WHO updates model list of essential medicines

New Delhi: The World Health Organization (WHO) has released the 20th WHO Model List of Essential Medicines (EML) and the 6th WHO Model List of Essential Medicines for Children (EMLc). The EML and EMLc are updated every two years and used by many countries to guide decisions about their national essential medicines lists, which help to ensure access to treatment of widespread or high-priority diseases, including priority infection syndromes.

The Center for Disease Dynamics and Economic and Policy (CDDEP) Fellow, Dr Sumanth Gandra was part of the Expert Committee that helped shape the revised list, evaluating the scientific evidence for medicines’ comparative effectiveness, safety, and cost-effectiveness. The Expert Committee recommended the addition of 30 new medicines to the EML and 25 new medicines to the EMLc, of which 10 and 12, respectively, were antibacterial agents.

A new grouping of antibacterial agents was also proposed, with three categories:

1. Access: First and second choice antibiotics for the empiric treatment of most common infection syndromes. These medicines should be widely available, at an affordable cost and of assured quality.

2. Watch: Antibiotics that are considered to have higher resistance potential and are recommended as first or second choice treatments for a limited number of syndromes;

3. Reserve: Antibiotics that should be used as “last resort” options and should be accessible when needed, but use should be limited to specific patients and settings.

Many low- and middle-income countries face regular shortages of antibiotics, high prices, and sub- standard or counterfeit antibiotics. When quality antimicrobials are not accessible, healthcare workers may prescribe suboptimal drugs, which could lead to increasingly resistant infections and adverse side effects. The EML, EMLc, and new categorization of antibacterial agents will further guide countries in ensuring access to appropriate antibacterial agents and support antimicrobial stewardship efforts.

According to Dr Gandra, “The Model List of Essential Medicines necessarily has a sharp focus on preserving antimicrobials. This list serves as a guide for the medicine supply system and is responsible for promoting health equity.”