Essential medicines

2017 marks the 40th anniversary of the WHO Model List of Essential Medicines

Essential medicines, as defined by the World Health Organization (WHO), are the medicines that "satisfy the priority health care needs of the population".[1] These are the medications to which people should have access at all times in sufficient amounts. The prices should be at generally affordable levels.[2]

The WHO has published a model list of essential medicines. Each country is encouraged to prepare their own lists taking into consideration local priorities. Over 150 countries have published an official essential medicines list.[3] The essential medicines list enables health authorities, especially in developing countries, to optimize pharmaceutical resources. The WHO List contains a core list and a complementary list.

The core list presents a list of minimum medicine needs for a basic health care system, listing the most efficacious, safe and cost-effective medicines for priority conditions. Priority conditions are selected on the basis of current and estimated future public health relevance, and potential for safe and cost-effective treatment.

The complementary list presents essential medicines for priority diseases, for which specialized diagnostic or monitoring facilities are needed. In case of doubt medicines may also be listed as complementary on the basis of higher costs or less attractive cost-effectiveness in a variety of settings. The list is important because it forms the basis of national drugs policy in more than 155 countries, both in the developed and developing world. Many governments refer to WHO recommendations when making decisions on health spending.

Theory and practice

The definition of essential medicines has changed over time.

The original 1977 WHO definition was that they were medicines "of utmost importance, basic, indispensable, and necessary for the healthcare needs of the population".[4] The concept was mentioned in one of the ten points of the 1978 Alma Ata Declaration on primary health care.

In 2002 definition was changed to:

Essential medicines are those that satisfy the priority health care needs of the population.[5]

And this remains the current definition as of 2017.[1]

Selection

Items are chosen as essential medicines based on how common the disease is that they treat, evidence of benefit and the degree of side effects, and the cost compared to other options.[6]

Cost-to-benefit ratio

Cost effectiveness is the subject of debate between producers (pharmaceutical companies) and purchasers of drugs (national health services). It is estimated that access to essential medicines could save 10 million people a year.[7]

History

The WHO Model List of Essential Medicines has been updated every two years since 1977. The current version, the 20th, was published in March 2017.

Children's list

The first edition of the "WHO Model List of Essential Medicines for Children", was published in 2007 while the 5th edition was published in 2015.[3][8] It was created to make sure that the needs of children were systematically considered such as availability of proper formulations.[3] The first edition contained 450 formulations of 200 different medications.[3]

Number of medications

The number of medications has nearly doubled, from the original 208 in 1977 to more than 340.[9] The range has increased over the years and now includes an antimigraine drug, antidotes, and antineoplastic drugs. The third list for children from 2011 contains 269 medications.[10]

Society and culture

Access to essential medicines are part of the Sustainable Development Goals, specifically goal 3.8.[11]

A number of organizations, which are global in scope, use the list to determine which medications they will supply.[3]

See also

References

  1. 1 2 "Essential medicines". World Health Organization. Retrieved 20 January 2017.
  2. ↑ "The Selection and Use of Essential Medicines (ss 4.2)". Essential Medicines and Health Products Information Portal. WHO Technical Report Series. WHO. 2003. p. 132.
  3. 1 2 3 4 5 Seyberth, Hannsjörg W.; Rane, Anders; Schwab, Matthias (2011). Pediatric Clinical Pharmacology. Springer Science & Business Media. p. 358. ISBN 9783642201950.
  4. ↑ "Action Programme on Essential Drugs" (pdf). Progress report by the Director - General. WHO. 26 Mar 1979. p. 1 point 2.
  5. ↑ "Trade, foreign policy, diplomacy and health". Essential Medicines. WHO. Dec 6, 2010.
  6. ↑ Kalle, H (9 February 2017). "Essential Medicines for Children". Clinical Pharmacology and Therapeutics. 101 (6): 718–720. doi:10.1002/cpt.661. PMID 28182281.
  7. ↑ Zacher, M.; Keefe, Tania J. (2008). The Politics of Global Health Governance: United by Contagion. Springer. p. 107. ISBN 9780230611955.
  8. ↑ "5th WHO Model List of Essential Medicines for Children (April 2015)" (PDF). WHO. April 2015. Retrieved 19 December 2015.
  9. ↑ "10 facts on essential medicines". February 2010. Retrieved 15 August 2015.
  10. ↑ Bansal, D; Purohit, VK (January 2013). "Accessibility and use of essential medicines in health care: Current progress and challenges in India". Journal of Pharmacology & Pharmacotherapeutics. 4 (1): 13–8. doi:10.4103/0976-500X.107642. PMC 3643337. PMID 23662019.
  11. ↑ Wirtz, VJ; Hogerzeil, HV; Gray, AL; Bigdeli, M; de Joncheere, CP; Ewen, MA; Gyansa-Lutterodt, M; Jing, S; Luiza, VL; Mbindyo, RM; Möller, H; Moucheraud, C; Pécoul, B; Rägo, L; Rashidian, A; Ross-Degnan, D; Stephens, PN; Teerawattananon, Y; 't Hoen, EF; Wagner, AK; Yadav, P; Reich, MR (28 January 2017). "Essential medicines for universal health coverage". Lancet. 389 (10067): 403–476. doi:10.1016/S0140-6736(16)31599-9. PMID 27832874.
  • "WHO Model Lists of Essential Medicines (current for adults and children)". WHO. Retrieved 2018-03-06.
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