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. 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.

Defined Daily Dose (DDD)

It is crucial that people with opioid dependence and those at risk of opioid overdose have access to prevention, harm reduction, treatment, and care, which are of good quality, affordable, ethical and evidence based. The list provides guidance on the development of new and necessary treatments to stop the spread of antimicrobial resistance (AMR). These include opioid agonist maintenance treatment (or OAMT) with medicines such as methadone and buprenorphine, pharmacological treatment with opioid antagonists (such as naltrexone) as well as psychosocial support.

Honduras: Listado Nacional de Medicamentos Esenciales LNME 2023 (Spanish)

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. WHO updates guidelines on opioid dependence treatment and overdose prevention The UNGASS marked a shift in the overall drug policy discourse to highlight the public health and human rights dimensions of the world drug problem and to achieve a better balance between supply reduction and public health measures.

Drug overdose: a film about life

Both publications are updated annually and available electronically and in hard copies. The ATC/DDD guidelines and the Index were both published for the first time in the current format in 1990. 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.

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 Opioid agonist maintenance treatment (OAMT) for people with opioid dependence is proven to be safe and effective in addressing a broad range of health…

WHO updates list of drug-resistant bacteria most threatening to human health

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,… This list beganwith 208 identified medicines and has grown to include 460 differentpharmaceuticals. WHO works with partners and Member States to strengthen regulation,including post-marketing surveillance, and to eliminate substandard andfalsified medicines. They are thelargest public expenditure on health after personal costs in many low-incomecountries, and the expense is a major cause of household impoverishment anddebt.

Access to appropriate medications is shown to have substantial impacts on community health and the related economic indicators. Universal health coverage Opioid overdose is easily reversed with the opioid antidote naloxone and with basic life… There is growing concern around the world about drug use and road safety. In 2013, an estimated 181.8 million people aged years…

• “Drug resistance threatens decades of progress in HIV, hepatitis and STI control.
• These pathogens require increased attention, especially in vulnerable populations including paediatric and elderly populations, particularly in resource-limited settings.
• Millennium Development Goal 8E aims for affordable access to essential medicines.Essential medicines, as defined by WHO, are those that “satisfy…
• 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.

In the choice of treatment, WHO recommends OAMT to be used for most patients as the intervention with strongest evidence of effectiveness for variety of outcomes. 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. 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.

• There is growing concern around the world about drug use and road safety.
• There are also international differences between PDDs, which can be up to four or five fold higher/lower.
• 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 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… More than 36 million years of healthy life loss (DALY) were attributable to drug use in 2019. Psychoactive drugs are substances that, when taken in or administered into one’s system, affect mental processes, e.g. perception, consciousness, cognition or mood and emotions. English and Spanish versions of the publications are available.

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.

Revisions of the Essential Medicines lists

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

DDD for Children

WHO Drug Information provides an overview of topics relating to drug development and regulation that are of current relevance and importance, and includes the lists of proposed and recommended International Nonproprietary Names for Pharmaceutical Substances (INN). 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. Changes to the index are made annually and a cumulative list including all ATC and DDD alterations made since 1982 is available  here .

These pathogens require Drug Overdose Facts 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. High priority pathogens, such as Salmonella and Shigella, are of particularly high burden in low- and middle-income countries, along with Pseudomonas aeruginosa and Staphylococcus aureus, which pose significant challenges in healthcare settings.

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.

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. Despite this transition, investment in R&D and other prevention and control strategies for CRPA remains important, given its significant burden in some regions.

Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection moving from critical to high priority in BPPL 2024 mirrors recent reports of decreases in global resistance. Gram-negative bacteria have built-in abilities to find new ways to resist treatment and can pass along genetic material that allows other bacteria to become drug-resistant as well. The updated BPPL incorporates new evidence and expert insights to guide research and development (R&D) for new antibiotics and promote international coordination to foster innovation.

The Framework builds on WHO’s Global health sector strategies and aligns with the Sustainable Development Goals and the Global Action Plan on Antimicrobial Resistance. “Drug resistance threatens decades of progress in HIV, hepatitis and STI control. It emphasizes antimicrobial stewardship, stronger surveillance systems, and equitable access to high-quality prevention, diagnosis and treatment services for HIV, hepatitis B and C and STIs. This feedback helps WHO develop high-quality guidelines that reflect diverse perspectives and respond to the needs of communities worldwide. To ensure transparency and inclusivity, WHO invites members of the public and interested organizations to review the biographies of the GDG members and provide feedback. GDG members were selected by WHO technical staff based on their technical expertise, their role as end-users (e.g., programme managers and healthcare providers), and their representation of affected communities.

ATC 3rd& 4th levels

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. Building on the value of the BPPL as a global tool, tailoring the list to country and regional contexts can account for regional variations in pathogen distribution and the AMR burden.