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INTRODUCTION TheSriLankacommitteeontheselectionanduseofessentialmedicines metoverthreemonthstorevisetheEssentialMedicinesListfortheyear 2009 based on clinical needs and the burden of disease. It was timed to followtherevisionoftheWorldHealthOrganisationModelList(WHO– ML) by the WHO expert committee in March 2009. In the past the Sri Lanka Essential Medicines List (SL – EML) has been irregularly revised. The committee strongly endorsed the need to revise the list every three years which would follow the revision of WHO –ML which takes place every2years. HistoryofEssentialMedicineListinSriLanka:SriLanka(thenCeylon) createdamedicineslistforboththestatehealthsectorandprivatesector in 1958. In addition to which, the Ceylon Hospitals Formulary was published by Professor Senaka Bibile to provide information for the use of these medicines. Professor Bibile also set up an international procurement system which decreased costs and at the same time increasedtheavailabilityofthesemedicines. Selection criteria: Essential medicines are selected with due regard to clinicalneedsanddiseaseprevalence,togetherwithevidenceonefficacy andsafety,andcomparativecost‐effectiveness(WHO,2002) Purpose: Essential medicines are intended to be available within the context of functioning health systems at all times, in adequate amounts,
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intheappropriatedosageforms,withassuredquality,andatapricethe individualandthecountrycanafford. Reflecting on the process of developing the 4th revision (2009) of the ListofEssentialMedicineforSriLanka: ThecommitteetrieditsbesttofollowtheWHOrecommendedprocessin selecting the essential medicines. WHO Model List was used as a template, but it was modified according to the needs of the Sri Lankan population. Needs of Sri Lankan population (patients) were determined using the statistics provided by the Annual Health Bulletin and the recommendations provided by academics and clinicians representing various professional organizations and health care system in Sri Lanka (SeeListofresourcepersonnel). ItshouldbeacknowledgedthattheSL–EMLhassomedifferencesfrom the WHO Model list. For example having an additional section on "Medicines acting on the ear, nose and oropharynx) and inclusion of medicines removed from the WHO – ML such as theophyllines, and havingmoremedicinesthanthatlistedintheWHO–ML. Thiswasdonetomakeitacceptabletoallthehealthcareprofessionalsin our country and after taking into consideration the local experience of expertsintherelevantfieldandresourcelimitations. In this revision, for the first time the committee in particular focussed heavilyonpaediatricmedicinestoensureaccessandavailability.

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