Essential medicines for emergency care in Africa

Area of Science:

• Public Health
• Pharmacology
• Emergency Medicine

Background:

• Essential Medicines Lists (EMLs) are crucial for medication access, with the WHO EML established in 1977.
• National EMLs are widely adopted, but often lack comprehensive coverage for acute illness and injury treatment.
• The need for a specialized EML for emergency care in Africa has been identified.

Purpose of the Study:

• To develop a consensus-based Essential Medicines List (EML) specifically for emergency care in Africa.
• To identify medications essential for various levels of emergency healthcare facilities.
• To address the gap in current EMLs regarding acute illness and injury management.

Main Methods:

• A multistep consensus process involving literature review, expert clinician ranking, and expert group evaluation.
• Candidate list generation based on existing literature and international EMLs.
• Finalization through an in-person consensus meeting after online surveys and expert reviews.

Main Results:

• The developed EML for emergency care in Africa includes 213 medicines.
• Twenty-five medicines essential for emergency care are not included in the 2017 WHO EML.
• The list is resource-stratified, with recommendations for basic (39 medicines), intermediate (96 medicines), and advanced (78 medicines) facilities.

Conclusions:

• The 25 novel medicines should be considered for national formularies to enhance emergency care systems in Africa.
• Resource-stratified lists facilitate easier implementation and practical expansion of emergency care delivery.
• This EML serves as a valuable tool for developing robust emergency care systems in resource-limited settings.