WHO expands essential lists with new drugs and diagnostics

WHO expands essential lists with new drugs and diagnostics

The World Health Organization’s (WHO) has updated the Essential Medicines List and List of Essential Diagnostics with the addition of some of the new drugs and advanced diagnostic tests.

The two lists focus on cancer and other global health challenges, with an emphasis on effective solutions, smart prioritization, and optimal access for patients, the agency said in a statement.

The Essential Medicines List (2019)

Among the five cancer therapies WHO added to the new medicines list two recently developed immunotherapies (nivolumab and pembrolizumab) which have delivered up to 50% survival rates for advanced melanoma, a cancer that until recently was incurable.

The Essential Medicines Committee strengthened advice on antibiotic use by updating the AWARE categories, which indicate which antibiotics to use for the most common and serious infections to achieve better treatment outcomes and reduce the risk of antimicrobial resistance. The committee recommended that three new antibiotics for the treatment of multi-drug resistant infections be added as essential.

New oral anticoagulants to prevent stroke as an alternative to warfarin for atrial fibrillation and treatment of deep vein thrombosis; biologics and their respective biosimilars for chronic inflammatory conditions such as rheumatoid arthritis and inflammatory bowel diseases and heat-stable carbetocin for the prevention of postpartum haemorrhage have also found their entries into the new essential medicines’ list (EML)

The EML Committee, however does not recommend drugs including methylphenidate, a medicine for attention deficit hyperactivity disorder (ADHD), as the committee found uncertainties in the estimates of benefit.

The List of Essential (in vitro) Diagnostics

The first List of Essential Diagnostics was published in 2018, concentrating on a limited number of priority diseases – HIV, malaria, tuberculosis, and hepatitis. This year’s list has expanded to include more noncommunicable and communicable diseases.

The global health agency added 12 tests to the Diagnostics List to detect a wide range of solid tumours such as colorectal, liver, cervical, prostate, breast and germ cell cancers, as well as leukaemia and lymphomas with the objective to promote early cancer diagnosis.

A new section covering anatomical pathology testing was incorporated to support cancer diagnosis.

The list was also expanded to include additional general tests which address a range of different diseases and conditions, such as iron tests (for anaemia), and tests to diagnose thyroid malfunction and sickle cell. Another notable update is a new section specific to tests intended for screening of blood donations.

The updated Essential Medicines List adds 28 medicines for adults and 23 for children and specifies new uses for 26 already-listed products, bringing the total to 460 products deemed essential for addressing key public health needs.

The updated List of Essential Diagnostics contains 46 general tests that can be used for routine patient care as well as for the detection and diagnosis of a wide array of disease conditions, and 69 tests intended for the detection, diagnosis and monitoring of specific diseases.

Both WHO lists are models for countries to develop their own national lists. National lists based on local disease burden and existing healthcare delivery infrastructure provide an excellent framework from which countries can plan and implement the laboratory services and the medicines they need. Access to these health products requires good procurement practices, effective supply chains, quality management protocols and qualified health care workforces, the statement said.

https://apps.who.int/iris/bitstream/handle/10665/325771/WHO-MVP-EMP-IAU-2019.06-eng.pdf?sequence=1&isAllowed=y

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