¹ For a full description of the new procedures for updating and disseminating the Model List of Essential Medicines, please refer to Annex 1 of document EB109/8 (7); this document is also available on the WHO web site at http://www.who.int/medicines.

1. Applications for inclusions, changes or deletions may be submitted to the Secretariat of the Expert Committee on the Selection and Use of Essential Medicines not only by relevant technical departments within WHO but also by any individual or organization.

2. Box 2, the standard review procedure for applications, should be modified, according to the new version provided in the present report of the Expert Committee (see page 6).

3. Specific procedures for deleting an item from the Model List should be developed, with possibilities for either a simplified consultation procedure or a systematic review. In both cases, the evidence for deletion should be carefully recorded.

4. Paragraph 7 on the selection criteria should be amended as follows:

Most essential medicines should be formulated as single compounds. Fixed-dose combination products should be selected only when the combination has a proven advantage in therapeutic effect, safety, adherence or in delaying the development of drug resistance in malaria, tuberculosis and HIV/AIDS.

5. The draft WHO model formulary should be updated to include the changes made to the Model List in 2002 and published as soon as possible (see Annex 1, Appendix 1).

6. Details of the applications for inclusions, changes or deletions should be maintained on the WHO Essential Medicines Library as part of the presentation of the underlying evidence for the proposed inclusions, changes or deletions. Archival files should be created for all items that have been considered at successive meetings of the Expert Committee.

7. Important sections of the WHO Essential Medicines Library should be made available in languages other than English. In this regard, WHO should consider the feasibility and potential benefits of creating Internet hot-links to reliable information sites in other languages, and to the web sites of well established drug regulatory agencies.

8. Additional resources and capacity should be made available to the WHO Secretariat of the Expert Committee and relevant WHO technical departments to ensure the full implementation of the new procedures.

9. Experiences with the new procedures should be carefully evaluated; this includes those aspects of the procedures that have not yet been implemented in full. When appropriate, the procedures should be further refined.

10. A separate mechanism with appropriate procedures should be created to identify and assess essential medical devices and health technologies.

11. The open session was useful to the work of the Committee, and a similar meeting should be included in the agenda for the next meeting.