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WHO Model List of Essential Medicines
2017 marked the 40th anniversary of the WHO Model List of Essential Medicines.
The WHO Model List of Essential Medicines (EML), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health system. The list is frequently used by countries to help develop their own local lists of essential medicine. As of 2016, more than 155 countries have created national lists of essential medicines based on the World Health Organization's model list. This includes countries in both the developed and developing world.
The list is divided into core items and complementary items. The core items are deemed to be the most cost effective options for key health problems and are usable with little additional health care resources. The complementary items either require additional infrastructure such as specially trained health care providers or diagnostic equipment or have a lower cost-benefit ratio. About 25% of items are in the complementary list. Some medications are listed as both core and complementary. While most medications on the list are available as generic products, being under patent does not preclude inclusion.
The first list was published in 1977 and included 212 medications. The WHO updates the list every two years. The 14th list was published in 2005 and contained 306 medications. In 2015 the 19th edition of the list was published and contains around 410 medications. The 20th edition was published in 2017 and comprises 433 drugs. The national lists contain between 334 and 580 medications.
A separate list for children up to 12 years of age, known as the WHO Model List of Essential Medicines for Children (EMLc), was created in 2007 and is in its 6th edition. It was created to make sure that the needs of children were systematically considered such as availability of proper formulations. Everything in the children's list is also included in the main list. The list and notes are based on the 19th and 20th edition of the main list. An α indicates a medicine is only on the complementary list.
An α indicates the medicine is only on the complementary list. For these items specialized diagnostic or monitoring or specialist training are needed. An item may also be listed as complementary on the basis of higher costs or a less attractive cost-benefit ratio.
^Thiopental may be used as an alternative depending on local availability and cost.
^Not recommended for anti‐inflammatory use due to lack of proven benefit to that effect
^Alternatives limited to hydromorphone and oxycodone
^There may be a role for sedating antihistamines for limited indications (EMLc).
^For use in eclampsia and severe pre‐eclampsia and not for other convulsant disorders
^Only listed for single‐dose treatment of uncomplicated ano‐genital gonorrhoea
^Third-generation cephalosporin of choice for use in hospitalized neonates
^Do not administer with calcium and avoid in infants with hyperbilirubinemia.
^Procaine benzylpenicillin is not recommended as first-line treatment for neonatal sepsis except in settings with high neonatal mortality, when given by trained health workers in cases where hospital care is not achievable.
^Only listed for the treatment of life‐threatening hospital‐based infection due to suspected or proven multidrug‐resistant infection
^Hydralazine is listed for use in the acute management of severe pregnancy‐induced hypertension only. Its use in the treatment of essential hypertension is not recommended in view of the availability of more evidence of efficacy and safety of other medicines.
^Methyldopa is listed for use in the management of pregnancy‐induced hypertension only. Its use in the treatment of essential hypertension is not recommended in view of the availability of more evidence of efficacy and safety of other medicines.
^Wirtz, VJ; Hogerzeil, HV; Gray, AL; Bigdeli, M; de Joncheere, CP; et al. (28 January 2017). "Essential medicines for universal health coverage". The Lancet. 389 (10067): 403–476. doi:10.1016/S0140-6736(16)31599-9. PMID27832874.