In light of the upcoming Lancet Commission on Accelerating Progress on Essential Medicines, I would like to draw your attention to our research on the time to inclusion of selected medicines for priority diseases in National Essential Medicines Lists (NEMLs) compared with the WHO Model List.
Our findings provide a historical perspective on the evolution of NEMLs and how the WHO Model List is used by countries.
We show that while the WHO Model List is a guiding tool for selecting medicines in low- and middle-income countries (LMICs), it is applied different between priority diseases. Specifically, medicines for NCDs (in this case diabetes and oncology) were included less in NEMLs in LMICs than medicines for communicable diseases (in this case hepatitis C, HIV and tuberculosis).
Moreover, high-income countries (using reimbursement lists as an alternative to NEMLs) did not wait for WHO recommendations on the selection of medicines, as medicines were included prior to their addition to the WHO Model List. Finally, in the most recent national lists, high-income countries included the most medicines for diabetes and oncology.
Despite still being considered high-income conditions, NCDs impose a large and growing health burden on LMICs, which is why it is especially concerning that fewer medicines for NCDs were included in NEMLs in these countries. Delays in the inclusion of medicines in NEMLs (as seen for oncology medicines) increase waiting times, which impacts the health of patients especially when there are no alternative treatments available.
Please refer to the article for more detailed information about our study, for example our findings on medicines deleted from the WHO Model List.