The WHO’s Essential Medicines List, updated biennially, guides nations in prioritizing safe, effective, and cost-efficient drugs for public health. For India, it serves as the basis for NLEM, regulating prices and ensuring affordable access, especially for cancer and diabetes care.
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Picture Courtesy: THE HINDU
Context
The World Health Organisation (WHO) added GLP-1 receptor agonists (e.g., semaglutide, dulaglutide, liraglutide, tirzepatide) to the Essential Medicines List (EML) for type-2 diabetes with comorbidities like obesity and cardiovascular/kidney disease.
Definition: Medications that mimic the natural hormone GLP-1, enhancing insulin release and lowering blood sugar.
Primary Aim: Treat type-2 diabetes.
Secondary Benefits:
Forms: Mostly injectables; oral semaglutide is available.
Origin: Started in 1977; updated biennially by the WHO Expert Committee.
Aim: Provide a core set of cost-effective, safe medicines for priority diseases.
Significance:
Rising non-communicable diseases (NCDs) Burden: 830 million diabetics globally (2022), projected 1.3 billion by 2050. In India: 77 million diabetic adults + high obesity prevalence, expected to rise to over 134 million by 2045.
Cost Barriers: GLP 1 Price in India, cost between ₹14,000 to ₹20,000 per month, depending on the brand and dosage, unaffordable for most (given 60% out-of-pocket spending).
Equity & SDGs: Directly linked to SDG 3 (Good Health & Well-being).
National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD): Provides technical and financial support to states, with NCD clinics at district and community levels for screening, management, and referrals.
Ayushman Bharat: Integrates diabetes screening and management into primary healthcare via Health and Wellness Centres. Ayushman Bharat – PMJAY also covers inpatient care costs for eligible families.
75/25 Initiative: Aims to screen and provide standard care to 75 million people with hypertension and diabetes by 2025.
Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP): Offers generic insulin and other diabetes medications at a fraction of the cost through special pharmacy outlets.
Free Drugs Service Initiative: Provides free essential medicines, including insulin, to the economically vulnerable under the National Health Mission.
Behavioral change campaigns: Initiatives like the Eat Right Campaign (FSSAI) and the Fit India Movement promote healthy eating and active lifestyles to reduce diabetes risk.
Upgrade Health and Wellness Centers into comprehensive chronic disease hubs with specialized staff, reliable medication supply, and improved referral systems.
Invest in a workforce of trained diabetes educators, empowering nurses and paramedics to support patient self-management, especially in rural areas.
Implement policy-driven changes to promote healthier diets through food regulations and create urban environments that encourage physical activity.
Scale digital health solutions like telemedicine and remote monitoring apps to overcome geographical barriers and aid self-management.
Increase affordability and access to advanced technology, such as continuous glucose monitors (CGMs), through public healthcare subsidies.
Use data and AI for predictive analytics to identify at-risk individuals, personalize treatments, and refine national health strategies.
Global Learning; Adopt models like Brazil’s generic policy, which cut drug costs by 40%.
Source: THE HINDU
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PRACTICE QUESTION Q. With reference to the WHO Model List of Essential Medicines (EML), consider the following statements:
Which of the above statements is/are correct? A) 1 only B) 2 only C) Both 1 and 2 D) Neither 1 nor 2 Answer: D Explanation: Statement 1 is incorrect: The WHO Model Lists of Essential Medicines are updated every two years by the Expert Committee on the Selection and Use of Essential Medicines. Statement 2 is incorrect. The EML serves as a guide and is not legally binding. It is intended for countries to adapt and develop their own national lists. |
The WHO EML is a list of medications considered to be the most effective and safe to meet the most critical needs in a health system. It serves as a guide for countries to develop their own national lists of essential medicines.
A medicine is selected for the EML based on several criteria, including its relevance to public health, demonstrated efficacy and safety from clinical trials, and comparative cost-effectiveness.
No, the WHO EML is not legally binding. It is a model list or a guidance document that countries can adapt to their specific national health priorities, disease burdens, and financial resources to create their own national essential medicines lists.
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