Policies and Programmes to Improve Use of Medicines: Recommendations from ICIUM 2004
As part of a global effort to improve the use of medicines, 472 leading policy makers, researchers, and
other stakeholders representing 70 countries gathered in Chiang Mai, Thailand, in April 2004 for the Second
International Conference on Improving Use of Medicines (ICIUM 2004). Evidence presented made it clear that
misuse of medicines continues to be widespread and has serious health and economic implications, especially
in resource poor settings. However, effective solutions for some serious medicines problems already exist.
Participants called upon governments to implement policies and programmes in the priority areas listed below.
Key recommendations include: (1) Countries should implement national medicines programmes to improve medicines
use; (2) Successful interventions should be scaled up to national level in a sustainable way; (3) Interventions
should address medicines use in the community. Detailed recommendations are available at
The conference highlighted the need to move from small scale research projects to implementing large scale
programmes that achieve public health impacts. Many promising and successful interventions were presented at
ICIUM, yet global progress is confined primarily to demonstration projects. There are few reports of effective
national efforts to improve the use of medicines on a large scale and in a sustainable manner. Thus a major
research gap is to answer the question How do we achieve large scale and sustained improvements within