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THE FUTURE OF PHARMACY
INTERNATIONAL PHARMACY JOURNAL
challenges to attaining their target by 2015, as they are far behind other regions of the world on most of the indicators pertaining to infant health. In these two regions, under-five mortality rates exceeded 50 deaths per 1,000 live births in 2008; with 76 deaths per 1,000 live births in South Asia and 144 deaths per 1,000 live births in sub-Saharan Africa.17 Furthermore the births of two-thirds of the children were unregistered in these two regions. The main causes of infant mortality identified were pneumonia, diarrhoeal diseases, preterm birth defects and birth asphyxia, illustrated in Fig. 2. Malnutrition was stated to be the principal cause of over a third of infant mortality worldwide. Other causes of infant mortality that have been reported in some regions are HIV/AIDS, neonatal sepsis, vitamin A deficiency, tuberculosis and measles.12,18 In many developing countries access to antibiotics, oral rehydration therapy and other interventions that have proven to CFTJNQMF SFNBJOMPX*O4PVUI"TJBPOMZPGVOEFSmWFZFBSPMETXJUIQOFVNP- nia receive antibiotics, and in sub-Saharan Africa less than a third of the children under-five with diarrhoea receive the recommended treatment. One hundred and forty-eight million children under the age of five are underweight and 22 million infants are not protected from diseases through routine immunisations.19 Particular efforts need to be made to fight pneumonia, diarrhoea, malaria and under-nutrition, with the use of effective preventative and curative measures in order to save the lives of millions of children.20
Access to essential medicines The World Health Organization has recognised priority medicines for preventing and treating maternal and infant health.21 According to the WHO, “Essential medi- cines are those that satisfy the priority health care needs of the population, with due regard to evidence on efficacy and safety, and comparative cost-effectiveness. They are intended to be available at all times in the context of functioning health systems, in adequate amounts, in the appropriate dosage forms, with assured quality and adequate information, and at an affordable price”.22 Deplorably there are drawbacks for maternal patients and infants in developing countries who rely solely on medicine supplies from the public sector. Availability of these priority medicines may be compromised by several factors such as poor medicine supply and distribution systems, insufficient health facilities and staff, as well as low investment in health and the high cost of medicines due to global recession.23 It is a requirement that countries maintain a list of essential medicines that are available in order to prioritise the purchase and distribution of medicines which influence the outcomes of maternal and infant health.24 In some of the countries in
41%
14% 14% 13% 8%
4% 3% 2% 1%
Ne on
ata l
Dia rrh
oe al d
ise ase
s
Pn eu
mo nia
Ot he
r in fec
tio ns
Ma lar
ia
No nc
om mu
nic ab
le Inju
ry
HIV /AI
DS
Me asl
es
Neonatal Preterm defects
Asphyxia
Sepsis
Other neonatal
Pneumonia
Congenital
Tetanus
Diarrhoea
12%
9%
6%
5%
4%
3%
1%
1%
Causes of infant mortality
Fig. 2: Global causes of infant mortality