The 24th meeting of the WHO Expert Committee on Selection and Use of Essential Medicines was held in Geneva, Switzerland, from 24 to 28 April 2023. The Committee considered 85 applications proposing additions, changes and deletions of medicines, medicine classes and formulations on the Model Lists of Essential Medicines. The Committee evaluated the scientific evidence for effectiveness, safety and cost- effectiveness of the medicines in question. The Committee also considered a review of the age-appropriateness of formulations of essential medicines for children, the AWaRe classification of antibiotics, and other matters relevant to the selection and use of essential medicines.

The Global Action Plan on Antimicrobial Resistance (AMR) calls for making AMR a core component of professional education and training. In 2018, the World Health Organization (WHO) published Competency framework for health workers’ education and training on AMR to ensure that academic institutions and regulatory agencies provided pre-service and in-service training to equip health workers with the adequate competencies to address AMR. This was followed by Health workers’ training and education on AMR: curricula guide, which outlines the learning objectives and expected outcomes of pre-service training of health workers to improve curricula. The tool for assessing AMR curricula for medical education complements other WHO tools. Its aim is to identify gaps in curricula for medical education so that they can be remediated. This tool will allow a rapid review of curricula for training medical students in a national or university context to evaluate the robustness of their content for achieving the core competencies listed in the Competency Framework for Health Workers’ Education and Training on AMR. It can also assist in designing a strategy to enhance the AMR elements in curricula for medical education and to stimulate or facilitate periodic structured discussions on AMR and health worker competencies among the faculty of medical universities and other relevant stakeholders. A robust medical curriculum, which sufficiently includes AMR elements, will contribute to ensuring that future doctors have the necessary awareness and skills to address AMR in policy and practice.

Over the past many years, new and novel antibiotics have been developed against resistant bacterial species, but their increased clinical usage has led to reduced bacterial susceptibility and increased bacterial resistance to these novel agents. When a new antibiotic is developed, bacterial species initially show susceptibility to the agent, but with the passage of time, as the use of the antibiotic increases, the bacterial species acquire resistance against the drug or even the drug class. This book provides a comprehensive overview of antimicrobial stewardship programs and the obstacles to implementing and maintaining such programs. Antimicrobial stewardship is an important part of a multifaceted approach to preventing the emergence of antibiotic resistance in various microbial species. The book highlights the basic and initial steps necessary for initiating an antimicrobial stewardship program, as well as explores the different strategies of antimicrobial stewardship.

The primary objective of this curriculum is to equip health and care workers with the essential knowledge and competencies necessary for delivering safe and effective care. By doing so it aims to significantly reduce HAIs and combat antimicrobial resistance, thereby safeguarding both patient and HCWs well-being. This curriculum is developed to meet the needs of IPC professionals responsible for developing learning resources and overseeing training within health care organizations. Moreover, the curriculum is intended to encompass all individuals involved in health care delivery and support. This holistic approach includes a wide range of staff -ranging from clinical workers to administrative and auxiliary services, thus ensuring a broad and inclusive approach to IPC training. The guide is designed to be flexible, allowing for adaptation to various educational and practical contexts to meet specific national and local IPC requirements and policies. It delineates three distinct competency levels within the curriculum: • foundational: introduces basic IPC principles applicable universally across all health and care worker roles; • intermediate: delivers more detailed IPC practices, particularly for clinical practitioners in direct contact with patients; • advanced: provides specialized IPC knowledge tailored for clinical specialists and managerial roles, reflecting the specific needs of their positions and settings. This curriculum serves as an essential reference tool to support the planning, development, and localization of IPC education materials, aligning closely with the WHO core components for IPC programmes and the directions provided within the WHO global strategy and action plan on IPC. It supports countries in their efforts to implement actions to improve IPC knowledge and skills among health and care workers according to the recommendations in the WHO global action plan and monitoring framework. By enhancing the IPC competencies of health and care workers, this guide supports the capacity of the health care system to effectively manage and prevent infections, which is particularly crucial in improving patient outcomes and promoting safer health care environments, including in the context of epidemics, pandemics and other public health emergencies.

The WHO guideline on the prevention and diagnosis of rheumatic fever (RF) and rheumatic heart disease (RHD) provides evidence-informed recommendations. It encompasses three areas; 1) primary prevention of rheumatic fever and rheumatic heart disease, specifically the identification and treatment of suspected group A (beta-haemolytic) Streptococcus (GAS) pharyngitis and skin infections; 2) secondary prevention of recurrent rheumatic fever and of rheumatic heart disease, specifically use of long-term antibiotic prophylaxis, interventions to increase adherence to antibiotic prophylaxis, and screening for early rheumatic heart disease; and 3) management of rheumatic fever, specifically the treatment with anti-inflammatory drugs. Rheumatic fever and RHD are associated with poverty, residential overcrowding, insufficient access to clean water and sanitation, and barriers to accessing care. Therefore, its adoption, adaptation and implementation should ensure: - Adequate living conditions including access to clean water, sanitation and living spaces, housing, and appropriate ventilation in homes and residences. - Equitable access to high-quality services for the prevention, screening, diagnosis and treatment of suspected or confirmed GAS infections and RF/RHD. It is intended for wide audience involved in the prevention and management of RF and RHD. Web annex A provides information on the processes, methods, and key questions, and web annex B, unpublished systematic review reports.

This report presents the recommendations of the WHO Expert Committee responsible for updating the WHO Model List of Essential Medicines. The first part contains a progress report on the new procedures for updating the Model List and the development of the WHO Essential Medicines Library. It continues with a section on changes made in revising the Model List followed by a review of some sections such as hypertensive medicines and fast track procedures for deleting items. Annexes include the 13th version of the Model List and items on the list sorted according to their 5-level Anatomical Therapeutic Chemical classification codes.

The Expert Committee on Specifications for Pharmaceutical Preparations works towards clear, independent and practical standards and guidelines for the quality assurance of medicines and provision of global regulatory tools. The Expert Committee develops standards through worldwide consultation and an international consensus-building process. The following new guidance texts were adopted and recommended for use: WHO good manufacturing practices for excipients used in pharmaceutical products (revision); IAEA/WHO good manufacturing practices for in-house cold kits for radiopharmaceutical preparations (new); WHO good practices for pharmaceutical quality control laboratories (revision); WHO/UNFPA female condom generic specification (new); WHO Biowaiver List: proposal to waive in vivo bioequivalence requirements for WHO Model List of Essential Medicines immediate-release (updated), solid oral dosage forms; WHO guideline on Biopharmaceutics Classification System-based biowaivers (revision); and Multisource (generic) pharmaceutical products: guidelines on registration requirements to establish interchangeability (republished). All of the above are included in this report and recommended for implementation.