WHO declares psoriasis biologics and sunscreen essential medicines

The global decision pushes countries to expand access and highlights skin health as a public health priority.

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In a landmark move for global dermatology, the World Health Organization has added the psoriasis biologics adalimumab and ustekinumab, along with high-SPF sunscreen for people with albinism, to its Essential Medicines List.

People with albinism face disproportionately high risks of UV-related skin damage and skin cancer.

The update follows the World Health Assembly’s recent declaration recognising skin diseases as a global health priority, further highlighting the need to improve access to lifesaving and life-enhancing dermatological care worldwide.

The applications for adalimumab and ustekinumab were submitted by the International League of Dermatological Societies (ILDS), with support from ILDS members, the International Psoriasis Council and dermatology and global patient societies. The Committee also highlighted that quality-assured biosimilars should be considered as therapeutic alternatives.

The application for broad-spectrum sunscreen was led by the UN Independent Expert on the enjoyment of rights by persons with albinism, the Global Albinism Alliance, and the UN Special Rapporteur on Human Rights in the Context of Climate Change, with strong support from ILDS and multiple global partners.

Inclusion on the EML means that countries are strongly encouraged to make these medicines available for the listed conditions. Governments that do not provide access may be required to explain why not.

The decision is expected to increase awareness and “pressure” health systems, particularly in low- and middle-income countries, to expand access.

For biologics, this move could see adalimumab and ustekinumab become available in more countries within months.

The WHO also recommends considering quality-assured biosimilars as therapeutic alternatives, supporting affordability.

Australian dermatologist and ILDS treasurer Professor Stephen Shumack welcomed the news.

“It will mean that over the next few months that these medications will likely become available in many countries where they have not to date,” he told Dermatology Republic.

“This is strongly encouraged and is aided also by the recent WHO declaration as well.”

He said the decision around adalimumab and ustekinumab was unlikely to have an impact on Australia as the medications were already available here.

“Although the fact that the WHO committee has made these recommendations means that it is a reminder that skin health is important for all people world-wide, including our own disadvantaged population, and the populations in our regional Pacific underdeveloped countries,” Professor Shumack said.

The effect of the WHO listing for high-SPF broad spectrum sunscreen (SPF 50+) might have benefits for Australia and it would hopefully mean this type of sunscreen would become more affordable in lower income countries where cost was an issue, he said.

“It may also be another reason for government subsidies for such sunscreens in developed countries such as Australia,” he told DR.

It was also a reminder of the need to ensure people with albinism were protecting themselves from the sun and also having regular skin checks.

“They should be checked carefully on at least and annual basis and with this check should be a reminder that they need to be extremely sun smart and avoid sun exposure as much as possible,” said Professor Shumack.

“Once they start to develop skin cancers and pre cancers they will need to be checked more often.”

Professor Christopher Griffiths, director of the Global Psoriasis Atlas and a special advisor to the ILDS on Global Health Research and Policy, also welcomed the news.

“The decision by the WHO to place adalimumab and ustekinumab biologic therapies on their essential medicines list for adults and children with psoriasis means that many thousands of people with psoriasis, wherever they may live in the world, now have access to these powerful and effective medicines,” he said.

According to the ILDS, the inclusion of both psoriasis biologics and sunscreen for albinism represents a breakthrough in access to effective, safe and affordable treatment options, advancing lifesaving and life-improving interventions and reinforcing skin health as a global public health priority.

“This achievement goes far beyond the addition of new medicines to a list, it represents a recognition that skin health is integral to universal health coverage and global health equity,” said ILDS immediate past president and chair of the ILDS-WHO Committee Professor Lars French.

“By bringing both psoriasis biologics and sunscreen for albinism onto the WHO Model List of Essential Medicines, the WHO is signalling that these are not optional interventions, but essential tools that can transform lives.”

The WHO’s EML is a global guide to help countries ensure that the most effective, safe, and affordable medicines for priority health needs are always available and accessible.

The list is updated every two years and includes over 500 medicines, with a separate list for children. It serves as a basis for public sector procurement, supply of medicines and health insurance.

The ILDS represents more than 227 member societies across 107 countries, comprising more than 200,000 dermatologists worldwide.

Through its official relations status with the WHO, the ILDS advocates for the inclusion of skin health in global health policy, advancing education, clinical care, research, and innovation to improve skin health outcomes worldwide.