The World Health Organization (WHO) has released updated editions of its Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc), adding new treatments for various types of cancer and for diabetes with associated comorbidities such as obesity. Medicines for cystic fibrosis, psoriasis, haemophilia and blood-related disorders are among the other additions.
WHO EML and EMLc include medicines for priority health needs of populations. They are adopted in over 150 countries, serving as a basis for public sector procurement, supply of medicines and health insurance, reimbursement schemes. The revisions mark the 24th edition of WHO EML and 10th edition of EMLc.
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“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,” said Dr Yukiko Nakatani, Assistant Director-General for Health Systems, Access and Data.
Launched in 1977 largely to promote better access to medicines in developing countries, the WHO Model Lists have become a trusted global policy tool for decisions related to the selection and universal coverage of medicines within all health systems.
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The WHO Expert Committee on the Selection and Use of Essential Medicines reviewed 59 applications, including 31 proposals for the addition of new medicines or medicine classes. As a result, 20 new medicines were added to the EML and 15 to the EMLc, along with new use indications for seven already-listed products. The updated lists now include a total of 523 essential medicines for adults and 374 for children, reflecting the most pressing public health needs.
Cancer medicines
Cancer is the second leading cause of death globally, claiming nearly 10 million lives each year and responsible for almost one in three premature deaths from noncommunicable diseases. Cancer treatments have been a major focus of the WHO EML for the past decade. With cancer medicines accounting today for about half of all new drug approvals by regulatory agencies, the Expert Committee applies rigorous criteria to recommend only those therapies that offer the greatest clinical benefit. As a result, few approved cancer medicines are included – only those proven to prolong life by at least 4-6 months.
Seven applications encompassing 25 cancer medicines were evaluated. As part of broader efforts to reduce inequities in cancer care, the Committee recommended increasing access to PD-1/PD-L1 immune checkpoint inhibitors, a class of immunotherapy medicines that help the body’s immune system recognize and attack cancer cells more effectively. Pembrolizumab was added to the EML as a first-line monotherapy for metastatic cervical cancer, metastatic colorectal cancer, and metastatic non-small cell lung cancer. For the latter, atezolizumab and cemiplimab are included as therapeutic alternatives.
The Committee also considered several expert-recommended strategies – highlighted in the cancer experts report – aimed at improving access to and affordability of cancer treatments. It endorsed evidence-based clinical and health system strategies, including dose optimisation approaches, to improve access. The Committee emphasized that while health system reforms require time and government action, clinical strategies can be implemented immediately to deliver faster benefits, especially in resource-limited settings.
Medicines for diabetes and obesity
Diabetes and obesity are two of the most urgent health challenges facing the world today. Over 800 million people were living with diabetes in 2022, with half going untreated. At the same time, more than 1 billion people worldwide are affected by obesity, and rates are rising especially fast in low- and middle-income countries. These two conditions are closely linked and can lead to serious health problems, including heart disease and kidney failure.
The WHO Expert Committee reviewed strong scientific evidence showing that a group of medicines called glucagon-like peptide-1 (GLP-1) receptor agonists can help people with type 2 diabetes – especially those who also have heart or kidney disease – by improving blood sugar control, reducing the risk of heart and kidney complications, supporting weight loss, and even lowering the risk of early death.
GLP-1 receptor agonists – semaglutide, dulaglutide and liraglutide – and the GLP-1/glucose-dependent insulinotropic polypeptide (GIP) dual receptor agonist (tirzepatide) have been added to the EML. They are used as glucose lowering therapy for adults with type 2 diabetes mellitus with established cardiovascular disease or chronic kidney disease and obesity (defined as body mass index (BMI) ≥ 30kg/m2). This provides clear guidance to countries on which patients can benefit most from these therapies.
High prices of medicines like semaglutide and tirzepatide are limiting access to these medicines. Prioritizing those who would benefit most, encouraging generic competition to drive down prices and making these treatments available in primary care – especially in underserved areas – are key to expanding access and improving health outcomes. WHO will continue monitoring developments, support fair pricing strategies, and help countries improve access to these life-changing 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,” said Deusdedit Mubangizi, WHO Director of Policy and Standards for Medicines and Health Products. “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.”
