WHO Model List of Essential Medicines

The WHO Model List of Essential Medicines (aka Essential Medicines List or EML[1]), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health system.[2] The list is frequently used by countries to help develop their own local lists of essential medicines.[2] As of 2016, more than 155 countries have created national lists of essential medicines based on the World Health Organization's model list.[1] This includes both developed and developing countries.[2][3]

The list is divided into core items and complementary items.[4] The core items are deemed to be the most cost-effective options for key health problems and are usable with little additional health care resources.[4] The complementary items either require additional infrastructure such as specially trained health care providers or diagnostic equipment or have a lower cost–benefit ratio.[4] About 25% of items are in the complementary list.[5] Some medications are listed as both core and complementary.[6] While most medications on the list are available as generic products, being under patent does not preclude inclusion.[7]

The first list was published in 1977 and included 208 medications.[8][2][9] The WHO updates the list every two years.[10] There are 306 medications in the 14th list in 2005,[11] 410 in the 19th list in 2015,[10] 433 in the 20th list in 2017,[12][13] 460 in the 21st list in 2019,[14][15][16] and 479 in the 22nd list in 2021.[17][18] Various national lists contain between 334 and 580 medications.[5][19] The Essential Medicines List (EML) was updated in July 2023 to its 23rd edition. This list contains 1200 recommendations for 591 drugs and 103 therapeutic equivalents.[20]

A separate list for children up to 12 years of age, known as the WHO Model List of Essential Medicines for Children (EMLc), was created in 2007 and is in its 9th edition.[10][21][22][23] It was created to make sure that the needs of children were systematically considered such as availability of proper formulations.[24][25] Everything in the children's list is also included in the main list.[26] The list and notes are based on the 19th to 23rd edition of the main list.[4][12][14][17][27] Therapeutic alternatives with similar clinical performance are listed for some medicines and they may be considered for national essential medicines lists.[17][18] The 9th Essential Medicines List for Children was updated in July 2023.[23][28]

Note: An α indicates a medicine is on the complementary list.[4][14][17]

Anaesthetics, preoperative medicines and medical gases

General anaesthetics and oxygen

Inhalational medicines

Injectable medicines

Local anaesthetics

Complementary:

Preoperative medication and sedation for short-term procedures

Medical gases

Medicines for pain and palliative care

Non-opioids and non-steroidal anti-inflammatory medicines (NSAIMs)

A skeletal model of the chemical structure of aspirin

Opioid analgesics

Complementary:

Medicines for other common symptoms in palliative care

Antiallergics and medicines used in anaphylaxis

Antidotes and other substances used in poisonings

Non-specific

Specific

Complementary:

Medicines for diseases of the nervous system

Antiseizure medicines

Complementary:

Medicines for multiple sclerosis

Complementary:

Medicines for parkinsonism

Anti-infective medicines

Anthelminthics

Intestinal anthelminthics

A skeletal model of the chemical structure of albendazole

Antifilarials

Antischistosomals and other antinematode medicines

Complementary:

Cysticidal medicines

Complementary:

Antibacterials

Access group antibiotics

Watch group antibiotics

Complementary:

Reserve group antibiotics

Reserve antibiotics are last-resort antibiotics. The EML antibiotic book was published in 2022.[29][30][31]

Complementary:

Antileprosy medicines

Antituberculosis medicines

Pure crystals of ethambutol

Complementary:

Antifungal medicines

Complementary:

Antiviral medicines

Antiherpes medicines

Antiretrovirals

Nucleoside/nucleotide reverse transcriptase inhibitors
Non-nucleoside reverse transcriptase inhibitors
Protease inhibitors
Two capsules of atazanavir
Integrase inhibitors
Fixed-dose combinations of antiretroviral medicines
Medicines for prevention of HIV-related opportunistic infections
Other antivirals

Complementary:

Antihepatitis medicines

Medicines for hepatitis B
Nucleoside/Nucleotide reverse transcriptase inhibitors
Medicines for hepatitis C
Pangenotypic direct-acting antiviral combinations
Non-pangenotypic direct-acting antiviral combinations
Other antivirals for hepatitis C

Antiprotozoal medicines

Antiamoebic and antigiardiasis medicines

Antileishmaniasis medicines

Antimalarial medicines

For curative treatment
For chemoprevention

Antipneumocystosis and antitoxoplasmosis medicines

Complementary:

Antitrypanosomal medicines

African trypanosomiasis
Medicines for the treatment of 1st stage African trypanosomiasis
Medicines for the treatment of 2nd stage African trypanosomiasis

Complementary:

American trypanosomiasis

Medicines for ectoparasitic infections

Medicines for Ebola virus disease

Medicines for COVID-19

No listings in this section.

Antimigraine medicines

For treatment of acute attack

For prophylaxis

Immunomodulators and antineoplastics

Immunomodulators for non-malignant disease

Complementary:

Antineoplastics and supportive medicines

Cytotoxic medicines

Complementary:

Targeted therapies

Complementary:

Immunomodulators

Complementary:

Hormones and antihormones

Complementary:

Supportive medicines

Complementary:

Therapeutic foods

Medicines affecting the blood

Antianaemia medicines

Complementary:

Medicines affecting coagulation

Complementary:

Other medicines for haemoglobinopathies

Complementary:

Blood products of human origin and plasma substitutes

Blood and blood components

Bag containing one unit of fresh frozen plasma

Plasma-derived medicines

Human immunoglobulins

Complementary:

Blood coagulation factors

Complementary:

Plasma substitutes

Cardiovascular medicines

Antianginal medicines

Antiarrhythmic medicines

Complementary:

Antihypertensive medicines

Complementary:

Medicines used in heart failure

Complementary:

Antithrombotic medicines

Anti-platelet medicines

Thrombolytic medicines

Complementary:

Lipid-lowering agents

Fixed-dose combinations for prevention of atherosclerotic cardiovascular disease

Dermatological medicines (topical)

Antifungal medicines

Anti-infective medicines

Anti-inflammatory and antipruritic medicines

Medicines affecting skin differentiation and proliferation

Complementary:

Scabicides and pediculicides

Diagnostic agents

Ophthalmic medicines

Radiocontrast media

Complementary:

Antiseptics and disinfectants

Antiseptics

Disinfectants

Diuretics

Complementary:

Gastrointestinal medicines

Complementary:

Antiulcer medicines

Antiemetic medicines

Complementary:

Anti-inflammatory medicines

Complementary:

Laxatives

Medicines used in diarrhoea

Oral rehydration

Medicines for diarrhoea

Medicines for endocrine disorders

Adrenal hormones and synthetic substitutes

Androgens

Complementary:

Estrogens

No listings in this section.

Progestogens

Medicines for diabetes

Insulins

Oral hypoglycaemic agents

Complementary:

Medicines for hypoglycaemia

Complementary:

Thyroid hormones and antithyroid medicines

Complementary:

Medicines for disorders of the pituitary hormone system

Complementary:

Immunologicals

Diagnostic agents

Sera, immunoglobulins and monoclonal antibodies

Vaccines

A vial of oral cholera vaccine

Recommendations for all

Recommendations for certain regions

Recommendations for some high-risk populations

Recommendations for immunization programmes with certain characteristics

Muscle relaxants (peripherally-acting) and cholinesterase inhibitors

Complementary:

Ophthalmological preparations

Anti-infective agents

Anti-inflammatory agents

Local anesthetics

Miotics and antiglaucoma medicines

Mydriatics

Complementary:

Anti-vascular endothelial growth factor (VEGF) preparations

Complementary:

Medicines for reproductive health and perinatal care

Contraceptives

Oral hormonal contraceptives

Injectable hormonal contraceptives

Intrauterine devices

Barrier methods

Implantable contraceptives

Intravaginal contraceptives

Ovulation inducers

Complementary:

Uterotonics

Antioxytocics (tocolytics)

Other medicines administered to the mother

Medicines administered to the neonate

Complementary:

Peritoneal dialysis solution

Complementary:

Medicines for mental and behavioural disorders

Medicines used in psychotic disorders

Complementary:

Medicines used in mood disorders

Medicines used in depressive disorders

Medicines used in bipolar disorders

Medicines for anxiety disorders

Medicines used for obsessive compulsive disorders

Medicines for disorders due to psychoactive substance use

Medicines for alcohol use disorders

Medicines for nicotine use disorders

Complementary:

Medicines acting on the respiratory tract

Antiasthmatic medicines and medicines for chronic obstructive pulmonary disease

Solutions correcting water, electrolyte and acid-base disturbances

Oral

Parenteral

Miscellaneous

Vitamins and minerals

Complementary:

Ear, nose and throat medicines

Medicines for diseases of joints

Medicines used to treat gout

Disease-modifying anti-rheumatic drugs (DMARDs)

Complementary:

Medicines for juvenile joint diseases

Complementary:

Dental medicines and preparations

Notes

An α indicates the medicine is on the complementary list for which specialized diagnostic or monitoring or training is needed. An item may also be listed as complementary on the basis of higher costs or a less attractive cost-benefit ratio.[4][14]

References

Further reading

External links