WHO Updates Essential Medicines Lists
Today, the World Health Organization (WHO) announced revisions to its Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc), introducing new treatments for various cancers and diabetes, particularly for those with risks like obesity. The updates also encompass medications for cystic fibrosis, psoriasis, hemophilia, and several blood disorders.
The EML and EMLc serve as crucial resources for addressing major health needs across populations. They’re now used in more than 150 countries, guiding public sector procurement, medicine supply, and health insurance frameworks. This marks the 24th edition of the WHO EML and the 10th for the EMLc.
According to Dr. Yukiko Nakatani, Assistant Director-General for Health Systems, Access, and Data, “The new versions of essential medicines lists represent a meaningful advance in enhancing access to innovative therapies that have demonstrated clinical benefits and significant potential for global health improvement.”
Since their launch in 1977, primarily to improve medicine accessibility in developing nations, the WHO Model Lists have evolved into a reliable global policy instrument for decisions regarding medicine selection and universal access within health systems.
The WHO Expert Committee evaluated 59 applications, including 31 requests to add new medicines or classes. Consequently, 20 new medicines were included in the EML and 15 in the EMLc, along with updates to indications for seven existing medicines. The updated lists now feature a total of 523 essential medicines for adults and 374 for children, targeted at the most urgent public health challenges.
Cancer Treatments
Cancer is currently the second leading cause of death worldwide, resulting in nearly 10 million fatalities annually, accounting for nearly one-third of premature deaths linked to noncommunicable diseases. The listing of cancer treatments has been a priority for the WHO EML over the last decade. Given that cancer therapies represent nearly half of all new drug approvals, the Expert Committee applies stringent criteria to recommend only those that notably extend life—by at least four to six months.
The Committee evaluated seven applications related to 25 cancer medicines. In a bid to mitigate disparities in cancer treatment, it suggested increasing access to PD-1/PD-L1 immune checkpoint inhibitors, which help the immune system better identify and attack cancer cells. Pembrolizumab has been approved for use as a first-line treatment for metastatic cervical cancer, metastatic colorectal cancer, and non-small cell lung cancer, with atezolizumab and cemiplimab offered as alternatives.
Strategies from cancer experts aimed at boosting access and affordability of treatments were also considered, detailed in the cancer experts report. Evidence-based clinical strategies, including dosage optimization, received endorsement from the Committee. While health reforms take time and government involvement, many clinical approaches can be rolled out quickly for immediate benefits, particularly in regions with limited resources.
Diabetes and Obesity Medications
Diabetes and obesity rank among the most pressing health challenges globally. In 2022, over 800 million individuals had diabetes, with approximately half lacking treatment. Concurrently, more than a billion people worldwide are grappling with obesity, and the incident rates are escalating, particularly in lower-income regions. These interconnected issues can precipitate serious health complications, such as heart disease and kidney failure.
Strong scientific evidence has led the WHO Expert Committee to endorse a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists for individuals with type 2 diabetes, especially those facing heart or kidney issues. These medicines not only improve blood sugar control but also lower the risks of associated complications and promote weight loss.
GLP-1 receptor agonists, including semaglutide, dulaglutide, and liraglutide, along with the GLP-1/GIP dual receptor agonist tirzepatide, are now included in the EML. These treatments are targeted at adults with type 2 diabetes who also have cardiovascular or chronic kidney conditions and a body mass index (BMI) of 30kg/m² or higher. This clarity aids countries in identifying who might benefit most from these therapies.
However, high costs for medicines like semaglutide and tirzepatide hinder access. Key measures advocated include prioritizing individuals who stand to gain the most, fostering generic competition to lower prices, and ensuring these treatments are accessible in primary care, particularly in underserved areas. The WHO remains committed to tracking developments, advocating for fair pricing, and supporting countries in enhancing access to these vital treatments.
In the words of Deusdedit Mubangizi, WHO Director of Policy and Standards for Medicines and Health Products, “A significant portion of out-of-pocket expenditures for noncommunicable diseases is directed toward medicines that should, theoretically, be available to everyone.” Achieving fair access to essential medicines requires a cohesive health system response, robust political engagement, and community-focused initiatives that ensure no one is left behind.
For further insights into the recommendations from the Expert Committee, detailing the additions, changes, and removals of medicines, please see the Executive Summary.
Note: The 25th WHO Expert Committee on the Selection and Use of Essential Medicines convened from May 5 to May 9, 2025, at WHO Headquarters in Geneva, Switzerland. The Committee evaluated 59 applications, scrutinizing the scientific validity of each medicine’s safety and efficacy relative to cost for informed recommendations. They also reviewed proposals concerning the AWaRe classification for antibiotics.
The Model Lists are updated biennially by an Expert Committee to address emerging health issues, highlight effective treatments, and enhance accessibility.
