WHO Model List of Essential Drugs

(March 2002)


Review of summary statements on reasons for inclusion of essential drugs and underlying evidence


The following three files contain short statements as to why individual drugs are on the WHO Essential Drug List. For those placed on the first Essential Drug List (1977) statements have been constructed. The remaining rationales use comments taken from the Technical Report Series when drugs were substituted or added to the list. 


This review has been prepared for EDM/PAR by Phil Wiffen, Regional Pharmaceutical Adviser, SEARO, and Co-ordinating Editor PaPaS Cochrane Group, Oxford, UK.


Included in the files is a column showing a preliminary assessment on availability of evidence to support recommendation of an individual drug.


Section 1




Section 10

Drugs affecting the blood

Section 11

Blood products and plasma substitutes



Section 17

Gastrointestinal drugs

Section 18

Hormones, other endocrine drugs & contraceptives



Section 27 

Vitamins and minerals


Explanatory notes  on the list (from Technical Report Series  895)


Many drugs are included in the list are preceded by a * to indicate that they represent an example of a therapeutic group and that various drugs could serve as alternatives. It is imperative that this is understood when drugs are selected at a national level, since choice is then influenced by the comparative cost and availability of equivalent products.


Numbers in parentheses following the drug names indicate:



Drugs subject to international control under the Single Convention on Narcotic Drugs, 1961 (38)


Drugs subject to international control under the Convention on Psychotropic Substances, 1971 (39)


Drugs subject to international control under the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988 (40)


Specific expertise, diagnostic precision, individualization of dosage or special equipment required for proper use


Greater potency or efficacy


In renal insufficiency, contraindicated or dosage adjustments necessary


To improve compliance


Special pharmacokinetic properties


Adverse effects diminish benefit/risk ratio


Limited indications or narrow spectrum of activity


For epidural anaesthesia


Sustained-release preparations are available.  A proposal to include such a product in a national list of essential drugs should be supported by adequate documentation


Monitoring of therapeutic drug concentrations (in plasma) can be used to improve safety and efficacy


Letters in parentheses after the drug names indicate the reasons for the inclusion of complementary drugs:


(A) When drugs in the main list cannot be made available


When drugs in the main list are known to be ineffective or inappropriate for a given individual 
(C) For use in rare disorders or in exceptional circumstances


Reserve antimicrobials to be used only when there is significant resistance to other drugs on the List


Explanatory notes on the evidence and comments columns


+It can be assumed that drugs were on the original EDL (EDL1) unless there is a later reference to a subsequent EDL list.


++ level of evidence used. 


CE6 refers to Clinical Evidence Issue 6 December 2001. SR - systematic review, RCT -randomised controlled trial.


Cochrane Library:  2002 Issue 1.


DARE database of abstracts of reviews from National Health Service (NHS) centre in York England published on their website (http://nhscrd.york.ac.uk/) and the Cochrane Library:

ADR- Adverse drug effect

AE- adverse effects.


Comment. The review of evidence is minimal but gives an indication of what is available. Some sections such as section 8 where drugs are used for a number of indications need a thorough work up beyond the scope of this first review. Other areas need to be linked to WHO guidelines which are also being reviewed in the light of available evidence.


Back to the EML Expert Committee Resources Menu

See also the Essential Medicines Library