World Health Organization essential medicines

World Health Organization Essential Medicines List (WHO EML) is a compilation of the most effective, safe, and cost-efficient medicines that are recommended to be universally accessible within the health systems of all countries. The list is updated and published every two years by the World Health Organization (WHO), aiming to guide national governments in the development of their own essential medicines lists, considering their specific healthcare needs, availability of resources, and disease prevalence.

History

The concept of essential medicines was first introduced by the WHO in 1977, recognizing the global need for access to the most important medications. The initial list contained about 200 drugs deemed essential for addressing the most pressing public health needs. Since then, the list has been regularly updated and expanded to include medicines for a wider range of diseases and conditions.

Criteria for Inclusion

The selection of medicines for the WHO EML is based on evidence of efficacy, safety, and comparative cost-effectiveness. Medicines are considered essential if they satisfy the healthcare needs of the majority of the population and are intended to be available within the context of functioning health systems at all times, in adequate amounts, in the appropriate dosage forms, with assured quality and adequate information, and at a price the individual and the community can afford.

Structure

The WHO EML is divided into two main parts: the core list and the complementary list. The core list comprises medicines that are the most cost-effective options for key health problems and are feasible for basic healthcare systems to provide. The complementary list includes essential medicines for which more specialized diagnostic or monitoring facilities, and/or specialist medical care, and/or specialist training are needed. In addition to these, the list also includes sections for antiretroviral drugs, vaccines, and medicines for treating tuberculosis, malaria, and other diseases prevalent in low- and middle-income countries.

Impact

The WHO EML has had a significant impact on global health, guiding countries in the prioritization of healthcare services and pharmaceutical procurement. It has helped improve access to medicines in resource-limited settings, contributed to the rational use of medicines, and influenced the pricing and availability of generic medicines worldwide.

Challenges and Criticisms

Despite its successes, the WHO EML faces challenges such as the inclusion of high-cost medicines, especially newer drugs for diseases like cancer and hepatitis C, which can be prohibitively expensive for low-income countries. There is also ongoing debate about the criteria for inclusion and the process by which medicines are selected, with calls for greater transparency and the involvement of a broader range of stakeholders.

Future Directions

The WHO continues to refine the process for selecting essential medicines, with an increasing focus on cost-effectiveness analysis and the impact of patent issues on access to essential drugs. The organization also works towards expanding the list to include more non-communicable diseases (NCDs) and to address emerging global health threats.