The WHO is considering adding medication that combats obesity to its “essentials medicine list”, which is used to guide government-purchasing decisions in low- and middle-income countries, reports Reuters.
This comes after requests from three doctors and a researcher in the United States, and covers the active ingredient liraglutide in Novo Nordisk’s obesity drug Saxenda, which will come off patent soon, allowing for cheaper generic versions.
A panel of advisers to the agency will review the request, with an updated essential medicines list due in September.
A decision by the WHO to include Saxenda and eventual generics on the list for adults would mark a new approach to global obesity by the health agency, and could also pave the way for a newer, more powerful treatment from Novo Nordisk called Wegovy to be recommended for low- and middle-income countries in future.
However, some public health experts warn against introducing such medicines too broadly as a solution to a complex condition that is still not completely understood.
“We believe it is a work in progress,” said Francesco Branca, WHO director of nutrition, referring to the use of drugs as obesity treatments.
He said there were still issues around the cost of liraglutide as well as the fact that it had not been in use long enough, which may make inclusion on the list unlikely.
“At the same time, WHO is looking at … drugs to reduce weight … in the context of a systematic review for guidelines for children and adolescents,” he said.
More than 650m adults worldwide are obese, triple the 1975 rate. Most of them live in low- and middle-income countries.
Expanding access
Including obesity drugs among the WHO's essential medicines could have great significance.
“At present, there are no medications on the (list) that specifically target weight loss for the ongoing global burden of obesity,” wrote US researcher Dr Sanjana Garimella from Yale New Haven Health, Dr Sandeep Kishore from the University of California, San Francisco, and colleagues, to the WHO in requesting the addition.
They said while the list includes mineral supplements for nutritional deficiencies, the absence of weight-loss treatments represents a “discrepancy” in global health equity, given the increasing number of deaths in poorer nations hastened by weight-related illness, including heart disease and diabetes.
Saxenda, a once-daily injection, has been shown to help people reduce 5%-10% of their body weight.
People using Wegovy, a weekly injection, have lost up to 15% of their weight. At the moment, Wegovy is in short supply and Novo is prioritising its launch and distribution in the US and other wealthy markets.
The Danish drugmaker said it was not involved in the application to consider liraglutide for inclusion on the WHO list, reports Reuters.
Both drugs belong to a class of medicines called GLP-1 receptor agonists, which have been used for years to treat diabetes. They affect hunger signals to the brain and slow the rate at which a person’s stomach empties, making them feel fuller longer. Eli Lilly has a similar diabetes drug nearing approval for weight loss.
For both Saxenda and Wegovy, there is a lack of long-term safety and effectiveness data for obesity. Studies suggest people will likely have to take the drugs for the rest of their lives to keep off the weight.
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