On 5 September 2025, the World Health Organization (WHO) released its updated Model List of Essential Medicines (EML) and EML for Children (EMLc). For the diabetes community, this update is historic.

EML is like a global guidebook. Every two years, an independent expert committee reviews the best evidence and decides which medicines are considered essential — meaning no health system should be without them. It doesn’t force countries to buy or reimburse these medicines. But it has huge influence: many governments use the list to shape their national formularies, procurement, and reimbursement decisions. And history shows it can change lives. For example, the inclusion of antiretroviral therapy for HIV in 2002 was a turning point that helped unlock access to life-saving drugs for millions worldwide. That’s why it matters that in 2025, WHO said clearly: rapid-acting insulin analogues and GLP-1 therapies are essential.

Rapid-acting insulin analogues — lispro (Humalog®), aspart (Novorapid®/Novolog®), glulisine (Apidra®) — are now officially recognized as essential for people with type 1, type 2, and gestational diabetes. And this is also in the children’s* list (*EML was established first in 1977, and from 2007, there’s a separate list recognizing the unique needs of children). Then there are the GLP-1 medicines: semaglutide (Ozempic®), liraglutide (Victoza®), dulaglutide (Trulicity®). Plus the dual agonist tirzepatide (Mounjaro®). For adults with type 2 diabetes who also have cardiovascular disease, chronic kidney disease, or obesity (BMI ≥ 30).

These drugs are life-changing, and WHO is saying loud and clear: countries must make sure these are available and affordable.

Rapid-acting insulin analogues result safer and more effective than older human regular insulin for many people. They act faster, match meals more closely, and lower the risk of dangerous lows. At the same time, regular human insulin is disappearing from many markets, leaving people with no real alternative unless analogues are recognized as essential. Finally, there is strong evidence that these insulins improve quality of life — giving children, parents, and adults living with diabetes more flexibility in their daily routines and less fear around meals.

The addition of GLP-1 receptor agonists reflects their growing importance in type 2 diabetes care. These medicines are proven to reduce the risk of cardiovascular disease, one of the leading causes of illness and death in type 2 diabetes. They also support weight management, which can improve health and long-term outcomes. Most importantly, GLP-1 receptor agonists represent a shift in diabetes treatment — from focusing only on lowering glucose numbers to actually preventing serious complications and improving overall health and well-being.

Why this matters

This is not about WHO in Geneva. It’s about us. It’s about the mother who doesn’t have to hear “sorry, no Novorapid® today” at the pharmacy. It’s about the adult with type 1 who can sleep without worrying if their insulin will still be covered next year. It’s about the person with type 2 and heart disease who could finally get Ozempic® or Trulicity® without paying half their salary for it.

And still — even in “well-being” countries — people are struggling to find and afford rapid insulins. Regular human insulin is disappearing, and families live in fear of not knowing what tomorrow brings. And many of you know this fear. You’ve felt it, standing at the counter with the prescription in hand, wondering if the medicine will be there. That is today’s reality. But let’s not forget: progress doesn’t just fall from the sky. Progress only happens because people make it happen. Because trial participants said yes, taking risks and giving up comfort. Because scientists and doctors kept working for years to prove the benefits.
Because advocates — many connected through #dedoc — gave their time, their energy, their voices, until change could not be ignored. At a time when misinformation and when self-proclaimed “experts” are louder than ever, spreading confusion and making harm, we must hold on to this truth: science is people. It is our bodies, our voices, our stories. And only together, we push it forward.

To all of you: thank you. Your courage and persistence open the door for millions more to live better lives.

So what does this mean for our countries?

Italy, Slovakia, Czech Republic, the US — all of them are members of WHO. But being a member doesn’t mean they automatically follow the WHO Essential Medicines List. Each country has its own rules about which medicines are covered and reimbursed.

The WHO list works more like a global signal. It tells governments and health systems: “these medicines are essential for life, not optional extras.” Some countries use this signal directly when they update their own national lists (over 150 countries). Others decide differently. But once WHO puts a medicine on the list, it becomes hard to justify why people should still struggle to get it.

And that gives everyone stronger ground to demand access — something worth remembering the next time you speak to decision-makers in your own country.

Source: https://www.who.int/