[india-drug] Review of the interagency New Emergency Health Kit 98

[Dr.Robin.Gray.grayr@who.int]

Review of the interagency New Emergency Health Kit 98
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Dear I-druggers,

The interagency New Emergency Health Kit was last updated in 1998 and 
is now being reviewed. The kit is intended as a primary healthcare
start up  kit to provide medicines and materials for 10,000 people for
3 months. It was never intended for re-supply after the early phase of
an emergency. The booklet explaining the kit has been translated into
Bengali, French, Russian,Spanish and the contents into Indonesian. The
English, French and Spanish versions are on: 
<http://www.who.int/medicines/library/par/new-emergency-health-kit/nehken.shtml>

There are a number of issues which require discussion and resolution. 

It has been possible to identify the destinations of  2110 kits sent 
during 2001 and 2002 and the majority are to malarial zones. The 1998
kit contains antimalarials as it was considered  justifiable as the
cost of including these medicines to non malarial zones was acceptable.
As a result of objections to the inclusion of antimalarials in kits
going to non malaria zones (e.g. the Balkans) and the increased
problematic complexity of antimalarial resistance the provision of an
antimalarial medicine module is being considered. These would be
provided unless a specific request was  made not to include them. This
is a subject of discussion. 

The provision of only single use disposable syringes was discussed in 
1998 and it was agreed to provide a small number of reusable syringes. 
Perhaps the time has now come to exclude the reusable syringes from the
kit.

The medicine recommended in 1998 for emergency contraception needs to 
be changed to be in line with WHO Reproductive Health and Research 
Department recommendations and the WHO Model List of Essential
Medicines. 

The recommendations in Annexes 1, 2 and 3 of the booklet contain basic
treatment guidelines, assessment and treatment of diarrhoea and 
management of the child with cough or breathing difficulty. These are
being reviewed for concurrence with the Integrated Management of
Childhood Illness recommendations.

The original epidemiological basis for medicines quantities and field
testing with refugee populations was undertaken by different 
organizations in the 1980s. The kit is limited and defined by volume,
weight, cost and type of end-user. Since 1998 there have been
remarkably few negative comments received and the overall concept and
content seems to have stood the test of time but updating is required. 

It would be useful to draw on the experience of i-druggers, who have 
used the kit, for their experience and suggestions. Comments to 
<grayr@who.int>  would be appreciated.

Thanks in anticipation of your help.

Dr Robin Gray
Medical Officer
WHO/EDM/PAR



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