The WHO Model List of Essential Medicines (aka Essential Medicines ListorEML[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[update], 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 providersordiagnostic 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[edit]
Anα 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]
^(For use in spinal anaesthesia during delivery, to prevent hypotension).
^No more than 30% oxygen should be used to initiate resuscitation of neonates less than or equal to 32 weeks of gestation.
^For use in eclampsia and severe pre‐eclampsia and not for other convulsant disorders.
^For buccal administration when solution for oromucosal administration is not available.
^The presence of both 25 mg/5 mL and 30 mg/5 mL strengths on the same market would cause confusion in prescribing and dispensing and should be avoided.
^ abcAvoid use in pregnancy and in women and girls of child-bearing potential, unless alternative treatments are ineffective or not tolerated because of the high risk of birth defects and developmental disorders in children exposed to valproate in the womb.
^Only for the presumptive treatment of epidemic meningitis in children older than two years and in adults.
^Alternatives are 4th level ATC chemical subgroup (J01CF Beta-lactamase resistant penicillins)
^cloxacillin, dicloxacillin and flucloxacillin are preferred for oral administration due to better bioavailability.
^Use in children <8 years only for life-threatening infections when no alternative exists.
^Procaine benzylpenicillin is not recommended as first-line treatment for neonatal sepsis except in settings with high neonatal mortality, when given by trained health workers in cases where hospital care is not achievable.
^Third-generation cephalosporin of choice for use in hospitalized neonates.
^Do not administer with calcium and avoid in infants with hyperbilirubinemia.
^Erythromycin is an alternative as second choice treatment for pharyngitis in children (EMLc only)
^For use in combination regimens for eradication of H. pylori in adults.
^Vancomycin powder for injection may also be used for oral administration
^Imipenem/cilastatin is an alternative for complicated intraabdominal infections and high-risk febrile neutropenia only, except for acute bacterial meningitis in neonates, where meropenem is preferred
^Liposomal amphotericin B has a better safety profile than the sodium deoxycholate formulation and should be prioritized for selection and use depending on local availability and cost.
^ abTo be used in combination with artesunate 50 mg.
^For the treatment of 1st and 2nd stage human African trypanosomiasis due to Trypanosoma brucei gambiense infection.
^To be used for the treatment of Trypanosoma brucei gambiense infection.
^To be used for the treatment of the initial phase of Trypanosoma brucei rhodesiense infection.
^To be used for the treatment of Trypanosoma brucei gambiense infection
^Only to be used in combination with eflornithine, for the treatment of Trypanosoma brucei gambiense infection.
^The presence of both 120 mg/5 mL and 125 mg/5mL strengths on the same market would cause confusion in prescribing and dispensing and should be avoided.
^Biscuit or paste of nutritional composition as determined by the UN joint statement on the community-based management of severe acute malnutrition and Codex alimentarius guidelines.
^periconceptual use for prevention of first occurrence of neural tube defects
^Alternatives are 4th level ATC chemical subgroup (C08CA Dihydropyridine derivatives)
^Includes atenolol, carvedilol, and metoprolol as alternatives. Atenolol should not be used as a first-line agent in uncomplicated hypertension in patients > 60 years.
^Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain)
^Hydralazine is listed for use only in the acute management of severe pregnancy-induced hypertension. Its use in the treatment of essential hypertension is not recommended in view of the evidence of greater efficacy and safety of other medicines.
^Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain) (for lisinopril) and 4th level ATC chemical subgroup (C08CA Dihydropyridine derivatives) (for amlodipine)
^Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain) (for lisinopril) and chlorthalidone, chlorothiazide, indapamide (for hydrochlorothiazide)
^ abAlternatives are 4th level ATC chemical subgroup (C09CA Angiotensin II receptor blockers (ARBs), plain)
^Methyldopa is listed for use only in the management of pregnancy-induced hypertension. Its use in the treatment of essential hypertension is not recommended in view of the evidence of greater efficacy and safety of other medicines.
^Alternatives are 4th level ATC chemical subgroup (C09CA Angiotensin II receptor blockers (ARBs), plain) (for telmisartan) and 4th level ATC chemical subgroup (C08CA Dihydropyridine derivatives) (for amlodipine)
^Alternatives are 4th level ATC chemical subgroup (C09CA Angiotensin II receptor blockers (ARBs), plain) (for telmisartan) and chlorthalidone, chlorothiazide, indapamide (for hydrochlorothiazide)
^Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain)
^World Health Organization (1977). The selection of essential drugs: report of a WHO expert committee [meeting held in Geneva from 17 to 21 October 1977]. Geneva: World Health Organization. hdl:10665/41272. ISBN92-4-120615-2. Technical report series; no. 615.
^ abc"WHO Model Lists of Essential Medicines". World Health Organization. The current versions are the 21st WHO Essential Medicines List (EML) and the 7th WHO Essential Medicines List for Children (EMLc) updated in June 2019.
^ abcdWorld Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.{{cite book}}: CS1 maint: location missing publisher (link)
^World Health Organization (2019). Executive summary: the selection and use of essential medicines 2019: report of the 22nd WHO Expert Committee on the selection and use of essential medicines. Geneva. hdl:10665/325773. WHO/MVP/EMP/IAU/2019.05. License: CC BY-NC-SA 3.0 IGO.{{cite book}}: CS1 maint: location missing publisher (link)
^ abcdWorld Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
^ abWorld Health Organization (2021). Executive summary: the selection and use of essential medicines 2021: report of the 23rd WHO Expert Committee on the selection and use of essential medicines: virtual meeting, 21 June–2 July 2021. Geneva: World Health Organization. hdl:10665/345554. WHO/MHP/HPS/EML/2021.01.
^World Health Organization (2021). The selection and use of essential medicines: report of the WHO Expert Committee on Selection and Use of Essential Medicines, 2021 (including the 22nd WHO model list of essential medicines and the 8th WHO model list of essential medicines for children). Geneva: World Health Organization. hdl:10665/351172. ISBN978-92-4-004114-1. WHO technical report series;1035. License: CC BY-NC-SA 3.0 IGO.
^World Health Organization (2019). World Health Organization model list of essential medicines for children: 7th list 2019. Geneva. hdl:10665/325772. WHO/MVP/EMP/IAU/2019.07. License: CC BY-NC-SA 3.0 IGO.{{cite book}}: CS1 maint: location missing publisher (link)
^World Health Organization (2021). World Health Organization model list of essential medicines for children: 8th list (2021). Geneva: World Health Organization. hdl:10665/345534. WHO/MHP/HPS/EML/2021.03.
^ abWorld Health Organization (2023). The selection and use of essential medicines 2023: web annex B: World Health Organization model list of essential medicines for children: 9th list (2023). Geneva: World Health Organization. hdl:10665/371091. WHO/MHP/HPS/EML/2023.03.
^World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
^World Health Organization (2023). The selection and use of essential medicines 2023: executive summary of the report of the 24th WHO Expert Committee on Selection and Use of Essential Medicines, 24 28 April 2023. Geneva: World Health Organization. hdl:10665/371291. WHO/MHP/HPS/EML/2023.01.
The selection and use of essential medicines. Twentieth report of the WHO Expert Committee 2015 (including 19th WHO Model List of Essential Medicines and 5th WHO Model List of Essential Medicines for Children). Geneva: World Health Organization. 2015. hdl:10665/189763. ISBN978-92-4-069494-1. ISSN0512-3054. WHO technical report series; no. 994.
The selection and use of essential medicines: report of the WHO Expert Committee, 2017 (including the 20th WHO Model List of Essential Medicines and the 6th Model List of Essential Medicines for Children). Geneva: World Health Organization. 2017. hdl:10665/259481. ISBN978-92-4-121015-7. ISSN0512-3054. WHO technical report series; no. 1006.
The selection and use of essential medicines: report of the WHO Expert Committee on Selection and Use of Essential Medicines, 2019 (including the 21st WHO Model List of Essential Medicines and the 7th WHO Model List of Essential Medicines for Children). Geneva: World Health Organization. 2019. hdl:10665/330668. ISBN978-92-4-121030-0. ISSN0512-3054. WHO technical report series;1021.
Medicine
Viruses
