WHO ESSENTIAL MEDICINES LIST – Refocusing the World Health Organization’s Model List of Essential Medicines on the needs of low and middle income countries

BMJ 2024;385:e077776, 16 April 2024

Veronika J Wirtz, professor in global health, Andrew L Gray, senior lecturer, Sangeeta Sharma, professor and head of department, Jing Sun, associated professor in pharmaceutical policy, Hans V Hogerzeil, emeritus professor in global health

Correspondence to: V J Wirtz vwirtz@bu.edu

In the wake of escalating medicine prices worldwide, Veronika Wirtz and colleagues argue for refocusing the WHO Model List of Essential Medicines on the needs of low and middle income countries, while retaining its global relevance as a model process.

Key messages

The World Health Organization’s Model List of Essential Medicines promotes equitable access to medicines for the priority health needs of the population.

But an increasing number of applications for very expensive and highly specialised medicines is challenging its global reputation.

WHO should reconfirm the original goals of the model list as a globally relevant model process with, as a practical example, a model list specifically geared to the needs of low and middle income countries.

WHO should enhance the functionality of the publicly accessible searchable electronic database of all decision data, including rejections, to aid national formulary committees and maintain the model list’s future relevance.

First published in 1977, the World Health Organization (WHO) Model List of Essential Medicines has been one of the most effective and recognised tools to promote equitable access to medicines, prioritising those that satisfy the health priorities of the population. Essential medicines are “selected with due regard of public health relevance, evidence on efficacy and safety, and comparative cost-effectiveness.” The list is updated every two years; Tedros Adhanom Ghebreyesus, director general of WHO, announced publication of the 23rd Model List of Essential Medicines in July 2023. This version sets a new record for the number of medicines included (502). The children’s list, which now includes 361 medicines, was first published in 2007 to consider children’s medicines needs more systematically and has since been published every two years alongside the main model list.

The inclusion of many high priced medicines over the past decade has prompted debate about the focus …[Sorry not open access!]