Essential medicines

Last updated
2017 marked the 40th anniversary of the WHO Model List of Essential Medicines V1 40 years Model List of Essential Medicines.001.png
2017 marked 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] Essential medicines are the medications that people should have access to at all times in sufficient amounts. These medications should be generally affordable. [2] Since 1977, the WHO has published a model list of essential medicines, with the current (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] Both the WHO adult and children's lists contain a notation indicating that a particular medication is "complementary", thus essentially there are two lists, the "core list" and the "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. Countries are encouraged to prepare their own lists taking into consideration local priorities. Over 150 countries have published an official essential medicines list. [5]

Contents

Theory and practice

The definition of essential medicines has changed over time.

The original WHO definition in 1977 was that they were medicines "of utmost importance, basic, indispensable, and necessary for the healthcare needs of the population". [6] 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. [7]

And this remains the definition as of 2019. [1]

Selection

Items are chosen as essential medicines based on how common the disease that is being treated, evidence of benefit, the degree of side effects and the cost compared to other options. [8] In order to explore the human rights law and WHO's essential medicines policies into national legislation regarding medicines affordability and financing needs to be understood to enhance universal access to essential medicines.Perehudoff K (2020-11-02), "Universal access to essential medicines as part of the right to health: a cross-national comparison of national laws, medicines policies, and health system indicators.", Global Health Action, 13 (1699342), doi:10.1080/16549716.2019.1699342, PMC   7605313 , PMID   33131456

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. [9]

History

The WHO made the Model List of Essential Medicines in 1977 as a way to introduce the idea that there are certain medicines that are more useful and required more often than other medicines, and that these medicines are often inaccessible to many different populations. [10]

The WHO Model List of Essential Medicines has been updated every two years since 1977. The 23rd version was published in July 2023. [11] Over that period, the number of medications has more than doubled, from the original 208 in 1977, [5] to more than 500 in 2023. [11]

Children's list

The first edition of the "WHO Model List of Essential Medicines for Children", was published in 2007, while the 9th edition was published in 2023. [5] [4] [11] It was created to make sure that the needs of children were systematically considered such as availability of proper formulations. [5] The first edition contained 450 formulations of 200 different medications [5] and the 2023 list contains 361 medications. [11]

Society and culture

Access to essential medicines are part of the Sustainable Development Goals, specifically goal 3.8. [12]

A number of organizations, which are global in scope, use the list to determine which medications they will supply. [5] Rather than strictly following the list, many nations refer to the essential medicines list as a guide for developing their own laws and regulations based on their own requirements. [13]

See also

Related Research Articles

<span class="mw-page-title-main">Amoxicillin/clavulanic acid</span> Combination antibiotic medication

Amoxicillin/clavulanic acid, also known as co-amoxiclav or amox-clav, sold under the brand name Augmentin, among others, is an antibiotic medication used for the treatment of a number of bacterial infections. It is a combination consisting of amoxicillin, a β-lactam antibiotic, and potassium clavulanate, a β-lactamase inhibitor. It is specifically used for otitis media, streptococcal pharyngitis, pneumonia, cellulitis, urinary tract infections, and animal bites. It is taken by mouth or by injection into a vein.

<span class="mw-page-title-main">Vecuronium bromide</span> Muscle relaxant

Vecuronium bromide, sold under the brand name Norcuron among others, is a medication used as part of general anesthesia to provide skeletal muscle relaxation during surgery or mechanical ventilation. It is also used to help with endotracheal intubation; however, agents such as suxamethonium (succinylcholine) or rocuronium are generally preferred if this needs to be done quickly. It is given by injection into a vein. Effects are greatest at about 4 minutes and last for up to an hour.

<span class="mw-page-title-main">Diazoxide</span> Medication used to treat low blood sugar and high blood pressure

Diazoxide, sold under the brand name Proglycem and others, is a medication used to treat low blood sugar due to a number of specific causes. This includes islet cell tumors that cannot be removed and leucine sensitivity. It can also be used in refractory cases of sulfonylurea toxicity. It is generally taken by mouth.

<span class="mw-page-title-main">Procarbazine</span> A chemotherapy medication used for several cancer types

Procarbazine is a chemotherapy medication used for the treatment of Hodgkin's lymphoma and brain cancers. For Hodgkin's it is often used together with chlormethine, vincristine, and prednisone while for brain cancers such as glioblastoma multiforme it is used with lomustine and vincristine. It is typically taken by mouth.

<span class="mw-page-title-main">Tetracaine</span> Local anaesthetic drug

Tetracaine, also known as amethocaine, is an ester local anesthetic used to numb the eyes, nose, or throat. It may also be applied to the skin before starting an intravenous (injection) to decrease pain from the procedure. Typically it is applied as a liquid to the area. Onset of effects when used in the eyes is within 30 seconds and last for less than 15 minutes.

<span class="mw-page-title-main">Rifabutin</span> Chemical compound

Rifabutin (Rfb) is an antibiotic used to treat tuberculosis and prevent and treat Mycobacterium avium complex. It is typically only used in those who cannot tolerate rifampin such as people with HIV/AIDS on antiretrovirals. For active tuberculosis it is used with other antimycobacterial medications. For latent tuberculosis it may be used by itself when the exposure was with drug-resistant TB.

<span class="mw-page-title-main">Sulfadiazine</span> Chemical compound

Sulfadiazine is an antibiotic. Used together with pyrimethamine, a dihydrofolate reductase inhibitor, it is the treatment of choice for toxoplasmosis, which is caused by a protozoan parasite. It is a second-line treatment for otitis media, prophylaxis of rheumatic fever, chancroid, chlamydia, and infections by Haemophilus influenzae. It is also used as adjunct therapy for chloroquine-resistant malaria and several forms of bacterial meningitis. It is taken by mouth. Sulfadiazine is available in multiple generic tablets of 500 mg. For urinary tract infections, the usual dose is 4 to 6 grams daily in 3 to 6 divided doses.

<span class="mw-page-title-main">Homatropine</span> Medication

Homatropine is an anticholinergic medication that is an antagonist at muscarinic acetylcholine receptors and thus the parasympathetic nervous system. It is used in eye drops as a cycloplegic, and as a mydriatic.

<span class="mw-page-title-main">Factor VIII (medication)</span> Pharmaceutical drug

Factor VIII is a medication used to treat and prevent bleeding in people with hemophilia A and other causes of low factor VIII. Certain preparations may also be used in those with von Willebrand's disease. It is given by slow injection into a vein.

<span class="mw-page-title-main">Amodiaquine</span> Chemical compound

Amodiaquine (ADQ) is a medication used to treat malaria, including Plasmodium falciparum malaria when uncomplicated. It is recommended to be given with artesunate to reduce the risk of resistance. Due to the risk of rare but serious side effects, it is not generally recommended to prevent malaria. Though, the World Health Organization (WHO) in 2013 recommended use for seasonal preventive in children at high risk in combination with sulfadoxine and pyrimethamine.

<span class="mw-page-title-main">Pyrantel</span> Medication for parasitic worm infections

Pyrantel is a medication used to treat a number of parasitic worm infections. This includes ascariasis, hookworm infections, enterobiasis, trichostrongyliasis, and trichinellosis. It is taken by mouth.

Procaine benzylpenicillin also known as penicillin G procaine, is an antibiotic useful for the treatment of a number of bacterial infections. Specifically it is used for syphilis, anthrax, mouth infections, pneumonia, diphtheria, cellulitis, and animal bites. It is given by injection into a muscle.

Delamanid is sold under the brand name Deltyba, is a medication used to treat tuberculosis. Specifically it is used, along with other antituberculosis medications, for active multidrug-resistant tuberculosis. It is taken by mouth.

Ethambutol/isoniazid/rifampicin, also known as ethambutol/isoniazid/rifampin, is a fixed-dose combination medication used to treat tuberculosis. It contains ethambutol, isoniazid, and rifampicin. It is used either along or with other anti-tuberculosis medication. It is taken by mouth. Side effects are those of the underlying medications. Use may not be suitable in children.

Lamivudine/nevirapine/stavudine (3TC/NVP/d4T) is a fixed-dose combination antiretroviral medication used to treat HIV/AIDS. It contains lamivudine, nevirapine, and stavudine. It is either used by itself or along with other antiretrovirals. It is taken by mouth twice a day.

Lamivudine/nevirapine/zidovudine (3TC/NVP/AZT) is a fixed-dose combination antiretroviral medication used to treat HIV/AIDS. It contains lamivudine, nevirapine, and zidovudine. It is either used by itself or along with other antiretrovirals. It is a recommended treatment in those who are pregnant. It is taken by mouth twice a day.

Artesunate/mefloquine is a medication used to treat malaria. It is a fixed dose combination of artesunate and mefloquine. Specifically it is recommended to treat uncomplicated falciparum malaria. It is taken by mouth.

<span class="mw-page-title-main">Fluorescein (medical use)</span> Pharmaceutical drug

Fluorescein is used to help in the diagnosis of a number of eye problems. When applied as a drop or within a strip of paper to the surface of the eye it is used to help detect eye injuries such as foreign bodies and corneal abrasions. When given by mouth or injection into a vein it is used to help evaluate the blood vessels in the back of the eye during fluorescein angiography.

Dolutegravir/lamivudine/tenofovir (DTG/3TC/TDF) is a fixed-dose combination antiretroviral medication used to treat HIV/AIDS. It is a combination of dolutegravir, lamivudine, and tenofovir disoproxil. As of 2019, it is listed by the World Health Organization (WHO) as the first line treatment for adults, with tenofovir/lamivudine/efavirenz as an alternative. It is taken by mouth.

References

  1. 1 2 "Essential medicines". World Health Organization (WHO). Archived from the original on October 2, 2008. 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. 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. 1 2 Organization WH (2019). "World Health Organization model list of essential medicines for children: 7th list 2019". World Health Organization. hdl: 10665/325772 .
  5. 1 2 3 4 5 6 Seyberth HW, Rane A, Schwab M (2011). Pediatric Clinical Pharmacology. Springer Science & Business Media. p. 358. ISBN   978-3-642-20195-0.
  6. ↑ "Action programme on essential drugs: progress report by the Director-General". World Health Assembly. 32. World Health Organization. 2019. hdl: 10665/153132 .
  7. ↑ "Trade, foreign policy, diplomacy and health". Essential Medicines. World Health Organization (WHO). Dec 6, 2010. Archived from the original on August 6, 2004.
  8. ↑ Kalle H (9 February 2017). "Essential Medicines for Children". Clinical Pharmacology and Therapeutics. 101 (6): 718–720. doi:10.1002/cpt.661. PMID   28182281. S2CID   23873145.
  9. ↑ Zacher M, Keefe TJ (2008). The Politics of Global Health Governance: United by Contagion. Springer. p. 107. ISBN   978-0-230-61195-5.
  10. ↑ Laing R, Waning B, Gray A, Ford N, 't Hoen E (17 May 2003). "25 years of the WHO essential medicines lists: progress and challenges". Lancet (London, England). 361 (9370): 1723–1729. doi:10.1016/S0140-6736(03)13375-2. hdl:10144/28005. ISSN   0140-6736. PMID   12767751 . Retrieved 24 July 2024.
  11. 1 2 3 4 World Health Organization (2023). The selection and use of essential medicines 2023. Executive Summary of the report of the 24th WHO Expert Committee on Selection and Use of Essential Medicines. Geneva: World Health Organization. hdl: 10665/371291 . WHO/MVP/EMP/IAU/2023.01. License: CC BY-NC-SA 3.0 IGO.
  12. ↑ Wirtz VJ, Hogerzeil HV, Gray AL, Bigdeli M, de Joncheere CP, Ewen MA, et al. (28 January 2017). "Essential medicines for universal health coverage". Lancet. 389 (10067): 403–476. doi:10.1016/S0140-6736(16)31599-9. PMC   7159295 . PMID   27832874.
  13. ↑ Perehudoff K, Demchenko I, Alexandrov NV, Brutsaert D, Ackon A, Durán CE, El-Dahiyat F, Hafidz F, Haque R, Hussain R, Salenga R, Suleman F, Babar ZU (2020-12-18). "Essential Medicines in Universal Health Coverage: A Scoping Review of Public Health Law Interventions and How They Are Measured in Five Middle-Income Countries". International Journal of Environmental Research and Public Health. 17 (24): 9524. doi: 10.3390/ijerph17249524 . ISSN   1660-4601. PMC   7765934 . PMID   33353250.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.