Five cancer therapies, three antibiotics for infections resistant to multiple essential drugs and the new oral anticoagulants are among the 28 medications for adults and 23 for children with whom the World Health Organization (WHO) has updated its Drug List Essentials This list is used by more than 150 countries worldwide as guidance when deciding on the drugs that represent a better value for money, according to the evidence and the impact on health.
In the case of oncological therapies, the five that provide better survival rates for lung, blood, prostate and melanoma tumors have been included. They are, for example, the immunotherapies nivolumab and prembrolizumab, whose increase in survival rates in advanced melanoma, until recently incurable, are currently at 50 percent.
Also three new antibiotics for the treatment of infections resistant to multiple essential drugs, in addition to the new oral anticoagulants to prevent stroke and as an alternative to warfarin for atrial fibrillation and deep vein thrombosis. These, in the opinion of the WHO, “are particularly advantageous for low-income countries since, unlike warfarin, they do not require regular monitoring.”
As essential drugs, WHO considers biological products and their respective biosimilars for chronic inflammatory diseases, such as rheumatoid arthritis and inflammatory bowel diseases; as well as thermostable carbetocin for the prevention of postpartum hemorrhage, a new formulation that has effects similar to oxytocin, the current standard therapy, but which offers “advantages” to tropical countries because it does not need refrigeration.
In the words of the Director General of WHO, Tedros Adhanmon Ghebreyesus, “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 the who can afford them “,
With these inclusions, there are already 460 products that are considered essential to address key public health needs. However, in the new update have not included some drugs for multiple sclerosis, or methylphenidate, a drug for attention deficit hyperactivity disorder (ADHD) because the Committee of Essential Drugs of the body found “uncertainties” in the profit estimates.
Essential diagnostics
Regarding the update of the Essential Diagnostics List to include more noncommunicable and communicable diseases, WHO has included 12 tests to detect a wide range of solid tumors such as colorectal, liver, cervical, prostate, breast and germ cell cancers , as well as leukemia and lymphomas. On the other hand, a new section has been created in the list that covers anatomical pathology tests, a service that the United Nations body advises to be available in specialized laboratories.
In relation to the tests to diagnose infectious diseases, the list focuses on those that prevail in low and middle income countries, such as cholera, dengue, zika, leishmaniasis and schistosomiasis. It has also incorporated the influenza test for health zones that do not have specific laboratories, and has expanded its list of diagnostic tests to incorporate additional tests that address various diseases and conditions such as iron tests (for anemia) or those that They are used to diagnose thyroid dysfunction and sickle cells, among others.
A section has also been added to the blood donation tests, which is part of the WHO strategy to make blood transfusions safer throughout the world.
The Essential Diagnostics List was introduced in 2018 to guide the provision of tests and improve treatment outcomes.