In a significant revision of antibiotics in the essential medicines’ list, the WHO has recommended grouping the drugs into three categories on the basis of their usage to promote their rational use as well as combat anti-microbial resistance. The three categories include access, watch and reserve. Besides, 30 medicines for adults and 25 for children have been added to the World Health Organisation’s (WHO) Model list of essential medicines for 2017, bringing the total number of drugs on the list to 433. The list is deemed essential for addressing the most important public health needs. “Safe and effective medicines are an essential part of any health system,” said Marie-Paule Kieny, WHO Assistant Director-General for Health Systems and Innovation. “Making sure all people can access the medicines they need, when and where they need them, is vital to countries’ progress towards universal health coverage,” Kieny said. Explaining the three categories, Sumanth Gandra from Center for Disease Dynamics, Economics and Policy said those antibiotics which are the first choice for treating most common infections and therefore should be widely available at an affordable cost and of assured quality are defined under the ‘access’ category.
Antibiotics that are considered to have higher resistance and potential and are recommended as first or second choice treatments for a limited number of syndromes fall under the ‘watch’ category. While, drugs which should be used as a “last resort” and accessible only when needed will fall under the ‘reserve’ category, Gandra said. Gandra is part of the WHO expert committee that helped shape the revised list and recommended these three categories. Many low and middle-income countries face regular shortages of antibiotics due to high prices, sub-standard or counterfeit drugs.
When quality antimicrobials are not accessible, health care workers may prescribe suboptimal drugs, which could lead to increasingly resistant infections, Gandra explained. “The new categorisation of antibiotics will further guide countries in ensuring access to appropriate antibacterial agents and support antimicrobial stewardship efforts,” the official added.