World Health Organization Model List of Essential Medicines
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| World Health Organization Model List of Essential Medicines | |
|---|---|
| Name | World Health Organization Model List of Essential Medicines |
| Publisher | World Health Organization |
| Published | 1977 |
| Country | Switzerland |
| Language | English, French, Spanish |
| Website | WHO EML |
World Health Organization Model List of Essential Medicines. It is a guide created by the World Health Organization to help countries prioritize the most important medications for their health systems. First published in 1977, the list aims to improve access to effective and affordable treatments globally. It serves as a model for national governments to develop their own essential medicines lists.
History and development
The concept was first proposed in 1975 by a committee of experts, with the inaugural list published in 1977 following a resolution by the World Health Assembly. The initial list contained 208 individual medications and was heavily influenced by the earlier work of the Himalayan Kingdom of Bhutan and the experiences of the Cuban Revolution in healthcare. The development was championed by figures like Halfdan T. Mahler, then Director-General of the World Health Organization. Its creation was a direct response to the need for a standardized approach to drug procurement in the wake of the Alma-Ata Declaration on primary healthcare.
Structure and content
The list is divided into two core sections: one for adults and a complementary list for children, known as the World Health Organization Model List of Essential Medicines for Children. Medications are organized by therapeutic categories, such as those for infectious diseases like malaria and HIV/AIDS, or for cardiovascular disease. Each entry typically includes the International Nonproprietary Name, recommended dosage forms, and strengths. The list also includes notes on use and, in some editions, references to relevant World Health Organization treatment guidelines.
Selection criteria and process
Medicines are selected by the World Health Organization Expert Committee on the Selection and Use of Essential Medicines, which convenes every two years. The primary criterion is that a medicine addresses a priority healthcare need, with consideration given to its efficacy, safety, and comparative cost-effectiveness. The process involves a rigorous review of evidence from sources like the Cochrane Collaboration and consultations with member states. The committee's recommendations are ultimately submitted for approval to the Director-General of the World Health Organization.
Impact and global adoption
The list has profoundly influenced national health policies, with over 150 countries now maintaining their own national essential medicines lists based on this model. It has guided the pharmaceutical procurement strategies of organizations like UNICEF and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Its adoption is considered a key component in achieving the health-related Sustainable Development Goals. The list has also shaped the research agendas of entities like the Drugs for Neglected Diseases Initiative and the Bill & Melinda Gates Foundation.
Updates and revisions
The list is updated on a biennial basis to reflect new therapeutic advances, emerging health threats, and changes in resistance patterns, such as those for antimicrobial resistance. Major revisions have included the addition of medicines for hepatitis C and new classes of drugs for diabetes mellitus. The update process is transparent, with calls for submissions published on the World Health Organization website and open meetings of the expert committee.
Criticisms and challenges
Criticisms have included debates over the inclusion of high-cost medicines, such as certain cancer drugs and treatments for rare diseases, which can strain the budgets of programs in developing countries. Some argue the process can be slow to incorporate new innovations from companies like Pfizer or Novartis. Challenges remain in ensuring consistent availability of listed medicines across different regions, particularly in areas affected by conflict like South Sudan or during health emergencies like the COVID-19 pandemic.