The WHO lists essential cancer medicines

A list that shapes what a country buys

In May 2015 the World Health Organization published a new edition of its Model List of Essential Medicines. That year WHO reopened the whole cancer section of the list. It reviewed 52 products, confirmed 30 treatments, and added 16 new cancer medicines.

Trastuzumab was one of the additions. It treats breast cancer that makes too much of a protein called HER2. Dr Kees De Joncheere, then WHO's director of essential medicines, said in the announcement that some of the added drugs bring real survival gains in common cancers. He said other regimens, for rarer blood cancers, were added to set a global standard.

The list itself buys nothing and ships nothing. It is advice. Countries use it to decide what their own health systems should stock first.

What "essential" means to the people who write the list

WHO picks essential medicines by need, not by how new they are. An expert committee meets every two years to redo the list. It weighs each medicine three ways: how well it works, how safe it is, and how reliable its quality is. It then compares the cost with other drugs in the same class.

That last step is the one people miss. Two drugs can both work. If one costs many times more for the same result, the cheaper one usually gets the place.

The current edition is the 24th Model List. WHO published it on 5 September 2025. The committee behind it met in Geneva in May 2025 and worked through 59 applications to add, change or drop medicines.

The two main kinds of cancer drug on the list

Most cancer medicines on the list sit in one of two groups.

Cytotoxic chemotherapy kills cells that are dividing. Cancer cells divide often, so they take the biggest hit. But normal cells that divide often are hit too. Those include bone marrow, hair roots, and the lining of the mouth and gut. That is where much of the side effect load comes from. Our page on chemotherapy covers how a course is planned and spaced.

Targeted therapy aims at one protein or one gene change in the tumor. Trastuzumab shows the idea well. It is a monoclonal antibody, a lab-made protein built to stick to a single target. NCI explains that it binds HER2, blocks the growth signal, and marks the cell for the immune system to kill.

Because trastuzumab only helps HER2-positive tumors, the tumor has to be tested first. A drug like this is useless without the test that finds the target. Our page on targeted therapy explains that step.

Being on the list is not the same as being in the cupboard

Cost is the barrier WHO keeps returning to. Its own selection process weighs price against other drugs in the same class, and the 2015 announcement stressed that without strategies to make new medicines more affordable, the public health gains on offer would be much reduced.

So a listing is a starting point. A person still needs a health system that has bought the drug, a lab that can run the test that shows the drug will help, a hospital that can give it safely, and staff to watch for side effects. A missing piece anywhere in that chain stops the medicine at the door.

This is why the same drug can be routine care in one country and unavailable in another, in the same year, with the same evidence behind it.

When to get checked

Essential medicines only matter if a cancer is found. NCI lists symptoms that are worth a doctor's visit when they do not clear up. Most turn out to be something else. See a doctor if any of these last more than a couple of weeks:

• A lump or firm patch in the breast or under the arm, or a change in the nipple.
• Blood in the urine, or pain or trouble passing urine.
• Blood in the stool, or a lasting change in bowel habits.
• A cough or hoarse voice that does not settle.
• Trouble swallowing, or heartburn that keeps coming back.
• Bleeding or bruising with no clear cause.
• Fever or night sweats with no clear cause.
• Severe tiredness that does not lift with rest.
• Weight loss or weight gain you cannot explain.
• A sore that will not heal, or a mole that changes.

NCI also makes one point worth repeating: cancer often causes no pain at all early on. Waiting to feel pain is not a safe test.

What this does not mean

Adding a medicine to the WHO list does not approve it in any country. National regulators do that separately.

It does not set a price, fund a purchase, or promise supply.

It is not a treatment plan. The list describes what a health system should be able to offer a population. It says nothing about which drug fits one person's cancer, stage, other illnesses or goals. Our page on what cancer is covers why those differences matter so much.

And the list moves. The 2015 cancer review is now five editions old. For what is on the list today, read the current edition rather than any news story about an older one.

Sources

• WHO, WHO moves to improve access to lifesaving medicines for hepatitis C, drug-resistant TB and cancers (8 May 2015) — https://www.who.int/news/item/08-05-2015-who-moves-to-improve-access-to-lifesaving-medicines-for-hepatitis-c-drug-resistant-tb-and-cancers
• WHO, Essential Medicines Lists — https://www.who.int/groups/expert-committee-on-selection-and-use-of-essential-medicines/essential-medicines-lists
• WHO, The selection and use of essential medicines, 2025: executive summary of the 25th Expert Committee — https://www.who.int/publications/i/item/B09544
• NCI, Trastuzumab — https://www.cancer.gov/about-cancer/treatment/drugs/trastuzumab
• NCI, Symptoms of Cancer — https://www.cancer.gov/about-cancer/diagnosis-staging/symptoms

How this article was prepared

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

The National Cancer Information Foundation publishes Cancer Explained. This page is for learning. It is not medical advice and does not suggest a test or treatment.

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