The World Health Organization (WHO) has updated its Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc), significantly enhancing access to vital treatments for cancer and diabetes. This revision, which marks the 24th edition of the EML and the 10th edition of the EMLc, includes new therapies for various types of cancer and diabetes, along with other conditions such as cystic fibrosis and haemophilia.
The updated lists now feature a total of 523 essential medicines for adults and 374 for children. These lists serve as critical tools for public sector procurement, health insurance, and reimbursement schemes in over 150 countries. “The new editions of essential medicines lists mark a significant step toward expanding access to new medicines with proven clinical benefits and high potential for global public health impact,” stated Dr. Yukiko Nakatani, Assistant Director-General for Health Systems, Access and Data.
Cancer Treatments Address Global Health Crisis
Cancer remains a pressing global health issue, being the second leading cause of death worldwide, responsible for nearly 10 million fatalities annually. In response, the WHO Expert Committee on the Selection and Use of Essential Medicines reviewed 59 applications, ultimately adding 20 new medicines to the EML. Among these are advanced cancer therapies that have undergone rigorous evaluation to ensure they prolong life significantly.
One notable addition is pembrolizumab, a PD-1 immune checkpoint inhibitor now recommended as a first-line monotherapy for metastatic cervical cancer, metastatic colorectal cancer, and metastatic non-small cell lung cancer. The committee also included alternative therapies, atezolizumab and cemiplimab, enhancing treatment options for patients. These updates align with a broader initiative to address inequities in cancer care and improve access to effective treatments, particularly in resource-limited settings.
The committee emphasized that while comprehensive health system reforms may take time, immediate clinical strategies can be implemented to deliver benefits quickly. This includes dose optimization approaches that can enhance access to life-saving treatments.
New Diabetes Treatments Offer Hope
In addressing the urgent health challenges posed by diabetes and obesity, the WHO’s updated lists include glucagon-like peptide-1 (GLP-1) receptor agonists. These medicines have shown strong evidence of effectiveness in managing type 2 diabetes, particularly for patients with concurrent cardiovascular or kidney diseases. In 2022, more than 800 million people were living with diabetes, with approximately half remaining untreated, highlighting the critical need for improved access to effective therapies.
The GLP-1 receptor agonists, including semaglutide, dulaglutide, and liraglutide, are now part of the EML, providing clear guidance on their use for adults with type 2 diabetes and obesity (defined as a body mass index of ≥ 30 kg/m²). These therapies not only aid in better blood sugar control but also significantly reduce the risk of serious complications related to diabetes.
Despite their proven benefits, the high cost of medications like semaglutide and tirzepatide poses a barrier to access. The WHO aims to address these challenges by promoting generic competition, encouraging the availability of these medicines in primary care settings, and focusing on underserved populations.
The WHO will continue to monitor developments surrounding essential medicines, advocating for fair pricing strategies and supporting countries in enhancing access to these critical treatments. “A large share of out-of-pocket spending on noncommunicable diseases goes toward medicines, including those classified as essential and that, in principle, should be financially accessible to everyone,” stated Deusdedit Mubangizi, WHO Director of Policy and Standards for Medicines and Health Products. The path toward equitable access requires a cohesive health system response backed by strong political will and coordinated efforts across multiple sectors.
The complete details of the Expert Committee’s recommendations, including the additions, changes, and removals of medicines, are available in the official Executive Summary issued by the WHO.
