Edited by: Olushayo Oluseun Olu, World Health Organization Regional Office for Africa, Republic of Congo
Reviewed by: Łukasz A. Poniatowski, Medical University of Warsaw, Poland
Janet L. Wale, HTAi Patient and Citizen Involvement in HTA Interest Group, Canada
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Health policy involves decisions at national, state, and local levels to achieve healthcare goals, with medicine policy being a critical component that requires integration and potential reform. The World Health Organization (WHO) recommends periodic monitoring and evaluation of the National Medicine Policy (NMP) under the National Health Policy (NHP), ideally every 2 to 3 years or comprehensively every 4 to 5 years.
This perspective aims to urge the Ministry of Health (MOH) of Ethiopia to update its national health and medicine policies to address emerging health issues, advancements in medical treatment, and global health agendas. It also aims to initiate a name change for Ethiopia’s “NDP” to “NMP” to focus on medicines for therapeutic purposes while avoiding confusion with the term “drug.”
A descriptive critical evidence synthesis was used to identify indicators and situations for monitoring, evaluating, and updating national health and medicine policies. The author presented published evidence to support the perspective that Ethiopia’s national health and medicine policies need to be updated.
Ethiopia’s national health and medicine policies have remained unchanged for over three decades, despite their critical role in guiding healthcare decision-making and reflecting political commitment to advancing healthcare goals through regular monitoring and evaluation. This underscores an urgent need to update these policies and periodically monitor and evaluate them at prescribed intervals: every 2 to 3 years for minor changes or every 4 to 5 years comprehensively. Additionally, the title “National Drug Policy (NDP)” should be changed to “NMP” to better reflect its focus on safe, effective, and approved medicines for healthcare, while avoiding negative associations with the general term “drugs”.
Given the dynamic nature of the health and pharmaceutical sectors, it is crucial for Ethiopia to urgently update the NHP and NMP and change the NDP title to “NMP” to eliminate ambiguity, emphasize approved medicines, and align with global best practices.
Ethiopia’s health system is divided into three tiers: primary (including health posts, health centers, and district hospitals), secondary (general hospitals), and tertiary (regional and national hospitals) (
The WHO defines health policy as decisions, plans, and actions taken by institutions and organizations at national, state, and local levels to achieve specific healthcare goals (
Policy monitoring is a continuous process that involves stakeholder engagement, progress evaluation, legislative endorsement, and outcome evaluation to ensure policy effectiveness (
The WHO has developed indicators to monitor an NMP in all countries using low-cost, non-complex methods (
Support from interest groups, concerned stakeholders, favorable macroeconomic conditions, technical expertise, and committed individuals within the MOH can help overcome barriers and advance an effective NMP (
The WHO Constitution’s eighth principle reinforces this, emphasizing that “informed recommendation and active cooperation from the public are of utmost importance in improving people’s health.” This highlights that both those who directly implement changes and those who challenge existing values with evidence-based arguments are crucial drivers of policy change (
In light of this scenario, as a researcher and expert in social and administrative pharmacy (SAPh), I offer my evidence-based recommendation on the importance of monitoring and evaluating health and medicine policies in Ethiopia. To do so, I conducted an extensive review of the MOH of Ethiopia
Utilizing a descriptive critical evidence synthesis approach, as mentioned above, I analyzed key indicators and situations relevant to monitoring, evaluating, and updating the policies. To support my argument, I also incorporated recently published evidence, highlighting emerging health issues, technological advancements in medical treatments, and shifts in global health priorities. This evidence forms the basis of my perspective, emphasizing the urgent need for Ethiopia to align its health and medicine policies with current and future health challenges.
This perspective aims to urge the MOH of Ethiopia to update its national health and medicine policies to address emerging health issues, advancements in medical treatment, and global health agendas. It also aims to initiate a name change for Ethiopia’s “NDP” to “NMP” to focus on medicines for health promotion, disease prevention, treatment, cure, and rehabilitation, while avoiding confusion with the broad term “drug,” which can include non-medical substances.
The healthcare and pharmaceutical sectors are constantly changing due to globalization (
Global health initiatives and policies are also important drivers of change in the sectors. Initiatives like One Health (
In addition, the sectors are increasingly expected to address global and emerging health threats. These include emerging and re-emerging diseases (
Another important aspect is the ongoing shift in healthcare systems and practices. This includes the need to integrate traditional medicine into the modern health system (
Furthermore, ethical and social considerations are central to healthcare discussions. Issues such as euthanasia (physician-assisted suicide—PAS) (
The above emerging issues and WHO indicators thus underscore the need for countries, which did not revise, to update their health and medicine policies. However, while the NMP should be periodically monitored, evaluated, or amended every 2 to 3 years (
As a result, the Ethiopian NHP and NMP are failing to align with current local and global health objectives. The Ethiopian Public Health Institute (EPHI) 2021–22 Final Report, published in July 2023, states that the NHP is under revision to address sociodemographic, epidemiologic, and economic shifts in Ethiopia. This revision aligns with Ethiopia’s goal of becoming a middle-income country, as well as commitments to UHC and the SDGs in the health sector. As to the report, the revised policy has undergone consultations and is awaiting ratification by the Council of Ministers (
The delay in updating the NHP and NMP may be due to factors like conflict and political instability for the current government of Ethiopia, particularly since 2018, driven by political entrepreneurs (
Nevertheless, as rationalized above, support from interest groups, shared stakeholder values, favorable macroeconomic conditions, technical expertise, and committed MOH individuals can overcome these challenges (
Moreover, it is recommended that the title “NDP” be changed to “NMP” to reduce ambiguity and better reflect the policy’s focus on promoting safe, effective, and high-quality essential medicines. Because, while “drug” broadly refers to any chemical substance, including harmful ones, “medicine” specifically denotes substances developed and approved to treat, cure, or prevent diseases, emphasizing their therapeutic purpose. This distinction clarifies the policy’s intent, aligns it with healthcare objectives, and ensures clarity for stakeholders. Additionally, using the term “medicine” aligns with international best practices, strengthening the policy’s commitment to public health and global consistency (
Health policy encompasses decisions, plans, and actions at national, state, and local levels to achieve healthcare goals, with medicine policy being a key component. Periodic monitoring and evaluation of the NMP under the NHP are essential to keep align with the evolving health and pharmaceutical sectors. However, Ethiopia’s national health and medicine policies have remained unchanged for over three decades, despite recommendations to ideally update them every 2 to 3 years or comprehensively every 4 to 5 years. Therefore, it is urgent to update these policies and periodically monitor and evaluate them according to the prescribed intervals. Additionally, changing the title from “NDP” to “NMP” is crucial to eliminate ambiguity, better reflect the focus on safe, effective, and approved medicines, and align with global best practices, while avoiding negative associations with the general term “drugs.”
The information relevant to the perspective is included in the article, further inquiries can be directed to the corresponding author.
Ethical approval was not applicable for the study in accordance with the local legislation and institutional requirements. Written informed consent in this study was not applicable in accordance with the national legislation and the institutional requirements.
EMB: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing.
The author(s) declare that no financial support was received for the research and/or publication of this article.
The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The author(s) declare that no Gen AI was used in the creation of this manuscript.
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