Major causes of morbidity and mortality in many developing countries such as malaria, tuberculosis, pneumonia, acute diarrheas, maternal diseases can be treated with simple essential medicines (Box 1). But, essential medicines will save lives and improve health, only if they are available, affordable and of good quality, and properly utilized.

In developed countries, the discovery of new medicines and their introduction in the existing health care system during the second part of the last century has dramatically improved health, reducing mortality and morbidity from many common diseases. The society in general have benefited from these advances through the regular access to the needed medicines in their health care system. However, in many developing countries the needed essential medicines are not always available, accessible and affordable to those in need.

The discovery of new medicines and their introduction into the market will not optimally have positive impacts on health if the needed essential medicines are not available and affordable, if they are not of good quality and if they are not properly utilized by the health care providers and consumers. This chapter will highlight the issues related to commonly occurring problems in the area of medicines in developing countries, and relevant policies and programme to deal with them. In particular, the chapter will highlight the problems of access to the needed medicines, the problems irrational use by providers and consumers and the problems of counterfeit medicines. The sections on equitable access to essential medicines and on promoting rational use are taken from WHO Policy Perspectives on Medicines (WHO, 2004; WHO, 2002) reflecting the positions advocated by WHO on these issues.