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The review surveys the problems of pharmaceutical promotion and public health. Global and domestic realities of pharmaceutical marketing are discussed. Various promotional activities of pharmaceutical industry are described with special emphasis on journal advertisements. Examples of unethical marketing practices of the global pharmaceutical companies are presented with details of the fines paid by the companies for unethical promotion of their products for «off-label» use or for long-term concealing of adverse drug reactions known by the companies long before they become freely available for the society. The review presents definition of «disease selling» as a technique extensively used by pharmaceutical industry to promote their products and increase income. Evidence of pharmaceutical promotion detrimental effects on physicians’ prescribing practices is presented in line with the evidence of funding distribution distortion: the global pharmaceutical expenditures for drug promotion are far exceeding research and development funding. The review describes, with few exceptions, the medical journal editors general lack of awareness of journal advertisements influence on prescribers’ knowledge, attitudes and medicine use. The review reveals promotional nature of advertisements as opposed to information delivery. It describes unethical marketing techniques including journal advertising used as an instrument of promotional idea delivery to physicians and the problem of promotional influence on prescribing. The review emphasizes that pharmaceutical industry self-regulation as well as medical journals peer reviewing process do not protect from misleading advertising. It concludes that pharmaceutical advertising, and advertising in medical journals as an example is not informative and threatens public health, requiring detailed regulation.

The review covers the history and evolution of the WHO initiatives in pharmaceutical policy - for better and safer use of medicines, their scientifically based selection and ethical promotion. The WHO Concept of Essential Medicines, the WHO vision of the Rational Use of medicines and the WHO Ethical Criteria for Medicinal Drug Promotion are reviewed. Contribution of these WHO designed initiatives, definitions and documents to Global Health, particularly relating to modern Russian health system problems is discussed. The principles and methodology of drug selection are presented. The review describes health system benefits of the WHO Essential Medicines Concept implementation at a national level. Advantages of the WHO Model List of Essential Medicines use not only as a model product, but as a model process and an healthcare instrument are emphasized. The WHO principles of the Rational Use of Medicines, the history of its International development, the WHO key strategies towards the Rational Use of Medicines and the major barriers on the way are described. The history of the WHO Ethical Criteria for medicinal drug promotion development is presented in line with the basic principles and objectives of this unique international document. The core goal of the WHO Ethical Criteria is to improve health and healthcare through the rational use of medicines. The global implementation of the WHO Essential Medicines Concept and the ever growing barriers to the rational use of medicines and advances in public health, as well the advances and problems of the Russian national health system, are discussed in the historical perspective.