Selection of WHO-recommended essential medicines for non-communicable diseases on National Essential Medicines Lists

Abstract

Background Non-communicable diseases (NCDs) are the leading cause of death worldwide. Inadequate and inequitable access to essential NCD medicines is a major concern, particularly in low- and middle-income countries. National Essential Medicines Lists (EMLs) are important policy tools that indicate which medicines are prioritized as essential within a country’s health system. This study sought to analyze a wide range of national essential medicines lists (EMLs) for their inclusion of priority non communicable disease (NCD) interventions recommended by the World Health Organization (WHO). Methods Three lists of WHO endorsed priority NCD interventions were included. A database with 137 national EMLs and the WHO EML was created from the WHO Repository and these EMLs were compared for listing of priority NCD interventions. Results Across 137 countries with national EMLs, the median percentage of 20 Best Buys interventions listed was 90% (IQR 80–95) and 31 Package of essential noncommunicable disease interventions (PEN) interventions listed was 94% (IQR 90–97), of 9 HEARTS interventions was 100% (IQR 89–100), and of the 43 unique interventions across the three priority lists was 88% (IQR 84–93). Less than 80% of the 43 interventions were listed by 22 (16%) countries and less than half of the interventions were listed by 2 countries: Angola (35%) and Cambodia (23%). Interventions listed on the fewest number of national EMLs were: influenza vaccine, HPV vaccine, hepatitis B vaccine, cervical cancer chemotherapy, codeine, promethazine, senna, and oxygen. Conclusion Most NCD interventions have been prioritized in national policy in most cases. The majority of priority medicines for NCDs described within key WHO NCD technical packages are listed on nearly all national EMLs across 137 countries of all income levels. Most NCD interventions have been prioritized in national policy in most cases, but in some countries and for select interventions such as the HPV vaccine, prioritization may be reviewed.

Influenza Vaccination for the Prevention of Cardiovascular Disease in the Americas: Consensus document of the Inter-American Society of Cardiology and the Word Heart Federation

“…An assessment carried out in 137 countries reveals that only 51 (37%) have included the influenza vaccine in their list of essential drugs [ 201 202 ]. In Latin America and the Caribbean, 30 countries have a list of essential drugs, however in only 11 (36.6%) the influenza vaccine is recognized as essential medicine [ 201 202 17 ].…”

The contribution of specific non-communicable diseases to the achievement of the Sustainable Development Goal 3.4 in Peru

“…Over the period of analysis, cardiovascular diseases and cancer mortality have largely driven the improvement in the overall unconditional probability of dying, particularly in the Coast and Amazon regions. Peru has adopted several of the Best Buys interventions, Package of Essential NCDs Interventions for Primary Health Care, and HEARTS Technical package for cardiovascular disease management in primary health care [27]. Yet the implementation of these policies and interventions may vary greatly across regions and time; also, how much they have contributed to lessen the burden of cardiovascular diseases has not been quantified.…”

Essential tobacco dependence medicines in 137 countries

“…The medicines listed on NEMLs may not actually be widely available and, conversely, medicines may be widely available even if they are not prioritized on NEMLs [6]. In contrast, however, treatments for cardiovascular disease are included in most NEMLs [7]. Only three tobacco dependence medicines were included in the analysis, although others exist.…”