Essential medicines

For the current list, see WHO Model List of Essential Medicines. For the current list for children, see WHO Model List of Essential Medicines for Children.


Essential medicines, as defined by the World Health Organization (WHO), are medicines that "satisfy the priority health care needs of the population".[1] Essential medicines should be accessible to people at all times, in sufficient amounts, and be generally affordable.[2] Since 1977, the WHO has published a model list of essential medicines, with the 2019 list for adult patients containing over 400 medicines.[3] Since 2007, a separate list of medicines intended for child patients has been published.[4] A new list was published in 2021, for both adults and children.[5]

Several changes have been implemented since the 2021 edition, including that medication cost should not be grounds for exclusion criteria if it meets other selection criteria, and cost-effectiveness differences should be evaluated within therapeutic areas. The following year, antiretroviral agents, usually used in the treatment of HIV/AIDS, were included on the list of essential medicines.[6]

The WHO distinguishes between "core list" and "complementary list" medications.

  • The core list contains 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 lists 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.

This list forms the basis of the 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. Countries are encouraged to prepare their own lists considering local priorities. Over 150 countries have published an official essential medicines list.[7] Despite these efforts, an estimated 2 billion people still lack access to essential medicines, with some of the major obstacles being low supply, including shortages of inexpensive drugs. Following these shortages, the US Food and Drug Administration (FDA) released a report in fall of 2019 with strategies to overcome and mitigate supply issues.[8]

  1. ^ Cite error: The named reference WHO2017Web was invoked but never defined (see the help page).
  2. ^ "The Selection and Use of Essential Medicines (ss 4.2)". Essential Medicines and Health Products Information Portal. WHO Technical Report Series. World Health Organization (WHO). 2003. p. 132. Archived from the original on February 1, 2014.
  3. ^ Organization WH (2019). "World Health Organization model list of essential medicines: 21st list 2019". World Health Organization. hdl:10665/325771.
  4. ^ Organization WH (2019). "World Health Organization model list of essential medicines for children: 7th list 2019". World Health Organization. hdl:10665/325772.
  5. ^ "The selection and use of essential medicines: report of the WHO Expert Committee on selection and use of Essential Medicine" (PDF). World Health Organization. 2021.
  6. ^ Hwang TJ, Kesselheim AS, Vokinger KN (2022-11-08). "Reforming the World Health Organization's Essential Medicines List: Essential but Unaffordable". JAMA. 328 (18): 1807–1808. doi:10.1001/jama.2022.19459. ISSN 1538-3598. PMID 36279114.
  7. ^ Seyberth HW, Rane A, Schwab M (2011). Pediatric Clinical Pharmacology. Springer Science & Business Media. p. 358. ISBN 978-3-642-20195-0.
  8. ^ "Essential Medicines: a balancing act". The Lancet Haematology. December 2019.