|
Some NGOs working in the health sector in the country have recently asked the Union Health Ministry to urgently revise the National List of Essential Medicines (NLEM) which was not revised after the current NLEM was notified in September, 2022. The NLEM was first formulated in India in the year 1996 and the Ministry has revised it periodically in 2003, 2011, 2015, and lastly in 2022. The NLEM 2022 had a total of 384 medicines of which 34 were new medicines added to the earlier list while 26 medicines from the previous list were deleted due to various reasons. The medicines have been categorised into 27 therapeutic categories. Periodic revision of NLEM is necessary as the Essential Medicines are those that satisfy the priority healthcare needs, based on efficacy, safety, quality and total cost of the treatment. The primary purpose of NLEM is to promote rational use of medicines considering the three important aspects of cost, safety and efficacy. It also helps in optimum utilization of healthcare resources and budget, drug procurement policies, health insurance, improving prescribing habits, medical education and training for UG/PG, and drafting pharmaceutical policies. It is true that the concept of NLEM is based on the premise that a limited list of carefully selected medicines will improve quality of healthcare, provide cost-effective healthcare and better management of medicines. Definitely, the NLEM is a dynamic document and it should be revised on a regular basis considering the changing public health priorities as well as advancement in pharmaceutical knowledge.
Now, the NGOs have asked the Ministry to revise this important document on the plea that the World Health Organisation (WHO) has revised its Model List of Essential Medicines (WHO List of Essential Medicines) on two occasions after the current NLEM was notified in India in 2022. The WHO has revised its list on two occasions, in 2023 and 2025, incorporating significant additions and updates. The WHO List of Essential Medicines, 2025 has a total of 523 medicines but the number of medicines listed in NLEM, 2022 is just 384. So, it is clear that several medicines mandated in the WHO’s list are absent in the NLEM, 2022. These omissions include critical medicines for the treatment of noncommunicable diseases such as cancer and diabetes. For instance, 17 active cancer-treating agents and four supportive agents for cancer treatment are absent in the NLEM. The list also includes nine monoclonal antibodies (mAbs) that are also missing in the NLEM, 2022. These mAbs have been proven critical for targeted therapies in many diseases, especially cancer. While recognizing the fact that NLEM should be based on the public health priorities of India, bringing many of these critical medicines under NLEM will make sure that these essential medicines are accessible to people and will also make them more affordable thereby advancing both constitutional guarantees and India’s global commitments to health equity. The prolonged delay in revising the NLEM will deny millions of citizens free access to newly recognized essential medicines within the public health system, while also restricting affordable access in the private sector. No doubt, the NLEM serves as the basis for national medicine policies and ensures that life-saving treatments are accessible to all populations, regardless of economic status. As a nation committed to universal access and the right to health, it is imperative that this matter receives immediate attention. The Union Health Ministry should now revise the NLEM and should ensure that it reflects the latest evidence, public health priorities, and the WHO Model List of Essential Medicines.
|