The World Health Organisation (WHO) has issued the WHO Model List of Essential Medicines for 2017, adding new treatments for HIV, hepatitis C virus (HCV), tuberculosis and leukemia.
The list, which is comprised of medicine considered be most important for addressing 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.
A major revision to the antibiotics section includes the categorisation of these agents into 3 groups: ACCESS, WATCH, and RESERVE. These categories are currently applied to antibiotics indicated for 21 of the most common infections; recommendations on when each category should be used are also provided. The grouping is intended to help boost treatment outcomes, decrease the development of drug-resistant bacteria, and save the “last resort” antibiotics that may be needed.
ACCESS group antibiotics (amoxicillin) should be available at all times to treat a variety of common infections. WATCH group antibiotics (ciprofloxacin) are those recommended as first- or second-line treatments for a smaller number of infections (cystitis, upper respiratory tract infections), which should be used significantly less to reduce development of resistance. RESERVE group antibiotics (colistin, some cephalosporins) include “last resort’ options that should only be used in the most severe situations when other alternatives have failed (multidrug-resistant bacteria).
Some of other new drugs added to the WHO Essential Medicines List include: dasatinib and nilotinib for chronic myeloid leukemia resistant to standard treatment; sofosbuvir + velpatasvir to treat all 6 types of HCV; dolutegravir for HIV tenofovir +/-; emtricitabine or lamivudine for HIV pre-exposure prophylaxis (PrEP); delamanid and clofazime for multi-drug resistant tuberculosis; isoniazid, rifampicin, ethambutol, pyrazinamide for pediatric tuberculosis; and fentanyl skin patches and methadone for pain management in cancer patients particularly for end-of-life care.
The WHO Essential Medicines List was initially launched in 1977 and is revised every 2 years by the Expert Committee on the Selection and Use of Essential Medicines.