The document discusses the WHO concept of essential medicines, which aims to improve healthcare by selecting a limited range of carefully chosen medicines that satisfy the priority health needs of populations. The essential medicines list seeks to promote availability and affordability of quality medicines. It has led to better health outcomes, management of medicines, and lower costs. The list is revised every two years based on disease prevalence, treatment needs, and other factors to include around 350 drugs across core and complementary lists.

1. WHO concept of essential
medicines
Dr. Gyanendra Raj Joshi
PharmD, RPh

2. Rational behind Essential Medicine
List
• Indiscriminate marketing of drugs without
considering the health needs
• Access of people living in rural areas to drugs
• For poor and disadvantaged medicines are :
– Unavailable
– Unaffordable
– Unsafe
– Improperly used

3. • The concept of essential medicines
A limited range of carefully selected essential
medicines leads to better health care, better
drug management, and lower costs.
• Definition of essential medicines
Essential medicines are those that satisfy the
priority health care needs of the population.

4. • 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.

5. Advantages
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•
•
•
•
•
Limited range
High Quality care
Better management of medicines
More cost effective use of resources
Real health gains
Increased public confidence

6. • 1977 First Model list published, ± 200 active
substances
• List is revised every two years by WHO Expert
Committee
• Latest list in March 2011 (17th edition)
containing 350 drugs
• 3rd WHO Model List of Essential Medicines for
Children

7. • 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.
• The complementary list presents essential
medicines for priority diseases, for which
specialized diagnostic or monitoring facilities,
and/or specialist medical care, and/or specialist
training are needed.

8. Selection of essential medicines
• Two steps:
– Market approval based on efficacy , safety and
quality.
– Evaluation based on comparison leading to a list
for different levels of care.

9. • Factors such as
– Pattern of prevalent disease,
– Treatment facility,
– Training and experience of available personnel,
– Financial resources
– Genetic , demographic and environmental factors.

10. Selection Criteria
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Evidence of efficacy and safety
Relative cost effectiveness
Pharmacokinetics
Availability
Desired dosage form, bioavailability and
stability ensured
• Single compounds , in some cases fixed dose
combinations

12. The Essential Medicines Target
National list of
essential medicines
Registered medicines
All the drugs
in the world
Levels of use
S
CHW
dispensary
Health center
Hospital
Referral hospital
Private sector
S
Supplementary
specialist
medicines

13. Clinical guidelines and a list of essential
medicines lead to better prevention and
care
List of common diseases and complaints
Treatment choice
Treatment guidelines
Essential medicines list
/ National formulary
Training and
Supervision
Financing and
Supply of drugs
Prevention
and care

14. Practical applications
• Basic and in service training of health care
providers
• Public sector procurement and distribution
• Medicine benefits as part of health insurance
• Drug donations and international aid
• Monitoring systems on availability and pricing
• Public education

15. Key policy issues
• Access depending on : rational selection,
affordable prices , sustainable financing and
reliable health systems
• Selection linked to standard clinical guidelines
• Policies for procurement and supply and
health insurance
• Systematic and transparent procedure