1 October 2021
Geneva – The International Diabetes Federation (IDF) and the Medicines Patent Pool (MPP) welcome the inclusion of SGLT2 inhibitors – oral medications used to lower blood glucose levels – to the 2021 World Health Organization (WHO) Essential Medicines List (EML), namely empagliflozin with canagliflozin and dapagliflozin as therapeutic alternatives. The WHO Expert Committee called on originators to license their medicines to MPP to scale up access in LMICs.
Nearly half a billion people live with diabetes worldwide, with four out of five living in LMICs[1]. At least 90 percent of all cases of diabetes are type 2, for which metformin represents the first-line therapy. SGLT2 inhibitors are a second-line treatment to add to metformin to improve glycaemic control. They have been shown to be particularly effective in reducing overall and cardiovascular mortality, non-fatal myocardial infarction, kidney failure and hospitalisations for heart failure in patients with, or at high risk of, cardiovascular disease and/or renal disease, for whom they represent a reference treatment.[2]
“IDF submitted SGLT2 inhibitors for inclusion onto the EML list. We are delighted that our request has been accepted. We will now work with countries towards including these medicines onto their national lists, as a first and crucial step towards making them available in LMICs,” said IDF President Professor Andrew Boulton. “As these are patented medicines, we will work further in partnership with MPP to make this treatment affordable and available to those in need.”
“At MPP, we have seen time and again that access to important treatments lags dramatically in LMICs,” said Charles Gore, Executive Director of MPP. “We hope originators will be willing to sit down with us as soon as possible to discuss how our public health-oriented licensing mechanism could contribute to making SGLT2 inhibitors accessible to those who need them in LMICs.”
More than 150 countries use the WHO EML to compile their own national essential medicines lists. Every two years, a WHO Expert Committee reviews the list. This year, the experts considered 88 applications, including 40 proposals to add 38 new medicines. The availability of the medicines included on the EML are regarded as minimum requirements for a functioning health system and should be available to all who need them. The addition of SGLT2 inhibitors in the 2021 EML increases the diabetes treatment options for countries and brings hope to the hundreds of millions of people who could benefit from these medicines.
Following the signing of a Memorandum of Understanding between IDF and MPP in August 2020, both organisations have been actively collaborating to apply MPP’s model to bring affordable generic diabetes treatments to LMICs.
Access the Executive summary – Report of the 23rd WHO Expert Committee on the Selection and Use of Essential Medicines
Access the WHO news release
Access the WHO EML
Access the WHO EMLc
[1] International Diabetes Federation. IDF Diabetes Atlas, 9th edn. Brussels, Belgium: 2019.
[2] Palmer S C, Tendal B, Mustafa R A, Vandvik P O, Li S, Hao Q et al. Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials BMJ 2021; 372 :m4573
Press and Media
The Medicines Patent Pool (MPP) is a United Nations-backed public health organisation working to increase access to and facilitate the development of life-saving medicines for low- and middle-income countries. Through its innovative business model, MPP partners with civil society, governments, international organisations, industry, patient groups, and other stakeholders to prioritise and license needed medicines and pool intellectual property to encourage generic manufacture and the development of new formulations.
To date, MPP has signed agreements with 22 patent holders for 13 HIV antiretrovirals, one HIV technology platform, three hepatitis C direct-acting antivirals, a tuberculosis treatment, a cancer treatment, four long-acting technologies, a post-partum haemorrhage medicine, three oral antiviral treatments for COVID-19 and 16 COVID-19 technologies.
MPP was founded by Unitaid, which continues to be MPP’s main funder. MPP’s work on access to essential medicines is also funded by the Swiss Agency for Development and Cooperation (SDC), Government of Canada, the World Intellectual Property Organization (WIPO) and the Government of Flanders. MPP’s activities in COVID-19 are undertaken with the financial support of the Japanese Government, the French Ministry for Europe and Foreign Affairs, the German Agency for International Cooperation, and SDC.