The World Health Organisation (WHO) has updated global guidance on medicines and diagnostic tests to address health challenges, prioritise highly effective therapeutics, and improve affordable access.
The two lists focused on cancer and other global health challenges, with an emphasis on effective solutions, smart prioritization, and optimal access for patients.
The two recently developed immunotherapies (nivolumab and pembrolizumab), WHO say, have delivered up to 50 per cent survival rates for advanced melanoma, a cancer that until recently was incurable.
“While several new cancer treatments have been marketed in recent years, only a few deliver sufficient therapeutic benefits to be considered essential,” the agency says.
“The five cancer therapies WHO added to the new Medicines List are regarded as the best in terms of survival rates to treat melanoma, lung, blood and prostate cancers.”
The updated Essential Medicines List adds 28 medicines for adults and 23 for children and specifies new uses for 26 already-listed products deemed essential for addressing key public health needs.
The list is divided into two sections depending on the user and setting: one for community settings, which includes self-testing; and a second one for clinical laboratories, which can be general and specialised facilities.
According to Tedros Adhanom Ghebreyesus, WHO’s Director-General, more than 150 countries around the world depend on the list as a guide to affordable, wholesome medicines.
“The inclusion in this list of some of the newest and most advanced cancer drugs is a strong statement that everyone deserves access to these life-saving medicines, not just those who can afford them,” he stated.
Other updates to the list include new oral anticoagulants to prevent stroke, as an alternative to warfarin treatment of deep vein thrombosis. These are “particularly advantageous” for low-income countries, according to WHO, because, unlike warfarin, they do not require regular monitoring.
.Biologics and their respective biosimilars for chronic inflammatory conditions such as rheumatoid arthritis and inflammatory bowel diseases, as well as heat-stable carbetocin for the prevention of postpartum haemorrhage.
According to the organisation, this new formulation has similar effects to oxytocin, the current standard therapy, but offers advantages for tropical countries as it does not require refrigeration.
The first list, issued last year, concentrated on a limited number of priority diseases, such as HIV, malaria, tuberculosis, and hepatitis. This year’s list includes more non-communicable and communicable diseases. In all, WHO added 12 tests to the Essential Diagnostics List to detect a wide range of solid tumours such as colorectal, liver, cervical, prostate, breast and germ cell cancers, as well as leukemia and lymphomas.
The list focuses on additional infectious diseases prevalent in low- and middle-income countries such as cholera, and neglected diseases like leishmaniasis, schistosomiasis, dengue, and zika.
The list was also expanded to include additional general tests, which address a range of different diseases and conditions, such as iron tests — for anaemia — and tests to diagnose thyroid malfunction and sickle cell anaemia, which is very widely present in sub-Saharan Africa.