Despite this transition, investment in R&D and other prevention and control strategies for CRPA remains important, given its significant burden in some regions. The fact that third-generation cephalosporin-resistant Enterobacterales are listed as a standalone item within the critical priority category emphasizes their burden and need for targeted interventions, especially in low- and middle-income countries. Changes between the 2017 and 2024 lists “Antimicrobial resistance jeopardizes our ability to effectively treat high burden infections, such as tuberculosis, leading to severe illness and increased mortality rates,” said Dr Jérôme Salomon, WHO’s Assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases. These pathogens require increased attention, especially in vulnerable populations including paediatric and elderly populations, particularly in resource-limited settings. Medium priority pathogens include Group A and B Streptococci (both new to the 2024 list), Streptococcus pneumoniae, and Haemophilus influenzae, which present a high disease burden.
Guidelines for ATC Classification and DDD assignment
DDDs are normally assigned based on use in adults.For medical products approved for use in children, the dose recommendations will differ based on age and body weight. The DDDs are allocated to drugs by the WHO Collaborating Centre in Oslo, working in close association with the WHO International Working Group on Drug Statistics Methodology. This limits comparisons of drug consumption at an international level. Drug consumption can be expressed in cost, number of units, number of prescriptions or by the physical quantity of drugs.
Defined Daily Dose (DDD)
The system has fourteen main anatomical or pharmacological groups (1st level). In Hanoi, WHO’s collaboration provides a rosy picture of health Digital version of Essential Medicines list (eEML) launched Promoting rational use of medicines Strengthening access to essential medicines
WHO guideline on balanced national controlled medicines policies to ensure medical access and safety
High prices, misuse of drugs and poor or unreliabledrug quality contribute to this issue. However, globalized trade can undermine regulation, and in resource-limited settings especially, incidence of substandard or falsified medicines is growing. Today there are thousands of drugs on the market able to prevent, treat and lessen the impact of ailments that would have been fatal just a few generations ago. 1st WHO Forum on alcohol, drugs and addictive behaviours 2nd WHO Forum on alcohol, drugs and addictive behaviours
Classification principles and challenges
Medicinal products containing two or more active ingredients are regarded as combinations in the ATC classification system and given different ATC codes from the product with a single component (one active ingredient). This will often give several classification alternatives and the main indication is decided by the WHO International Working Group for Drug Statistics Methodology on the basis of available literature and a qualified assumption of the most prevalent indication worldwide. The challenge occurs when a medicinal product (same strength and route of administration) is approved and used for two or more equally important indications, and the main therapeutic use differs from one country to another.
The ATC index with DDDs
Changes to the index are made annually and a cumulative list including all ATC and DDD alterations made since 1982 is available here . For drugs where the recommended dosage differs for different indications (e.g. antipsychotics) it is important that diagnosis is linked to the prescribed daily dose given. The PDD can be determined from studies of prescriptions, medical or pharmacy records, and it is important to relate the PDD to the diagnosis on which the drug is used.
- WHO’s work on antimicrobial resistance
- Despite this transition, investment in R&D and other prevention and control strategies for CRPA remains important, given its significant burden in some regions.
- In many ATC main groups, pharmacological groups have been assigned on the 2nd, 3rd and 4th levels allowing drugs with several therapeutic uses to be included, without specifying the main indication.
- In 2013, an estimated 181.8 million people aged years…
- Since 1977, WHO has maintained a list of essentialmedicines as a means to promote health equity around the world.
Treatment and care for people with drug use disorders in contact with the criminal justice system: alternatives…
WHO drug information provides an overview of topics of current relevance relating to drug development and regulation. The Global status report on alcohol and health and treatment of substance use disorders presents a comprehensive overview of alcohol consumption, alcohol-related… WHO recommends that essential medicines, including those that are controlled, be available to all patients at all times at a price that the individual… Access to medicines is essential for attainment of universal health coverage, which is central to achievement of the health-related Sustainable Development…
Guidelines and recommendations concerning medicines, biologicals, vaccines, medical devices, herbals and related products WHO Drug Information is a quarterly journal providing an overview of topics relating to medicines development and regulation which is targeted to a wide audience of health professionals and policy makers. It is estimated that worldwide there are almost 14.8 million people who inject drugs, of whom 15.2% live with HIV and 38.8% – with hepatitis C. Production, distribution, sale or non-medical use of many psychoactive drugs is either controlled or prohibited outside legally sanctioned channels by law.
Although it was not designed as a global standard, the listnow acts as a guide for the procurement and supply of medicines at the nationaland local level. Universal health coverage can only be achieved when thereis affordable access to safe, effective and quality medicines and healthproducts. Equal access and the reliable supply of medicines is anongoing goal of WHO and global health delivery systems, the achievement ofwhich is hampered by several factors. Working to increase access to essentialpharmaceuticals while limiting the spread of falsified products is at the heart of WHO’s global strategy on medicines.
For enquiries, please send an e-mail to It presents a range of perspectives on how current challenges impact the manufacture, prescribing and access of medicines throughout the world and introduces newly-released guidance documents. Latest lists of proposed and recommended International Nonproprietary Names for Pharmaceutical Substances (INN) are also included. Over 3 million annual deaths due to alcohol and drug use, majority among men UN Commission approves WHO recommendations to place psychoactive substances under international control
For example, low strength finasteride tablets used for treatment of baldness are classified under D11AX Other dermatologicals and the high strength tablets used for benign prostatic hyperplasia (BPH) are classified under G04C Drugs used in BPH. For example, calcium channel blockers are classified in the pharmacological group C08 (see classification of verapamil below), which avoids specifying whether the main indication is coronary heart disease or hypertension. Medicinal substances are classified according to their main therapeutic use on the basic principle of only one ATC code for each medicinal product (as defined by route of administration and in some cases strength).
- Quality-assured, safe and effective medicines, vaccines and medicaldevices are fundamental to a functioning health system.
- Tanzania making steady progress in access to essential medicines and health products as new challenges emerge
- Without urgent, coordinated action, it could lead to increased new infections and treatment failures and higher preventable morbidity and mortality, and undermine global elimination goals.
- Changes between the 2017 and 2024 lists
- It presents a range of perspectives on how current challenges impact the manufacture, prescribing and access of medicines throughout the world and introduces newly-released guidance documents.
In 2022, approximately 60 million people globally engaged in non-medical opioid use, including the use of drugs like heroin, morphine, codeine, fentanyl, methadone, tramadol, and other similar substances. Currently, WHO is convening a guideline development group (GDG) for update of both guidelines with an aim to improve availability and access to treatment of opioid dependence and reduce the number of deaths from opioid overdose by providing evidence-based recommendations on the psychosocially assisted pharmacological treatment and interventions on prevention and management of opioid overdose. WHO announces development of updated guidelines for the psychosocially assisted pharmacological treatment of opioid dependence and community management of opioid overdose
The new framework proposes a unified approach to prevent the emergence and spread of resistance and reduce Drug Treatment and Recovery its impact through integrated, people-centred strategies. Without urgent, coordinated action, it could lead to increased new infections and treatment failures and higher preventable morbidity and mortality, and undermine global elimination goals. Drug resistance is a major challenge to prevention and treatment efforts. Such drugs are usually only given one code and this may be a problem for users in countries where other uses are predominant. Substandard and falsified medical products This second review of the world medicines situation (first published in 1988 as The WorldDrug Situation) presents the available evidence on global production,…
In the guidelines, WHO recommends the use of a range of treatment options for opioid dependence. Since 1977, WHO has maintained a list of essentialmedicines as a means to promote health equity around the world. At the same time, antimicrobial resistance is challenging the effectiveness of many commonly used medicines in one of the most concerning threats to global health today. Since then there have been incredible advances in drugs for a wide range of health concerns including disease, mental health and other conditions.
Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence (2009) In many ATC main groups, pharmacological groups have been assigned on the 2nd, 3rd and 4th levels allowing drugs with several therapeutic uses to be included, without specifying the main indication. Tanzania making steady progress in access to essential medicines and health products as new challenges emerge
In resolution S-30/1, the General Assembly adopted the outcome document of the special session on the world drug problem entitled “Our joint commitment to effectively addressing and countering the world drug problem”. Target 3.5 of UN Sustainable Development Goal 3 sets out a commitment by governments to strengthen the prevention and treatment of substance abuse. Since its creation, WHO has played an important role within the UN system in addressing the world drug problem.
DDDs provide a fixed unit of measurement independent of price, currencies, package size and strength enabling the researcher to assess trends in drug utilization and to perform comparisons between population groups. An operational handbook accompanies the guidelines, providing practical advice for large-scale implementation. Primarily aimed at health policymakers and National TB Programme (NTP) managers, they also support healthcare providers and technical organizations engaged in TB care. WHO’s work on antimicrobial resistance For example, antibiotic-resistant Mycoplasma genitalium, which is not included in the list, is an increasing concern in some parts of the world.
This Centre is located at the Norwegian Institute of Public Health (NIPH) and the main activities of the Centre are drawn up in an agreement between the WHO Headquarters and the Government of Norway. There are also international differences between PDDs, which can be up to four or five fold higher/lower. When there is a substantial discrepancy between the PDD and the DDD, it is important to take this into consideration when evaluating and interpreting drug utilization figures. The PDD will give the average daily amount of a drug that is actually prescribed. DDDs sometimes need to be reviewed because dosages may change over time, e.g. due to the introduction of new main indications or new research making it necessary to change the DDD. Estimating prevalence of drug use in children is not possible by using crude sales data presented in DDDs owing to the variability of children’s doses.