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South Africa has committed to “achieve Universal Health Coverage including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all”, one of the 17 Sustainable Development Goals set out by the United Nations. Therefore, an Essential Medicines List (EML) with supporting Standard Treatment Guidelines (STGs) has been developed, for different levels of care.
The respective STGs and EML for primary healthcare and hospital levels (adults and paediatrics), and the EML for tertiary level of care are described below. The STGs and EML satisfies the priority needs of the South African population, provided for by the National Drug Policy of 1996 and is based on the WHO EML concept of evidence-medicine principles of comparative efficacy, safety, and affordability. Developed and maintained by the ministerially appointed National Essential Medicines List Committee (NEMLC), Technical Expert Review Sub-Committees of NEMLC and the Essential Drugs Programme from the Affordable Medicines Directorate of the National Department of Health (NDoH).
The rationale for inclusion or exclusion of a medicine to the EML is described in NEMLC evidence reports, medicine reviews and costing analyses.
The therapeutic interchange database lists therapeutic alternatives for medicines listed on the respective EML.
The Primary Healthcare (PHC) EML and STGs allow for the management of patients with relatively common conditions at primary level of care. They also guide referral of patients with more complex or uncommon conditions to facilities with the skills and resources to provide further investigation and management. As such, they serve as a progression to Adult and Paediatric hospital level EMLs and STGs. The PHC STGs and EML should be used by healthcare workers providing care at clinics, community health centres, and gateway clinics at hospitals. Pharmaceutical and Therapeutics Committees (PTCs) are responsible for ensuring the availability of medicines listed in the PHC EML at those facilities, as well as at higher levels of care.
*Note: The updated chapters contained in this folder supersedes those contained in the complete PDF.
The Primary Health Care (PHC) implementation slides are a quick tool intended to succinctly summarise the key changes from the recent review cycle of the Standard Treatment Guidelines (STGs) and Essential Medicines List. The slides are ideally to be used as a training tool for staff implementation specifically at the PHC level of care. The slides should be used in conjunction with the National Essential Medicines List committee (NEMLC) report, applicable evidence reviews and costings published together with the chapter. The information provided on the slides does not supersede or replace the STG itself.
Medicine Review and Costing Analyses
A Medicine Review is the process whereby relevant clinical evidence on a specific medicine is gathered and analysed, with the findings presented in a Medicine Review Technical Report that is presented to the NEMLC for appraisal. A Medicine Review is conducted to determine if a medicine should be added or deleted from the EML for a specific indication.
Costing analyses compare the cost of two regiments or formulations. Aspects like costs of treatments and human resources are considered, and clearly state the assumptions made when conducting the analysis.
The National Drug Policy makes provision for an Essential Drugs Program (EDP), which is a key component in promoting rational medicines use. Each treatment guideline in the Paediatric Hospital Level Standard Treatment Guidelines (STGs) and Essential Medicines List (EML) has been designed as a progression in care from the current Primary Health Care (PHC) STGs and EML. In addition, where a referral is recommended, the relevant medicines have either been reviewed and included on the Tertiary level EML, or are in the process of being reviewed. The STGs serve as a standard for practice, but do not replace sound clinical judgment. It is important to remember that the recommended treatments provided in this book are guidelines only, and are based on the assumption that prescribers are competent to handle patients with the relevant conditions.
*Note: The updated chapters contained in this folder supersedes those contained in the complete PDF.
A Medicine Review is the process whereby relevant clinical evidence on a specific medicine is gathered and analysed, with the findings presented in a Medicine Review Technical Report that is presented to the NEMLC for appraisal. A Medicine Review is conducted to determine if a medicine should be added or deleted from the EML for a specific indication.
Costing Analyses compare the cost of two regiments or formulations. Aspects like costs of treatments and human resources are considered, and clearly state the assumptions made when conducting the analysis.
South Africa has committed to “achieve universal health coverage including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all“, one of the 17 Sustainable Development Goals set out by the United Nations. As such, it gives us great pleasure to present the Fifth Edition of the Adult Standard Treatment Guidelines and Essential Medicines List for Hospital Level care, which aims to enable equitable access to safe, effective, and affordable essential medicines at hospital level across South Africa. The Adult Standard Treatment Guidelines and Essential Medicines List for Hospital Level provide a platform for transparency to enable equitable access to safe, effective, and affordable treatment options at hospital level taking into consideration the changing clinical needs of our population and the pragmatic implications of the introducing a new health technology.
*Note: The updated chapters contained in this folder supersedes those contained in the complete PDF.
Medicine Review and Costing Analyses
A Medicine Review is the process whereby relevant clinical evidence on a specific medicine is gathered and analysed, with the findings presented in a Medicine Review Technical Report that is presented to the NEMLC for appraisal. A Medicine Review is conducted to determine if a medicine should be added or deleted from the EML for a specific indication.
Costing analyses compare the cost of two regiments or formulations. Aspects like costs of treatments and human resources are considered, and clearly state the assumptions made when conducting the analysis.
The evidence-based medicine recommendations included in the Tertiary and Quaternary Essential Medicines List (EML) are reviewed through the transparent critical appraisal of global evidence, using a systematic evidence-to-decision framework. The Tertiary and Quaternary Hospital Level EML, which constitutes a list of essential medicines for approved indication, is ratified and distributed quarterly following NEMLC approval. It guides the selection, procurement and use of medicines at Tertiary and Quaternary level health establishments in the public sector in South Africa.
Medicine Review and Costing Analyses
A Medicine Review is the process whereby relevant clinical evidence on a specific medicine is gathered and analysed, with the findings presented in a Medicine Review Technical Report that is presented to the NEMLC for appraisal. A Medicine Review is conducted to determine if a medicine should be added or deleted from the EML for a specific indication.
Costing analyses compare the cost of two regiments or formulations. Aspects like costs of treatments and human resources are considered, and clearly state the assumptions made when conducting the analysis.
The National Essential Medicines List Committee (NEMLC) operates with transparency and values feedback from stakeholders on policies and guidelines. As such, documents are published for comment for a limited period of time from stakeholders prior to approval by NEMLC.
