Islamabad: The World Health Organization (WHO) has updated its Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc), adding breakthrough drugs for cancer, diabetes and obesity — a move aimed at making these life-saving treatments more accessible in low- and middle-income countries, including Pakistan where millions continue to struggle for timely diagnosis and affordable medicines.
The revised lists — the 24th edition of EML and 10th of EMLc — now include modern therapies for cervical, lung and colorectal cancers, diabetes with associated heart and kidney disease, as well as medicines for cystic fibrosis, psoriasis, haemophilia and blood-related disorders. WHO’s lists serve as a global benchmark, guiding over 150 countries, including Pakistan, in procurement, health insurance and reimbursement policies.
“These updates mark a significant step toward expanding access to medicines with proven clinical benefits and high potential for global public health impact,” said Dr. Yukiko Nakatani, WHO’s Assistant Director-General for Health Systems, Access and Data.
Cancer, the second leading cause of death worldwide claiming nearly 10 million lives each year, has been a focus of WHO’s essential medicines policy for over a decade. The committee of experts this year recommended greater access to PD-1/PD-L1 immune checkpoint inhibitors — a new class of immunotherapies that help the body fight cancer. Pembrolizumab has been added for metastatic cervical, colorectal and non-small cell lung cancers, while atezolizumab and cemiplimab are listed as alternatives. Only cancer drugs that prolong survival by at least four to six months were considered for inclusion, reflecting WHO’s strict criteria.
The other major addition is in diabetes and obesity treatment, conditions that together threaten the health of more than 800 million diabetics and over one billion obese people worldwide. Pakistan, where nearly 33 million adults are living with diabetes and obesity is rising at an alarming rate, stands to benefit significantly from these changes. WHO has added GLP-1 receptor agonists — semaglutide, dulaglutide and liraglutide — along with the dual GLP-1/GIP receptor agonist tirzepatide. These medicines not only improve blood sugar control but also reduce risks of heart and kidney disease, support weight loss and lower early mortality in patients with type 2 diabetes and obesity.
However, WHO acknowledged that the extremely high prices of drugs such as semaglutide and tirzepatide are already limiting access even in wealthier countries. It urged governments to prioritize those most at risk, encourage generic competition, and make these medicines available at primary healthcare level to bridge the gap for millions in underserved communities.
“A large share of out-of-pocket spending on non-communicable diseases goes toward medicines that, in principle, should be financially accessible to everyone,” said Deusdedit Mubangizi, WHO Director of Policy and Standards for Medicines and Health Products. He stressed that achieving equity in access requires strong political commitment, fair pricing and people-centred health programmes.
In total, 20 new medicines have been added to the EML and 15 to the EMLc, bringing the lists to 523 essential medicines for adults and 374 for children. For Pakistan, where cancer drugs remain prohibitively expensive and diabetes-related complications are overwhelming hospitals, the WHO revisions provide both a policy direction and a reminder of the urgent need for stronger health system reforms.
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