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A national medicine policy (NMP), formerly referred to as a national drug policy (NDP) is a document that serves as a political commitment and guide for action by the government to provide safe, efficacious, quality assured, available, affordable and rationally used medicines. This is the first study to review the implemented components of the NMPs of the 16 South African Development Community (SADC) countries over the past ten years (2011-2021). Information published between 2011 and 2021 of each country such as pharmaceutical profiles, official government documents, WHO/HAI/World Bank datasets and research studies on the implemented components were appraised. Significant progress has been made by 16 SADC countries over the period 2011-2021 in implementing the NMP. The most commonly implemented components included the concept of essential medicines, pricing, and regulation. Though traditional and herbal medicines component is yet to be implemented by the majority. The pharmacist-patient ratio of 1:2300 was below the target for all countries, prompting the need to strengthen the pharmacy personnel in the healthcare systems. Medicine pricing, affordability, and availability studies are necessary to develop equitable pricing policies that will improve the accessibility of medicines in all countries and the SADC region. With the exception of the Republic of Tanzania, SADC countries need to urgently revise their NMPs, thus adopting progressive processes such as incorporating Health Technology Assessment (HTA) in the NMP. All SADC countries require a strong, internationalistic evaluation culture built-in their policy formulation. As the first study to investigate the implemented NMPs in the SADC region, it could serve as a springboard for the countries to address their common pharmaceutical challenges thus improving their readiness for universal health coverage (UHC). Future in-depth cross-country studies in the SADC region are necessary to comprehensively evaluate the implemented components of NMPs.

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BACKGROUND: Effective pharmaceutical inventory management is essential for optimizing healthcare outcomes and supply chain performance. However, challenges such as stockouts, overstocking, and wastage can hinder this process. This study examines the interrelationships between overstocking, stockouts, and wastage in eight healthcare facilities in Northern KwaZulu-Natal, South Africa. It also explores the extent of these challenges and investigates the use of medicine redistribution as a strategy to address inventory management issues. METHODS: A retrospective quantitative analysis was conducted using pharmacy inventory records from public healthcare facilities. Eight facilities, including hospitals and a community healthcare center in King Cetshwayo District, were purposively sampled. Linear regression analysis was used to examine the association between medicine redistribution as the outcome and the predictors - stockouts, overstocking, and wastage. Pearson's correlation was utilized to evaluate associations between the predictors. Descriptive statistics were employed to quantify the levels and extent of overstocking, stockouts, and wastage related to expiry. RESULTS: The study included eight healthcare facilities with pharmacy warehouses managed by pharmacists. A total of 392 medicines were analyzed (49 per facility). Stockouts affected 85.6% of medicines, while overstocking and expiry-related wastage impacted 50.6% and 15.2% of medicines, respectively. The most common stock-out medicines were salbutamol 200mcg inhalant (4.0%), paracetamol 500 mg tablets (3.5%), and azithromycin 500 mg tablets (3.3%). Overstocking, stock with short-dated expiry, and expired medicines explained 68% of redistribution transactions to other facilities (r² = 0.68). A moderate, statistically significant correlation was observed between overstocking and expiry-related wastage (r² = 0.47, p-value = 0.020). Stockouts had a weak correlation with redistribution, accounting for only 4.5% (p-value < 0.01). A weak correlation was found between stockouts and overstocking (r = 0.10), as well as between stockouts and expired medicines (r = -0.20). CONCLUSION: This study highlights significant challenges in inventory management, particularly regarding stockouts, overstocking, and expiry-related wastage in the evaluated healthcare facilities. Medicine redistribution emerged as a viable strategy to address these challenges. Improving inventory management practices and implementing targeted interventions are crucial for optimizing pharmaceutical supply chain performance and enhancing healthcare delivery outcomes in this setting.

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The lack of appropriate medicines for children has a significant impact on health care practices in various countries around the world, including Thailand. The unavailability of pediatric medicines in hospital formularies causes issues regarding off-label use and extemporaneous preparation, resulting in safety and quality risks relating to the use of medicines among children. This research aimed to identify missing pediatric formulations based on the experience of healthcare professionals in a teaching hospital in northern Thailand. A cross-sectional survey was conducted to collect data on missing pediatric formulations, the reasons for their inaccessibility, their off-label uses, their reactions to the situation, and suggestions to improve access to these identified medications. The survey was distributed to all physicians, nurses, and pharmacists involved in prescribing, preparing, dispensing, and administering pediatric medicines. A total of 218 subjects responded to the survey. Omeprazole, sildenafil, and spironolactone suspension were most often identified as missing formulations for children by physicians and pharmacists. They are unavailable on the Thai market or in any hospital formulary. For nurses, sodium bicarbonate, potassium chloride, and chloral hydrate were the most problematic formulations in terms of preparation, acceptability, and administration. These medicines were difficult to swallow because of their taste or texture.

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The study aims at exploring the composition and characteristics of the medicinal plant resources of six major ethnic minorities living in Xishuangbanna, as well as the characteristics of traditional utilization of ethnic medicine, and promote the rational protection and inheritance and utilization of ethnic medicine resources and traditional knowledge. Based on the fourth survey of traditional Chinese medicine resources in Xishuangbanna, Yunnan province, through the methods of literature collection, interviewing and field investigation, this paper analyzed the data of the types, medicinal parts and attending diseases of medicinal plant resources of Dai, Hani, Jinuo, Wa, Lahu and Bulang nationalities. The results showed that there were 1 048 medicinal plant resources of the six ethnic minorities, and the medicinal plants were 735, 497, 272, 295, 280 and 49 in the six nationalities, respectively. The cross-use of medicinal plants among the six nationalities accounted for 62.45%, 78.07%, 88.60%, 87.46%, 82.25% and 95.92%, respectively. The main medicinal plants used by the six major ethnic minorities are root and rhizome, whole grass, leaf and stem. Various ethnic medicinal plants are mainly used in the treatment of diseases of digestive system, respiratory system, rheumatic disease, trauma, snake and insect bite and other external diseases. This study showed that Xishuangbanna has rich resources of ethnic medicinal plants. The ethnic medicine culture with Dai medicine as the main part has a long history and diversified theories, forming a unique ethnic characteristic culture. However, all ethnic medicine resources and the application of traditional knowledge are faced with the risk of gradually decreasing, it is suggested to strengthen the mining, Xishuangbanna folk medicine of ethnic culture protection and inheri-tance, and to develop regional economy and the international community has a positive influence.

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Appropriate producing areas can guarantee the quality of Tibetan medicine, but research on the suitable ecological factors and suitable producing areas of Tibetan medicinal plants is scarce. This paper used the Geographic Information System for Global Medicinal Plants(GMPGIS) to analyze the ecological suitability of Tibetan medicinal plants nationwide. For the first time, the range of ecological factors and main soil types of Tibetan medicinal plants were extracted, such as the average annual temperature-19.4-24.2 ℃, annual average precipitation 17-4 088 mm, annual average sunshine 124.2-171.6 W·m~(-2). The main soil types were black calcareous soil, thin layer soil, chestnut soil and so on. Based on 337 sampling points, the largest ecological similarity area of Tibetan medicine across the country was obtained through ecological similarity analysis. In addition to Tibet and Qinghai provinces and Tibetan Autonomous Prefectures in Sichuan, Gansu, and Yunnan provinces, Jiuquan city and Linxia county in Gansu province, Panzhihua and Ya'an in Sichuan province, and Xinjiang, Inner Mongolia, and Shanxi provinces also had larger suitable cultivation areas. In addition, by analyzing the current situation of Tibetan medicine industry, the research pointed out that there were some problems such as unreasonable development and utilization of resources, lack of standards and norms, weak basic research and imperfect industrial system, and made corresponding countermeasures for sustainable development of resources, formulation of standards and specifications, promotion of medicine through science and technology, expansion of domestic and foreign markets, etc. This study provided the basis for guiding the rational layout of production bases, introduction and breeding of plant Tibetan medicine nationwide, laying the foundation for the scientific and standardized production of high-quality Tibetan medicine, clarifying the development direction of Tibetan medicine industry, and providing ideas for the development strategy of Tibetan medicine and other national medicine industry.

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Appropriate producing areas can guarantee the quality of Tibetan medicine, but research on the suitable ecological factors and suitable producing areas of Tibetan medicinal plants is scarce. This paper used the Geographic Information System for Global Medicinal Plants(GMPGIS) to analyze the ecological suitability of Tibetan medicinal plants nationwide. For the first time, the range of ecological factors and main soil types of Tibetan medicinal plants were extracted, such as the average annual temperature-19.4-24.2 ℃, annual average precipitation 17-4 088 mm, annual average sunshine 124.2-171.6 W·m~(-2). The main soil types were black calcareous soil, thin layer soil, chestnut soil and so on. Based on 337 sampling points, the largest ecological similarity area of Tibetan medicine across the country was obtained through ecological similarity analysis. In addition to Tibet and Qinghai provinces and Tibetan Autonomous Prefectures in Sichuan, Gansu, and Yunnan provinces, Jiuquan city and Linxia county in Gansu province, Panzhihua and Ya'an in Sichuan province, and Xinjiang, Inner Mongolia, and Shanxi provinces also had larger suitable cultivation areas. In addition, by analyzing the current situation of Tibetan medicine industry, the research pointed out that there were some problems such as unreasonable development and utilization of resources, lack of standards and norms, weak basic research and imperfect industrial system, and made corresponding countermeasures for sustainable development of resources, formulation of standards and specifications, promotion of medicine through science and technology, expansion of domestic and foreign markets, etc. This study provided the basis for guiding the rational layout of production bases, introduction and breeding of plant Tibetan medicine nationwide, laying the foundation for the scientific and standardized production of high-quality Tibetan medicine, clarifying the development direction of Tibetan medicine industry, and providing ideas for the development strategy of Tibetan medicine and other national medicine industry.

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OBJECTIVE: Improving access to effective and safe medicines is one of the major goals of all health systems. To achieve this goal, assessment is a fundamental phase of national medicine programs for access improvement. Collecting and compiling applicable indicators and impart a comprehensive framework for assessing access to medicine, are the aims of this study. METHODS: To investigate the published materials on access to medicines framework or indicators, a literature review with a systematic search was conducted using PubMed/ Medline, Scopus, and Google Scholar databases. The results were completed with a general search of documents in Iran Food and Drug Administration (IRFDA). Two independent researchers reviewed all the articles and documents. Thereafter the related indicators were extracted. In focused group discussion of academics and IRFDA experts, duplicate entries or ineffectual concepts were cleaned from the preliminary indicators. In the next step, Delphi questionnaire was sent to the 17 experts that work in academia, Social Security Insurance, IRFDA, Ministry of Health and Iran Pharmacist Association. The results of Delphi technique were finalized in an expert panel. RESULTS: One hundred and thirty one indicators were found in systematic search. After primary extraction of related indicators, 77 indicators were sent to the 17 experts in a Delphi form. The results of Delphi were finalized in a specialized-working group and 67 indicators were accepted in 5 categories including physical availability and geographical accessibility (19 indicators), affordability (23 indicators), human resources (4 indicators), quality and safety (5 indicators), information and rational use (16 indicators). CONCLUSION: The indicators that inclusively assess the full access to medicine in the concept of rational use have been categorized into five categories in this study. To determine the access to medicine status in each country further local surveys are necessary for all several indicators in each category. Graphical abstract The graphical abstract of accomplished steps.

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OBJECTIVE： To provide reference for improving China’s national medicine policy framework. METHODS： The medicine policy documents of 2009-April 2019 were collected， and then policy texts were categorized according to national medicine policy elements of WHO. According to the number and strength of policies， the construction of national medicine policy framework was analyzed. The main reform measures of different themes were extracted and summarized. On this basis， the logic of medicine reform in China was analyzed. RESULTS & CONCLUSIONS： National medicine policy framework has been established primarily， but it is not balanced， such as the number and intensity of policies on human resources and medicine financing are slightly inadequate. Analysis of China’s national medicine policy framework reveals that： （1） in the process of construction， “quality assurance” and “affordability” are the two main policy lines， and “quality improvement” and “cost reduction” are the two main policy objectives； （2） the construction of national medicine policy framework has a phased reform focus， and it has gone through a process from “demand-side reform” to “supply-side and demand-side reform”； （3） the importance of medicine procurement in the reform has been strengthened continuously. It is suggested to strengthen the balance of national medicine policy， improve human resources， medicine financing and rational medicine use policy construction； it is also suggested to strengthen top-level design， establish a multi-department collaborative decision-making and coordination mechanism， and enhance the coordination of medicine policies； in addition， the role of procurement links reform should be further played .

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[Objective]To discuss the medical development situation of Tangut and the medicine cultural communication and fusion of the Central Plains, it decoded the medical prescriptions treating miscellaneous diseases in Heishui town. [Methods]It is done by arranging, decoding and translating the excavated Heishui town Tangut script which treats the people who can't swallow food and the pharyngitis and treats the constipation of men and women. Besides it can connect with the medical theory of Central Plains to discuss from the pathology dosage and eating aspects. [Results]The two medical prescriptions of Tangut which treating miscellaneous diseases are imbued with strong folk features. So it should be recorded by Tangut doctor. [Conslusion]Most of the Tangut medical pathology come from the traditional Chinese medicine theory. But it also has its own uniqe national features. So the medical culture of Central Plains has a deep influence on other peripheral ethnomedicine.

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Shaman is an ancient, mysterious and premitive religion for the world. There are abundant cultural resources ofShaman in China located in the core area ofShaman culture. That"all beings have spirit"is believed in Shamanism, which reveres nature, applies suggestion effect, focuses on arousing human potential, highlights psychotherapy, conquers diseases with inherent built-in power and promotes longevity.Shaman culture closely combined with daily life of ancestors in the north struggles with diseases, which forms traditional medicine culture with unique north characteristics. This culture pays more attention to fresh famous-region drug adoption, non-medicine treatment, curing miscellaneous diseases of the regions, flexible medical methods and simple medical morals. The study onShamanculture influence on the forming and development of traditional medicine culture of Longjiang is beneficial to enrich traditional culture content of national medicine, replenish Chinese medicine treasure, promote national culture and international impact.

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Shaman is an ancient, mysterious and premitive religion for the world. There are abundant cultural resources ofShaman in China located in the core area ofShaman culture. That"all beings have spirit"is believed in Shamanism, which reveres nature, applies suggestion effect, focuses on arousing human potential, highlights psychotherapy, conquers diseases with inherent built-in power and promotes longevity.Shaman culture closely combined with daily life of ancestors in the north struggles with diseases, which forms traditional medicine culture with unique north characteristics. This culture pays more attention to fresh famous-region drug adoption, non-medicine treatment, curing miscellaneous diseases of the regions, flexible medical methods and simple medical morals. The study onShamanculture influence on the forming and development of traditional medicine culture of Longjiang is beneficial to enrich traditional culture content of national medicine, replenish Chinese medicine treasure, promote national culture and international impact.

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In the context of cognitive science,taking "diabetes mellitus" as an example,through sorting out and analyzing the treatment experience of Ren Jixue,Yan Dexin,and Lv Renhe,to explore the etiology and pathogenesis of its metaphysical characteristics and the cognitive roots of different governance.The experience of three doctors in the treatment of diabetes mellitus is based on the "natural fire","no firewood at the end of the cauldron","hub adverse" and other source domain construction;the unique experience of the physician formed different cognitive structures,resulting in the diversity of the origin of the conceptual metaphor of diabetes mellitus,and thus the diversity of metaphorical cognition of "diabetes mellitus".

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The concept of defining essential medicines and establishing a list of them was aimed to improve the availability of affordable medicines for the world's poor. Access to essential medicines is a major determinant of health outcomes. Several countries have made substantial progress towards increasing access to essential medicines, but access to essential medicines in developing countries like India is not adequate. In this review we have tried to present the Indian scenario in respect to availability and accessibility of essential medicines over last one decade. To enhance the credibility of Indian healthcare system, procurement and delivery systems of essential medicines have to be strengthened through government commitment, careful selection, adequate public sector financing, efficient distribution systems, control on taxes and duties, and inculcating a culture of rational use of medicines in current and future prescribers.

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Objective To observe the clinical efficacy of She medicine in treating lumbar intervertebral disc herniation (LIDH) in acute pain stage, and to explore its action mechanism.Method Sixty patients with LIDH in acute pain stage were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by She medicine, while the control group was by oral administration of Loxoprofen tablets. Visual Analogue Scale (VAS) was observed before and after intervention, and the clinical efficacies were compared.Result The excellence rate was 83.3% in the treatment group versus 60.0% in the control group, and the difference was statistically significant (P<0.05). The VAS score changed significantly after intervention in both groups (P<0.01). After intervention, there was a significant difference in comparing the VAS score between the two groups (P<0.05).Conclusion She medicine is an effective approach in treating LIDH in acute pain stage, and it can significantly reduce pain.

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O setor magistral representa um importante segmento do mercado brasileiro de medicamentos. Entretanto, a qualidade dos produtos fornecidos pelos estabelecimentos é frequentemente discutida e a Agência Nacional de Vigilância Sanitária (ANVISA) tem demonstrado uma preocupação com os produtos magistrais, pela promoção de consultas públicas abordando o assunto e pelo aumento do rigor nas legislações específicas. Assim sendo, as farmácias magistrais desempenham um importante papel no contexto da Política Nacional de Medicamentos, que objetiva garantir a promoção do uso racional e o acesso da população a medicamentos essenciais. Tendo em vista a importância da abordagem da qualidade dos produtos manipulados, este artigo apresenta relevantes informações sobre o perfil de qualidade do serviço de saúde prestado por esse setor, mediante a revisão da legislação e de trabalhos científicos que englobam o assunto.

The magistral sector represents a significant segment in the Brazilian pharmaceutical market. However, the quality of magistral formulations is often questioned and the National Agency of Sanitary Vigilance (ANVISA) has demonstrated a concern regarding these products, which has been verified in many public consultations approaching this subject and in new legislation aiming to improve public health. Thus, magistral pharmacies play an important role in the context of the National Medicine Politics, which aim to assure promotion of rational use and population access to essential medicines. Due to the paramount importance of the magistral formulation quality, this article presents information about the basic importance and the quality profile of these products, through the revision of the legislation and of scientific works that approach the subject.

El sector magistral representa un importante segmento del mercado brasileño de medicinas. Sin embargo, la calidad de los productos ofrecidos por estos establecimientos es frecuentemente discutida y la Agencia Nacional de Vigilância Sanitária (ANVISA), ha demostrado preocupación con los productos magistrales, por la promoción de consultas públicas abordando el asunto y por el aumento del rigor en las legislaciones específicas. Siendo así, las farmacias magistrales desempeñan importante rol en el contexto de la política Nacional de Medicinas, que busca garantizar la promoción del uso racional y el acceso de la población a las medicinas esenciales. Considerando la importancia del abordaje sobre la calidad de los productos manipulados, este artículo presenta relevantes informaciones sobre el perfil de la calidad del servicio de la salud ofrecido por ese sector, a través de la revisión de la legislación y de trabajos científicos que engloban el asunto.

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Por meio de um levantamento bibliográfico sobre as políticas públicas no setor de medicamentos brasileiro, o artigo examina as principais características das ações aplicadas na área, ressaltando seus resultados e deficiências, bem como as dificuldades encontradas para consolidar uma política de medicamentos no Brasil. O estudo realizado se fundamentou na análise de artigos por meio das bases de dados Scielo e Lilacs e de outras fontes. Desde a extinta Central de Medicamentos (CEME) até a aprovação da Política Nacional de Medicamentos (PNM), todas as ações e projetos foram voltados principalmente para a reorientação da Assistência Farmacêutica na atenção básica, garantindo, por conseguinte, o acesso e o uso racional dos medicamentos essenciais.

Through a bibliography review of public policies in Brazilian medicine sector, this paper examines the main characteristics of actions implemented in this area, lighting their results and deficiencies, as well as the difficulties to consolidate a policy for medicines in Brazil. The study is based on analysis of articles searched in the Scielo and Lilacs databases and other sources. Since the extinct Medicine Center to the approval of the National Medicine Policy, all the actions and programs aimed mainly at the reorientation of Pharmaceutical Assistance in primary health are, to guarantee access and rational use of essential medicines essential.

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OBJECTIVE:To explore the establishment of performance indicator system for evaluating national essential drug system in China.METHODS:Reference to the field of health policy performance evaluation research and practice at home and abroad.WHO indicators for evaluating national drug policies,and a qualitative study on the theory and approach of policy evaluation was conducted.RESULTS & CONCLUSION:To establish a China-specific performance evaluation indicator system,policy goals should be specified,and evaluation criterions and policy components should be also defined firstly.An indicator system framework of national essential drug system which based on WHO recommendatory indicators should be proposed accordingly.But detailed indicators should be established based on field research and experts counseling.

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To probe tentatively into the relations of Terminalia chebula Retz., Terminalia billerica (Gaertn.) Roxb, and Phyllanthus emblica L. between TCM and Tibetan medicine. Methods　Textual researches of materia medica were carried out and their history in clinical application were traced. Results　T. chebula, T. billerica, P. emblica were all of foreign origin and were introduced into China with Buddhism. As compared in medical practice, the Tibetan autonomony region has their particular choice and preference. Conclusion　We should apply modern scientific research achievements to carry out deep mutual exchanges to enrich TCM.

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Object To probe tentatively into the relations of Terminalia chebula Retz., Terminalia billerica (Gaertn.) Roxb, and Phyllanthus emblica L. between TCM and Tibetan medicine. Methods Textual researches of materia medica were carried out and their history in clinical application were traced. Results T. chebula, T. billerica, P. emblica were all of foreign origin and were introduced into China with Buddhism. As compared in medical practice, the Tibetan autonomony region has their particular choice and preference. Conclusion We should apply modern scientific research achievements to carry out deep mutual exchanges to enrich TCM.