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WHO and national lists of essential medicines in Mexico, Central and South America, and the Caribbean: are they adequate to promote paediatric endocrinology and diabetes care?
  1. Amanda Rowlands1,2,
  2. Alejandra Acosta-Gualandri1,
  3. Jaime Guevara-Aguirre3,
  4. Jean-Pierre Chanoine1,2
  1. 1Endocrinology and Diabetes Unit, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
  2. 2Global Pediatric Endocrinology and Diabetes (GPED), Vancouver, British Columbia, Canada
  3. 3Colegio de Medicina, Universidad San Francisco de Quito, Quito, Ecuador
  1. Correspondence to Dr Jean-Pierre Chanoine; jchanoine{at}


Paediatric endocrinology and diabetes is a paediatric specialty with less common conditions and higher cost medicines. Access to medicines for our specialty in low and middle income countries remains limited. We analysed the content of the WHO (children and adults) and of all available national Model Lists of Essential Medicines (EMLs) for Mexico, the Caribbean, Central and South America from a paediatric endocrinology and diabetes standpoint. A master list of medicines deemed necessary in paediatric endocrinology and diabetes was established and compared with the WHO and national EMLs, taking into account the gross national income. The WHO EMLs, which are largely recognised as an international benchmark and drive the content of the national EMLs, included many but not all medicines present on our master list. Interestingly, several national EMLs from richer countries included medicines that were not present in the WHO EMLs. Our analysis suggests that these medicines could be considered by the WHO for inclusion in their EMLs, which may promote the adoption of more medicines by individual countries. We also propose several changes to the WHO and national EMLs that could facilitate access to medicines in our specialty: age cut-off for a child using physical maturity rather than a set age limit; greater standardisation of the formatting of the national EMLs for easier comparison and collaborations between countries; greater emphasis on age-specificity and population-specificity for some medicines; and formatting of the EMLs in a disease-focused manner rather than as individual medicines.

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  • Handling editor Soumitra Bhuyan

  • Contributors AR did the literature search, collected and interpreted the data and wrote the draft of the manuscript and of the figures. AA and JG-A critically reviewed the master list of medicines, read the manuscript and provided input on the interpretation of the data and on the discussion. J-PC designed the study, led the focus group for the master list of medicines, discussed the interpretation of the results, and revised the manuscript and the figures. All authors have read and approved the manuscript. J-PC had full access to all the data in the study and had final responsibility for the decision to submit for publication.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data are available to all authors.