WHO updates ‘essential drugs’ list, aims to fight superbugs

The World Health Organisation on Tuesday published an updated list of "essential medicines", grouping antibiotics in a new fashion to help beat drug resistance and adding drugs for the treatment of certain types of cancer, tuberculosis, HIV and hepatitis C.

The updated list adds 30 medicines for adults and 25 for children and specifies new uses for nine drugs, and pushes the total number of essential medicines to 433. In comparison, India's National List of Essential Medicines 2015 contains 376 drugs.

The new WHO recommendations are aimed at reducing the use of certain categories of ''last resort'' antibiotics as part of its ongoing efforts to combat the rise of superbugs.

Public health officials have been frequently pointing to the increasing rate of new strains of pathogens that are becoming antibiotic-resistant, saying these ''nightmare bacteria'' pose a catastrophic threat. Overuse of antibiotics in livestock as well as in humans is the main cause, and India is a prime culprit in this regard.

Such resistance has created a world in which even the most minor of infections and illnesses can quickly turn deadly and in which diseases once thought conquered, such as tuberculosis and gonorrhea, are becoming untreatable in more and more cases.

The WHO's new advice, the biggest revision in 40 years regarding this last-resort category of drugs, puts antibiotics in three categories - watch, access and reserve - that describe which antibiotics can be used more liberally and which ones should be saved for more serious cases.

Many countries use the WHO essential list to guide their own decisions about which products they should ensure are easily available for their populations. The WHO defines essential medicines as drugs that "satisfy the priority needs of the population".

The essential list includes antibiotics used in treating only 21 of the commonest infections. The WHO said the classification might later be expanded to cover the antibiotics used in other infections.

"The rise in antibiotic resistance stems from how we are using and misusing these medicines," Suzanne Hill, director of the essential medicines and health products division at the WHO, said in the statement.

"The new WHO list should help health system planners and prescribers ensure people who need antibiotics have access to them, and ensure that they get the right one, so that the problem of resistance does not get worse."

''The aim is to contain antibiotic resistance, optimize antibiotic treatment and to preserve 'last-resort' antibiotics,'' Marie-Paule Kieny, assistant director-general for health systems and innovation at the WHO, told reporters during a briefing from Geneva. ''We don't see this as a quick-fix solution,'' she added, but scientific evidence supports the idea that this could reduce the number of dangerous infections.

The global health agency has recommended that the "access" antibiotics be available at "all times" as treatments for a range of common infections. One example is amoxicillin, widely used to treat infections such as pneumonia.

The "watch" antibiotics are not recommended as first or second-choice treatments except in case of a small number of infections. The use of ciprofloxacin, for example, should be "dramatically reduced" except in cases of urinary tract and upper respiratory tract infections to avoid any further development of resistance.

The "reserve" category of antibiotics, such as colistin and some cephalosporins, should be considered "last resort" options. They should be used only in the most severe circumstances when all other alternatives have failed, such as in life-threatening infections from multi-drug-resistant bacteria.

The WHO's updated list adds 10 antibiotics for use in adults and 12 in children, and two oral cancer medicines, dasatinib and nilotinib, for the treatment of chronic myeloid leukaemia that has become resistant to standard treatment.

The revised list also includes a new pill for hepatitis C that combines two medications, a more effective treatment for HIV, and new paediatric formulations for tuberculosis and pain-relieving drugs.