Antibiotics in national essential medicine list: alignment with WHO-AWaRe framework in Bangladesh and South Asian perspectives

Abstract

The list of essential medicines varies between countries due to several important reasons. Different countries have different health priorities. For example, malaria or tuberculosis is a major concern in many African and Asian countries, so antimalarial and antitubercular drugs are essential there, while they are less relevant in countries where malaria is rare. Health system capacity is an important factor to consider as some medicines require special storage (like refrigeration), trained professionals to administer, or advanced diagnostic tools. Countries with limited healthcare infrastructure may not include such medicines on their essential lists. Sometimes economic factors like budget constraints influence what medicines a country can afford to provide widely. Lower-income countries may prioritize low-cost, high-impact drugs over expensive treatments. Local regulations and national health policies, medicine approval processes, import laws vary from country to country. A drug considered essential and approved in one country may not be legally available in another. Moreover, cultural and social factors like public perception, traditional medicine practices, and cultural attitudes toward certain treatments can influence what’s considered essential for that population. Countries with domestic pharmaceutical industries may prioritize medicines they can produce locally, ensuring consistent supply. While countries often refer to the World Health Organisation (WHO) model list of essential medicines, they adapt it to local needs, sometimes adding or omitting drugs based on national contexts.