Essential Medicines

The core list presents a list of minimum medicine needs for a basic health‐care system, listing the most
efficacious, safe and cost‐effective medicines for priority conditions. Priority conditions are selected on the
basis of current and estimated future public health relevance, and potential for safe and cost‐effective
treatment.
The complementary list presents essential medicines for priority diseases, for which specialized diagnostic
or monitoring facilities, and/or specialist medical care, and/or specialist training are needed. In case of doubt
medicines may also be listed as complementary on the basis of consistent higher costs or less attractive costeffectiveness
in a variety of settings.
The square box symbol (􀂆) is primarily intended to indicate similar clinical performance within a
pharmacological class. The listed medicine should be the example of the class for which there is the best
evidence for effectiveness and safety. In some cases, this may be the first medicine that is licensed for
marketing; in other instances, subsequently licensed compounds may be safer or more effective. Where there
is no difference in terms of efficacy and safety data, the listed medicine should be the one that is generally
available at the lowest price, based on international drug price information sources. Not all square boxes are
applicable to medicine selection for children — see the second EMLc for details.
Therapeutic equivalence is only indicated on the basis of reviews of efficacy and safety and when consistent
with WHO clinical guidelines. National lists should not use a similar symbol and should be specific in their
final selection, which would depend on local availability and price.