By Elizabeth Merab

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The World Health Organization has recommended greater use of cheap copies of expensive cancer drugs in a bid to make lifesaving medicine more widely available in poor countries.

The agency recently published two lists — Essential Medicines and Essential Diagnostics — to help countries prioritise critical health products that should be widely available and affordable throughout health systems.

ADVANCED DRUGS

The two lists focus on cancer and other global health challenges.

“The inclusion in this list of some of the newest and most advanced cancer drugs is a strong statement that everyone deserves access to these lifesaving medicines, not just those who can afford them,” said WHO director-general Dr Tedros Adhanom Ghebreyesus.

The 12 medicines WHO added to the new list for five cancer therapies are regarded as the best in terms of survival rates to treat melanoma, lung, prostate, multiple myeloma and leukaemia cancers, Dr Tedros said.

For example, two recently developed immunotherapies (nivolumab and pembrolizumab) have delivered up to 50 per cent survival rates for advanced melanoma, a skin cancer that, until recently, was incurable.

“While several new cancer treatments have been marketed in recent years, only a few deliver sufficient therapeutic benefits to be considered essential,” said Dr Tedros.

These two lists that are critical for global health: The 21st WHO Model List of Essential Medicines, and the second WHO Model List of Essential Diagnostics are meant to help countries prioritise critical health products that should be widely available, accessible, and affordable throughout health systems, especially in low- and middle-income countries.

The United Nations agency has also added three new antibiotics based on recommendations from an expert committee.

The new drugs include ceftazidime-avibactam, meropenem-vaborbactam, and plazomicin, all used to treat multidrug-resistant infections caused by pathogens deemed a “critical priority” by WHO, such as a group of bacteria (enterobacteriaceae) resistant to a class of highly effective antibiotic agents commonly used for the treatment of severe or high-risk bacterial infections (carbapenems).

RESERVE LIST

The surge in drug-resistant infections is one of the world’s most ominous health threats, and public health authorities say one of the biggest causes is farmers who dose millions of pigs, cows and chickens with antibiotics to keep them healthy — sometimes in crowded conditions before slaughter.

Overuse of the drugs has allowed germs to develop defences to survive. Drug-resistant infections in animals are spreading to people, jeopardising the effectiveness of drugs that have provided quick cures for a range of ailments and helped lengthen lives over much of the past century.

The newly added antibiotics are classified as “reserve” antibiotics under the WHO’s AWaRe (Access, Watch, and Reserve) designation, developed by the agency in 2017 to guide responsible antibiotic prescribing, curb development of resistance, and ensure that antibiotics remain effective and are available when needed.

Drugs in the reserve group are considered a last resort and therefore are kept for treatment of confirmed or suspected infections caused by multidrug-resistant bacteria. Other antibiotics in the reserve group include colistin, polymyxin B, fosfomycin, and linezolid.

New oral anticoagulants to prevent stroke are an alternative to warfarin for atrial fibrillation and treatment of deep vein thrombosis.

These are particularly advantageous for low-income countries as, unlike warfarin, they do not require regular monitoring.