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. The Intersectoral Global Action Plan On Epilepsy and Other Neurological Disorders promotes the inclusion and updating of essential and affordable medicines and health products for neurological disorders in national EMLs, as guided by the WHO list. However, neurological conditions remain poorly represented on the WHO EML, and multiple sclerosis is a case in point, as there are no treatments listed for the disease. Neurology organisations are working hard to tackle this situation and, on Dec 11, 2022, the Multiple Sclerosis International Federation (MSIF) applied to WHO for the addition of disease-modifying treatments for multiple sclerosis to their EML.

MSIF, an alliance of national multiple sclerosis organisations, first applied in 2018 for three disease-modifying treatments—glatiramer acetate, fingolimod, and ocrelizumab—to be added to the WHO EML. The WHO Expert Committee on Selection and Use of Essential Medicines did not recommend adding any of the three therapies to the 2019 WHO EML, noting that there was no clear evidence that glatiramer acetate, fingolimod, or ocrelizumab were superior to other multiple sclerosis drugs in terms of safety, efficacy, and affordability, and that the application had excluded commonly used drugs and off-label medications.1

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References

  1. Neurology, N. L. (2023). Towards equitable access to treatment for multiple sclerosis. Lancet Neurology, 22(3), 189. https://doi.org/10.1016/s1474-4422(23)00041-8

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