THE starting point of an essential drug policy is their selection in the light of the health needs of the population.

Selection implies a balancing of different variables: efficacy, safety, cost, health infrastructure and personnel able to prescribe. The main instrument for regulation of selection is via each national drug/medicine registration board, though porous borders and the activities of counterfeit manufacturers can dilute the effectiveness of the process.

In most of the literature, a drug is defined as a substance that can alter the normal function of the body whilst most of the literature in pharmacology looks at a drug as a substance with therapeutic or medicinal property.

The use of plants in medicine has a long history and herbs extracted from them are known to have been prepared as far back as 3000 BC. However, globalization and modernization has brought about some improved efficiency and increased therapeutic value in use of these herbs by putting them in tablets, injection, capsules and many other forms of presentation.

The dilemma of having one herb treating 500 to 1000 diseases has been overcome by improved medical knowledge to lessen on the effects of toxicity in our bodies. The increasing numbers of herbal dependant community in Zambia should not come as a surprise due to a number of challenges in our drug management in our health care system.

In most of our Zambian health institution, the provision of health services against leading causes of death and disability has not been possible without safe, effective, good quality and low-cost pharmaceuticals. It is universally accepted that medicines are indispensable for the diagnosis, treatment, mitigation, or prevention of disease or symptoms.

Inequalities in terms of access to essential medicines remain wide-spread in many parts of the world. A favourable number of Zambians like all developing nations do not have regular access to cost effective essential medicines or use medicines incorrectly. Consequently, most of the herbal products have become more expensive than western conventional medicines in our Zambian community.

Undisputedly, herbal products have good therapeutical values but the knowledge of most of the prescribers on these products and disease processes deserve much to be desired. Man's insatiable appetite for quick working medicines like a "Rojer Ramjet pill" has lead to irrational demand for anything that they see "pleasing".

In the practice of medicine there are certain baseline factors to be considered like the function of the liver or kidney before prescribing certain drugs. Simply I can state here that the benefits of the administration of medicines, has to be weighed against the risks instead of eyeing for profit at the expense of ones reputation.

"My warning to the public is to be aware of the therapeutic content of the herbs they are taking and side effect that may arise". Drugs save lives and improve health, hence the need for the consumers to take self precaution measures.

In conclusion, I would urge our hardworking government and the stakeholder in the health care system to consider taking drug management as an essential component of effective and affordable health care services.

There are practical ways in which government, policy makers, essential drugs mangers, NGOs, donors, prescribers, patients and dispensers can work to ensure that high quality essential medicines are available, affordable and used rationally unlike the prevailing situation. In my experience within a lot of health institution I have been made to believe that government with its shareholders or partners buy the drugs for its health facility but the reason as to why essential drugs are not in the reach of the consumers is for you and me to find out.

The author is a male nurse at Luanshya Mine Hospital, Dip-T.Educ, Dip-MCPD Dip-OD Dip-Nsg, Cert Psy couns, Cert ART mgt. Cell: 0966565670, Email: jonesmuna@yahoo.com

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