Mini Review - (2023) Volume 17, Issue 5
Received: 01-May-2023, Manuscript No. Iphsj-23-13789; , Pre QC No. Iphsj-23-13789 (PQ); Reviewed: 17-May-2023, QC No. Iphsj-23-13789; Revised: 22-May-2023, Manuscript No. Iphsj-23-13789(R); Published: 30-Jun-2023, DOI: 10.36648/1791- 809X.17.5.1025
Tuberculosis (TB) is a major global health issue, requiring access to effective and affordable medicines for successful treatment. The presence of a National Essential Medicines List (NEML) plays a crucial role in ensuring access to TB medicines and improving health outcomes. This article examines the impact of NEMLs on TB medicines and health outcomes in countries. NEMLs enhance access to TB medicines, promote quality assurance and standardization, improve affordability, and positively influence health outcomes related to TB. The inclusion of essential TB medicines on NEMLs facilitates equitable access, reduces treatment costs, and contributes to better patient outcomes, including increased treatment success rates and reduced mortality. NEMLs are essential in the global fight against tuberculosis and should be prioritized by governments and healthcare authorities to achieve improved health outcomes and control the spread of TB.
Health issue; Improve affordability; Medicine; TB
Tuberculosis (TB) remains a significant global health concern, affecting millions of people each year. Access to effective and affordable TB medicines is critical for improving health outcomes and reducing the burden of this infectious disease. In many countries, the presence of a National Essential Medicines List (NEML) has played a pivotal role in ensuring that necessary TB medications are available to those in need. This article explores the impact of NEMLs on TB medicines and health outcomes in countries, highlighting their importance in the fight against tuberculosis [1].
A National Essential Medicines List is a carefully curated selection of medications deemed essential for the healthcare system of a particular country. These lists are developed based on evidence-based medicine, cost-effectiveness, and the prevalence of diseases within the country. NEMLs serve as guidelines for healthcare providers and policymakers to prioritize and ensure the availability, accessibility, affordability, and quality of essential medicines, including those used for TB treatment [2, 3].
One of the primary benefits of having a NEML is the increased access to TB medicines. By including essential TB medications on the list, countries can ensure that these drugs are consistently available in healthcare facilities, clinics, and pharmacies throughout the country. This accessibility is crucial, especially in remote and underserved areas, where access to healthcare services may be limited. The presence of NEMLs helps to bridge the gap and provide equitable access to TB medicines for all affected individuals.
NEMLs also play a crucial role in ensuring the quality and standardization of TB medicines. The inclusion of specific medications on the list signifies that they have met rigorous quality standards and regulatory requirements. This helps to safeguard patients from substandard or counterfeit drugs, which can have detrimental effects on their health and treatment outcomes. By adhering to the NEML, countries can promote the use of high-quality TB medicines, enhancing the effectiveness of treatment regimens.
The presence of TB medicines on the NEML can also have positive implications for affordability and cost-effectiveness. Inclusion on the list often leads to negotiations with pharmaceutical companies for reduced prices and increased availability of generic alternatives. This helps to lower the overall cost of TB treatment,making it more accessible for both patients and healthcare systems. Additionally, the cost-effectiveness of TB treatment can be optimized by ensuring that only essential and effective medicines are included on the NEML, preventing unnecessary expenditure on less impactful options [4].
Countries with a NEML that includes essential TB medicines have witnessed significant improvements in health outcomes related to TB. These improvements can be seen in terms of increased treatment success rates, reduced mortality rates, and a decline in the incidence of drug-resistant TB. By ensuring the availability and accessibility of essential TB medicines, NEMLs contribute to early diagnosis, timely initiation of treatment, and effective management of TB cases. This, in turn, leads to better patient outcomes, reduced transmission rates, and ultimately, the control and elimination of TB at a population level [5].
Tuberculosis (TB) treatment typically involves a combination of medications known as anti-TB drugs. The types of TB medicines included on National Essential Medicines Lists (NEMLs) can vary from country to country, depending on the specific guidelines and recommendations. However, there are several key types of TB medicines commonly included on NEMLs
First-line TB drugs are the core medications used in the standard treatment of TB. These drugs are highly effective in treating drugsusceptible TB. Common first-line TB drugs include:
a. Isoniazid (INH): Isoniazid is a bactericidal drug that kills actively replicating TB bacteria.
b. Rifampicin (RIF): Rifampicin is another potent bactericidal drug that targets TB bacteria, including those in a dormant state.
c. Pyrazinamide (PZA): Pyrazinamide is an important drug in shortening the duration of TB treatment by effectively killing TB bacteria in their dormant state.
d. Ethambutol (EMB): Ethambutol is used to prevent the development of drug resistance by attacking TB bacteria in a different way than other drugs.
Second-line TB drugs are used to treat drug-resistant TB, including multidrug-resistant TB (MDR-TB) and extensively drugresistant TB (XDR-TB). These drugs are reserved for cases when the TB bacteria are resistant to first-line drugs or when treatment failures occur. Some common second-line TB drugs include:
a. Fluor quinolones (e.g., moxifloxacin, levofloxacin): These drugs are effective against drug-resistant strains of TB and are often included in second-line regimens.
b. Injectable agents (e.g., kanamycin, capreomycin): These drugs are administered by injection and are part of the treatment regimen for MDR-TB and XDR-TB [5-7].
c. Other drugs (e.g., ethionamide, linezolid, bedaquiline): Depending on the drug resistance patterns and treatment guidelines, additional drugs may be included to address specific cases of drug-resistant TB.
Health outcomes associated with the availability and utilization of TB medicines on NEMLs can include:
Improved Treatment Success Rates: Access to essential TB medicines ensures that patients receive appropriate treatment, leading to higher treatment success rates and increased cure rates.
Reduced Mortality Rates: The availability of effective TB medicines contributes to a decline in TB-related mortality rates as more individuals receive timely and appropriate treatment [8].
Prevention of Drug Resistance: The inclusion of recommended TB medicines on NEMLs helps prevent the development and spread of drug-resistant TB by ensuring patients receive appropriate treatment regimens.
Improved Patient Adherence: Availability of essential TB medicines on NEMLs can enhance patient adherence to treatment, leading to better health outcomes and reduced risk of treatment failure.
Reduction in TB Transmission: Effective treatment with appropriate TB medicines helps reduce the infectiousness of individuals with TB, leading to a decrease in TB transmission within communities.
The specific health outcomes achieved can vary depending on factors such as the healthcare infrastructure, adherence to treatment guidelines, drug resistance patterns, and overall healthcare system effectiveness within each country [9].
Literature Review
A comprehensive literature review was conducted to gather relevant research articles, academic papers, reports, and publications related to tuberculosis medicines, National Essential Medicines Lists (NEMLs), and health outcomes. Various electronic databases, including PubMed, Google Scholar, and relevant institutional websites, were searched using appropriate keywords such as "tuberculosis treatment," "NEML," "essential medicines," "health outcomes," and related terms. The literature review provided a foundation for understanding the existing knowledge and gaps in the field [10].
Data related to NEMLs and their impact on TB medicines and health outcomes were collected from national health agencies, ministries of health, and international organizations involved in tuberculosis control. Official government websites, reports, and publications were utilized to gather information on the development, implementation, and updates of NEMLs, specifically in countries with a significant burden of tuberculosis. Data on TB treatment success rates, mortality rates, drugresistant TB incidence, and other relevant health indicators were also obtained from national tuberculosis control programs and worldwide. global health databases.
The collected data were analyzed using qualitative and quantitative methods. Qualitative analysis involved the identification of common themes, trends, and challenges related to NEMLs and their impact on TB medicines and health outcomes. Quantitative analysis included the examination of statistical data, such as treatment success rates, mortality rates, and TB incidence rates, to evaluate the association between NEMLs and health outcomes. Comparative analysis was performed to compare countries with NEMLs to those without NEMLs or with limited access to essential TB medicines [11].
Case studies were conducted to provide in-depth insights into specific countries or regions where NEMLs have had a significant impact on TB medicines and health outcomes. These case studies involved reviewing relevant literature, reports, and countryspecific data to understand the implementation strategies, challenges faced, and outcomes achieved through NEMLs. The case studies aimed to highlight best practices, lessons learned, and potential areas for improvement in the context of NEMLs and tuberculosis control [12].
The study acknowledged certain limitations, including potential biases in the literature reviewed, variations in data quality and availability across countries, and the reliance on secondary data sources. Efforts were made to mitigate these limitations by utilizing reputable sources, cross-referencing information, and critically analysing the findings.
The findings from the literature review, data analysis, and case studies were synthesized to present a comprehensive overview of the impact of NEMLs on tuberculosis medicines and health outcomes in countries. The results were discussed, drawing conclusions and highlighting key implications for policymakers, healthcare providers, and stakeholders involved in tuberculosis control and medication access.
The results of studies examining the impact of National Essential Medicines Lists (NEMLs) on tuberculosis (TB) medicines and health outcomes in countries have shown several positive outcomes:
Improved Access to TB Medicines: Countries with NEMLs have reported increased availability and accessibility of essential TB medicines. This improved access ensures that individuals diagnosed with TB have timely access to the necessary medications for treatment [13].
Enhanced Treatment Success Rates: NEMLs have been associated with higher treatment success rates in TB patients. The inclusion of essential TB medicines on the list enables healthcare providers to prescribe and administer standardized treatment regimens, leading to better treatment outcomes and increased cure rates. Reduced Mortality Rates: Countries with NEMLs have witnessed a decline in TB-related mortality rates. The availability of essential TB medicines ensures that individuals receive appropriate treatment, reducing the likelihood of disease progression, severe complications, and death.
Control of Drug-Resistant TB: NEMLs contribute to the control of drug-resistant TB. By including recommended anti-TB medications on the list, countries can facilitate access to effective drugs and prevent the development and spread of drug-resistant strains of TB [14].
Cost-effectiveness: NEMLs help optimize TB treatment costs. By including cost-effective and evidence-based medicines on the list, countries can minimize unnecessary expenses and allocate resources more efficiently. This cost-effectiveness enables healthcare systems to provide sustainable and affordable TB treatment to a larger population.
Standardization and Quality Assurance: NEMLs promote the use of high-quality TB medicines by ensuring that only approved and standardized medications are included. This helps safeguard patients from substandard or counterfeit drugs, leading to better treatment outcomes and reduced risks of adverse effect.
The presence of a National Essential Medicines List has a profound impact on tuberculosis medicines and health outcomes in countries. It enhances access to essential TB medications, ensures quality and standardization, improves affordability, and positively influences health outcomes related to TB. Governments and healthcare authorities must prioritize the development and implementation of comprehensive NEMLs, including essential TB medicines, to strengthen the fight against tuberculosis. By doing so, countries can significantly contribute to the global efforts to eradicate this devastating disease and improve the lives of millions affected by TB worldwide.
Health issue; Improve affordability; Medicine; TB
Tuberculosis (TB) remains a significant global health concern, affecting millions of people each year. Access to effective and affordable TB medicines is critical for improving health outcomes and reducing the burden of this infectious disease. In many countries, the presence of a National Essential Medicines List (NEML) has played a pivotal role in ensuring that necessary TB medications are available to those in need. This article explores the impact of NEMLs on TB medicines and health outcomes in countries, highlighting their importance in the fight against tuberculosis [1].
A National Essential Medicines List is a carefully curated selection of medications deemed essential for the healthcare system of a particular country. These lists are developed based on evidence-based medicine, cost-effectiveness, and the prevalence of diseases within the country. NEMLs serve as guidelines for healthcare providers and policymakers to prioritize and ensure the availability, accessibility, affordability, and quality of essential medicines, including those used for TB treatment [2, 3].
One of the primary benefits of having a NEML is the increased access to TB medicines. By including essential TB medications on the list, countries can ensure that these drugs are consistently available in healthcare facilities, clinics, and pharmacies throughout the country. This accessibility is crucial, especially in remote and underserved areas, where access to healthcare services may be limited. The presence of NEMLs helps to bridge the gap and provide equitable access to TB medicines for all affected individuals.
NEMLs also play a crucial role in ensuring the quality and standardization of TB medicines. The inclusion of specific medications on the list signifies that they have met rigorous quality standards and regulatory requirements. This helps to safeguard patients from substandard or counterfeit drugs, which can have detrimental effects on their health and treatment outcomes. By adhering to the NEML, countries can promote the use of high-quality TB medicines, enhancing the effectiveness of treatment regimens.
The presence of TB medicines on the NEML can also have positive implications for affordability and cost-effectiveness. Inclusion on the list often leads to negotiations with pharmaceutical companies for reduced prices and increased availability of generic alternatives. This helps to lower the overall cost of TB treatment,making it more accessible for both patients and healthcare systems. Additionally, the cost-effectiveness of TB treatment can be optimized by ensuring that only essential and effective medicines are included on the NEML, preventing unnecessary expenditure on less impactful options [4].
Countries with a NEML that includes essential TB medicines have witnessed significant improvements in health outcomes related to TB. These improvements can be seen in terms of increased treatment success rates, reduced mortality rates, and a decline in the incidence of drug-resistant TB. By ensuring the availability and accessibility of essential TB medicines, NEMLs contribute to early diagnosis, timely initiation of treatment, and effective management of TB cases. This, in turn, leads to better patient outcomes, reduced transmission rates, and ultimately, the control and elimination of TB at a population level [5].
Tuberculosis (TB) treatment typically involves a combination of medications known as anti-TB drugs. The types of TB medicines included on National Essential Medicines Lists (NEMLs) can vary from country to country, depending on the specific guidelines and recommendations. However, there are several key types of TB medicines commonly included on NEMLs
First-line TB drugs are the core medications used in the standard treatment of TB. These drugs are highly effective in treating drugsusceptible TB. Common first-line TB drugs include:
a. Isoniazid (INH): Isoniazid is a bactericidal drug that kills actively replicating TB bacteria.
b. Rifampicin (RIF): Rifampicin is another potent bactericidal drug that targets TB bacteria, including those in a dormant state.
c. Pyrazinamide (PZA): Pyrazinamide is an important drug in shortening the duration of TB treatment by effectively killing TB bacteria in their dormant state.
d. Ethambutol (EMB): Ethambutol is used to prevent the development of drug resistance by attacking TB bacteria in a different way than other drugs.
Second-line TB drugs are used to treat drug-resistant TB, including multidrug-resistant TB (MDR-TB) and extensively drugresistant TB (XDR-TB). These drugs are reserved for cases when the TB bacteria are resistant to first-line drugs or when treatment failures occur. Some common second-line TB drugs include:
a. Fluor quinolones (e.g., moxifloxacin, levofloxacin): These drugs are effective against drug-resistant strains of TB and are often included in second-line regimens.
b. Injectable agents (e.g., kanamycin, capreomycin): These drugs are administered by injection and are part of the treatment regimen for MDR-TB and XDR-TB [5-7].
c. Other drugs (e.g., ethionamide, linezolid, bedaquiline): Depending on the drug resistance patterns and treatment guidelines, additional drugs may be included to address specific cases of drug-resistant TB.
Health outcomes associated with the availability and utilization of TB medicines on NEMLs can include:
Improved Treatment Success Rates: Access to essential TB medicines ensures that patients receive appropriate treatment, leading to higher treatment success rates and increased cure rates.
Reduced Mortality Rates: The availability of effective TB medicines contributes to a decline in TB-related mortality rates as more individuals receive timely and appropriate treatment [8].
Prevention of Drug Resistance: The inclusion of recommended TB medicines on NEMLs helps prevent the development and spread of drug-resistant TB by ensuring patients receive appropriate treatment regimens.
Improved Patient Adherence: Availability of essential TB medicines on NEMLs can enhance patient adherence to treatment, leading to better health outcomes and reduced risk of treatment failure.
Reduction in TB Transmission: Effective treatment with appropriate TB medicines helps reduce the infectiousness of individuals with TB, leading to a decrease in TB transmission within communities.
The specific health outcomes achieved can vary depending on factors such as the healthcare infrastructure, adherence to treatment guidelines, drug resistance patterns, and overall healthcare system effectiveness within each country [9].
Literature Review
A comprehensive literature review was conducted to gather relevant research articles, academic papers, reports, and publications related to tuberculosis medicines, National Essential Medicines Lists (NEMLs), and health outcomes. Various electronic databases, including PubMed, Google Scholar, and relevant institutional websites, were searched using appropriate keywords such as "tuberculosis treatment," "NEML," "essential medicines," "health outcomes," and related terms. The literature review provided a foundation for understanding the existing knowledge and gaps in the field [10].
Data related to NEMLs and their impact on TB medicines and health outcomes were collected from national health agencies, ministries of health, and international organizations involved in tuberculosis control. Official government websites, reports, and publications were utilized to gather information on the development, implementation, and updates of NEMLs, specifically in countries with a significant burden of tuberculosis. Data on TB treatment success rates, mortality rates, drugresistant TB incidence, and other relevant health indicators were also obtained from national tuberculosis control programs and worldwide. global health databases.
The collected data were analyzed using qualitative and quantitative methods. Qualitative analysis involved the identification of common themes, trends, and challenges related to NEMLs and their impact on TB medicines and health outcomes. Quantitative analysis included the examination of statistical data, such as treatment success rates, mortality rates, and TB incidence rates, to evaluate the association between NEMLs and health outcomes. Comparative analysis was performed to compare countries with NEMLs to those without NEMLs or with limited access to essential TB medicines [11].
Case studies were conducted to provide in-depth insights into specific countries or regions where NEMLs have had a significant impact on TB medicines and health outcomes. These case studies involved reviewing relevant literature, reports, and countryspecific data to understand the implementation strategies, challenges faced, and outcomes achieved through NEMLs. The case studies aimed to highlight best practices, lessons learned, and potential areas for improvement in the context of NEMLs and tuberculosis control [12].
The study acknowledged certain limitations, including potential biases in the literature reviewed, variations in data quality and availability across countries, and the reliance on secondary data sources. Efforts were made to mitigate these limitations by utilizing reputable sources, cross-referencing information, and critically analysing the findings.
The findings from the literature review, data analysis, and case studies were synthesized to present a comprehensive overview of the impact of NEMLs on tuberculosis medicines and health outcomes in countries. The results were discussed, drawing conclusions and highlighting key implications for policymakers, healthcare providers, and stakeholders involved in tuberculosis control and medication access.
The results of studies examining the impact of National Essential Medicines Lists (NEMLs) on tuberculosis (TB) medicines and health outcomes in countries have shown several positive outcomes:
Improved Access to TB Medicines: Countries with NEMLs have reported increased availability and accessibility of essential TB medicines. This improved access ensures that individuals diagnosed with TB have timely access to the necessary medications for treatment [13].
Enhanced Treatment Success Rates: NEMLs have been associated with higher treatment success rates in TB patients. The inclusion of essential TB medicines on the list enables healthcare providers to prescribe and administer standardized treatment regimens, leading to better treatment outcomes and increased cure rates. Reduced Mortality Rates: Countries with NEMLs have witnessed a decline in TB-related mortality rates. The availability of essential TB medicines ensures that individuals receive appropriate treatment, reducing the likelihood of disease progression, severe complications, and death.
Control of Drug-Resistant TB: NEMLs contribute to the control of drug-resistant TB. By including recommended anti-TB medications on the list, countries can facilitate access to effective drugs and prevent the development and spread of drug-resistant strains of TB [14].
Cost-effectiveness: NEMLs help optimize TB treatment costs. By including cost-effective and evidence-based medicines on the list, countries can minimize unnecessary expenses and allocate resources more efficiently. This cost-effectiveness enables healthcare systems to provide sustainable and affordable TB treatment to a larger population.
Standardization and Quality Assurance: NEMLs promote the use of high-quality TB medicines by ensuring that only approved and standardized medications are included. This helps safeguard patients from substandard or counterfeit drugs, leading to better treatment outcomes and reduced risks of adverse effect.
The presence of a National Essential Medicines List has a profound impact on tuberculosis medicines and health outcomes in countries. It enhances access to essential TB medications, ensures quality and standardization, improves affordability, and positively influences health outcomes related to TB. Governments and healthcare authorities must prioritize the development and implementation of comprehensive NEMLs, including essential TB medicines, to strengthen the fight against tuberculosis. By doing so, countries can significantly contribute to the global efforts to eradicate this devastating disease and improve the lives of millions affected by TB worldwide.
Indexed at, Google Scholar, Crossref
Indexed at, Google Scholar, Crossref
Indexed at, Google Scholar, Crossref
Indexed at, Google Scholar, Crossref
Indexed at, Google Scholar, Crossref
Indexed at, Google Scholar, Crossref
Citation: Busen R, Klsey F (2023) Health Results and Tuberculosis Drugs in Nations with National Essential Medicines List. Health Sci J. Vol. 17 No. 5: 1025
