Evidence-based pharmacy in developing countries

Many developing nations have developed national drug policies, a concept that has been actively promoted by the WHO. For example, the national drug policy for Indonesia[1] drawn up in 1983 had the following objectives:

• To ensure the availability of drugs according to the needs of the population.
• To improve the distribution of drugs in order to make them accessible to the whole population.
• To ensure efficacy, safety quality and validity of marketed drugs and to promote proper, rational and efficient use.
• To protect the public from misuse and abuse.
• To develop the national pharmaceutical potential towards the achievements of self-reliance in drugs and in support of national economic growth.

To achieve these objectives in Indonesia, the following changes were implemented:

• A national list of essential drugs was established and implemented in all public sector institutions. The list is revised periodically.
• A ministerial decree in 1989 required that drugs in public sector institutions be prescribed generically and that Pharmacy and Therapeutics committees be established in all hospitals.
• District hospitals and health centers have to procure their drugs based on the essential drugs list.
• Most drugs are supplied by three government-owned companies.
• Training modules have been developed for drug management and rational drug use and these have been rolled out to relevant personnel.
• The central drug laboratory and provincial quality control laboratories have been strengthened.
• A major teaching hospital has developed a program on rational drug use, developing a hospital formulary, guidelines for rational diagnosis and treatment guidelines for the rational use of antibiotics.
• Generic drugs have been available at affordable costs to low-income groups.