WHO New Essential Medicines List (EML) released
The World Health Organization’s new list of essential medicines (EML) was issued last week. To address the rising issue of antimicrobial resistance, this 40th Edition has divided the antibiotics on the list in three groups, the last of which are to be used as a last resort. Additionally, the highlights of the new EML include the first combination therapy to treat all six types of hepatitis C, a new medicine to treat pediatric tuberculosis as well as two new oral medicines to treat cancer.
The WHO Essential Medicines List (EML) is used by many countries to increase access to medicines and guide decisions about which products they ensure are available for their populations. This latest EML adds 55 medicines to the list, of which 30 for adults and 25 for children, bringing the total to 433 drugs deemed essential for addressing the most important public health needs. All medicines are chosen according to evidence of safety, efficacy, and public health relevance.
Addressing the issue of antimicrobial resistance
The 2017 list took into account a review of all 39 essential antibiotics on the list against 21 common syndromes, categorizing them into three groups: "Access", "Watch" and "Reserve". WHO Assistant Director-General for Health Systems and Innovation Marie-Paule Kieny explained that this classification seeks to contain antimicrobial resistance, optimise antibiotic treatment, and preserve last resort antibiotics.
The antibiotics in the “Access” category have a low resistance potential and should be available at all times, including for example amoxicillin. Those in the “Watch” category have a higher resistance potential and should be limited to a number of indications, and antibiotics in the “Reserve” category should be kept as a last resort for life-threatening infections, due in particular to multi drug-resistant bacteria, Kieny elaborated. Examples of medicines in the “Reserve” category are 4th and 5th generations of cephalosporins
“We hope that this new categorisation of antibiotics emerging at a time when political awareness of the issue is high, will increase countries’ commitment to tackle the problem in targeted ways,” she said. “The political will is there,” she added, but it should be translated into strong policies, including better monitoring of antibiotics use.
Hepatitis C, Leukaemia, TB
Suzanne Hill, director, WHO Essential Medicines and Health Products, remarked on the new addition on the list of the first combination therapy to treat all six types of hepatitis C (sofosbuvir + velpatasvir). This approach has two major benefits, she said. First, it allows countries without sophisticated diagnostic equipment to have an option to use one treatment covering all kinds of hepatitis C, and the second is that the treatment is once a day, easy and convenient to take, improving the treatment outcome.
Also on the list a new medicine to treat tuberculosis in children and adolescents who have the form of the illness that is multidrug resistant, she said.
Two additional oral cancer medicines to treat leukaemia that has become resistant to standard treatment have been added to the list, Hill said.
Pressure to bring down medicine prices
Currently, many of these medicines are sold at very high prices and may be unaffordable for health systems, irrespective of the wealth of the country, Hill said.
When these expensive medicines are included in the List of Essential Medicines, it “sends a strong message to all public health actors,” Hill said, adding that “those medicines provide true public health benefits and really should be made available when needed…The essential medicine list is one of the first steps in the direction of fair pricing because when we designate a medicine as essential, buyers have some leverage in negotiating for the final purchase price.”
IDA Foundation’s range is modelled on the WHO EML. We believe that using the EML as a guide allows us to offer the most complete and up-to-date assortment of key health products. For more information about our range, see our Product Indicator.
For the official WHO press release on the new EML edition, see the WHO website.