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UN agency releases list of medicines vital for saving mothers and children

UN agency releases list of medicines vital for saving mothers and children

Mothers sitting on the floor with their children in India
The United Nations health agency today released its first ever list of the most vital medicines for saving the lives of mothers and children, and stressed the need to ensure their availability in developing countries.

The list of the top 30 medicines includes oxytocin, a drug used to treat severe bleeding after childbirth, the leading cause of maternal death, as well as simple antibiotics to treat pneumonia, which kills an estimated 1.6 million children under the age of five every year.

Access to appropriate medicines is vital to achieving global health goals, according to the World Health Organization (WHO), which noted that almost all of the maternal and child deaths occur in developing countries.

“The vast majority can be prevented when the right medicines are available in the right formulations and are prescribed and used correctly,” it stated in a news release. Other medicines on the list include those for treating high blood pressure and sexually transmitted infections among women, as well as diarrhoea, malaria and AIDS-related illness among children.

WHO added that most priority medicines are not available where needed, pointing out that surveys conducted in 14 African countries show that children’s medicines are available in only 35 per cent to 50 per cent of public and private centre pharmacies and drug stores.

The availability of medicines in developing countries for maternal and child health is compromised, the agency said, by poor supply and distribution systems, insufficient health facilities and staff, low investment in health and the high cost of medicines.

“We know that basic, cheap oral rehydration salts and zinc stop children from dying from diarrhoea, and we recommend that all countries make them accessible. But our surveys show that, at present, ORS is available in less than half of pharmacies and kiosks in African countries and zinc is not available at all in many places,” said Elizabeth Mason, Director of WHO’s Department of Maternal, Newborn, Child and Adolescent Health.

“This list is designed to help countries prioritize, so that they focus on getting the most critical things available and save the most lives,” she added.

WHO said that medicines appropriate for children are often not available, partly because of a lack of awareness that children need different medicines from adults. As a result, health workers are forced to adapt medicines intended for adults. Tablets are crushed into imprecise portions and dissolved into unpalatable drinks that are difficult for children to swallow and are potentially ineffective, toxic or harmful.

The agency recommends that medicines for children should be provided in doses that are easy to measure and easy for children to take. A newly developed artemesinin combination tablet for malaria is dissolved in liquid and is sweet tasting, making it easier for children to swallow and ensuring that they receive correct and effective doses.

The top 30 list also features five urgently needed medicines that do not currently exist for the prevention and treatment of tuberculosis, particularly in HIV-infected children, and for newborn care.

Treatment guidelines for tuberculosis in children have been developed recently by WHO but the recommended dosage requires a child to swallow many tablets a day over a long period of time.

Combining the essential ingredients into one tablet results in a pill around the size of a one-euro coin – too large for a child to swallow. Therefore, WHO is calling for more research to develop appropriate, palatable formulations for children.