Unedited Report of the 19th WHO Expert Committee on the Selection and Use of Essential Medicines
The report of the 19th Expert Committee on Selection and Use of Essential Medicines, held in April 2013, along with the 18th WHO Model List Essential Medicines and the 4th Model List of Essential Medicines for Children, has been released. The lists continue to be a very powerful public health tool and will assist countries in achieving Universal Health Coverage.
The 18th list includes new medicines such as bevacizumab (a monoclonal antibody for neovascular age-related macular degeneration) and pegylated interferon (for hepatitis C); it also expanded the uses of some medicines already on the list, i.e. chlorhexidine (an effective widely used antiseptic) as gel, which has been proven to be effective neonatal cord care in community deliveries. Fresh frozen plasma, platelet concentrates, red blood cells and whole blood (being made available through voluntary, non-remunerated blood donation) was included. The list also specified new uses for familiar medicines; spironolactone, a diuretic used for decades in the hypertension is now included with an enlarged indication of heart failure, and dexamethasone, a commonly used steroid, for acceleration of foetal lung maturation in anticipated preterm birth. Both these medicines are widely used in these conditions but have not been submitted for regulatory approval as they are generic medicines and have no sponsors. Inclusion of these 2 indications in the lists reinforces their use.
The 18th WHO Model List of Essential Medicines and the 4th Model List of Essential Medicines for Children which were the outcomes of the 19th Expert Committee, provide evidence-based lists for countries to consider in procurement and supply of medicines for their health care systems. The WHO Essential Medicines Lists are a model, both as a process (the complete applications being posted on the Internet, available for comment and the final decisions as well as their basis then being available in the technical report), and a product (lists that can be adapted by the countries).
For decades the Essential Medicines Concept and the List has been an important tool in health care for countries and in the future will becomes an crucial strategy for enhancing access to medicines within the framework of Universal Health Coverage.