The WHO Essential Medicines List: What It Is and Why It Matters

Since 1977, the World Health Organization has maintained a Model List of Essential Medicines (EML) — the medicines considered most important for meeting a population’s priority health needs. The list is updated every two years by an expert committee and currently covers several hundred active ingredients, from basic analgesics to cancer treatments and antivirals.

What “essential” means

Essential medicines are selected on the basis of disease prevalence, evidence of efficacy and safety, and comparative cost-effectiveness. The idea is not that other medicines are unnecessary, but that a functioning health system should ensure these particular medicines are always available, in adequate quantities, in the right dosage forms, at prices people and systems can afford.

There is a companion list for children (the EMLc), reflecting the different formulations and doses paediatric care requires.

How countries use the model list

The WHO list is a model, not a mandate. More than 150 countries derive their own national essential medicines lists from it, adapting for local disease burden and budgets. National lists then drive public-sector procurement, standard treatment guidelines and training.

South Africa maintains its own Essential Medicines List with accompanying Standard Treatment Guidelines, split into primary healthcare, adult hospital and paediatric hospital levels. The national EML determines what the state buys on tender and what a public clinic is expected to stock.

Why the list matters for access and pricing

Inclusion on the WHO list carries real weight: it strengthens the case for generic manufacture, guides donor and procurement-agency purchasing, and is frequently cited in pricing and licensing negotiations. The 2015 addition of new hepatitis C antivirals and successive expansions of the cancer section, for example, put sustained international pressure on the prices of those medicines.

For South African readers, a practical takeaway: most medicines on the national EML have multiple registered suppliers and regulated Single Exit Prices, which you can compare using the HealthSA search page.