Record number of lifesaving essential medicines approval by WHO could make universal health coverage a reality

The World Health Organisation has updated the list of essential medicines including the new entry of lifesaving medicines for Multiple Sclerosis, taking the world closer to a universal health coverage dream.

In a landmark change of decision, both the Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc) have been updated by the World Health Organisation (WHO) last month. The new lists contain a record number of new essential medicines for lifesaving ailments like cancer, multiple sclerosis, infectious diseases and cardiovascular problems.

This comes at a time when WHO recently launched an investment platform for universal health coverage in the global south.

More lifesaving essential medicines to make healthcare more accessible

The new edition of extensive lifesaving essential medicines for these health conditions seeks to empower people with wider choices, bringing innovative drugs to the forefront of healthcare. As these new medicines become globally available, the healthcare scene of the world might change as it is likely to make an impact on the health budget of countries, especially low and middle-income economies.

Speaking about the updated lists, WHO Director-General Dr Tedros Adhanom Ghebreyesus highlighted the importance of the two lists and why it's crucial for the world as it serves as "a definitive evidence-based guide for the most important medicines for delivering the biggest health impact". It has been used for more than four decades.

Dr Tedros also reiterated WHO's commitment to supporting every country in the world in its struggle to get access to quality medicine as inflation causes more supply chain disruption.

With rising prices and disruptions, equitable and consistent access to quality-assured essential medicines has become a problem, said Dr Tedros. The updated list is a step towards addressing it.

This comes at a time when WHO called for urgent action in ending morphine supply inequality across the world.

Lifesaving essential medicines approved for Multiple Sclerosis

The World Health Organisation under the able leadership of the WHO Expert Committee on Selection and Use of Essential Medicines scrutinised 85 applications of more than 100 lifesaving essential medicines and formulations to curate the 2023 update of Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc). Based on this extensive work 502 new lifesaving drugs were added to the Essential list and 361 were added to the children's essential list.

This includes lifesaving essential medicines for multiple sclerosis (MS) which so far has been largely left off the EML list. Multiple sclerosis is a chronic disease that impairs the nervous system of 2.8 million people globally. WHO have approved three lifesaving medicines for people suffering from multiple sclerosis in the 2023 EML update which includes rituximab, glatiramer acetate and cladribine.

The World Health Organisation has listed the use of administering these lifesaving medicines along with their respective prices and information on the generic and biosimilar variants of the medicines. This would enhance access to treatment for multiple sclerosis across the world and reduce the global burden of the disease.

WHO has also decided to support the usage of off-label rituximab due to the strong evidence hinting at its high efficacy and safety in treating multiple sclerosis. This could mark the way for far-reaching health benefits globally.

The Secretariat to WHO EML, Dr Benedikt Huttner highlighted how the 2023 updated lists could make way for universal health coverage as it provides wider guidance to healthcare facilities and governments around the world on the correct circumstances of usage of lifesaving essential medicines and means of procuring them.

Dr Huttner spoke in favour of the rituximab approval for multiple sclerosis highlighting how the evidence-based usage and affordability of the medicine including biosimilars could be effective in preventing relapsing and remitting of the disease in the absence of on-label alternatives.

Polypills approved for heart disease prevention

As a first, the World Health Organisation also approved the usage of multiple medicines or polypills taken in fixed doses to prevent heart diseases and ailments. This includes medicines that are designated as cholesterol-lowering agents and blood sugar-regulating or lowering agents.

One or more of these medicines along with an aspirin or without it has been advised to prevent cardiovascular diseases. Scientists all over the world have tested these combinations suggested by the WHO expert committee and they have been found to be effective in primary and secondary heart disease prevention.

Other lifesaving essential medicines and treatments approved:

• WHO also approved a list of new antibiotics and combinations to treat multidrug-resistant bacterial infections including rifampicin-resistant tuberculosis and hepatitis C.
• Apart from that, two new lifesaving essential medicines for cancer have been added to the list which reduces the toxic effect of conventional cancer drugs on the bone marrow and stimulates white blood cell production, thus giving rise to better immunity.
• A string of lifesaving essential medicines for childhood cancers including rare types like Burkitt lymphoma are also on the new updated EMLc.

• Human insulin listed in the EML and EMLc has been updated to include cartridge and pre-filled pen delivery systems as it is easier to use than vials and syringes.
• Two new medicines, acamprosate and naltrexone, have been approved for alcohol disorder and the associated mental health problems.

The World Health Organisation has also updated the children's essential list of medicines with the correct dosage and medicinal strength of more than 70 approved child-specific medicines. In a major change ready-to-use therapeutic food has been approved as a treatment for acute malnutrition in children up to five years of age, especially infants.

Along with these recommendations and approvals WHO also delisted 32 medicinal applications including glucagon-like peptide-1 receptor usage for weight loss, Risdiplam for spinal muscular atrophy and donepezil for dementia in Alzheimer's patients.

These updates were decided in the four-day meeting of the 24th WHO Expert Committee on the Selection and Use of Essential Medicines held in Geneva between April 24 to 28.