The Model List currently contains a variety of items, such as vaccines, diagnostic agents and chemicals, sera, immunoglobulins, and various non-medicine items such as condoms, insect repellents and other preventive equipment. The Committee acknowledged that the inclusion of these additional items opened the door to many more applications of this nature (e.g. impregnated bednets) which, in turn, could lead to much additional work in areas where personal preferences dominate and objective evidence on which to base comparisons is relatively scarce.
As a general principle, the Committee recommended that any item that is normally subject to regulatory control could be considered for inclusion in the Model List. Such items would typically be subject to clinical studies on efficacy and safety, the results of which the Committee considered that it had the necessary expertise to assess. Items that enter the human body, such as radio contrast media and other invasive diagnostic tests, intrauterine devices, vaccines, sera and im-munoglobulins, would come under this category. Several other items, which have long been included, such as condoms, should probably be maintained on the Model List. However, for new applications it was considered that a more pragmatic approach was needed. The Committee thus recommended that a separate mechanism with appropriate procedures be established to identify and assess essential medical devices and health technologies.
A request to create an active web link within the Essential Medicines Library to information on HIV/AIDS diagnostic test kits was referred back to the WHO Secretariat for consideration. With regard to vaccines, the Committee agreed to a proposal put forward by the Department of Vaccines and Biologicals, WHO, that the latter, through its Advisory Committees and a transparent review process, would synthesize its current recommendations on vaccines into a format that is compatible with the Model List of Essential Medicines. This draft list of vaccines, together with relevant supporting evidence, would be forwarded to the Committee for consideration for adoption as part of the Model List. The Committee recommended that the core children’s vaccines, as well as vaccine combinations, should be included in this systematic review.
The Committee noted that the misuse of injections is a serious and widespread problem that demands interventions at several levels. In situations of high injection use, the use of injectable medications needs to be reduced through the development and promotion of clinical guidelines and through the training of health professionals and consumers. When injectable medications are being supplied, the necessary equipment for sterile injections should also be provided.