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WHO Essential Medicines List Application

Towards Equitable Access to Treatment for Multiple Sclerosis

Access to treatments for neurological disorders is egregiously insufficient, particularly in low-income and middle-income countries (LMICs). The inclusion of therapeutic agents on the WHO Model List of Essential Medicines (referred to as the essential medicines list [EML]) is an initial step to potentially increase their availability worldwide, as the list serves as a guide for the development of national and institutional EMLs.

Neurology organizations are working hard to tackle this situation and, on Dec 11, 2022, the Multiple Sclerosis International Federation (MSIF) and the WHO Collaborating Centre Bologna applied to WHO for the addition of disease-modifying treatments for multiple sclerosis to their EML.

MSIF has developed a new application with the help of two independent panels: the MSIF Off-Label Treatments panel (MOLT) co-chaired by Prof Bassem Yamout and Dr Shanthi Viswanathan and the MSIF Essential Medicines Panel (MEMP) chaired by Dr Deanna Saylor. Both panels are independent, multi-disciplinary and have international representation.The panels were tasked with reviewing DMTs for MS: all DMTs that have regulatory approval, as well as some DMTs that are used ‘off-label’. The panels considered DMTs for relapsing and progressive MS, and also took into account the needs of special populations, including adolescents, and pregnant or breast-feeding women.

The panels were tasked with reviewing DMTs for MS: all DMTs that have regulatory approval, as well as some DMTs that are used ‘off-label’. The panels considered DMTs for relapsing and progressive MS, and also took into account the needs of special populations, including adolescents, and pregnant or breast-feeding women.

The WHO EML application was endorsed by MENACTRIMS as well as several international organizations such as:

  • World Federation of Neurology (WFN)
  • African Academy of Neurology (AFAN)
  • Indian Academy of Neurology (IAN)
  • European Academy of Neurology (EAN)
  • American Academy of Neurology (AAN)
  • Neurology Society of Ghana (NSG)
  • Neurological Association of Zambia (NAZ)
  • Nigerian Society of Neurological Sciences (NSNS)
  • Neurological Society of Kenya (NSK)
  • Neurology Association of South Africa (NASA)
  • Pan-Asian Committee for Treatment and Research in Multiple Sclerosis (PACTRIMS)
  • Latin American Committee for Treatment and Research in Multiple Sclerosis (LACTRIMS)
  • Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS)
  • European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS)

The application to the WHO EML is now publicly available on the WHO website as of 9 February 2023. Open comment will be possible for four weeks from this date. The WHO EML Expert Committee will meet 24-28 April 2023 to assess all the applications, and outcome is expected by June 2023.

The approval by WHO of the MSIF application will be a crucial first step to ensure that people with multiple sclerosis will be able to access appropriate treatment options in LMICs.

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