Health systems standard 3: Drugs and medical supplies
People have access to a consistent supply of essential medicines and consumables.
Key actions (to be read in conjunction with the guidance notes)
Review the existing lists of essential medicines of the disaster-affected country early in the response to determine their appropriateness (see guidance note 1).
Establish and endorse a standardised essential medicines and medical equipment list that contains items appropriate for the health needs and the competence level of health workers (see guidance notes 1–2).
Establish or adapt an effective medicines management system (see guidance note 3).
Ensure essential medicines for the treatment of common illnesses are available.
Accept donations of medicine only if they follow internationally recognised guidelines. Do not use donations that do not follow these guidelines and dispose of them safely.
Key indicator (to be read in conjunction with the guidance notes)
No health facility is out of stock of selected essential medicines and tracer products for more than one week (see guidance note 4).
- Essential medicines list: Most countries have an established essential medicines list. This document should be reviewed, when necessary, in consultation with the lead health authority early in the disaster response to determine their appropriateness. Occasionally, alterations to essential medicines lists may be necessary, e.g. if there is evidence of resistance to recommended antimicrobials. If an updated list does not already exist, guidelines established by WHO should be followed, e.g. the WHO Model Lists of Essential Medicines. The use of standard pre-packaged kits should be limited to the early phases of a disaster.
- Medical equipment: Care should be taken in defining a list of the necessary equipment available at different healthcare levels. This should also be linked to the required competency of the staff.
- Drug management: Health agencies need to establish an effective system of drug management. The goal of such a system is to ensure the efficient, cost-effective and rational use of quality medicines, storage and correct disposal of expired medicines. This system should be based on the four key elements of the medicines management cycle: selection, procurement, distribution and use.
- Tracer products: These include a list of essential or key medicines that are selected to regularly evaluate the functioning of the drug management system. The items to be selected astracer products should be relevant to local public health priorities and should be available at all times at the health facilities. Examples include amoxicillin and paracetamol.