ETHIOPIAN ESSENTIAL MEDICINES LIST

1 Ministry of Health/ ETHIOPIAN Food and DrugAuthorityETHIOPIAN ESSENTIALMEDICINES LISTSIXTH EDITIONSEPTEMBER, from from Ministry of classification of CLASSIFICATION OF RESPIRATORY CENTRAL NERVOUS SYSTEM USED IN USED IN MUSKULOSKELETAL AND JOINT USED IN ENDOCRINE DISORDER AND AND GYENECOLOGICAL BLOOD PRODUCTS AND MEDICINES AFFECTING THE USED FOR CORRECTING FLUID, ELECTROLYTE AND ACID ANTINEOPLASTICSAND SUPPORTIVE USED FOR BENIGN PROSTATE EAR, NOSE AND THROAT DERMATOLOGICAL 000 000. SERA AND ANTIDOTES AND OTHER SUBSTANCES USED IN RADIOCONTRAST 1:List of individuals and institutions that have contributed in drafting, reviewing, validating andediting of the 6th edition of medicine ! Bookmark not :Antimicrobial ResistanceAMS:Antimicrobial stewardshipAWaRe:Access, Watch, ReserveAAUCHSA ddis Ababa University College of Health SciencesCHAIC linton Health Access initiativeDR-TB:Drug Resistant TuberculosisEFDA: ETHIOPIAN Food and Drug administrationEEML: ETHIOPIAN ESSENTIAL medicine ListEPSA: ETHIOPIAN Pharmaceuticals Supply AgencyJSIJohn Snow IncMOH:Ministry of HealthMTaPS:Medical supplies and pharmaceuticals service programPMED:Pharmaceutical and medical equipment directorateRHBR egional Health BureauSPHMMCS aint Paul Hospital Millennium Medical CollegeSTG:Standard Treatment GuidelineTASHT ikurAnbessa Specialized hospitalTB:TuberculosisTWG:Technical Working GroupUSAIDU nited States Aid for International DevelopmentWHO.

2 World Health OrganizationAcknowledgementThe Ministry of Health and ETHIOPIAN Food and Drug Authoritywould like to acknowledge everymember that was involved in the revision of the EEML, for their commitment and unreserved effortin finalizing the task in a very short period of timeduring this Pandemic EEML revision wouldn t be possible without the involvement of the development partners andtheMinistry ofHealth and ETHIOPIAN Food and Drug Authority recognized, USAID/MTaPS andCHAI for their technical and financial support; WHO,GHSC-PSM and JSI for their technicalsupport throughout this revision special thanks go to the USAID/MTaPS for the technical and financial support provided inediting, proof reading and printing of the from EFDAR egular availability of safe, effective and quality MEDICINES are backbone of the provision ofhealthcare services at all levels.

3 Such issues and the rational use of MEDICINES is well addressed inthe ETHIOPIAN government documents, the Health Policy, the Drug Policy and used to publish the National ESSENTIAL Drug List for more than three decades. The firstEdition was published by the then medicine regulatory section of the ministry of health in 1987 the science of medicine and pharmacy is dynamic that necessitate regular periodic revision, suchrevision had been conducted and the last version was the 2014GC fifth edition of the NationalEssential MEDICINES list. Though revision of this fifth edition is a bit delayed it gave us chance toexplore areas extensively and enriching of our legal basis. Proclamation 1112/2019 article :EFDA prepare and as necessary, revise list of ESSENTIAL MEDICINES .

4 Whenever to this, the National ESSENTIAL medicine List is hereby revised for the six time, followingseries of consultative workshops, posting the draft on different websites including EFDA as well asbased on scientific evidences and experiences in the different disciplines. We believe that this is animportant tool to be as a reference for ensuring access, be it through public, private or , providers, purchasers and regulators of health service are advised to use the list, consider thatthese are focus areas to provide services in different areas. There are many changes from theprevious edition. Among others, Antimicrobial Resistance is the global and National threat wherebythis revised edition categorized antibiotics into Access, Watch and Reserve (AWaRe), newtherapeutic classes included, addition and deletion of MEDICINES in the different , I would like to express my heart felted gratitude to all those who directly participated in therevision process: the staff of MOH, EFDA, Technical Working Group, development partners, theparticipants of the review workshops as well as those indirectly involved to extended their mind andhands in the revising and printing of the list.

5 Let me take this opportunity to encourage healthprofessionals and interested parties to continue their usual support in updating the list by forwardingcomments andsuggestions to the Ethiopia Food and Drug ,Director General, ETHIOPIAN Food and Drug Authority (EFDA)Foreword-Message from Ministry of HealthPharmacotherapy has always been an integral part of health care system and will remainso in thefuture. This relies on the availability of safe, effective and affordable medicineswith the requiredquality, in reasonable amount. Moreover, on the rationalprescribing, dispensingand use of suchmedicines. ETHIOPIAN drug policy ensures that MEDICINES whichare required for prevention,diagnosis, treatment, mitigation and rehabilitation of diseasesaffecting the majority of Ethiopianpeople have to be identified and classified to respectivelevels of health service National ESSENTIAL medicine List is hereby revised for thesixthtime in light of the aboveprinciple.

6 Hence, users ofthis MEDICINES list are advised to refer to the list whenever they providethe services indifferent area. It givesusgreat pleasure to introduce this edition of the list to allbeneficiaries, which is the fruit of the joint effort of theMOH/PMED, EFDA, developmentpartnersas well as the participants of the thatthis listwill serve as useful guideforthe procurement and to satisfy the majority public medicine ,wewould like to expressourgratitude to all those who have directly or indirectlyextendedtheir helping hands inthe revising and printing of the General,Medical Service General Directorate, MOHS ynopsisTheMinistry of Health (MOH)andEthiopian Food and Drug Authority (EFDA)established amultidisciplinary team of professionals, namely theEthiopian ESSENTIAL MEDICINES List (EEML)ReviewTechnical Working Groups (TWG)

7 , Core team members, Expert consultants from differentHealth facilities in reviewing and ensuring that the EEML is based on the most current information,both globally and nationally. The EEML review convened a series of meetings and discussions witha variety of medical specialists as well as internal and externalconsultation andvalidation meetingsto obtain this final this EEML 2020, MEDICINES are listed by24major therapeutic categorieswithin which there are73subcategories of which, three major categories and six sub-therapeutic categories newlyincorporated. Within each category, MEDICINES appear in alphabetical order and with the appropriatedosage forms listing does not imply preference for one medicine over newcategorization of antibiotics into Access, Watch and Reserve (AWaRe) classeswasintroduced toguide and emphasize the importance of the rational use of antibiotics in line with global guidanceprovided by the World Health Organization(WHO).

8 The National ESSENTIAL medicine List will serve as a usefultool for: healthcare financing andmedicines supply budgeting; procurement, supply and distribution; managing donations, promotingappropriate use of MEDICINES and satisfying the majority of public needs. All health workers at alllevels are encouraged to make use of the EEML and the document should be updated every addition to the printed version, digital platforms, including applicationversionsshouldbemade available in future provision of complete healthcare service by health facilities necessitates the availabilityof safe,effectiveand affordable MEDICINES of the required quality, in adequate quantity at alltimes. Thereare vast numbers ofmedicine in the market. Availing all this medicine in acertain country will neverbe a wise chose as well the cost of those medicine is ,for insuring theavailability of the safe, effective and good quality MEDICINES ,limiting the number of medicine usedin a country is , ESSENTIAL medicine list is aminimumlist thataimstoenhanceaccess toessential MEDICINES in the existingnational health caresystems.

9 Itis one of the safeguard toensure accessibility of safe, effective and quality medicine at service delivery has also akeyrole in the promotion of the aboveconcept and the majoritypopulation need preparation of ESSENTIAL medicine list is vital forassuring availability of EEML 2020,has benchmarked different national and global guidelines and evidence-basedapproaches. The revision process passedthroughthe following steps: Establishingoftechnical working group, Developing working documents such as Guide for EML revision, medicine Selection criteria byTWG. Preparing zero draft list Forming of core technical team Involving expertise for consultation Seeking consultation from health facilities, academic institutions and regional health bureaus Aligning with the STG, which is under revision Reviewing offinalEEML by TWG Editing and formatting of thefinal version of the EEMLF inalization of the documentand editorial workwasundertaken to produce a print ready form forapprovalby the MoH and EFDA EEML was revised based on the concept ofWorld Health Organization(WHO) model werecarefully and systematically selectedusing an evidence-based approachwith dueconsideration ofpublic health relevance, efficacy and safety,comparative cost-benefit,availabilityof medicinesin ,addition, deletion, or change/modificationswas made tothe previous edition of the EML.

10 The EEML contains610medicines, as compared to the previousedition which contains484medicines. The categories were similar to the previous edition except theaddition ofthreenew major categoriesand sixsub newly added major categoriesinclude MEDICINES for benign prostate hyperplasia, vaccines and radio contrast following materials have been used as a source document while revising the viral hepatitis management guideline for Hepatitis C Virus (November, 2019) guideline for prevention and control of viral hepatitis (2016-2020) guideline for TB, DR-TB and Leprosy in Ethiopia, 6thedition (August, 2018) Malaria Guideline (March, 2018) consolidated Guideline for comprehensive HIV prevention, care and treatment(August, 2018) Model List 21st edition (Adults) and 7th edition (Children) of 2019 WHO AWaRe Classification of Antibiotics for Evaluation and Monitoring of use(WHO/EMP/ )