{"id":32078,"date":"2014-08-01T11:27:18","date_gmt":"2014-08-01T10:27:18","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=32078"},"modified":"2014-08-01T14:06:54","modified_gmt":"2014-08-01T13:06:54","slug":"the-bmj-today-essential-medicines-evidence-and-influence","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2014\/08\/01\/the-bmj-today-essential-medicines-evidence-and-influence\/","title":{"rendered":"The BMJ Today: Essential medicines, evidence, and influence"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/05\/helen_mac.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-31642\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/05\/helen_mac-150x150.jpg\" alt=\"helen_mac\" width=\"150\" height=\"150\" \/><\/a>Today <a href=\"http:\/\/www.bmj.com\/content\/349\/bmj.g4798\">an Analysis article questions<\/a> the quality of applications to the World Health Organization&#8217;s essential medicines list. The WHO essential medicines list is a skeletal formulary of medicines that all countries should consider making available. Although the list just covers the basics, the medicines included such as amoxicillin and haloperidol are taken seriously\u2014to be a WHO essential medicine is a big deal.<\/p>\n<p>Corrado Barbui and Marianna Purgato audited the quality of drug applications against the standards and evidence that WHO asks for. They focus on the quality of the evidence presented in the application. Overall, they are not impressed, and their audit leads <a href=\"http:\/\/www.bmj.com\/content\/349\/bmj.g4798\">to a discussion<\/a> about how the applicants and WHO could raise standards. You can <a href=\"https:\/\/soundcloud.com\/bmjpodcasts\/are-essential-medicines-essential?utm_source=soundcloud&amp;utm_campaign=share&amp;utm_medium=twitter\">listen to Barbui setting out his concerns and solutions in a Podcast too<\/a>.<!--more--><\/p>\n<p>Debate articles are the bread and butter of the Analysis section of <em>The BMJ<\/em>, and Barbui and Purgato\u2019s evaluation provided a strong base for them to illustrate the problems and call for change. But even if the quality of prospective essential medicine applications were impeccable, would we have a perfect list?<\/p>\n<p>A\u00a0<a href=\"http:\/\/www.bmj.com\/content\/349\/bmj.g4823\">Commentary by Colin Millard and colleagues<\/a>\u00a0suggests perhaps not. They take the example of misoprostol, which was included as an essential medicine in 2011 for the prevention of postpartum haemorrhage, following multiple unsuccessful applications. Little new evidence to show the efficacy of the drug compared to oxytocin accumulated. However,\u00a0misoprostol has some practical advantages in lower resource settings because it is easier to store and has various routes of administration.<\/p>\n<p>Although Millard and colleagues are bothered by evidence for misoprostol, the focus of their commentary lies elsewhere\u2014with influence. They\u00a0want to understand whether it was influence, in the absence of evidence, that led to the application finally being approved. The authors\u00a0present a graph showing the number of organisations supporting applications for misoprostol and are concerned about the vested interest and positions of some of the organisations involved.<\/p>\n<p>We hope that these complementary perspectives will give readers an insight into the processes that lie behind the list. And that they&#8217;ll\u00a0spark debate about how the list might better serve patients around the globe in the future.<\/p>\n<p><em><strong>Helen Macdonald<\/strong>\u00a0is the analysis editor, The BMJ.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Today an Analysis article questions the quality of applications to the World Health Organization&#8217;s essential medicines list. The WHO essential medicines list is a skeletal formulary of medicines that all [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/08\/01\/the-bmj-today-essential-medicines-evidence-and-influence\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[447,5750],"tags":[],"class_list":["post-32078","post","type-post","status-publish","format-standard","hentry","category-india","category-the-bmj-today"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The BMJ Today: Essential medicines, evidence, and influence - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/08\/01\/the-bmj-today-essential-medicines-evidence-and-influence\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The BMJ Today: Essential medicines, evidence, and influence - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Today an Analysis article questions the quality of applications to the World Health Organization&#8217;s essential medicines list. The WHO essential medicines list is a skeletal formulary of medicines that all [...]More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/bmj\/2014\/08\/01\/the-bmj-today-essential-medicines-evidence-and-influence\/\" \/>\n<meta property=\"og:site_name\" content=\"The BMJ\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/bmjdotcom\/\" \/>\n<meta property=\"article:published_time\" content=\"2014-08-01T10:27:18+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2014-08-01T13:06:54+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/05\/helen_mac-150x150.jpg\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:site\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/08\\\/01\\\/the-bmj-today-essential-medicines-evidence-and-influence\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/08\\\/01\\\/the-bmj-today-essential-medicines-evidence-and-influence\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"The BMJ Today: Essential medicines, evidence, and influence\",\"datePublished\":\"2014-08-01T10:27:18+00:00\",\"dateModified\":\"2014-08-01T13:06:54+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/08\\\/01\\\/the-bmj-today-essential-medicines-evidence-and-influence\\\/\"},\"wordCount\":378,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/08\\\/01\\\/the-bmj-today-essential-medicines-evidence-and-influence\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2014\\\/05\\\/helen_mac-150x150.jpg\",\"articleSection\":[\"South Asia\",\"The BMJ today\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/08\\\/01\\\/the-bmj-today-essential-medicines-evidence-and-influence\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/08\\\/01\\\/the-bmj-today-essential-medicines-evidence-and-influence\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/08\\\/01\\\/the-bmj-today-essential-medicines-evidence-and-influence\\\/\",\"name\":\"The BMJ Today: Essential medicines, evidence, and influence - 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