in Moscow. The agencies have somewhat different approaches to it. The Russian Red Cross are purchasing all drugs locally, whereas some of the international agencies are purchasing no locally produced drugs.
According to the WHO Guidelines for Drug Donations, drugs that comply with national standards should not be excluded on the sole ground that they do not meet the quality standards of the donor country. Agencies providing drugs for an emergency should, in principle, be able to purchase drugs locally when standards are acceptable. However, WHO is not in a position to guarantee the quality of locally-produced drugs.
This newsletter is not an official WHO publication. The information is compiled by the WHO Unit for Emergency Health Coordination for North Caucasus, and intended for public information. For comments, please contact: par@who.org.ru or Irina Tarakanova tel 8 (501) 414 08 25. Contact address of WHO in Moscow: 28 Ostozhenka str, tel. 8 (501) 414 08 25.
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