Essential medicines

Essential medicines, as defined by the World Health Organization (WHO), are the medicines that "satisfy the priority health care needs of the population".^[1] Essential medicines are the medications that people should have access to at all times in sufficient amounts. These medications should be generally affordable.^[2] Since 1977, the WHO has published a model list of essential medicines, with the current (2019) list for adult patients containing over 400 medicines.^[3] But there is now a new current list from 2021 of the essential medicine list for adults and children's by the WHO.^[4] But since the 2021 list came out there has been some changes that have been implemented including what the medication cost should not be the grounds for exclusion criteria if it meets other selection criteria and secondly, cost effectiveness differences should be within therapeutic areas. As the next year antiretroviral agents were included in the list of essential medicines.^[5] Since 2007, a separate list of medicines intended for child patients has been published.^[6] Both the WHO adult and children's lists contain a notation indicating that a particular medication is "complementary", thus essentially there are two lists, the "core list" and the "complementary list". The core list presents a list of minimum medicine needs for a basic health care system, listing the most efficacious, safe and cost-effective medicines for priority conditions. Priority conditions are selected on the basis of current and estimated future public health relevance, and potential for safe and cost-effective treatment. The complementary list presents essential medicines for priority diseases, for which specialized diagnostic or monitoring facilities are needed. In case of doubt, medicines may also be listed as complementary on the basis of higher costs or less attractive cost-effectiveness in a variety of settings. The list is important because it forms the basis of national drugs policy in more than 155 countries, both in the developed and developing world. Many governments refer to WHO recommendations when making decisions on health spending. Countries are encouraged to prepare their own lists taking into consideration local priorities. Over 150 countries have published an official essential medicines list.^[7] Despite these efforts, an estimated 2 billion people still lack access to essential medicines as some of the major obstacles they are due to low supply such as shortages of inexpensive drugs. Following these shortages the US Food and Drug Administration (FDA) released a report in fall of 2019 strategies to overcome and mitigate these drug shortages.^[8]