(Resource list in this article recently updated on March 13, 2023)
The WHO Essential Medicines List (EML) of essential medicines is prepared by the World Health Organization (WHO) with input from the World Health Assembly (WHA). First introduced in 1977 to help document essential medicines, the model list serves as a guide to informed decisions regarding availability of medicines for both developed and developing countries.
The list is updated regularly following evidence-based reviews by international experts, with one review completed every two years. A second list called Basic Essential Medicines List for Children up to 12 years of age is also published separately. The current versions are the 21st WHO Essential Medicines List (EML) and the 7th WHO Essential Medicines List for Children (EMLc) updated in June 2019. Source: WHO
WHO Essential Medicines List (EML) is created and updated based on guidance and recommendations from a range of stakeholders, including governments, experts in drug policy, researchers, and international agencies working on health issues. Essential medicines should be available at all times and should also be readily available in adequate amounts.
As the world is facing the issue of affordable and accessible medicines for the treatment of a myriad of diseases, developed countries are trying to increase the production of new and comparatively safer medicines to replace those that are currently available. Some of the new drugs are expensive and thus they are only available in a number of developed countries or limited number of developing countries. On the other hand, there are also medicines that are cheap and effective, but are not available in the developing countries at all.
The 23rd WHO Expert Committee meeting on the Selection and Use of Essential Medicines will be coordinated from WHO Headquarters, Geneva and held virtually on 21 June to 2 July 2021 to revise and update the WHO Model List of Essential Medicines (EML) and the WHO Model List of Essential Medicines for Children (EMLc). Source: WHO
Of the many issues any country faces, one of the most pressing is the issue of access to medicine. WHO model list is based on the highest level of evidence available from clinical trials to support their use. These drugs are designed to treat malaria, tuberculosis, and several other diseases that affect the poorest people on the planet. It is a guide to essential medicines for priority diseases in developing countries, with specific recommendations for the supply of these medicines. At least half of the people or more living in a country are prescribed essential medicines, this prescription rate is essentially low. In case of developing countries and due to lack of resources, the available data is sometimes insufficient or unverified to accurately determine the trend.
The list of essential medicines is used as a reference by governments when prioritizing the availability of medicines for their healthcare systems and for making decisions regarding coverage and availability. The list has the potential to transform the way diseases are treated in developing countries, and also has a strong impact on the global health agenda.
Assessing health gains using Country-Level Cost-Effectiveness guide
The essential drugs list has the potential to transform the way diseases are treated in developing countries, and also has a strong impact on the global health agenda. In order to consider a drug for this list, it needs to have a cost-effectiveness ratio (CER) of $5,000 or higher per quality-adjusted life year (QALY).
Cost-effectiveness analysis (CEA) compares the cost of an activity, called an intervention, with the known or expected health gain. Source: Cost-Effectiveness Analysis for Priority Setting. Cost-effectiveness thresholds (CETs) are typically used to assess whether an intervention is worthwhile and should reflect health opportunity cost. Source: Country-Level Cost-Effectiveness Thresholds.
Scope of the Essential Medicines List
The WHO’s list of Essential Medicines is the official list of what every country must have at the highest available levels (according to some) for at least 60 days or more. According to the list, these so-called “essential medicines” must be accessible to everyone without any restrictions. The list also calls for the introduction of affordable alternative medicines. It is a list of medicines that is intended to be accessible to all people in all parts of the world, regardless of class, wealth status or geography to ensure that everyone has access to needed medicine. Currently, many of these medicines are commonly available in the low- and middle-income countries.
The WHO Essential Medicines List is an essential tool for ensuring access to essential medicines for developing countries and WHO member states. Lists are periodically updated and reviewed by WHO in order to keep up with the latest developments in medicine.
WHO has put in place several measures to assure that drugs are as available and as accessible to the people as possible. Consideration is given to several factors, such as:
1. Effectiveness of medications
2. Availability in developing countries
2. Cost of medication
3. Increase access to important new drugs
Benefits of utilizing the Essential Medicines List
The WHO Essential Medicines List is a global list of essential medicines that are essential for public health systems to have access to. There are a number of benefits, for example:
- The list is used as a reference by governments when prioritizing medicines for their healthcare systems and for making decisions regarding coverage and availability.
- With the WHO essential drugs list, governments can make decisions about purchasing medicines for their health systems, and utilize the most cost-effective way to purchase the medicines.
The results largely depend on individual efforts, such as:
- How countries can obtain new medications
- How countries can improve the Essential Medicines List specific to their needs
- How governments and other organizations (medical community) should handle the list in their country.
WHO Essential Medicines List has the potential to transform the way diseases are treated in developing countries, and also has a strong impact on the global health agenda.
The availability of essential drugs is one of the major reasons for higher life expectancy rates in developing countries. The lack of access to these essential drugs can have a detrimental impact on overall health and mortality rates in developing countries. Furthermore, if these drugs are freely available in developing countries, they would also improve global health by reducing the spread of infectious diseases. It has been proven that medicines are more effective if delivered in affordable ways and without the use of excessive medical tests and treatments. In response to these concerns, many policies have been implemented that aim at the access to healthcare for all through medicines policy, but the problem remains: How to ensure that these newly accessible medicines remain affordable to the whole population in developing countries?
Ensuring availability of Essential Medicines
WHO provides a basic model listing of the medicines that are considered to be essential drugs that are used regularly in the treatment of certain conditions in humans. They are not intended to be life-saving. Instead, they are the essential medicines that are generally safe and effective, affordable without costly medical care. These are the medicines most patients would see first line treatment even in countries with limited health infrastructure.
When most developing countries adopt a development strategy, there are considerations for diseases and medical conditions that are widely prevalent in their population. To address this, and as stated earlier, the World Health Organization’s (WHO) Essential Medicines List (EML) has been updated periodically also to include new medicines for both prevention and treatment of chronic diseases. The chronic diseases can be difficult to treat because of the overall health and financial status of the country, cultural beliefs, size of population, and degree of awareness. This is accompanied by a steady increase in poverty, unemployment, and a high number of people living in absolute poverty status.
Lack of access to these essential drugs can have a detrimental impact on overall health and mortality rates in developing countries.
In the pursuit of improving health in the world, WHO has a number of initiatives and projects under way, which include things like sustainable development of key public health initiatives, work to promote international agreements and joint ventures (e.g., with local governments), as well as more traditional and proactive efforts such as implementing new disease treatment plans and supporting WHO’s efforts to improve global health.
WHO Provides guidance on the cost-effectiveness of essential medicines for health systems and benefits to the countries with limited budgets. WHO in its meetings actively outline how the concept of essential medicines needed to be expanded to ensure that the entire population has access to the highest quality medicines at affordable prices.
Over the years, the EML has helped push the world towards an international agenda for health security and sustainable development by promoting access and quality of essential medicines. The EML has been central to the WHO strategy to reduce the burden of diseases and the need for healthcare in developing countries through the delivery of essential medicines.
The availability of essential drugs is one of the major reasons for higher life expectancy rates in developing countries. The lack of access to these essential drugs can have a detrimental impact on overall health and mortality rates in developing countries. This situation further exacerbates the already existing gap in health expenditure between rich and poor nations.
The World Health Organization (WHO) Essential Medicines List (MDL) is an initiative to ensure more drug availability and affordability worldwide according to the needs and priorities. This list provides the basic drug repertoire that countries need to cover their essential healthcare needs. In the last decade, the availability of essential drugs for several diseases especially chronic diseases like diabetes, tuberculosis, and hypertension has increased, especially for the low and middle-income countries.
Although the introduction of essential medicines into the health systems of many developing countries has resulted in substantial improvements to health outcomes, one of the most challenging issues is that very scant resources are devoted worldwide to promoting their implementation and changing prescribing habits.
Bonus Topic: What’s New in WHO’s Essential Medicines List (EML) of 2021*
The 23rd WHO Expert Committee meeting on the Selection and Use of Essential Medicines will be coordinated from WHO Headquarters, Geneva and held virtually on 21 June to 2 July 2021 to revise and update the WHO Model List of Essential Medicines (EML) and the WHO Model List of Essential Medicines for Children (EMLc). What’s new… is there an impact of the COVID-19 pandemic on the way EML will be used or something else?
*Bonus topics are selected based on our readers’ interest. You can read more in the future.
MDS-3: Managing Access to Medicines and Health Technologies – Download the complete guide.
Chapter 16. Managing Medicine Selection
Model List of Essential Medicines (Product, Gneral information & Indications) – Database
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