Essential medicines lists are for high income countries too

On 26 July 2023, the World Health Organization published the 23rd edition of its essential medicines list.1 First devised in 1977, the list comprises medicines “that satisfy the priority healthcare needs of the population.” As such, the concept of essential medicines deserves wider attention from high income countries.

Historically, the US has been a consistent opponent of the essential medicines concept.2 So it is remarkable that, almost unnoticed, on 6 August 2020, US President Biden issued an executive order directing the US Food and Drug Administration to “identify a list of essential medicines … that are medically necessary to have available at all times in an amount adequate to serve patient needs and in the appropriate dosage forms.”3

The essential medicine concept is intended to “carve out a core subset of therapeutic substances from the broader universe of commercial pharmaceutical products, and appropriate them into a public health commons.”2 Essential medicines have joined clean water, safe food supply, and adequate housing as necessities whose absence constitutes a basic failure of universal human rights.4 Access …