E-drug: 25 years of the WHO essential medicines lists
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25 years of the WHO essential medicines lists: progress and
challenges
Richard Laing, Brenda Waning, Andy Gray, Nathan Ford, Ellen 't
Hoen. Lancet 361: 1723-29 (17 May 2003)
The first WHO essential drugs list, published in 1977, was described
as a peaceful revolution in international public health. The list helped
to establish the principle that some medicines were more useful than
others and that essential medicines were often inaccessible to many
populations. Since then, the essential medicines list (EML) has
increased in size; defining an essential medicine has moved from an
experience to an evidence-based process, including criteria such as
public-health relevance, efficacy, safety, and cost-effectiveness. High
priced medicines such as antiretrovirals are now included.
Differences exist between the WHO model EML and national EMLs
since countries face varying challenges relating to costs, drug
effectiveness, morbidity patterns, and rationality of prescribing.
Ensuring equitable access to and rational use of essential medicines
has been promoted through WHO's revised drug strategy. This
approach has required an engagement by WHO on issues such as
the effect of international trade agreements on access to essential
medicines and research and development to ensure availability of
new essential medicines.
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