🟠 Moderate Evidence
A comprehensive analysis of the World Health Organization’s Essential Medicines List (EML) from 1977 to 2025 reveals that a core set of medications has remained fundamentally stable across nearly five decades of global health change. Researchers Lilly Josephine Bindel and Roland Seifert, publishing in the Global Health Journal (June 2026), identified which essential drugs have persisted through the list’s 24 iterations, providing insight into pharmaceutical constants in international health policy.
Key takeaways
- A stable “core essential drugs” subset has remained on WHO’s list across all 24 editions from 1977 to 2025, despite major changes in global disease burden and drug development
- The analysis by Bindel and Seifert establishes a methodology for identifying medications of sustained global public health priority
- These core drugs represent consensus on fundamental pharmaceutical interventions needed across all healthcare systems, regardless of income level
Study at a Glance
| Source | Global Health Journal |
| Study type | Comparative policy analysis across 24 WHO Essential Medicines Lists |
| Time period | 1977–2025 (48 years) |
| Primary focus | Identification of medications present across all 24 EML editions |
| Authors | Lilly Josephine Bindel, Roland Seifert |
WHO Essential Medicines List: Continuity and Change (1977–2025)
Number of medications across 24 list editions, showing core stable subset and expansion over time
Source: Bindel & Seifert, Global Health Journal, 2026 | Georgian Medical Journal News
A pharmacological baseline for global health
The WHO’s Essential Medicines List has served since its inception as the gold standard for identifying which medications all healthcare systems should have access to, regardless of a country’s economic resources. The list has expanded significantly over 48 years—from a compact initial formulation in 1977 to a more comprehensive modern version—reflecting new disease knowledge, emerging health threats, and advances in pharmacotherapy. However, according to Bindel and Seifert’s analysis in the Global Health Journal, beneath this expansion lies a remarkable continuity.
The identification of a “core essential drugs” subset—medications that have maintained their place on every single iteration of the list—offers policymakers and clinicians a robust evidence base for understanding pharmaceutical fundamentals. These drugs represent the interventions that successive WHO expert committees, convening at roughly two-year intervals, have consistently deemed indispensable to human health across all settings and income levels.
Implications for healthcare systems and drug access
The persistence of this core set has direct implications for how countries prioritize pharmaceutical procurement and regulation. By clarifying which medicines have proven their essential status across nearly five decades of global epidemiological change—from the dominance of infectious diseases in 1977 to the current burden of noncommunicable diseases—policymakers can make evidence-informed decisions about which medications should be universally available and affordable within their own healthcare systems.
For low- and middle-income countries in particular, the core essential drugs represent a starting point for establishing functional drug formularies without duplicating expensive proprietary research. The WHO’s work on access to medicines has long emphasized that availability of core essentials is a marker of healthcare quality. Bindel and Seifert’s comparative analysis provides quantitative backing for this principle: if a drug has remained essential across 48 years and 24 list revisions, its value is unlikely to be temporary or market-driven.
Changing disease burdens, stable medications
The most striking finding is the contrast between pharmaceutical stability and epidemiological change. In 1977, infectious diseases dominated the global disease burden; by 2025, cardiovascular disease, diabetes, cancer, and mental health conditions account for the majority of disability-adjusted life-years. Yet according to Bindel and Seifert’s research, many drugs that addressed 1977’s disease priorities remained on the 2025 list alongside new additions for modern conditions. This suggests not replacement, but cumulative addition—the WHO’s approach to list updates favors retaining proven interventions while incorporating new ones.
This approach reflects a pragmatic view: even as disease patterns shift, older medications retain value because they address persistent health needs (e.g., antibiotics for infections remain essential despite the shift toward NCDs) and their generic manufacture is mature and affordable. The stability of core drugs is, in this sense, not a sign of scientific stagnation but of sustained value and accessibility.
A core set of essential medications has remained on the WHO Essential Medicines List across all 24 editions from 1977 to 2025, demonstrating remarkable pharmaceutical consensus despite sweeping changes in global disease burden and healthcare technology.
— Lilly Josephine Bindel and Roland Seifert, Global Health Journal, 2026
What does this mean for patients, clinicians, and policy?
What this means
Frequently asked questions
What is the WHO Essential Medicines List, and why does it matter?
The WHO Essential Medicines List is a curated selection of medications deemed necessary to satisfy the priority healthcare needs of a population. It guides governments on which medicines to prioritize for procurement, manufacture, and access. Inclusion on the list signals that a drug is safe, effective, and cost-effective for use in all healthcare settings, from wealthy hospitals to rural clinics in low-income countries.
How often has the list changed since 1977?
According to Bindel and Seifert’s analysis in the Global Health Journal, the WHO has published 24 editions of the Essential Medicines List from 1977 to 2025—roughly every two years. While the total number of medications has grown to reflect new therapeutic options and emerging health needs, the analysis identified a stable “core subset” present in all iterations, demonstrating the list’s underlying pharmacological consistency.
What drugs are in the “core essential drugs” subset identified by this research?
Bindel and Seifert’s research identifies which drugs have been continuously present across all 24 editions, but the specific list depends on the full details of their analysis. The core medications typically include foundational drugs for infections (antibiotics), cardiovascular disease (e.g., aspirin, diuretics), pain and inflammation (analgesics), and emergency care (epinephrine). These represent universal healthcare priorities that transcend changes in disease burden or technology.
The analysis by Bindel and Seifert contributes to an evolving conversation about pharmaceutical equity and rational drug selection in global health. As new medicines continue to enter the market and health priorities shift—driven by aging populations, climate-related disease, and pandemic preparedness—the WHO’s challenge remains constant: determining which drugs all healthcare systems need, and which can be added without undermining access to fundamentals. The discovery of a persistent core set suggests that this balance is achievable, and that scientific consensus on essential medicines is more durable than the pace of pharmaceutical innovation might suggest. Future editions of the Essential Medicines List will reveal whether this core set continues to anchor global drug policy.
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Medically reviewed by Prof. Giorgi Pkhakadze, MD, MPH, PhD. Spotted an error? Contact the editorial team.
