The World Health Organization updated its guidelines for essential medicines Wednesday to include drugs to treat multiple sclerosis, heart conditions, cancer and more. But obesity medications were not added to the list, despite requests this year from researchers in the United States.
During its meeting in April, WHO’s review committee considered over 100 therapeutics before recommending 24 medicines for adults and 12 for children to be added to the Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc).
The additions bring the total number of medications on the EML and EMLc to 502 and 361, respectively.
Updated every two years, the lists are registers of medications that WHO considers to be minimum requirements for every health care system to have available. The lists are internationally recognized guides for countries’ health systems, helping them prioritize medications that are effective and affordable. Each addition, according to WHO, is considered “essential to address key public health needs.”
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WHO advisers to consider whether obesity medication should be added to Essential Medicines List
“Essential medicines are those that satisfy the priority health care needs of a population,” the report says. “They are intended to be available in functioning health systems at all times, in appropriate dosage forms, of assured quality and at prices individuals and health systems can afford.”
New on the 2023 list are medications to treat multiple sclerosis, or MS, a chronic, often fatal nervous system disease that affects 2.8 million people around the world, according to WHO. The new guidelines include three medications to slow its progression.
One of them, rituximab, is normally used to treat some cancers and autoimmune diseases, but the WHO guidelines recommend off-label use for MS due to “strong evidence of its efficacy and safety.”
“Given the evidence base and the increased affordability of rituximab … it has been prioritized over on-label alternatives as an essential medicine to treat relapsing-remitting and progressive MS,” said Dr. Benedikt Huttner, the EML team lead, in a statement.
The guidelines also recommend, for the first time, “polypills” to treat heart disease and other cardiovascular issues. The term refers to a combination of medicines to treat heart issues: medication to lower blood pressure, a statin to lower cholesterol, a medication to make the heart beat with less force and sometimes aspirin.
A growing body of research shows that polypills can be an inexpensive, effective way to reduce the risk of heart problems, with studies indicating that they can cut the risk of cardiovascular problems by almost 40%. But even though heart complications like heart disease and heart attacks kill 18 million people each year, only a few companies manufacture polypills, and few people take them.
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Combination ‘polypills’ can help solve world’s heart problems, experts say, if more people can get them
The inclusion of polypills on the WHO guidelines could change that. Some health officials believe that their place on the Essential Medicines List would encourage governments and insurance companies to recommend them, particularly in low- and middle-income countries.
“These treatments could have a very large public health impact globally, without jeopardizing the health budgets of low- and middle-income countries,” said Dr. Tedros Adhanom Ghebreyesus, WHO’s director-general, in a news briefing Wednesday.
WHO rejected the inclusion of several patented cancer medications due to concerns over their high price, but the guidelines did add two cancer treatments: a medication for Kaposi sarcoma, a cancer that causes lesions in the skin and gastrointestinal tract, and cancer treatments that improve white blood cell production and reduce some cancer medicines’ toxic effects on the bone marrow.
Other additions include ceftolozane and tazobactam, a combination antibiotic used to treat multidrug-resistant bacteria, and monoclonal antibodies against Ebola.
Notably absent from the Essential Medicines List are compounds called GLP-1 receptor agonists, commonly used in some diabetes and obesity medications like Ozempic and Wegovy.
A request to add GLP-1 receptor agonists to the list came in March from four researchers at Yale University, Brigham and Women’s Hospital, and the University of California, San Francisco. However, the WHO committee rejected the application, citing the compounds’ “uncertain long-term clinical benefit and safety in this patient population.”
Amid celebrity promotion and their rising popularity for weight loss, some medications containing GLP-1 receptor agonists have been in shortage in the United States.
Shortages have also affected several essential medications on WHO’s list, including the hormone insulin for diabetes control and the antibiotic bicillin, a long-acting injectable form of penicillin.
“Rising prices and supply chain disruptions mean that all countries now face increasing problems in ensuring consistent and equitable access to many quality-assured essential medicines,” Ghebreyesus said. “WHO is committed to supporting all countries to overcome these obstacles to increase equitable access to essential medicines.”
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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