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===Drug===

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In 2005, UNHCR provided protection to approximately 20 million refugees and other persons of concern. Provision of comprehensive health care services in refugee settings is essential as population displacement and overcrowding are associated with increased risk of communicable disease transmission and excess mortality. Refugee health care systems are based on the concept of Primary Health Care (PHC) through which essential health care is made accessible to individuals, families and the community.

Health service provision is provided to refugees and other populations of concern through Implementing Partners (IPs, directly funded by UNHCR) and Operational Partners (OPs, with other sources of funding). Provision of supplies and equipment necessary for preventive and curative health care is carried out through a variety of mechanisms: centrally through UNHCR headquarters (HQ), nationally through Ministry of Health central pharmacies, and on the local market. Drug ordering from countries in which UNHCR works is not always appropriate or efficient. There are many examples of poor prescribing practices, purchase of drugs of dubious quality, orders unrelated to actual needs, poor drug storage and distribution, and irrational drug prescribing. In addition, local purchase may not be indicated, and there is limited data on stock ruptures, wastage, and other supply management elements. Centrally, UNHCR has developed an Essential Drugs List (EDL) to meet the immediate minimum drug needs for a basic refugee health care system. With an annual expenditure of more than $2 million US, there is an urgent need to address essential drugs management in UNHCR. This has led to an updating of the UNHCR EDL and to this manual. The 2006 UNHCR EDL is based on the 2005 WHO Model List of Essential Medicines and will be updated every 2 years as is the WHO list. This manual is a revision of the UNHCR Essential Drugs Manual (1989) and is the result of literature research, field visits, participation at conferences, and correspondence with experts. The manual is for the use of UNHCRs health partners, and for UNHCR health programme officers who supervise drug procurement in the field. It is meant to be a practical tool for field staff of UNHCR and partners with the aim of improving drug management in all parts of the drug management cycle.

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