Ensuring palliative medicine availability: the development of the IAHPC list of essential medicines for palliative care

According to the World Health Organization (WHO), essential medicines are those that satisfy the primary health-care needs of the population⁽¹⁾. The concept was laid down by WHO in 1977 with the recommendation that essential medicines be selected with due regard to disease prevalence, evidence on efficacy and safety, and comparative cost-effectiveness. Essential medicines are intended to be available at all times in adequate amounts, in the appropriate dosage forms, with assured quality, and at a price the individual and the community can afford.

The essential drugs concept can be applied in all countries and at various levels (national, provincial, municipality, hospital) and is especially valuable in resource-poor settings, as it seeks to prioritize medications and thereby improve access to treatment. Focusing formularies on essential drugs may lower costs due to economies of scale.

In addition to the concept, the WHO also developed a Model List of Essential Medicines which is updated every 2 years. The concept and the WHO Model List are presented to countries so that governments can construct their own essential medicines policies and lists.

Over a period of more than 30 years, the Essential Medicines concept provided a basis for numerous national essential medicines programmes whereby countries developed their own essential medicines lists based on local needs. Use of this concept by countries around the world has had a considerable impact: The number of people with access to essential drugs has grown from roughly 2.1 billion in 1977 to an estimated 3.8 billion in 1999, and the number of countries that have formulated or updated a national drug policy grew from 14 in 1989 to 66 in 1999. By the end of 1999, more than 150 WHO Member States had a national essential medications list; and 127 of the lists had been revised within the previous 5 years⁽²⁾.