CSRUISM
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IAMMS has taken a task of improving use of Indian
originated drugs and their adverse reaction monitoring.
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The
centre has received many ADRs of herbal drugs, which
were never ever reported earlier.
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These reactions for their causal relationships are
assessed according to Naranjo ADR Probability Scale
Evaluation & WHO Causality Categories.
Our members of IAMMS went to attend
International Conference
for Improved Use of Medicines (ICIUM
2004) with a plan to discuss the following abstract:
THE
CONCEPT AND THE PRINCIPLES OF RATIONAL DRUG MANAGEMENT
IN UNANI MEDICINE
Rahman
Syed Ziaur* & Latif Abdul**
Drugs are an essential tool for preventive, curative and
rehabilitative health care. However, holistic health
care has to consider drugs just as one tool among many
others and avoid the irrational overuse of
pharmaceuticals. The number and type of drugs is
constantly increasing, while the financial resources for
health care services in general remain limited.
Therefore rational drug management has become an
increasingly important topic in order to make optimal
use of the drug budget and to offer health services of
the highest possible standard. Unani Medicine, which is
an ancient system of medicine and more commonly
practiced in Indian Subcontinent, has an age-old concept
and principles of rational drug management. Some
authorities even consider Unani System of Medicine as a
holistic approach. Study of Unani Medicine in relation
with drug safety and quality assurance is thus
imperative. The concept of Temperament (Mizaj)
and Pulse Examination (Moain-e Nabdh) in
diagnosis and therapy, selection of drugs according to
their potency into 4 degrees (Darjat-e Advia), Use of
Correctives (Tadbir) to minimize toxicity on the
basis of temperament of drugs and its impact in
minimizing side-effects and Use of Substitutes (Abdal
al Advia) for better efficacy and cost-effectiveness
are the main concern for rational drug management in
Unani Medicine.
International Conference
Calls for Improved Use of Medicines
Chiang
Mai, Thailand –
About 450 leading multi-disciplinary researchers,
national and international policy makers, patient
advocates and clinicians representing nearly 80
countries, gathered in Chiang Mai, Thailand, for the
Second International Conference on Improving Use of
Medicines (ICIUM
2004). Participants reported on the many advances made
during the past years and, at the same time, expressed
concern over the continued, widespread improper use of
medicines. While agreeing that the unprecedented level
of funding now available to increase availability of
medicines in non-industrialized nations is essential,
they cautioned that the increased access to quality
drugs is beneficial only if the medicines are used
properly.
“Improper use of
medicines will lead to resistance making therapy more
expensive in the future,” said Dr. Hans V. Hogerzeil,
Interim Director of the World Health Organization’s
Department of
Essential Drugs and Medicines Policy (WHO/EDM).
“To save lives, increased availability of medicines and
treatment must be accompanied by responsible use.”
Overuse, underuse, and
misuse of medicines along with poor patient adherence to
therapy are contributing to the emergence and rapid
spread of disease strains that are resistant to
currently available treatment. Resistance to
conventional drugs has been observed in patients with
respiratory infections, HIV/AIDS, diarrheal diseases,
tuberculosis, and malaria along with other ailments.
Once the ability to use important
drugs is lost due to resistance, their effectiveness is
lost to every patient, whether in Africa, Asia or
anywhere else in the world.
Members of the
international community who assembled for ICIUM 2004
reviewed impressive research generated since the first
International Conference on Improving Use of Medicines
in 1997. The previous conference was a milestone which
resulted in unprecedented consensus on interventions to
improve medicine use and a definitive global research
agenda to increase understanding of issues that impact
the appropriate use of medicines.
Since the 1997 meeting,
“we now face a much more complex and challenging
international health environment in which there is a
potential for promoting improved use of medicines,” said
Dr. Jonathan Quick, President-elect and CEO designate of
Management Sciences for Health. A key participant in
1997, Dr. Quick, former head of WHO/EDM, stated that
“measurable progress is possible. To achieve sustained
long term impact, we must learn to use the levers of
health insurance, public information and public opinion,
and political leadership. We must also build strong
fundamentals of technical, financial, and human
resources, and focus on clear public health priorities.”
As one of the exciting
new developments, emerging health insurance systems
promise to be effective tools to improve access to and
use of medicines. “The future of the concept of
essential medicines lies with health insurance” said Dr.
Hogerzeil. “Insurance systems can emerge in
resource-deprived settings. Increasingly, reimbursement
schemes will leverage programs of rational use, medicine
pricing and pharmaceutical policies in general." He went
on to suggest that the WHO could help countries by
establishing practical guidelines for creating or
strengthening health insurance systems.
In the struggle to combat
increasing antimicrobial resistance, according to Dr.
Hogerzeil, one of the most exciting things is the
potential for 3-day therapy of childhood pneumonia, the
major killer of under 5-year olds in developing
countries. Short-course antibiotic therapy for
non-severe pneumonia seems to be effective, lower
treatment cost, increase adherence, cause less adverse
effects, and decrease the emergence of resistant
bacteria. If the evidence is really conclusive, this is
not only important for Africa, but for Europe and the
rest of the world as well.
Looking to the future,
Eva Ombaka, who heads the Ecumenical Pharmaceutical
Network in Kenya, strongly encouraged “harnessing the
people’s power” to improve medicine use in the
community. In the keynote address she said, “Community
leaders, faith leaders, and the youth are untapped
resources that should be used.”
ICIUM
2004 is part of a global effort to improve the use of
medicines, particularly in non-industrialized countries.
The ICIUM 2004 Conference was
collaboratively organized by the Boston University
School of Public Health Center for International Health,
Harvard Medical School Department of Ambulatory Care &
Prevention, International Network for Rational Use of
Drugs, Management Sciences for Health through its
Rational Pharmaceutical Management Plus (RPM Plus) and
Strategies for Enhancing Access to Medicines (SEAM)
Programs, the Thai Network for Rational Use of Drugs,
and the World Health Organization Department of
Essential Drugs and Medicines Policy.
Major support for the
conference was provided by the Bill & Melinda Gates
Foundation, Canadian International Development Agency,
Swedish International Development Cooperation Agency,
U.S. Agency for International Development, World Health
Organization (WHO)—Geneva, WHO Country Office for
Thailand, and WHO Regional Office for South-East Asia (SEARO).
In addition, more than 20 other organizations
contributed to the success of the conference by
sponsoring attendance of multiple participants.
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For
more information on ICIUM
2004
please visit
www.icium.org or
contact Mandi Mayer of Management Sciences for Health,
Washington, DC at +1 703-524-6575 (mmayer@msh.org)
or John Chalker, Yealmpton, Devon, UK at +
44-1752-881-501 (jchalker@msh.org), Dennis Ross-Degnan
of Harvard Medical School, Boston at +1 617-509-9920 (drossdeg@hms.harvard.edu),
or Chitr Sitthi-Amorn of Chulalongkorn University,
Bangkok at +662-2188141
(schitr@chula.ac.th).
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