local needs. Generally, had the cost of shipping been donated instead, then many more people would have benefited. In response to this, the WHO has generated guidelines for drug donations from a consensus of major international agencies involved in emergency relief. If these are followed, a significant improvement in terms of patient benefit and use of human resources will result. WHO guidelines for drug donations 2005 Selection of drugs Drugs should be based on expressed need, be relevant to disease pattern and be agreed with the recipient. Medicines should be listed on the country's essential drugs list or WHO model list. Formulations and presentations should be similar to those used in the recipient country. Quality assurance (QA) and shelf life Drugs should be from a reliable source and WHO certification for quality of pharmaceuticals should be used. No returned drugs from patients should be used. All drugs should have a shelf life of at least 12 months after arrival in the recipient country. Presentation, packing and labelling All drugs must be labelled in a language that is easily understood in the recipient country and contain details of generic name, batch number, dosage form, strength, quantity, name of manufacturer, storage conditions and expiry date. Drugs should be presented in reasonable pack sizes (e.g. no sample or patient starter packs). Material should be sent according to international shipping regulations with detailed packing lists. Any storage conditions must be clearly stated on the containers, which should not weigh more than 50 kg. Drugs should not be mixed with other supplies. Information and management Recipients should be informed of all drug donations that are being considered or under way. Declared value should be based on the wholesale price in the recipient country or on the wholesale world market price. Cost of international and local transport, warehousing, etc., should be paid by the donor agency unless otherwise agreed with the recipient in advance. Evidence-based pharmacy practice While modern practices, including the development of clinical pharmacy, are important, many basic issues await significant change in developing countries. Medicines can often be found stored together in pharmacological groups rather than in alphabetical order by type. Refrigerator space is often inadequate and refrigerators unreliable. There are different challenges, such as ensuring that termites do not consume the outer packages and labels or that storage is free of other vermin such as rats. Dispensary packaging and labelling can be