The World Health Organization (WHO) has released this year’s Essential Medicines List (EML), adding new treatments for HIV, hepatitis C virus (HCV), tuberculosis and leukemia.
The list, which is comprised of drugs considered most important to address public health needs, includes 433 drugs, with 30 new drugs for adults and 25 new ones for children, as well as additional indications for nine existing drugs.
An important review of the antibiotic section includes the categorization of these agents into three groups: ACCESS, WATCH and RESERVE. These categories currently apply to antibiotics indicated for 21 of the most common infections; recommendations are also given as to when each category should be used. The grouping is intended to help increase treatment outcomes, slow the development of drug-resistant bacteria, and save “last resort” antibiotics that may be needed.
ACCESS antibiotics (eg, amoxicillin) must be available at all times to treat a variety of common infections.
Antibiotics from the WATCH group (eg, Ciprofloxacin) are recommended as first or second line treatments for fewer infections (eg cystitis, upper respiratory tract infections) that should be used significantly less to reduce the development of resistance.
RESERVE antibiotics (eg, Colistin, some cephalosporins) include “last resort” options that should only be used in the most severe situations when other alternatives have failed (eg, multiresistant bacteria).
Some of the new drugs added to the WHO Essential List of Medicines include:
– Dasatinib and nilotinib for standard treatment resistant chronic myeloid leukemia
– Sofosbuvir + velpatasvir to treat all six types of HCV
– Dolutegravir for HIV
– Tenofovir +/- emtricitabine or lamivudine for pre-exposure prophylaxis to HIV (PrEP)
– Delaramide and clofazime for multidrug-resistant tuberculosis
– Isoniazid, rifampicin, ethambutol, pyrazinamide for pediatric tuberculosis
– Fentanyl and methadone skin patches for the treatment of pain in cancer patients, in particular for end-of-life care
The WHO Essential List of Medicines was initially launched in 1977 and reviewed every two years by the Expert Committee on the Selection and Use of Essential Medicines.