Essential medicines, as defined by the World Health Organization (WHO) are "those drugs that satisfy the health care needs of the majority of the population; they should therefore be available at all times in adequate amounts and in appropriate dosage forms, at a price the community can afford."
The WHO has published a model list of essential medicines. Each country is encouraged to prepare their own lists taking into consideration local priorities. Over 150 countries have published an official essential medicines list. The essential medicines list enables health authorities, especially in developing countries, to optimize pharmaceutical resources. The WHO List contains a core list and a 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 many countries, both developed and developing (e.g. South Africa, Eritrea) and governments refer to WHO recommendations when making decisions on health spending.
Theory and practice
The original 1977 WHO definition of "essential medicines" was that they were 'of utmost importance, basic, indispensable, and necessary for the healthcare needs of the population'. The concept was mentioned in one of the ten points of the 1978 Alma Ata Declaration on primary health care.
The difficulty of putting this into practice is reflected in the rather longer and more categorical 2002 definition:
'Essential medicines are those that satisfy the priority health care needs of the population. They are selected with due regard to public health relevance, evidence on efficacy and safety, and comparative cost-effectiveness. Essential medicines are intended to be available within the context of functioning health systems at all times in adequate amounts, in the appropriate dosage forms, with assured quality and adequate information, and at a price the individual and the community can afford. The implementation of the concept of essential medicines is intended to be flexible and adaptable to many different situations; exactly which medicines are regarded as essential remains a national responsibility.'
The "WHO Model List of Essential Medicines" has been updated every two years since 1977. The current version, the 19th, was published in 2015. The fifth edition of "WHO Model List of Essential Medicines for Children", was also published in 2015.
Cost effectiveness is the subject of fierce debate between producers (pharmaceutical companies) and purchasers of drugs (national health services).
Number of medications
The number of medications has nearly doubled, from the original 208 in 1977 to more than 340. The range has increased over the years and now includes an antimigraine drug, antidotes, and antineoplastic drugs. The third list for children from 2011 contains 269 medications.
- Campaign for Access to Essential Medicines
- Universities Allied for Essential Medicines
- Department of Essential Drugs and Medicines
- List of World Health Organization Essential Medicines
- "The Selection and Use of Essential Medicines (ss 4.2)". Essential Medicines and Health Products Information Portal. WHO Technical Report Series. WHO. 2003. p. 132.
- "Action Programme on Essential Drugs" (pdf). Progress report by the Director - General. WHO. 26 Mar 1979. p. 1 point 2.
- "Trade, foreign policy, diplomacy and health". Essential Medicines. WHO. Dec 6, 2010.
- "19th WHO Model List of Essential Medicines (April 2015)" (PDF). WHO. April 2015. Retrieved 19 December 2015.
- "5th WHO Model List of Essential Medicines for Children (April 2015)" (PDF). WHO. April 2015. Retrieved 19 December 2015.
- "10 facts on essential medicines". February 2010. Retrieved 15 August 2015.
- Bansal, D; Purohit, VK (January 2013). "Accessibility and use of essential medicines in health care: Current progress and challenges in India.". Journal of pharmacology & pharmacotherapeutics. 4 (1): 13–8. doi:10.4103/0976-500X.107642. PMID 23662019.
- "WHO Model Lists of Essential Medicines". WHO. Retrieved 2014-07-21.
- "WHO Model List of Essential Medicines, 19th edition (April 2015)" (PDF). World Health Organization (WHO). August 2015. Retrieved 2016-03-10.
- "WHO Model List of Essential Medicines for Children, third edition (March 2011)" (PDF). World Health Organization (WHO). March 2011. Retrieved 2011-07-03.