E-drug: WHA 2001-Essential Drugs List
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Dear e-druggers,
Please see below the recommendations of Medecins Sans Frontieres
for the upcoming meeting of the Executive Committee for the World
Health Assembly. MSF will be focusing on advocating for improvements
to the Essential Drugs List to include newer medicines, many of which
are
very expensive. MSF believes the EDL should reinforce the idea that
drugs medically essential for the rich are also essential for the
poor.
If you support this action and your country is on the Executive
Committee (the list of 32 countries can be found at
http://www.who.int/executive_board/members/index.en.html) please
feel free to forward this document to your Ministry of Health or
other delegates involved in the WHA.
Thanks and best wishes,
Suerie Moon
MSF Access to Essential Medicines Campaign
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Issues for the 107th WHO Executive Board 2001
Proposals by M�decins Sans Fronti�res with regard to the WHO
essential drug policy to increase access to essential drugs.
The WHO Model List of Essential Drugs (EDL) has been one of the most
important public health instruments of the last two decades to
increase access to needed medicines and promote their rational
selection and use. Essential Drugs are "those that satisfy the health
care needs of the majority of the population; they should therefore
be available at all times in adequate amounts and in the appropriate
dosage form". The first EDL was published in 1977 and the list has
since then been regularly revised and updated.
The EDL is still an important public health tool. The list suggests a
limited number of drugs with a good benefit/risk ratio. As
affordability is a criteria for inclusion on the EDL, most drugs are
off-patent and in most cases multiple generic sources are available.
The need to increase access to medicines including new medicines has
been reaffirmed by a series of WHA resolutions. The most recent are:
HIV/AIDS: confronting the epidemic WHA53.14 in May 2000 and the
Revised Drug Strategy WHA 52.19 in 1999.
In view of (1) epidemiological changes, in particular the AIDS
epidemic and increasing resistance to the most basic treatments to
combat infectious diseases, and (2) the way medicines are traded in a
globalised world, there is an urgent need to reinforce the basic
concept of the EDL - which is as a medical tool. It is vital that the
different criteria for inclusion in the EDL are clarified and
prioritised, and that new medicines of medical importance are
included in the list, even when the originator's brand products are
costly.
MSF held a meeting with international experts, including the WHO,
entitled 'Translating the Essential Drug Concept in the 2000's
Context' in Geneva, 19 September 2000.The meeting discussed the need
for reinforcing and expanding the EDL. Participants agreed that
drugs medically essential for the rich are also essential for the
poor and proposed the following two-part EDL.
The core list would include well-documented drugs with a good
benefit/risk ratio that are affordable and linked to guidelines that
are updated, reliable and relevant to the developing world.
A second part would list drugs with a good benefit/risk ratio, but
that are very expensive, difficult to use, or lacking adequate
evidence of field efficacy and therefore require operational
research. This second part will also list medical areas where new
drugs are needed, i.e. "missing" drugs.
The second part would help public health institutes, donors,
politicians, and other actors to prioritise policy agendas.
Furthermore, the drugs on the second part would have priority to move
onto the core list. The meeting agreed that the UN, in particular the
WHO, should be responsible for ensuring that steps are taken to
resolve the issues that have confined the drugs to the second part of
the list.
MSF proposes that the 54th World Health Assembly supports the WHO's
efforts to update the EDL concept and to expand the EDL with a second
part that contains expensive products but are nevertheless essential
to treat current diseases. To help Member States and others involved
in drug procurement and policy, this second list should be accompanied
with information about prices and possible providers and patent status
in the different Member States. The sources need to be validated for
assured quality by WHO in collaboration with other relevant UN
agencies such as UNICEF. This information will help Member States to
identify the most appropriate providers. The Member States
acknowledged the need for greater price transparency last year at the
53rd WHA (See resolution: HIV/AIDS: confronting the epidemic
WHA53.14.) Finally, the WHO should take a strong leading role in
overcoming barriers that may result from intellectual property
protection by assisting countries and regions to develop and
implement laws and regulations that will help overcome pricing issues.
The Executive Board could help to make this happen by proposing to the
World Health Assembly to support the following actions by WHO:
- to strengthen the WHO Model List of Essential Drugs with a listing
of essential medicines not yet included because of price or cost
consideration, but that are therapeutically needed;
- to provide information on prices of these products in a price
database which will enable Member States to identify affordable
sources of quality essential medicines;
- to collaborate with WIPO to include in the price database
information about patent status in the Member States of new essential
drugs;
- to provide Member States with model laws and regulations on
compulsory licensing and other legal measures to overcome barriers
to access to expensive medications;
- to encourage operational research to identify and simplify the best
available treatments and to promote the rational use of drugs;
- to define a need driven research and development agenda to assist
policy makers, funding agencies and the research community in
setting the right priorities in addressing the needs of developing
countries with regards to pharmacotherapy;
- to actively pursue strategies to encourage a global policy for
equity pricing of essential medicines in developing countries.
Paris, 05/01/01
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Suerie Moon
Access to Essential Medicines Campaign
M�decins Sans Fronti�res (MSF)
rue du Lac 12
CP 6090
1207 Geneva
Switzerland
tel: +41 (22) 849 84 01
fax: +41 (22) 849 84 04
access-com@geneva.msf.org
www.accessmed.msf.org
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