Since 1975, WHO has received repeated requests from the World Health Assembly for information on the quality, price and therapeutic aspects of individual pharmaceutical products included in the Model List. At its previous meeting in 1999, the Expert Committee stressed the importance of the links between the selection of medicines for the Model List, medicines information and clinical treatment guidelines (2). It also supported the suggestion that there should be wider dissemination of the evidence used by the Committee in the course of its work and recommended the careful recording of the reasons for its final recommendations regarding the inclusion or otherwise of medicines in the Model List.
The new procedures for updating and disseminating the Model List include the creation, by WHO, of an electronic Essential Medicines Library to make information about essential medicines more widely available using CD-ROMs and the Internet (see section 3.2). Within the latter, links to WHO clinical guidelines, the WHO model formu-lary, existing United Nations price information services and information on international nomenclature and quality standards are envisaged.
The Committee was informed of progress in the preparation of the Essential Medicines Library. The database structure has been created and the Model List entered, together with brief summaries of the reasons for the inclusion of each medicine and key references to systematic reviews. Summaries of WHO clinical guidelines are being finalized and electronic links to the WHO model formulary are under development. The aim is to launch the Essential Medicines Library web site in late 2002, and to continue to add other components of the library as and when they become available. An overview of the structure of the Essential Medicines Library, showing the main external partners, is given in Figure 1.
The Expert Committee expressed its satisfaction with the progress achieved to date, and agreed that all available means of disseminating the information in the WHO Essential Medicines Library should be explored and encouraged, including for example, CD-ROMs and Internet downloads to national centres for local dissemination. Specific electronic files could be provided on request to the WHO’s Department of Essential Drugs and Medicines Policy.1
1 Requests for information should be addressed to the Department of Essential Drugs and Medicines Policy, World Health Organization, 1211 Geneva 27, Switzerland.
With regard to the content of the Essential Medicines Library, the Committee recommended that details of the applications for the addition to the Model List of all new medicines should be maintained on the library web site (as part of the presentation of the underlying evidence for their inclusion), as well as records of the Committee’s decisions and archival files for items that have been considered at previous meetings.
The Committee noted that most of the information under the Essential Medicines Library umbrella was held in external data sources that were outside its control and responsibility. However, in this regard it wished to make an exception for the text of the WHO model formu-lary for newly added medicines. Although not formally approved by the Committee, the WHO model formulary had been initiated as a result of a recommendation made by the Committee and several of its members had been involved in the project. Furthermore, the WHO model formulary is a natural repository for information the Committee might wish to make available when making its recommendations on the inclusion of medicines in the Model List. For these reasons, the Committee endorsed the requirement in the new procedures that the text of the WHO model formulary monograph for a new medicine should be considered by the Committee at the same time as its application for inclusion in the Model List.
Figure 1 The Essential Medicines Library
ATC, Anatomical Therapeutic Chemical classification; BNF, British National Formulary; DDD, Defined Daily Dose; MSH, Management Sciences for Health; MSF, Médecins sans Frontières; WCC, WHO Collaborating Centre; WHO/EC, WHOExpert Committee on the Selection and Use of Essential Medicines; WHO/EDM, WHO Department of Essential Drugsand Medicines Policy; WHO/QSM, Quality and Safety (Medicines) team of WHO/EDM
The Committee recommended that key sections of the Essential Medicines Library be made available in languages other than English. To this end, it recommended that WHO should consider the feasibility and potential benefits of creating Internet hot-links to appropriate information sites in other languages, and to the web sites of well established drug regulatory agencies. Review articles appearing in independent publications could be included in the systematic review process for medicines proposed for inclusion.