THE PHARMACEUTICAL INDUSTRY

THE PHARMACEUTICAL INDUSTRY CONTENTS ITEM PAGE OVERVIEW OF THE PHARMACEUTICAL INDUSTRY 2 UGANDA S COMPETITIVE ADVANTAGE IN SECTOR 6 INVESTMENT OPPORTUNITIES 8 FACILITATION SERVICES & INCENTIVE REGIME 10 APPENDICES APPENDIX 1: USEFUL CONTACTS IN UGANDA 12 APPENDIX 2: LIST OF PHARMACEUTICAL MANUFACTURERS 13 APPENDIX 3: STOCK LIST AND PRICES OF PHARMACEUTICALS 14 APPENDIX 4: ANNUAL DRUG REQUIREMENTS (DISH Project results) 16 APPENDIX 5: COST OF 1 YEAR SUPPLY OF ESSENTIAL DRUGS ( ) 17 APPENDIX 6: MEDICAL BASIC KIT OF DRUGS 21 APPENDIX 7: ESSENTIAL DRUG LIST FOR UGANDA 22 APPENDIX 8: IMPORTS OF PHARMACEUTICALS BY VALUE 30 APPENDIX 9: IMPORTS OF PHARMACEUTICALS BY QUANTITY 31

OVERVEIW OF THE PHARMACEUTICAL INDUSTRY The estimated consumption of drugs in Uganda is approximately US $ 80 to 100 million p.a. Imports of pharmaceutical and health products account for over 6% of total imports. National Medical Stores (NMS) imports most of the pharmaceutical and health products. NMS is an autonomous government corporation, established by the National Medical Stores Statute no. 12 of 1993 to be responsible for ensuring continuous distribution of pharmaceutical products in a financially viable and sustainable manner. Pharmaceutical companies in Uganda are categorized into 2 groups the manufacturers and distributors. Some of the firms produce a range of pharmaceutical products including; injectables, liquid mixtures, Aspirin, assembling capsules, disposable syringes, paracetamol, surgical gauze etc. A list of small scale and large-scale manufacturers is annexed under Annex 2:Contacts of Manufacturers in Uganda There are about 217 pharmacies which are mainly concentrated in Kampala, 1917 registered drug shops throughout the country, 1500 clinics which also act as drug outlets and 98 hospitals distributed in the 56 districts. Government Policy The National Drug Policy relates to the regulation of the importation, production, distribution, marketing, exportation, and use of pharmaceuticals in the public as well as the private sector and to any matter related to the above. The National Drug Authority (NDA) is charged with the implementation of the National Drug Policy. All Statutory requirements are contained in: - The National Drug Policy and Authority Statute, 1993; The National Drug Policy and Authority (issue of licenses) Regulations, 1993; The National Drug Policy and Authority (Certificate of Suitability of Premises) Regulations, 1995; A number of guidelines and sops, which are obtainable from the National Drug Authority, Head Office. National Drug Authority (NDA) The National Drug Authority (NDA) is an autonomous body set up by the government by statute No. 13 of 1993, to implement the National Drug Policy based on the concept of Essential Drugs. NDA is the guardian of public interest concerning drugs. Any drug promotion information reaching the public in Uganda must first be vetted by and obtain approval from NDA. 2

Control of Medicines According to the National Drug policy Statute 1993, Part 1 Sector 2, Drug means any substance or preparation used or intended to be used for internal or external application in the treatment or prevention of disease or improving physiological reactions. Please note that drug includes herbal medicines. In Uganda, drugs are classified into three categories:- - Class A Narcotics; - Class B Restricted drugs prescription only drugs/medicines + pharmacy only medicines; and - Class C Over-the-counter (OTC) drugs/medicines. Class A and B are drugs which must be dispensed only on prescription by a registered medical Practitioner, Dental Surgeon and Veterinary Surgeon. Drug Registration Drugs are registered by NDA to ensure that before any human or veterinary drug is made available on the Ugandan market, it is thoroughly scrutinized for it s quality, effectiveness and safety and then, if found to be suitable, registered for use in Uganda. The products that require registration are: 1) Pharmaceutical preparations, eg tablets, capsules, syrups, injections, creams, ointments eye/ear drops etc 2) Biological preparations eg vaccines and antisera 3) Traditional / Herbal medicines Guidelines for submission of applications and for evaluation of the applications are published and updated annually. Separate guidelines have been produced for the following: 1) Human pharmaceutical products 2) Veterinary pharmaceutical products 3) Human vaccines and immunological products 4) Human traditional medicines 5) Veterinary traditional medicines Registration of Herbal Medicines All imported herbal medicines should be registered. To date 66 applications have been approved. Locally manufactured herbal medicines that meet the required standards will be registered as soon as the guidelines and sale of herbal medicines are approved. Summary of Drug Registration Process Prospective applicants Applications for registration submitted Evaluation of applications Recommendation to Committee on National Formulary Recommendation to NDA Board ADDITION TO NATIONAL DRUG REGISTER Annual retention process/continuous review of register Drug Register The number of medicinal products on the drug register as at 2002 is as follows: Human medicines 2,621 Veterinary medicines (including acaricides) 371 Herbal preparations 66 3

Table 1 below shows the number of medicinal products on the Uganda Drug Register prior to 2002 Table 1: Number of medicinal products on the drug register (1996 2001) Year Cumulative no. Year Cumulative no. 1996-1999 2333 1997 1754 2000 2481 1998 2515 2001 2900 est Drug Registration Fees Table 2 shows the amounts required for the drug registration process Table 2: Drug Registration Fees (US $) Type of Drug Foreign Products Registration Fee Locally repacked foreign products Locally manufactured Products (LSM) Inspection 5,000 300 200 Suitability of 200 200 100 Premises Requirements and Procedures to be followed by Investors Setting Up Pharmaceutical Manufacturing Plants and/or Pharmacies in Uganda According to the Licensing Requirements Guidelines 2002: All Applicants Collect application forms from NDA headquarters or a District Assistant Drug Inspector In case of new applications or any modifications; a sketch plan of the premises In case of renewal applications; a copy of the 2001 license Applicants must comply with all other statutory requirements Pharmacies Pharmacies need to also submit the following: The certificate of practice of the supervising pharmacist For retail pharmacies (human): a copy of the certificate of the dispenser For retail (veterinary): a copy of certificate of the qualified veterinary professional Small Scale Pharmaceutical Manufacturers Small-scale pharmaceutical manufacturers need to also submit the following: The certificate of practice of the supervising pharmacist The certificate of the dispenser A complete list of products to be manufactured and their registration status Large Scale Pharmaceutical Manufacturers Large-scale pharmaceutical manufacturers need to also submit the following: The certificate of practice of the production pharmacist The certificate of the Head of Quality Control / Assurance 4

A complete list of products to be manufactured and their registration status NB: More detailed information on the licensing procedures and the fees applicable can be obtained from NDA (address under Appendix 1: Useful Contacts in Uganda) Regular Export of Drugs The requirements are as follows: 1) Order from importer 2) Copy of the authority given to importer by competent authority in the country of import 3) 3 copies of invoices prepared by exporter showing batch numbers and quantities to be exported 4) Application for a provisional export permit and verification certificate 5) The consignment shall be inspected for compliance with approved specifications 6) Payment of appropriate fee Sectoral Performance The pharmaceutical and health products sector in general shows an increasing trend. The domestic industrial production has been growing steadily since 1995 (see Figure 1), but local production cannot meet the country s needs. Figure 1: Trends in the Index of Drug Production in Uganda 1995 1999 Index 3000 2500 2000 1500 1000 500 0 1995 1996 1997 1998 1999 Years Domestic demand versus domestic production leaves a substantial gap, which calls for imports. The imports of pharmaceutical and health products account for over 6 per cent of the total imports. Table 3 and Table 4 in Appendices 8 and 9 respectively, show the trends of imports over the period 1995-99 5

UGANDA S COMPETITIVE ADVANTAGE IN THE SECTOR Investment Friendly Environment A stable and predictable economic environment; A fully liberalized economy; Access to regional and international markets; An abundant natural resource base; Existence of a well trained, English speaking labor force; Continued government investment in infrastructure development; and Government commitment/support to the private sector. Strategic location at the heart of Africa Investment Protection Uganda s constitution guarantees the right to property; MIGA coverage: Uganda became a member of the Multilateral Investment Guarantee Agency (MIGA) in 1992. Under this agency, foreign investors can insure their investments in Uganda against a wide range of non-commercial risks including expropriation, currency transfers, and breach of contract and civil strife. Foreign investors can apply for MIGA through UIA; Overseas Investment Insurance Scheme The scheme provides insurance cover for UK companies against the perceived political risks of investing in foreign markets; Overseas private Investment Corporation (OPIC) An agreement signed in 1998 with the above US agency seeks to guarantee American Investment in Uganda; and Uganda has also signed bilateral investment protection agreements with a number of other countries. MARKETS Uganda s population is estimated at 21.6 million as of 2002 and is growing at a rate of about 3 per cent per annum. This trend is likely to continue and Uganda is projected to have a population of 36.8 million by 2015. This is a sizeable market to depend on. Besides, there is the common market for Eastern and Southern Africa States (COMESA) which is Africa s single regional economic grouping with an estimated population of 367 million in 20 countries. The Ugandan economy has been one of the fastest growing economies in the whole world, with an average of 6.4% for the last 8 years. This reflects an increase in the potential market for pharmaceutical and health products DEMAND FOR PHARMACEUTICALS 95% of current domestic demand is being met through imports. Uganda s imports of drugs in 1999 amounted to US $ 73,776,000 against domestic production of US$7,440,632. This shows a supply gap to be filled through increased local production. The local market situation is further supported by the high growth of income owing to the improved performance of the national economy. 6

Imports By Value ( 000$) SITC Grouping, 1998-2001 SITC Description 1998 1999 2000 2001 54 Medical & Pharmaceutical products 53,462 36,113 34,183 49,394 Source: Uganda Bureau of Statistics Statistical Abstract 2002 The Delivery of Improved Services for Health (DISH) project, which was funded by the US Agency for International Development (USAID), in 2002, carried out Drug Needs Quantification Exercise and District-level Drug Logistics projects in 12 of Uganda s 56 districts. Some of the results, which are annexed under (Appendix 2: Annual drug requirements for the 20 most commonly prescribed drugs, Appendix 3: Cost of one year supply of essential drugs for average health center, Cost of one year supply of essential drugs for average health center and Hospital). The results indicate a high demand for the drugs in question The AIDS epidemic, which has struck the country since the 1980 s, is an indicator of potential market for pharmaceutical and health products. There is high domestic demand for AIDS related drugs and condoms. Uganda is an associate member of the EU under the Lome Convention. Goods that qualify under the Rules of Origin enter member countries both duty free and quota free. Double Taxation Agreements with different countries including; Tanzania, Kenya, S. Africa, United Kingdom and Italy. Similarly various trade agreements have also been signed with a number of countries in Africa, Europe and America. 7

INVESTMENT OPPORTUNITIES Based on the comparative advantage and supply situation highlighted above, the pharmaceutical and health products sector offers a number of investment opportunities that include: Drugs The essential drug list prepared by the National Drug Authority consists of about 300 items of drugs for treatment of various diseases in Uganda. At the current consumption level of drugs worth US$80 to US$100 million, and 10 locally based pharmaceutical industries with a minimum annual turnover of $ 3 million, both the domestic and regional markets cannot be adequately supplied. The importation of drugs to make up the deficit implies an import substitution opportunity for manufacturers. Family Planning and Contraceptives According to the Uganda demographic and health survey of 1995, knowledge of family planning methods is nearly universal with 94% Ugandans (age 15-49 years) knowing at least one contraceptive method. There are over 8 million people in Uganda above 15 years of age, forms a huge market potential of contraceptives and condoms. HIV/AIDS The prevalence of AIDS and the intensity of anti-aids campaigns have made condoms increasingly popular in Uganda with various brands being imported today. Up to 60 million condoms were distributed by the Ministry of Health, social marketing groups, and the private sector. Table 2 shows the cumulative reported AIDS cases over the period 1994-1998. However the data in the table does not represent the actual situation since not all AIDS cases are reported. Table 2 Uganda; Cumulative Reported AIDS Cases: 1994-1999 Year 1994 1995 1996 1997 1998 1999 Reported Cases 46120 48312 51344 53306 54712 55861 Source: STD/AIDS Control Program Medical Equipment Selected medical equipment and goods can be produced domestically and thereby replace imports. These products include simple surgical instruments, disposable syringes, injectable water and hospital furniture. There is only one factory producing disposable syringes but in any case supplying less than 20% of the market requirements. Two companies namely; Tumpeco and Clinical Equipment presently produce hospital furniture but also short of national requirements by over 80%. The rest of the other products are not locally made. Herbal Medicine Uganda is well known for its bio-diversity in flora and fauna. Scientists believe that Uganda s forests could generate a variety of sources of drugs and herbal medicine. This is still a virgin area that calls for different researchers and pharmacists to exploit. The National Drug Authority is in the process of outlining guidelines for the registration of herbal medicines. 8

The Neem Tree There is a global trend now towards the use of alternative, ecologically beneficial agricultural and health agents. The Neem tree s potential in solving public health problems is quite known today. The seeds, bark and leaves contain compounds with proven antiseptic, antiviral, antipyretic, anti-inflammatory, anti-ulcer and anti-fungal uses. The tree can be used as birth control for women and men. Neem oil is an effective insect repellent and insecticide, and can be used in the production of medicated soap with neem odour, which is proved to have very effective anti germ properties. A neem tree normally starts fruiting after 3-5 years. In about 10 years it becomes fully productive. In favorable conditions, fresh fruit yield per grown tree is about 50 kgs per year. Raw material based products Uganda is well endowed with water, sugar, cotton, and starch necessary to produce various medical products. Resource based industries tapping these raw materials as their primary inputs could seize an opportunity in Uganda to produce items like; surgical cotton/gauze, sanitary pads, bandages, glucose, water for injections, infusions, syrups, oxygen etc. 9

Facilitation Services and the Incentive Regime The Uganda Investment Authority (UIA) is a Government body to promote and facilitate investment in Uganda. The UIA can help investors: Obtain necessary information on investment in Uganda. Implement their project ideas through professional advice and assistance in locating relevant project support services. Issue the necessary investment licence and helping investors to secure secondary licenses and approvals e.g. work permits, trading licences etc. Arranging contacts for an investor and organizing itineraries for visiting foreign missions within the country. Assisting investors in seeking joint venture partners and linking with possible funding agencies. THE INCENTIVE REGIME Uganda s fiscal incentive package provides for generous capital recovery terms, particularly for investors whose projects entail significant investment in plant and machinery and whose investments are medium or long term. The incentive package includes:- Category 1 Initial Investment Allowances which are deductible once from the company s income. Initial allowances are based on the value of plant and machinery: - Kampala, Entebbe, Namanve, Jinja & Njeru areas 50% Outside Kampala, Entebbe, Namanve & Jinja area 75% Start-up costs 25% Scientific Research expenditure 100% Training expenditure 100% Industrial buildings 20% Category 2 Deductible Annual Allowances Depreciable assets specified in 4 classes under declining balance method:- Class 1 Computers & Data handling equipment 45% 10

Class 2 Automobiles, Construction and Earth moving equipment 35% Class 3 Buses, Goods Vehicles, Tractors, Trailers, Plant & Machinery for farming, manufacturing and mining 30% Class 4 Cars, Locomotives, Vessels, Office furniture, fixtures etc. 20% Category 3 Other Annual Depreciation Allowances Industrial Buildings, Hotels & Hospitals 5% Assessed losses arising out of company operations including the loss from the investment allowances can be carried forward indefinitely. In addition, Uganda s corporation tax rate of 30% is one of the lowest in Africa. All plant and machinery is imported duty and tax-free. Investors who register as VAT Traders are allowed VAT refunds on all construction materials used on their projects within a period not exceeding 4 years of project implementation. Further more, there are no taxes on all exports from Uganda. Exporters are also allowed duty draw back facilities on all taxes paid on raw materials used for the manufacture of exports. Uganda also has a fully liberalized foreign exchange regime with no restrictions on the movement of capital. 100% ownership of projects by foreign investors is allowed. 11

Appendix 1: USEFUL KEY CONTACTS IN UGANDA 1. Uganda Investment Authority Plot 28 Kampala Road P.O.Box 7418, Kampala. Tel: 251562/5, 234109 Fax: 342903 E-mail: info@ugandainvest.com 9. Privatisation Unit P.O.Box 10944, Kampala, Uganda Fax: 251997 E-Mail: pmu@imul.com 2. Ministry of Health P.O.Box 8, Entebbe. Tel:042-0201/28868/20675/20848 10. Kibuli Muslim Nursing Home P.O.Box 374, Kampala. Tel: 236476/236477/254612 3. National Drug Authority Plot 46/48, Lumumba Avenue P.O.Box 23096, Kampala. Tel: 255665/255626 Fax: 255758 E.Mail: nda@imul.com 4. Uganda Revenue Authority P.O.Box 8147 Nakawa Headquarters Kampala. Tel: 291429/221427/221730 11. City Pharmacy of Kampala Uganda Limited Plot 23, Kampala Road Tel: 2574022 Fax: 254027 12. Kampala Pharmaceutical Industries (1996) Ltd. Plot 4314 Stretcher road P.O.Box 7551, Kampala Tel: 285186/285166 kpi@swiftuganda.com 5. Mulago Hospital Complex P.O.Box 7051, Kampala. Tel: 554748 Fax: 532591 13. Cox Diagnostics and Research Centre, Plot 44 Lumumba Avenue Tel: 345940 Fax: 256075 6. Nsambya Hospital P.O.Box 7146, Nsambya Hill Kampala. Tel: 267870/266998/267013. 7. Kampala Medical Centre Plot 67 Kampala Road P.O.Box 105 Kampala. Tel: 233388 Fax:258885 14. Global Distributors (U) Ltd. Plot 15 William Street Dawda House P.O.Box 10994, Kampala. Tel: 236757 8 Rubaga Hospital P.O.Box 14130, Kampala. Tel: 234226 12

Appendix 2: LIST OF PHARMACEUTICAL MANUFACTURERS SMALL SCALE MANUFACTURERS MANUFACTURER PHYSICAL ADDRESS MAIL PHARMACIST TYPE OF PRODUCTS MAVID PHARMACY PLOT 39, LUWUM STREET, KAMPALA 886 NJALA PAUL SOLUTION JOINT MEDICAL STORES UGANDA KWEFUGA AFICAN INDUSTRIES KISAKYE PHARMACEUTICALS BYCHEM LABORATORIES LTD K.P.I.(1996) LTD UGANDA PHARMACEUTICALS MEDIPHARM INDUSTRIES RENE INDUSTRIES GOGONYA ROAD, NSAMBYA store@jms.co.ug PLOT 256, KIGALA ROAD NATETE PLOT 13, WILLIAM STREET PLOT 1098/1099, JINJA ROAD Tel: 256-41-221456 PLOT M44B STRETCHER ROAD, NTINDA PLOT 1&3 OBOJA ROAD, JINJA PLOT 65, KAKAJO ROAD PLOT 680 KAMULI KIREKA Fax: 256-41-236596 4501 KUSEMERERWA DONNA CREAMS/OINTMENTS 15065 GATARE JOHN OINTMENTS 30219 MUKASA SOLUTION LARGE SCALE MANUFACTURERS 11635 CATHERINE KISUMBA LINCTUS, SUSPENSIONS, LINMENT 7551 TAPAN KUMAR TABLETS, CAPSULES, SYRUPS, MIXTURES 484 MUTABAZI TABLETS, CAPSULES WILLIAM 6218 BBOSA DAVID SYRUPS, ORS 6034 APOLLO ANGOLE TABLETS, CAPSULES, SYRUPS All the above companies are in Kampala apart from Uganda pharmaceuticals Ltd in Jinja, and Rene Industries Ltd in Wakiso Source: National Drug Authority 13

Appendix 3: STOCK LIST AND PRICES OF PHARMACEUTICALS Raw Materials for IV Production No. Item Unit of Measure Unit Price (UShs.) 101070 Dextrose Anhydrous BP 10kg 273,060.00 101150 Potassium Chloride BP Kg 17.887.00 Medical Gases & Inhalation Products No. Item Unit of Measure Unit Price (UShs.) 106025 Oxygen 1 4.950.00 203045 Salbutamol 1 each 3,546.60 Dental Consumables No. Item Unit of Measure Unit Price (UShs.) 131130 Pumice Fine 5Kg 373,931.87 131005 Alginate 1.125Kg 28,320.00 131130 Pumice Fine 1Kg 59,070.00 151 005 Acetic Acid 2.5L 16,380.00 Chemicals & Reagents No. Item Unit of Measure Unit Price (UShs.) 101030 Barium Sulphate Kg 5,780.00 101025 Acid Salicylic BP 25Kg 315,000.00 Skin Creams No. Item Unit of Measure Price (UShs.) 201010 Benzyl Benzoate Lotion 25% 200ML 2,076.00 201005 Acyclovir Skin Cream 5% 10g 5,620.00 201010 Benzoic Acid + Salicyclic Acid Oitment 6% + 3% 500g 5,620.00 Eye Drops/Ointments No. Item Unit of Measure Price (UShs.) 202006 Acyclovir 5g 8,958.00 202016 Betamethasone 10ML 2,463.84 Vaginal Preparations No. Item Unit of Measure Price (UShs.) 204001 Miconazole Vaginal Cream 40g 5,900.00 204008 Clotrimazole 6 835 Syrups No. Item Unit of Measure Price (UShs.) 205004 Amoxycillin 100ML 740 Disinfectants & Anticeptics No. Item Unit of Measure Price (UShs.) 205079 Phenoxymethylpenicillin 100ML 700 a009 Sulfamethoxazole + Trimethopri 60ML 380 14

Anaesthetic Agents No. Item Unit of Measure Price (UShs.) 211010 Ether 500ML 11,250.00 211010 Ethyl Chloride 100ML 9,478.00 Vaccines & Immunologicals No. Item Unit of Measure Price (UShs.) 217005 Antirabies Human Immunoglobulin 2ML 132,101.00 217015 Antivenom Sera (East Central) 10ML 42,780.00 Tablets/Capsules No. Item Unit of Measure Price (UShs.) 220006 Acetazolamide 100 45,522.70 220010 Acetylsalicyclic Acid 100 2,760.00 220019 Acyclovir 100 35,251.00 220019 Allopurinol 250 6,490.00 Narcotics No. Item Unit of Measure Price (UShs.) 223006 Codeine 100 11,827.20 223010 Morphine 1ML 895.75 Medical Supplies No. Item Unit of Measure Price (UShs.) 301005 Bandage Crepe 1EACH 443 301015 Bandage Crepe 1 Each 367 Whtie Embossed 125CM, 0.002MM Thick No. Item Unit of Measure Price (UShs.) 302003 Apron Polyethelene Disposable 1000 100,055.92 Source: National Medical Stores 15

Appendix 4: ANNUAL DRUG REQUIREMENTS STANDARDISED PER 1,000 NEW OPD CASES FOR THE 20 MOST COMMONLY PRESCRIBED DRUGS.(FIGURES IN ISSUE UNITS) HC=Health Center Stock card Method Register Method ITEM DESCRIPTION HC II HC III HC II HC III No. of Times prescribed 1 1 Paracetamol 500 mg/tablet 5,570 6,310 5,695 5,118 3,397 2 Chloroquine 150mg base/tablet 5,626 5,822 3,508 2,858 2,787 3 Acetylsalicylic acid 300mg/tablet 5,229 4,526 3,675 3,242 1,282 4 Mebendazole 100mg/tablet 2,787 2,510 1,394 1,416 1,153 5 Cotrimoxazole 480mg/tablet 4,397 5,033 2,447 2,237 1,081 6 Chloroquine inj.40mg/ml(5ml) 160 145 822 323 918 7 Procaine benzyl penicillin for(ppf) 66 73 373 259 871 8 Pyrimethamine / Sulphadoxine tab 1,020 996 223 227 752 9 Metronidazole 200mg/tablet 2,117 2,190 946 1,750 627 10 Chlorpheniramine 4mg/tablet 1,490 1,165 725 587 455 11 Ferrous Sulphate tablets 2,338 2,510 1,124 1,107 384 12 Phenoxymethylpenicillin tabs 3,862 3,813 1,619 1,158 378 13 Ampicillin cap 250mg 3,023 2,532 1,621 1,063 314 14 Tetracycline caps 250 mg 2,142 2,166 873 1,416 280 15 Ibuprofen 200mg/tablet 2,137 2,237 1,218 511 277 16 Cotrimoxazole 120 mg/tablet 2,793 2,421 374 554 265 17 Magnesium Trisillicate tablet 1,746 1,906 714 759 244 18 Folic Acid 1 mg/tablet 1,613 1,895 251 733 238 19 ORS ( Powder sachets) 318 232 178 79 237 20 Benzyl penecillin 1mU 84 94 230 84 185 Source: Delivery of Improved Services for Health (District-level Drug Logistics results DISH project) 1 The frequency is based on observation of 6,400 encounters in the register study. 16

Appendix 5: COST OF ONE-YEAR SUPPLY OF ESSENTIAL DRUGS FOR AVERAGE HEALTH CENTRE IV AND HOSPITAL, BASED ON THE STOCK CARD METHOD (FIGURES IN UGANDAN SHILLINGS) HC=Health Center HC IV Hospital Average annual OPD attendance 14,063 Average annual OPD attendance 28,090 ITEM DESCRIPTION TOTAL COST ITEM DESCRIPTION TOTAL COST Tablets and capsules Tablets and capsules 1 Erythromycin 250mg/tablet 1,634,143 1 Quinine 300mg/ tabs 3,227,251 2 Amoxycillin cap 250 mg 1,276,966 2 Erythromycin 250mg/tablet 3,165,978 3 Phenoxymethylpenicillin 250mg/tablet ( 1,263,434 3 Amoxycillin cap 250 mg 3,094,862 4 Quinine 300mg/ tabs 1,217,695 4 Phenoxymethylpenicillin 250mg/tablet 2,531,460 5 Ampcillin cap 250mg 1,047,632 5 Ciprofloxacin tablets 250mg/tablet 1,850,345 6 Ciprofloxacin tablets 250mg/tablet 945,222 6 Chloroquine 150mg base/tablet 1,724,809 7 Chloroquine 150mg base/tablet 863,186 7 Ampcillin cap 250mg 1,594,476 8 Cotrimoxazole 480mg/tablet 681,033 8 Ketoconazole 200 mg/tablet 1,560,116 9 Pyrimethamine / Sulphadoxine tablet 658,869 9 Chloramphenicol 250 mg/capsule 1,283,036 10 Chloramphenicol 250 mg/capsule 614,837 10 Nalidixic acid 500mg/tablet 1,263,075 11 Nalidixic acid 500mg/tablet 553,831 11 Codeine 30mg/tablet 1,184,663 12 Codeine 30mg/tablet 463,691 12 Pyrimethamine / Sulphadoxine tablet 1,142,736 13 Paracetamol 500 mg/tablet 387,463 13 Paracetamol 500 mg/tablet 1,111,950 14 Tolbutamide 500mg/tablet 370,757 14 Cotrimoxazole 480mg/tablet 930,510 15 Cimetidine tablets 200mg/tablet 340,485 15 Tetracycline caps 250 mg 852,873 16 Griseofulvin 500mg /tablet 338,530 16 Cimetidine tablets 200mg/tablet 835,585 17 Tetracycline caps 250 mg 329,157 17 Methyldopa 200mg/tablet 769,004 18 Methyldopa 200mg/tablet 298,909 18 Metronidazole 200mg/tablet 734,771 19 Ibuprofen 200mg/tablet 270,112 19 Tolbutamide 500mg/tablet 546,533 20 Mebendazole 100mg/tablet 232,286 20 Doxycycline 100 mg/tablet 533,933 21 Metronidazole 200mg/tablet 226,233 21 Ibuprofen 200mg/tablet 532,067 22 Ketoconazole 200 mg/tablet 222,053 22 Griseofulvin 500mg /tablet 499,460 23 Propranolol 40mg/tablet 207,048 23 Mebendazole 100mg/tablet 411,045 24 Doxycycline 100 mg/tablet 199,786 24 Hyoscine tablets 406,115 25 Carbamazepine tablets 200mg/talet 189,943 25 Acetylsalicylic acid 300mg/tablet 404,352 26 Amodiaquine 200 mg/tablet 163,294 26 Nystatin tab.500,000iu/tablet 383,122 27 Cotrimoxazole 120 mg/tablet 157,482 27 Carbamazepine tablets 200mg/talet 368,436 28 Acetylsalicylic acid 300mg/tablet 153,376 28 Magnesium Trisillicate 370mg/tablet 308,826 29 Nystatin tab.500,000iu/tablet 127,949 29 Prednisone 5mg/tablet 306,881 30 Ferrous Sulphate tablets 60mg 126,304 30 Amodiaquine 200 mg/tablet 242,129 31 Multivitamin 1mg/tablet 125,269 31 Ferrous Sulphate tablets 60mg 236,651 32 Phenytoin 100mg/tablet 120,427 32 Cotrimoxazole 120 mg/tablet 223,883 33 Digoxin 0.25mg/tablet 115,951 33 Multivitamin 1mg/tablet 179,430 34 Prednisone 5mg/tablet 103,609 34 Ascorbic acid tablets 167,801 35 Magnesium Trisillicate 370mg/tablet 92,932 35 Nifedipine tablets 161,915 36 Ascorbic acid tablets 75,719 36 Atenolol 50mg /tablet 160,081 37 Frusemide Tab 5mg /tablet 74,108 37 Propranolol 40mg/tablet 154,088 38 Diazepam 5mg/tablet 71,113 38 Vitamin A caps 200,000IU 144,653 39 Nitrofurantoin 100mg /tablet 63,318 39 Aminophylline 100mg/tablet 129,934 40 Phenorbarbitone 30mg/tablet 59,874 40 Diazepam 5mg/tablet 123,456 41 Charcoal Activated 250mg 56,173 41 Phenytoin 100mg/tablet 119,749 42 Diclofenac tablets 50mg tablets 53,784 42 Frusemide Tab 5mg /tablet 103,078 43 Chlorpromazine 25mg/tab 50,931 43 Diethyl carbamazine 50mg/tablet 100,356 44 Promethazine 25 mg/tablet 48,768 44 Nitrofurantoin 100mg /tablet 98,676 45 Pyridoxine (Vitamin B6) tablets 46,276 45 Phenorbarbitone 30mg/tablet 84,801 46 Folic Acid 1 mg/tablet 41,912 46 Digoxin 0.25mg/tablet 78,773 17

HC IV Hospital Average annual OPD attendance 14,063 Average annual OPD attendance 28,090 47 Vitamin B. Complex Tablets 38,646 47 Promethazine 25 mg/tablet 77,884 48 Vitamin A caps 200,000IU 37,765 48 Carbimazole 5mg /tablet 73,182 49 Aminophylline 100mg/tablet 36,792 49 Chlorpromazine 25mg/tab 72,596 50 Imipramine 25mg /Tablet 35,241 50 Folic Acid 1 mg/tablet 70,524 51 Calcium lactate 300mg/tablet 33,734 51 Diclofenac tablets 50mg tablets 68,740 52 Nifedipine tablets 28,287 52 Pethidine 50mg/tablet 61,519 53 Amitryptiline tablets 25 mg/tablet 26,299 53 Calcium lactate 300mg/tablet 54,310 54 Salbutamol 4mg/tab 23,570 54 Bisacodyl 10mg/tablet 45,089 55 Pethidine 50mg/tablet 16,970 55 Amitryptiline tablets 25 mg/tablet 43,250 56 Chlorpheniramine 4mg/tablet 15,076 56 Salbutamol 4mg/tab 41,674 57 Glibenclamide tablets 5mg/tablet 12,376 57 Vitamin B. Complex Tablets 38,646 58 Metochlopromide 10 mg /tablet 11,312 58 Chlorpheniramine 4mg/tablet 34,317 59 Bisacodyl 10mg/tablet 10,991 59 Glibenclamide tablets 5mg/tablet 31,267 60 Benzhexol tablets 2mg/tablet 5,952 60 Benzhexol tablets 2mg/tablet 28,285 Syrups 61 Imipramine 25mg /Tablet 20,402 61 Cotrimoxazole syrup 240mg/5ml 362,158 62 Pyridoxine (Vitamin B6) tablets 16,110 62 Chloroquine 75mg base/ml syrup 100ml 268,024 63 Metochlopromide 10 mg /tablet 14,843 63 Amoxycillin suspension 125 mg/5ml 258,289 Syrups Injections 64 Amoxycillin suspension 125 mg/5ml 1,076,103 64 Sodium Chloride IV sol. 0.9% (500 ml) 642,816 65 Cotrimoxazole syrup 240mg/5ml 256,509 65 Benzathine Penicillin 2.4 mu/vial 641,783 Injections 66 Benzyl penecillin 1mU 588,043 66 Benzyl penecillin 1mU 2,935,613 67 Procaine benzyl penicillin forte (PPF) 433,900 67 Sodium Chloride IV sol. 0.9% (500 ml) 2,627,005 68 Quinine inj. 300 mg/2ml 424,161 68 Insulin soluble 40 IU/ml 2,408,082 69 Lignocaine inj. 2% 20ml vial 403,669 69 Insulin lente 40 mg/ml 2,114,816 70 Chloroquine inj.40mg/ml(5ml) 353,179 70 Procaine benzyl penicillin forte (PPF) 1,765,207 71 Water for injection 10 ml ampoules 340,959 71 Ringers lactate IV sol. 500ml 1,732,655 72 Ringers lactate IV sol. 500ml 265,076 72 Benzathine Penicillin 2.4 mu/vial 1,708,289 73 Cloxacillin 250mg/capsule 264,424 73 Dextrose 5% sol(500ml) 1,373,597 74 Cloxacillin inj 500mg 254,966 74 Quinine inj. 300 mg/2ml 1,137,458 75 Dextrose 5% sol(500ml) 247,123 75 Chloroquine inj.40mg/ml(5ml) 1,131,833 76 Chloramphenicol inj. 1.0 G/vial 227,392 76 Water for injection 10 ml ampoules 838,950 77 Dexamethasone injection 8mg/2ml 219,859 77 Chloramphenicol inj. 1.0 G/vial 800,853 78 Ketamine 500mg/10ml 168,056 78 Lignocaine inj. 2% 20ml vial 674,603 79 Bendrofluazide 10 mg/tablet 161,583 79 Ketamine 500mg/10ml 550,926 80 Hydrocortisone succinate inj. 100 mg 132,775 80 Metronidazole (infusion) 500 mg/100 ml 545,655 81 Darrows Half Strength i/v 500 ml 130,841 81 Cloxacillin 250mg/capsule 494,209 82 Methylergometrine 0.2 mg/ml ampoule 120,666 82 Hydrocortisone succinate inj. 100 mg vial 492,957 83 Pethidine inj 100mg/2ml 109,978 83 Aminophylline inj. 100 mg/ampoule 402,360 84 Gentamycin inj. 80 mg/2ml ampoule 96,952 84 Cloxacillin inj 500mg 377,099 85 Diazepam inj. 10 mg/ml (2ml ampoule) 74,203 85 Gentamycin inj. 80 mg/2ml ampoule 352,806 86 Frusemide inj 20 mg/ml ( ampoule) 64,940 86 Ampicillin powder for injection 500mg 324,890 87 Atropine inj.1mg/ml 29,616 87 Methylergometrine 0.2 mg/ml ampoule 282,794 88 Chlorpromazine inj. 50 mg/2ml 28,969 88 Darrows Half Strength i/v 500 ml 259,126 89 Oxytocin inj. 10 I.U./ml ampoule 22,799 89 Pethidine inj 100mg/2ml 255,123 90 Metochlopromide inj. 10 mg /2ml 22,514 90 Frusemide inj 20 mg/ml ( ampoule) 248,464 91 Aminophylline inj. 100 mg/ampoule 21,703 91 Diazepam inj. 10 mg/ml (2ml ampoule) 213,636 92 Adrenaline inj.1 mg/ml ampoule 18,439 92 Vitamin B Complexinj 193,061 93 Ampicillin powder for injection 500mg 17,862 93 Promethazine inj 25 mg/ml 176,574 94 Phytomenadione inj. 1 mg/ml 9,441 94 Bendrofluazide 10 mg/tablet 140,531 Others 95 Atropine inj.1mg/ml 113,097 95 Ether Anaethetic 500ml 711,889 96 Hydrallazine inj.20mg/2ml 108,621 96 ORS ( Powder sachets) 553,515 97 Dexamethasone injection 8mg/2ml 103,880 97 Diazepam rectal tube 2mg/ml (2.5ml) 300,098 98 Morphine inj.15 mg in 1ml 91,882 18

HC IV Hospital Average annual OPD attendance 14,063 Average annual OPD attendance 28,090 98 Nystatin Pessaries 100,000 IU 221,864 99 Chlorpromazine inj. 50 mg/2ml 67,137 99 Clotrimazole cream 1% 15gm 202,139 100 Adrenaline inj.1 mg/ml ampoule 60,644 100 Chloramphenicol ear drops 164,489 101 Oxytocin inj. 10 I.U./ml ampoule 59,239 101 Tetracycline eye ointment 1% tube 146,195 102 Phytomenadione inj. 1 mg/ml 48,687 102 Chloramphenicol eye drops 0.5%. 143,665 103 Digoxin inj. 500 mcg/2ml ampoule 27,237 103 Calamine lotion 100ml 132,648 104 Phytomenadione inj. 10 mg/ml 15,382 104 Gentamycin eye /ear drops 0.3% 78,195 Others 105 Hydrocortisone cream 1% 65,910 105 Halothane inhalation (250 ml) Bottle 3,340,784 106 Hydrogen peroxide 6% solution 36,979 106 Cetrimide + Chlorhexidine( 0.5 + 0.05)% 2,942,682 solution 5L 107 Gentian Violet 1% aqueous paint 8,028 107 Diazepam rectal tube 2mg/ml (2.5ml) 1,935,857 Total excluding Contraceptives and 27,287,653 108 ORS ( Powder sachets) 1,658,855 Sundries Contraceptives 109 Ether Anaethetic 500ml 1,462,299 108 Medroxy progesterone acetate inj 150mg 1,674,215 110 Nystatin Pessaries 100,000 IU 534,461 109 Levonorgestrel implants 319,395 111 Silversulphadiazine cream 1% 250mg 333,668 110 Ethinylestradiol + Levonorgestrel (30 + 188,363 112 Tetracycline eye ointment 1% tube 313,685 300 mcg)tabs 111 Ethinylestradiol + Levonorgestrel (30 + 135,162 113 Clotrimazole cream 1% 15gm 270,855 150 mcg) tabs 112 Levonorgestrel 75 mcg tablets 108,718 114 Betamethasone eye drops (bottle) 5 ml 252,246 Medical supplies 115 Chloramphenicol eye drops 0.5%. 213,133 113 Gloves surgical 1,409,259 116 Calamine lotion 100ml 203,871 114 Syringes and needles 5 ml 1,168,130 117 Chloramphenicol ear drops 184,384 115 Cotton wool roll (500 G) 539,000 118 Hydrogen peroxide 6% solution 73,988 116 Gloves disposable (Examination) 464,227 119 Gentamycin eye /ear drops 0.3% 73,718 117 iv cannula 22G 350,995 120 Whitfield ointment 34,848 118 Blood giving sets 345,039 121 Benzyl benzoate emulsion 25% 60ml 22,862 119 Syringes and needles 2ml 229,430 122 Gentian Violet 1% aqueous paint 12,514 120 Suture catgut chromic 0 196,043 Total excluding Contraceptives and 79,312,663 supplies 121 Infusion giving sets (Adult) 134,935 Contraceptives 122 Cord ligatures 132,109 123 Medroxy progesterone acetate inj 150mg 3,840,234 123 iv cannula 18G 128,523 124 Ethinylestradiol + Levonorgestrel (30 + 966,654 150 mcg) tabs 124 Butterfly needles 23 102,609 125 Levonorgestrel 75 mcg tablets 592,889 125 Butterfly needle 21 84,172 126 Ethinylestradiol + Levonorgestrel (30 + 529,153 300 mcg)tabs 126 Gauze absorbent cotton 67,235 127 Levonorgestrel implants 333,985 127 Suture catgut chromic 2/0 51,142 Medical supplies 128 Nasogastric tube 18 G 37,159 128 Gloves surgical 3,838,444 129 Syringes and needles 10 ml 35,811 129 Syringes and needles 5 ml 3,547,914 130 Crepe bandage 100mm x 4m 34,222 130 Cotton wool roll (500 G) 2,845,418 131 Scalpel blades size 22 29,168 131 Infusion giving sets (Adult) 2,218,848 132 iv cannula 20G 1,390,913 133 Blood giving sets 1,139,400 134 Gloves disposable (Examination) 1,091,942 135 iv cannula 22G 960,861 136 iv cannula 18G 652,117 137 Suture catgut chromic 0 378,747 138 Butterfly needle 21 348,381 139 Syringes and needles 2ml 328,632 140 Suture catgut chromic 1 297,297 141 Gauze absorbent cotton 296,080 19

HC IV Hospital Average annual OPD attendance 14,063 Average annual OPD attendance 28,090 142 Butterfly needles 23 277,234 143 Bandage P.O.P 100mm x 2.5m 242,261 144 Cord ligatures 221,946 145 Suture catgut chromic 2 174,656 146 Suture needle size 8 145,387 147 Scalpel blades size 22 138,828 148 Nasogastric tube 18 G 133,841 149 Crepe bandage 100mm x 4m 119,394 150 Syringes and needles 10 ml 106,827 151 Suture catgut chromic 2/0 106,616 152 Syringes and needles 20ml 45,129 153 Urine bags 29,607 Total 35,252,714 Total 106,652,300 Source: Delivery of Improved Services for Health (District-level Drug Logistics results DISH project) 20

Appendix 6: Medical Basic Kit of Drugs supplied By NMS to different Health Units 1 Acetylsalicylic acid 300mg 22 Metronidazole 200mg 2 Hydrophilic bandage 7.5cm x 10m, w.o.w. 23 Needle luer 22g x 1-1/4 (0.7x32mm), non-disp. 3 Benzylbenzoate 25% application 24 Suture needle 3/8 cutting 1 L, 3M, 2S 4 Benzylpencillin 1miu 25 Oral rehydration salts for 1000ml water 5 Chlorhexidine digluconate 20% 26 Paracetamol 500mg 6 Chloroquine phosphate 40mg base/ml, 5ml 27 Phenoxymethylpenicillin 250 7 Chloroquine phosphate 40 mg base/ml, 2ml 28 Adhesive tape 7.50cm x 5m 8 Chloroquine phosphate 150mg base 29 Procaine penicillin 3miu/Benzylpenicillin 1miu 9 Chloroquine maleate 4mg 30 Salbutamol 4mg 10 Co-trimoxazole 100mg + 20mg 31 Benzoic acid 6% + salicylic acid 3% ointment 11 Cotton wool BP 500gr 32 Sulphadimidine 500mg 12 Diazepam 5mg rectiolum (rectal tube 2.5ml) 33 Suture catgut chromic 2/0, x 76cm 13 Epinephrine 1mg/ml, 1ml (=adrenaline) 34 Suture silk black 1,2 x 76cm 14 Ferrous sulphate 200mg BP (film coated) 35 Syringe, luer, 10ml, synthetic, autoclavable 15 Folic acid 1mg 36 Syringe, luer, 2ml, synthetic, autoclavable 16 Gauze compresses sterile 75 x 75mm, 12 ply 37 Syringe, luer, 5ml, synthetic, autoclavable 17 Gentianviolet 38 Tetracycline hcl eye ointment 1% 5g 18 Surgical gloves, size 7.5 non-sterile, reusable 39 Tetracyline hcl 250mg 19 Lidocaine hcl 2% 20ml 40 Water for injection 10ml 20 Magnesium trisilicate compound 250/120mg 21 Mebendazole 100mg 21

Appendix 7: Essential Drug List for Uganda 1. ANAESTHETICS ROUTE/FORM STRENGTH LEVEL 1.1 General Anaesthetics and oxygen ether inhalation Hosp. halothane inhalation Ref. isopropyl-phenol injection R ketamine injection 500mg/10ml Hosp. ketamine injection 10mg, 10ml Hosp. nitrous oxide inhalation gas Hosp. oxygen (medicinal) inhalation gas Hosp. thiopental (thiopentone) powder for inj. 500mg Hosp. 1.2 Local anaesthetics bupivacaine injection 0.25%, 0.5% Ref. ethyl chloride aerosol H.C. ligonocaine inj. for epidur 2% Hosp. ligonocaine dental cartridge 2% HC ligonocaine injection 2% HC ligonocaine spray 5% Hosp. ligonocaine paste 2-4% HC ligonocaine ointment 5% HC ligonocaine heavy inj. for spinal 5% Hosp. ligonocaine topical gel 2% HC ligonocaine + epinephrine (adrenaline) dental cartridge 2%+1:80 000 HC 1.3 Preoperative medication atropine injection 1 mg/ml HC diazepan rectal tube 5 mg/2.5ml HC droperidol injection 5mg/ml Hosp lorazepam injection 4mg/ml Hosp. morphine injection 15mg/ml Hosp. 2 ANALGESICS, ANTIPYRETICS 2.1 Non-opioids acetylsalicyclic acid tablet 300mg, 75mg CBHC diclofenac tablet 25mg Hosp. diclofenac injection 25mg/ml Hosp. ibuprofen tablet 200mg Hosp. paracetamol tablet 500mg HC paracetamol suppositories 100mg HC 2.2 Antigout drugs allopurinol tablet 100mg Hosp. colchicine tablet 500µg Hosp. indomethacin tablet 25mg Hosp. probenecid tablet 500mg Hosp. 2.3 Opioid analgesics codeine tablet 30mg Hosp. dihydrocodeine tablet 30mg R morphine injection 15 mg/ml Hosp. morphine tablet 30mg Hosp. morphine tablet, long acting 10mg, 30mg, 60mg Ref. papavertum & hyscine injection hyosc Hbr 20mg.Pap.+0.4mg Ref. pethidine tablet 50mg Hosp. Pethidine injection 50mg/ml,100mg/2ml Hosp. 3 ANTI-ALLERGICS AND DRUGS USED IN ANAPHYLAXIS 3.1 astemizole tablet 10mg Ref. chlorphernamine (chlorpheniramine) tablet 4mg HC Route/Form Strength Level cyproheptadine tablet 4mg Hosp. cyproheptadine syrup 2mg/5ml Hosp. dexamethasone injection 8mg/2ml Hosp. epinephrine (adrenaline) injection 1mg/ml HC Hydrocortisone powder for inj. 100mg HC prednisolone tablet 25mg HC promethazine tablet 25mg HC promethazine injection 25mg/ml HC 4 ANTIDOTES 4.1 General charcoal activated powder/tablet 50mg tablet HC ipecacuanha syrup 0.14% Hosp. pralidoxime injection 1g/5 ml Hosp. 4.2 Specific atropine injection 1mg/ml HC benztropine injection 2 mg/ 2 ml Hosp. 22

calcium folinate (folinic acid) tablet 15mg Ref. calcium folinate (folinic acid) injection 3mg/ml Ref deferoxamine powder for inj. 500mg Hosp. dimercaprol injection 100mg/ ml Hosp. ferric hexacyanoferrate powder * Hosp. methionine tablet 250mg Hosp. methylthioninium chloride (methlene blue) injection 100mg/10ml Hosp. naloxone injection 20µg/ml,400µg/ml Hosp. penicillamine tablet 250mg Hosp. sodium calcium edetate injection 1g/5ml Hosp. sodium nitrite injection 300mg/10ml Hosp. sodium thiosulphate injection 1.5 g/50 ml Hosp. 5 ANTIEPILEPTICS AND ANTICONVULSANTS carbamazepine tablet 200mg Hosp. carbamazepine syrup 100mg/5ml Hosp. clonazepam tablet 2mg Ref. clonazepam injection 1mg/2ml Ref. diazepam injection 10mg/2ml HC diazepam rectal tube 5mg/2.5ml HC ethosuximide tablet 250mg Hosp. thosuximide syrup 250mg/5ml Hosp. magnesium sulphate injection 50% Hosp. (specifically for convulsions in exlampsia) phenobarbital (phenobarbitone) injection 200mg/ml Hosp. phenobarbital (phenobarbitone) tablet 30mg, 60mg HC phenytoin injection 20mg/2ml Ref. phenytoin tablet/caps 50mg, 100mg HC phenytoin suspension 30mg/5ml Hosp. valproic acid tablet 200mg R 6 ANTIINFECTIVE DRUGS Route/Form Strength Level 6.1.1. Intestinal anthelminthics mebendazole tablet 100mg CBHC niclosamide tablet 500mg HC 6.1.2 Antifilarials diethylcarbamazine tablet 50mg Hosp. ivermectin tablet 600mg Hosp. 6.1.3 Antischistosomals niridazole tablet 500mg Ref. praziquantel tablet 600mg Hosp. 6.2.1 Penicillins amoxicillin tablet/caps 250mg,500mg Hosp. amoxicillin injection 500mg/10ml Ref. amoxicillin powder for syrup 125mg/5ml Hosp. amoxicillin + clavulanic acid tablet 250mg + 125mg Ref. ampicillin powder for syrup 125mg/5ml Hosp. ampicillin tablet/caps 250mg Hosp. ampicillin powder for inj. 500mg/10ml Hosp. benzathine bezylpenicillin powder for inj. 2.4 MU/10ml vial Hosp. benzylpenicillin powder for inj. 1 MU/0.6g HC ciprofloxacin tablets 250mg Ref. cloxacillin powder for syrup 125mg/5ml Hosp. cloxacillin powder for inj. 500mg/10ml Hosp. flucloxacillin capsule 250mg Hosp. phenoxymethylpenicillin (Pen V) tablet 250mg Hosp.+ procaine benzylpenicillin forte (PPF) powder for inj. 4 MU/10ml vial HC 6.2.2 Other antibacterial drugs cefuroxime axitel tablet 250mg R cefuroxime sodium injection 750mg/vial R cefuroxime suspension 125mg/5ml R cephalexin tablet 250mg R chloramphenicol powder for inj. 1g/vial Hosp. chloramphenicol capsule 250mg Hosp. doxycycline tablet 100mg Hosp. erythromycin powder for oral 125mg/5ml Hosp. erythromycin tablet 250mg Hosp. gentamycin injection 80mg/2ml Hosp. linomycin capsule 500mg Ref. metronidazole infusion 500mg/100ml R metronidazole tablets 200mg Hosp. nalidixic acid tablet/caps 500mg Ref. nitrofurantoin tablet 100mg Hosp. sulfamethoxazole + trimethoprim tablet 100mg + 20mg HC sulfamethoxazole + trimethoprim tablet 400mg + 80mg HC sulfamethoxazole + trimethoprim syrup 240mg/5ml HC tetracycline tablet/caps 250mg HC 6.2.3 Antileprosy drugs 23

clofazimine capsule 100mg R dapsone tablet 100mg R rifampicin tablet/caps 150mg R thalidomide tablet 50mg R Route/Form Strength Level 6.2.4 Antituberculosis drugs ethambutol tablet 400mg Ref. isoniazid tablet 100mg HC pyrazinamide tablet 500mg Ref. rifampicin tablet/caps 150mg Ref. rifampicin syrup 100mg/5ml Ref. rifampicin + isoniazid capsule/tabs 150mg + 100mg Ref. rifampicin + isoniazid tablet/caps 300mg + 150mg Ref. rifampicin + isoniazid syrup 100mg + 50mg/5ml Ref. streptomycin powder for inj. 1g/vial HC 6.3 Antifungal drugs amphotericin B powder for inj 50mg/vial Ref. fluconazole tablet/caps 50,100, 200mg Ref. flucytosine tablet 200mg Ref. griseofulvin tablet 125mg, 500mg Hosp. ketoconazole suspension 100mg/5ml Hosp. ketoconazole tablet 200mg Hosp. miconazole pessaries 100mg Hosp. nystatin pessary 100 000 I.U HC nystatin suspension 100 000 I.U./ml Ref. nystatin tablet 500 000 I.U HC 6.4.1 Antiamoebic drugs metronidazole table 200mg Hosp. 6.4.2 Antileishmaniasis drugs pentamidine isethionate powder for inj. 200mg Ref. sodium stibogluconate injection 10% antimony R 6.4.3 Antimalarial drugs amodiaquine tablet 200mg Hosp. chloroquine injection 80mg/ml HC chloroquine injection 200mg base/5ml HC chloroquine tablet 150mg base CBHC chloroquine syrup 50mg/5ml HC primaquine tablet 7.5mg, 15mg HC proguanil tablet 100mg Ref. pyrimethamine tablet 25mg Hosp. pyrimethamine + sulfadoxine tablet 25mg+500mg HC quinine injection 300mg/ml HC quinine tablet 300mg HC quinine mixture 100mg/5ml HC 6.4.4. Antitrypanosomal drugs (African trypanosomiasis) melarsoprol injection 3.6% R pentamidine isethionate powder for inj. 200mg R suramin sodium powder for inj. 1g/10ml R 6.4.5. Antitrichomoniasis drugs tinidazole tablet 500mg Ref. 6.5 Antiviral drugs acyclovir tablet 200mg R gancyclovir sodium (for cytomegalovirus injection 500mg R infections) 7. ANTIMIGRAINE DRUGS acetylsalicylic acid tablet 300mg CBHC ergotamine tablet 1mg Hosp. propranolol (for prophylaxis only) tablet 10mg, 20mg Hosp. 8. ANTINEOPLASTIC AND IMMUNOSUPRESSIVE DRUGS 8.1 Immunosuppressive drugs azathioprine tablet 50mg R 8.2 Cytotoxis drugs asparaginase (colaspase) powder for inj. 100mg Ref. cyclophosphamide injection 500mg/vial Ref. cyclophosphamide tablet 50mg Ref. cytarabine powder for inj. 100mg/vial Ref. dacarbazine powder for inj. 100mg/vial Ref. dactinomycin powder for inj. 500µg/vial Ref. daunorubicin powder for inj. 20mg/vial Ref. doxorubicin (adriamycin) powder for inj. 50mg/vial Ref. fluorouracil injection 500mg/10ml R. calcium folinate (folinic acid) tablet 15mg Ref. calcium folinate (folinic acid) injection 3mg/ml Ref. hydroxyurrea capsule 500mg R mercaptopurine tablet 50mg R methotrexate tablet 2.5mg R 24

methotrexate injection 500mg/10ml Ref. mustine powder for inj. 10mg/vial R procarbazine capsule 50mg R stilboestrol tablet 5mg R thioguanine tablet 40mg R vincristine powder for inj. 1mg, 5mg/vial R 8.3 Hormones and antihormones dexmethasone tablet 4mg Hosp. examethasone injection 8mg/2ml Hosp. prednisolone tablet 5mg Hosp. stilboestrol tablet 5mg R tamoxifen tablet 10mg R 9. ANTI-PARKISONISM DRUGS benzhexol tablet 2mg Hosp. benztropine injection 2mg/2ml Hosp. levodopa + carbidopa tablet 100mg + 10mg Ref. levodopa + carbidopa tablet 250mg + 25mg Ref. 10 DRUGS AFFECTING THE BLOOD 10.1 Antianaemia drugs ferrous salt tablet 60mg iron CBHC ferrous salt syrup 60mg/5ml HC folic acid tablet 1 mg, 5mg HC hydroxocobalamin injection 1 mg/ml Hosp. 10.2 Anticoagulants and antagonists heparin injection 5000I.U Hosp. phytomenadione injection 1 mg/ml Hosp. phytomenadione injection 10mg/ml Hosp. protamine sulphate injection 50mg/5ml Hosp. warfarin tablet 1mg, 3mg Hosp. 10.3 Fibrinolytic Agents strptokinase injection 250,000 I.U R 11. BLOOD PRODUCTS AND BLOOD SUBSTITUTES 11.1 Plasma substitute dextran 70 injectable sol. 6% Hosp. polygeline solution injection 3.5% Hosp. 11.2 Plasma fractions for specific uses albumin hum. fac. IX comp. conc. injection dried 25% R albumin human factor VIII conc. injection dried 25% R 12. CARDIOVASCULAR DRUGS 12.1 Antianginal drugs cinnarizine tablet 75mg Ref. glyceryl trinitrate tablet sublingual 500µg Hosp. glyceryl trinitrate patch 0.2mg Hosp. isosorbide dinitrate tablet 5mg Hosp. nifedipine tablet 10mg Hosp. propranolol tablet 40mg Hosp. 12.2 Antidysrhythmic drugs lignocaine injection 100mg/5ml Hosp. procainamide tablet 250mg Ref. propranolol injection 1 mg/ml R propranolol tablet 40mg Hosp. quinidine tablet 200mg Hosp. verapamil tablet 40mg Hosp. 12.3 Antihypertensive drugs atenol tablet 100mg Hosp. captopril tablet 25mg R diazoxide injection 300mg/20ml Hosp. hydralazine tablet 25mg, 50mg Hosp. hydralazine injection 20mg/ml Hosp. methyldopa tablet 250mg HC propranolol tablet 40mg,80mg Hosp. 12.4 Cardiac glycosides digoxin tablet 250µg, 62.5µg Hosp. digoxin injection 500µg/2ml Hosp. 12.5 Drugs used in vascular shock dopamine injection 40mg/ml Hosp. epinephrine (adrenaline) injection 1mg/ml HC 13 DERMATOLOGICAL DRUGS 13.1 Antifungal drugs benzoic acid + salicylic acid ointment 6% + 3% HC clotrimazole cream 1% Hosp. griseofulvin tablet 250mg, 500mg Hosp. nystatin cream 100,000 i.u/g HC sulphur + salicylic acid ointment 2% + 2% Hosp. 13.2 Antiinfective drugs 25

chlorhexidine cream 5% Hosp. framycetin impregnated gauze 1% Hosp. iodine tincture 2% HC methylrosanilinium (GV) aqueous sol. 1% CBHC neomycin + bacitracin ointment 5mg + 500i.u/g Hosp. 13.3 Antiinflammatory and antipruritic drugs calamine lotion 15% HC hydrocortisone ointment 1% Hosp. 13.4 Astringent drugs aluminium diacetate solution 13% Hosp. 13.5 Keratoplastic and keratolytic agents coal tar ointment 1% Hosp. dithranol ointment 0.1% Hosp. podophylline resin paint/tincture 15% Hosp. salincylic acid ointment 2%, 5% HC 13.6 Scabicides and peduculicides benzyl benzoate lotion 25% HC 14. DIAGNOSTIC AGENTS 14.1 Ophthalmic drugs fluorescein eye drops 1% Hosp. homatropine drops 1% Hosp. physostigmine eye drops 0.25% Hosp. 14.2 Radiocontrast media barium sulphate powder in water 75%w/v Hosp. diatrizoate injection 60%,76% Ref. iodised oil fluid injection 38% Ref. ioglycamate injection 17%,35% Ref. iohexol injection 18%,24%,30%,35% Ref. iopanoic acid tablet 500mg Hosp. iothalamate injection 54%,60%,70% Ref. 15 DISINFECTANTS cetrimide + chlorhexidine solution 0.05%,0.5% HC chlorhexidine gluconate solution 20% CBHC glutaraldehyde solution 2% Hosp. hydrogen peroxide solution 6% Hosp. povidone iodine solution 10% HC sodium hypochlorite solution 8% CBHC 16 DIURETICS bendrofluazide tablet 5mg HC furosemide injection 20mg/2ml Hosp. furosemide tablet 40mg Hosp. mannitol injectable sol. 20% Hosp. spironolactone tablet 50mg Hosp. 17 GASTROINTESTINAL DRUGS 17.1 Antacids and other antiulcers drugs bismuth chelate tablet 120mg Ref. cimetidine tablet 200mg, 400mg Hosp. magnesium trisilicate cpd tablet 250mg, 120mg HC ranitidine tablet 150mg Ref. 17.2 Antiemetic drugs Route/Form Strength Level chlorpromazine tablet 25mg HC chlorpromazine injection 50mg/2ml Hosp. chlorpromazine suppositories 100mg Hosp. prochlorperazine tablet 5mg HC prochlorperazine injection 12.5mg/ml Hosp. prochlorperazine suppositories 5mg, 25mg HC promethazine tablet 25mg HC promethazine injection 25mg/ml Hosp. metoclopramide tablet 10mg Hosp. metoclopramide injection 5mg/ml Hosp. 17.3 Antihaemorrhoidal drugs bismuth subgallate suppository 59mg HC 17.4 Antiinflamatory drugs sulfasalazine tablet 500mg R 17.5 Antispasmodic drugs atropine injection 1 mg/ml Hosp. hyoscine butylbromide tablet 10mg Hosp. hyoscine butylbromide injection 20mg/ml R 17.6 Cathartic drugs bisacodyl tablet 5mg HC bisacodyl (paediatric) suppositories 5mg Hosp. 17.7.1 For oral rehydration oral rehydration salts powder for 1 L V CBHC 17.7.2 Antidiarrhoeal drugs codeine phosphate(symptomatic, for adults only) tablet 30mg Hosp. 26