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| WHO Expert Committee on Selection and Use of Essential Medicines | |
|---|---|
| Name | WHO Expert Committee on Selection and Use of Essential Medicines |
| Formation | 1975 |
| Type | Advisory committee |
| Headquarters | World Health Organization headquarters, Geneva |
| Region served | Global |
| Leader title | Chair |
| Parent organization | World Health Organization |
WHO Expert Committee on Selection and Use of Essential Medicines is a standing advisory body convened by the World Health Organization to provide evidence-based guidance on medicines that satisfy priority health needs. The committee advises on the development, revision, and implementation of the WHO Model List of Essential Medicines and interacts with agencies such as the United Nations, World Bank, and national ministries of health. It synthesizes inputs from regulatory authorities like the European Medicines Agency, clinical guideline developers such as the National Institute for Health and Care Excellence, and global procurement actors including UNICEF and Médecins Sans Frontières.
The committee was established in the mid-1970s under the auspices of the World Health Organization following the launch of theWHO Model List of Essential Medicines initiative. Early sessions engaged experts connected to institutions like Harvard University, University of Oxford, Centers for Disease Control and Prevention, and the Pan American Health Organization. Over successive decades the committee has intersected with major global health events and actors including the Alma-Ata Declaration, the Millennium Development Goals, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Sustainable Development Goals. Influential figures affiliated with the committee have had links to organizations such as the Bill & Melinda Gates Foundation and the Wellcome Trust.
The committee's mandate is issued by the World Health Assembly and focuses on selection, therapeutic interchange, and rational use of medicines. It provides technical recommendations to WHO Director-General and to national authorities including ministries of health in countries like India, Brazil, South Africa, and United States. Functions include appraisal of new evidence from trialists at centers like Johns Hopkins University, assessments drawing on regulatory decisions from the Food and Drug Administration, and engagement with procurement agencies such as Global Alliance for Vaccines and Immunization. The committee also issues guidance relevant to public health programmes run by bodies such as UNAIDS and UNICEF.
Membership is composed of international experts from academic centers such as University of Toronto, Karolinska Institutet, and University of Cape Town, and representatives from regulatory bodies including the Medicines and Healthcare products Regulatory Agency and the Pharmaceuticals and Medical Devices Agency. Chairs and members have often been affiliated with professional societies like the International Society of Pharmacoeconomics and Outcomes Research and the World Medical Association. Meetings are typically convened in Geneva during sessions of the World Health Assembly cycle, with virtual consultations involving partners such as World Bank economists and representatives from Médecins Sans Frontières.
The committee applies explicit criteria including public health relevance, evidence of efficacy and safety, and comparative cost-effectiveness, drawing on systematic reviews from groups like the Cochrane Collaboration and guideline panels associated with National Institute for Health and Care Excellence. Methodology integrates inputs from regulatory agencies such as the European Medicines Agency and trial data from institutions like Fred Hutchinson Cancer Center and Mayo Clinic. Health technology assessment approaches from entities like the Institute for Clinical and Economic Review inform decisions about therapeutic value and prioritization. The process includes review of pharmacovigilance data from networks like the Uppsala Monitoring Centre.
Outputs include the WHO Model List of Essential Medicines, the WHO Model List of Essential Medicines for Children, and technical reports addressing categories such as antimicrobials, oncology agents, and maternal health medicines. The committee issues recommendations that have influenced national lists in countries such as Thailand, Nigeria, Mexico, and Philippines, and guided procurement by organizations like UNICEF and the Global Fund. Specific recommendations have intersected with landmark regulatory approvals from the Food and Drug Administration and therapeutic guidelines from institutions including World Cancer Research Fund affiliates.
Committee recommendations have underpinned policy reforms in low- and middle-income countries and informed purchasing decisions by international procurement consortia such as Medicines Patent Pool and UNITAID. Implementation has affected supply chains coordinated with actors like UNICEF Supply Division and national agencies including Brazilian Health Regulatory Agency. Influence extends to educational curricula in universities such as Makerere University and University of Nairobi, and to clinical practice guidelines used in hospitals affiliated with All India Institute of Medical Sciences and Groote Schuur Hospital.
Critiques have focused on transparency, perceived influence of industry linked through entities like multinational pharmaceutical companies headquartered in Basel and New York City, and debates over inclusion of high-cost specialty medicines approved by agencies such as the European Medicines Agency and the Food and Drug Administration. Some civil society organizations including Médecins Sans Frontières and patient advocacy groups have contested decisions on access to antiretrovirals and oncology drugs, prompting public debates involving stakeholders like the World Trade Organization and the World Bank. Methodological disputes have referenced comparative effectiveness assessments from Institute for Clinical and Economic Review and calls for greater engagement with regional institutions such as the African Union.