Vol. 23, No. 6
Publications from the World Health Organization
The Use of Essential Drugs, 9th Report of the WHO Expert
Committee (including the Revised Model List of Essential Drugs), WHO
Technical Report Series No. 895, 2000, v + 61 pages (available in English;
French and Spanish in preparation), ISBN 92-4-120895-3, CHF 14.-/USD
12.60; In developing countries: CHF 9.80, Order No. 1100895.
This report presents and explains the 11th model list of essential
drugs issued by WHO as part of its efforts to extend the benefits of
modern drugs to the world's population. Intended to guide the selection
of drugs in countries where the need is great and resources are small,
the list identifies a core group of prophylactic and therapeutic substances
judged capable of meeting the vast majority of health needs and, thus,
deserving priority in purchasing decisions and procurement schemes.
The model list also serves as an information and educational tool for
health professionals and consumers, and facilitates the development
of treatment guidelines, national formularies, information for patients,
and other measures to improve drug use. WHO model lists, the first of
which was issued in 1977, are regularly updated to ensure that recommendations
are in line with the latest data on the comparative safety, efficacy,
and costs of specific drugs, as well as their relevance to priority
health problems. Factors of stability, quality control, and international
availability are also considered when validating and revising the lists.
The first part of the report provides updated information on several
components of national drug policy necessary to ensure that essential
drugs, corresponding to essential health needs, are available at all
times in adequate amounts and in the proper dosage. Information includes
guidelines for the selection of pharmaceutical dosage forms, the importance
of bioavailability in assessments of drug quality, recommended use of
the Anatomical Therapeutic Chemical classification system and the Defined
Daily Dose as a measuring unit when conducting drug utilization studies,
and the growing problem of resistance to some of the widely available
and relatively cheap antimicrobials included in the list.
In view of the increasingly high levels of resistance to standard antituberculosis
drugs, the report designated nine drugs and formulations as essential
for the treatment of multidrug-resistant tuberculosis. The report also
describes plans for a major revision of the procedures used when updating
the model list.
The 11th WHO model list of essential drugs is pre-sented in the second
part, together with an explanation of changes made when revising the
list. Organized according to therapeutic group, the list includes information
on route of administration, dosage forms, and strengths for each of
306 drugs. To qualify for inclusion, a drug must be supported by sound
data demonstrating safety, efficacy, and consistent performance in a
variety of medical settings.
The report concludes with an explanation of changes made in the list.
These changes include the addition of nevirapine for the prevention
of mother-to-child transmission of HIV, of artesunate for the treatment
of malaria resistant to older drugs, and of levonorgestrel for emergency