The WHO has updated the list of essential medicines which will help people access the medicines they need under medical supervision at the right time.

This approach aids the progress towards a better health care delivery.The updated list of essential medicines is classified as a core list and a complementary list. The core list comprises of medicines required for a basic healthcare system which are both safe and cost-effective. The complementary list comprises of medicines for priority diseases which require special diagnostic testing and a specialist medical care.

For addressing the most important public health issues, 30 essential medicines for adults and 25 for children have been added to the list. For 9 already listed drugs, new uses have been specified making the list of essential medicines for general public health issues to 433.

The WHO has categorized the antibiotics for making their use much safer and efficient; also, new medicines for certain chronic diseases have been added to the list.

Categorization of Antibiotics

Misuse or overuse of antibiotics leads to the development of antibiotic drug-resistant bacteria which will pose a challenge to the scientific community and a threat to the mankind. Hence, the WHO has revised the list of antibiotics and has categorized them as – ACCESS, WATCH and RESERVE, along with recommendations on when and how a category drug should be used.

• Antibiotics used for a wide range of common infections are grouped under the ACCESS category and should be made available for general public at all times.
• Antibiotics used for the treatment of a small number of infections which are recommended as a first or second line of choice for treatment are grouped under the WATCH category.
• Last resort antibiotics such as certain cephalosporins and colistin are grouped under the RESERVE category. Only under severe circumstances when all alternatives have failed and the infection is life threatening, this antibiotic category should be used.

Addition of new drugs

The updated list has added certain drugs for treating chronic diseases such as HIV, tuberculosis, Hepatitis C and leukaemia. Some of them are mentioned as follows:

• Two drugs for treating oral cancer (dasatinib and nilotinib) are added to the list.
• Drugs for treatment of hepatitis C (sofosbuvir + velpatasvir combination) have been included.
• For treatment of HIV infection, dolutegravir drug has been added based on the evidence of the medicine’s efficacy and high barrier to resistance.
• Clofazimine for the treatment of multidrug-resistant tuberculosis in children and adults and delamanid for treating the same in children and adolescents.
• For treating paediatric tuberculosis, formulations of isoniazid, rifampicin, ethambutol and pyrazinamide medicines have been included.

References

1. WHO updates Essential Medicines List with new advice on use of antibiotics, and adds medicines for hepatitis C, HIV, tuberculosis and cancer. World Health Organization. News Release. Accessed on 4 July 2017 http://www.who.int/mediacentre/news/releases/2017/essential-medicines-list/en/

2. 20th Essential Medicines List (2017). World Health Organization. Accessed on 4 July 2017 http://www.who.int/medicines/news/2017/21st_essential_med-list/en/

3. Helen Branswell. Health officials set to release a list of drugs everyone on Earth should be able to access. (2017) Accessed on 4 July 2017 https://www.statnews.com/2017/06/05/essential-medicines-list-who/

4. Michael Mezher. WHO Essential Medicines Update Adds Antibiotic use Framework and new HCV & HIV Drugs. Regulatory Affairs Professional Society. Accessed on 4 July 2017 http://www.raps.org/Regulatory-Focus/News/2017/06/06/27845/WHO-Essential-Medicines-Update-Adds-Antibiotic-use-Framework-and-new-HCV--HIV-Drugs/