The World Health Organization (WHO) has announced significant updates to its Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc). Released on March 15, 2024, the new editions include vital treatments for various cancers and diabetes, along with associated conditions like obesity. This revision represents the 24th edition of the WHO EML and the 10th edition of the EMLc, reflecting the ongoing commitment to prioritize health needs around the globe.
Dr. Yukiko Nakatani, Assistant Director-General for Health Systems, Access and Data, stated, “The new editions of essential medicines lists mark a significant step toward expanding access to new medicines with proven clinical benefits and with high potential for global public health impact.” The WHO model lists serve as a foundation for public sector procurement and health insurance schemes in over 150 countries.
Among the new additions, the updated lists now feature treatments for cystic fibrosis, psoriasis, haemophilia, and various blood-related disorders. The WHO Expert Committee on the Selection and Use of Essential Medicines evaluated 59 applications, resulting in the inclusion of 20 new medicines in the EML and 15 in the EMLc. The revised EML now comprises a total of 523 essential medicines for adults and 374 for children, responding to pressing public health challenges.
Cancer Treatments Targeted for Global Health Impact
Cancer, currently the second leading cause of death worldwide, claims nearly 10 million lives annually. The WHO has focused on cancer treatments, recognizing that they account for about half of all new drug approvals by regulatory agencies. During this review, the Committee assessed seven applications involving 25 cancer medicines. Only those therapies that demonstrate significant clinical benefits were recommended for inclusion.
Notably, the immune checkpoint inhibitor pembrolizumab has been added as a first-line treatment for metastatic cervical cancer, metastatic colorectal cancer, and metastatic non-small cell lung cancer. Additionally, atezolizumab and cemiplimab have been included as alternative therapeutic options. The Committee emphasized the need for broader access to these innovative treatments, particularly PD-1/PD-L1 inhibitors, which enhance the immune system’s ability to combat cancer cells.
The Committee also highlighted strategies from cancer experts aimed at improving access and affordability. They support evidence-based clinical and health system strategies, including optimizing dosages to enhance availability. While systemic reforms may take time, immediate clinical strategies can be implemented to yield quicker benefits, especially in resource-limited settings.
Addressing Diabetes and Obesity as Urgent Health Issues
Diabetes and obesity have emerged as critical global health challenges. In 2022, over 800 million people were living with diabetes, with approximately half of them untreated. Furthermore, more than 1 billion individuals worldwide are affected by obesity, with rates rising rapidly, particularly in low- and middle-income countries. These intertwined conditions can lead to severe health complications, including cardiovascular disease and kidney failure.
The WHO Expert Committee reviewed substantial scientific evidence regarding glucagon-like peptide-1 (GLP-1) receptor agonists, which have shown efficacy in managing type 2 diabetes, especially in patients with comorbid heart or kidney disease. Semaglutide, dulaglutide, liraglutide, and the GLP-1/glucose-dependent insulinotropic polypeptide (GIP) dual receptor agonist tirzepatide have been added to the EML. These medicines are particularly recommended for adults with type 2 diabetes and established cardiovascular disease or chronic kidney disease, alongside obesity.
The high costs of these medications pose significant barriers to access. The WHO advocates for prioritizing patients who would benefit most from these therapies, encouraging generic competition to lower prices, and ensuring availability in primary care settings, especially for underserved populations. Deusdedit Mubangizi, WHO Director of Policy and Standards for Medicines and Health Products, emphasized the importance of equitable access, stating, “Achieving equitable access to essential medicines requires a coherent health system response backed by strong political will, multisectoral cooperation, and people-centred programmes that leave no one behind.”
The updated lists and recommendations provide a framework for countries to improve access to these life-saving treatments. Detailed information on the additions, changes, and recommendations is available in the WHO Executive Summary.
