WHO Expands Essential Medicines List with New Cancer, Diabetes and Obesity Drugs

The World Health Organization (WHO) has published the latest editions of its Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc), introducing major updates that include new treatments for cancer, diabetes, and obesity, along with therapies for cystic fibrosis, psoriasis, haemophilia, and blood disorders.

These revisions, marking the 24th edition of the EML and the 10th edition of the EMLc, are considered a milestone in global health policy. More than 150 countries use the WHO lists to guide procurement, reimbursement, and universal health coverage strategies.

“The new editions of essential medicines lists mark a significant step toward expanding access to new medicines with proven clinical benefits and with high potential for global public health impact,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Health Systems, Access and Data.

A Global Health Policy Tool Since 1977

Launched nearly five decades ago, the WHO Model Lists were initially designed to support medicine access in developing countries. Today, they serve as a gold standard reference for national health systems worldwide, helping governments prioritize medicines for public procurement, health insurance coverage, and essential supply chains.

This year, the Expert Committee on the Selection and Use of Essential Medicines reviewed 59 applications, including 31 proposals for new medicines or classes. The outcome:

• 20 new medicines added to the adult EML.

• 15 new medicines added to the EMLc.

• 7 existing medicines granted new indications.

With these updates, the lists now include 523 medicines for adults and 374 for children, reflecting the most urgent public health needs.

Tackling the Global Cancer Burden

Cancer remains the second leading cause of death worldwide, claiming almost 10 million lives annually. It accounts for nearly one in three premature deaths from noncommunicable diseases.

Over the past decade, WHO has increasingly focused on cancer medicines. However, given the rapid rise of costly new drugs, only those offering proven survival benefits of at least 4–6 months make it onto the lists.

Key decisions from the 2025 update include:

• Addition of pembrolizumab as a first-line monotherapy for metastatic cervical cancer, metastatic colorectal cancer, and metastatic non-small cell lung cancer (NSCLC).

• Inclusion of atezolizumab and cemiplimab as alternatives for metastatic NSCLC.

These drugs belong to the PD-1/PD-L1 immune checkpoint inhibitors, a class of immunotherapies that enhance the body’s ability to detect and destroy cancer cells.

The Committee also endorsed clinical strategies to improve access, such as dose optimisation approaches, while urging governments to pursue health system reforms and affordability measures to ensure equitable access.

Diabetes, Obesity, and New GLP-1 Therapies

The update also prioritizes medicines for type 2 diabetes and obesity, two of the fastest-growing health crises globally.

• Over 800 million people live with diabetes, half of them untreated.

• More than 1 billion people are affected by obesity, with rates surging fastest in low- and middle-income countries.

The Committee added several glucagon-like peptide-1 (GLP-1) receptor agonists and related drugs to the EML, including:

• Semaglutide, dulaglutide, liraglutide (GLP-1 agonists).

• Tirzepatide (GLP-1/GIP dual receptor agonist).

These drugs lower blood sugar, support weight loss, reduce risks of heart and kidney complications, and even improve survival in patients with comorbidities. They are recommended for adults with type 2 diabetes with cardiovascular or kidney disease and obesity (BMI ≥ 30kg/m²).

However, the high costs of semaglutide and tirzepatide remain a major barrier. WHO emphasized the need to prioritize patients most likely to benefit, encourage generic competition, and integrate these treatments into primary care systems.

Beyond Noncommunicable Diseases

The new editions also address treatments for:

• Cystic fibrosis – providing guidance on rare but life-threatening genetic conditions.

• Haemophilia and other blood disorders – expanding access to clotting factor therapies.

• Psoriasis and inflammatory conditions – adding options for chronic, debilitating skin diseases.

These updates highlight WHO’s efforts to balance life-saving therapies for common diseases with specialized treatments for rare conditions.

Equity and Affordability Challenges

Access to essential medicines remains uneven, particularly in low-resource settings. Many of the newly added treatments are expensive, patent-protected, and not widely available, raising concerns about affordability.

“A large share of out-of-pocket spending on noncommunicable diseases goes toward medicines, including those classified as essential and that, in principle, should be financially accessible to everyone,” said Deusdedit Mubangizi, WHO Director of Policy and Standards for Medicines and Health Products.

WHO stressed that achieving equitable access requires:

• National policy reforms to integrate essential medicines into health coverage.

• Global cooperation to lower drug prices through generics and fair pricing models.

• People-centered programs that guarantee no one is left behind.

Looking Forward

The updated lists are expected to guide national health authorities, donors, and insurance providers in making evidence-based decisions on which medicines to fund and distribute. They also send a strong message to pharmaceutical companies and policymakers that lifesaving therapies must be made available at affordable prices worldwide.

“Equitable access to essential medicines requires strong political will and a coherent health system response,” WHO said in its closing remarks, urging governments to act on the Committee’s recommendations.