Syed Akbar Hyderabad: With drug resistance emerging as a major health challenge in thecountry, the Central government has come out with a "New List of Essential Medicines",fine-tuning the earlier list made eight years ago. Since the NLEM-2003 was prepared the country has witnessed a spurt in the number of drugresistance cases and emergence of new pathogens and infections. Diseases that were notrecorded in India earlier have created a medical scarce in the country in the last eightyears. Novel human influenza, bird flu, drug resistant superbug bacteria, sars andchikungunya, besides more virulent forms of dengue and multi-drug resistant tuberculosishave been claiming thousands of lives. "The appropriate use of medicines selected in the NLEM promotes rational use ofmedicines. Such rational use of medicines, especially antimicrobial drugs, reducesdevelopment of drug resistance. The list also serves as a reference for assessing thehealthcare access of the populace. It also serves as a tool for public education andtraining of healthcare providers," says the new document on essential medicines. The government has included as many as 348 medicines in the NLEM-2011, deleting 47medicines from the NLEM-2003. It has added 43 medicines to the new list keeping in viewthe changed medical and health scenario in the country. Besides helping in controlling the problem of drug resistance and emergence of superbugs,the NLEM-2011 guides the hospital drug policies, procurement and supply of medicines inpublic sector, medicine cost reimbursement and medicine donations. It helps in monitoringthe pricing of medicines The list serves as a reference document for correct dosage form and strength forprescribing. Since preference is given to single drug formulations as opposed to fixeddose combinations, the NLEM-2011 is expected to improve prescribing practices as well asthe health outcomes. The Centre has added generic drugs carefully avoiding brands to makemedicines affordable. India is one of the few countries where doctors prescribe drugsbased on their brand value, rather than their medicinal value. India prepared its first National List of Essential Medicines in 1996 almost two decadesafter the World Health Organisation came out with a list of its own in 1976. The list wasrevised in 2003 and the new list for 2011 addresses latest infections and pathogens.