Not all medications are the same. Some may alleviate symptoms but have serious side effects. Others are safe, cure serious medical conditions and improve lives. The World Health Organization (WHO) collects the most important medicines in a model list of essential medicines. The list is a recommendation for health systems worldwide and includes about 600 different drugs, such as anesthesia, antiviral drugs or pain and fever treatments.
“Medicines on the List are defined as the priority health needs of the population. They need to be safe, effective, available and affordable at all times,” said Benedict Huttner, Team Leader of Essential Medicines at WHO.
The goal is to ensure that medicines are used as wisely as possible and to improve medical care worldwide. “Our list of essential medicines is a template based on countries’ own national lists,” Hutner said.
More than 150 countries around the world already do this – low- and middle-income countries rely on WHO recommendations.
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Obesity medications can be added to the essential medication list
Every two years, WHO consultants discuss which drugs should be added to the list.
“Anyone can submit a suggestion: academic institutions, pharmaceutical companies and individuals – it’s completely open,” Huttner told DW.
For the 2023 update, researchers in the US have suggested adding an obesity drug called Saxenda to the list. It’s a daily injection that affects hunger signals in the brain and slows the rate at which a person’s stomach empties, making them feel fuller for longer.
Saxenda is a prescription drug that contains the active ingredient liraglutide. This substance will soon be free of patent restrictions, allowing the development of cheaper generic versions.
It will be the first obesity medicine on the WHO’s list of essential medicines.
Obesity is a global problem
People living with overweight or obesity accumulate excess fat, which presents a risk to their long-term health.
A body mass index (BMI) above 30 is considered obese.
“Obesity is a global problem that is increasing basically everywhere,” said Francesco Branca, Director of the Department of Nutrition for Health and Development.
The World Health Organization reports that more than 650 million adults worldwide are obese. More than 4 million people die every year due to obesity such as heart disease, diabetes and cancer. The most affected regions are North America, Europe and the Middle East.
Once considered a problem only in high-income countries, obesity is now increasing dramatically in low- and middle-income countries, especially in urban settings.
“This is creating incredible pressure on health systems that already have to deal with other types of emergencies,” Branca told DW. “Now they have this additional burden of obesity that they’re not equipped for.”
Possible side effects of obesity medications
Inclusion of anti-obesity drugs in WHO’s list of essential medicines can help reduce the burden of obesity.
But some health experts doubt the need for obesity drugs.
Some obesity medications have potential side effects, such as inflammation of the pancreas, gall bladder problems or increased heart rate. Also, long-term safety and efficacy data are lacking.
“These drugs were actually developed to treat diabetes. The use for obesity is a relatively new application,” explained WHO Director Branca. “It will be important to see what the long-term results are because these drugs need to be used for life. Otherwise the weight loss will be reversed.”
Obesity is also a complex condition that cannot be cured by medication alone.
Health experts say that drug treatment is only one aspect of non-pharmacological approaches such as improved nutritional habits, exercise and psychological support.
“Lifestyle interventions are a key to the management of obesity,” Branca said.
“Sustained efforts in prevention strategies and education, gender-focused interventions should prioritize the use of obesity drugs,” Zulfiqar Bhutta, an obesity expert at the University of Toronto, said in a Reuters report.
Another important aspect is that obesity management is not only about weight loss but also about improving a person’s bodily functions such as blood pressure, mental health and mobility.
“So medication can be part of a therapeutic strategy, but it’s not a silver bullet that will solve obesity,” Branca said.
WHO to analyze the benefits and risks of obesity drugs
Researchers who suggested the Saxenda drug, including Sanjana Garimela of the Yale School of Medicine and Sandeep Kishore of the University of California, did not respond to DW’s request for comment ahead of publication.
WHO consultants will review the request by the end of April 2023. They are an international group of experts in health, medicine and evidence-based medicine, who will analyze the benefits, risks and costs of obesity drugs and other recommended drugs. . They will make recommendations, which will either be accepted or rejected by the WHO Director-General. An updated list of essential medicines is expected to be published in July 2023.