SYLLABUS
GS-2: Issue related to health.
Context: Recently, the World Health Organisation (WHO) updated its Model Lists of Essential Medicines (EML) to add the GLP-1 class of drugs for diabetes.
More on the News
• The WHO Model Lists are updated every two years by an expert committee to address new health challenges, prioritise effective therapies, and expand affordable access to essential medicines.
• The decision was taken at the 25th meeting of the WHO Expert Committee on the Selection and Use of Essential Medicines held from May 5 to 9, 2025.
• The committee reviewed evidence showing that GLP-1 receptor agonists can benefit people with type 2 diabetes, especially those suffering from cardiovascular or kidney disease.
• Based on committee review, medicines such as semaglutide, dulaglutide, liraglutide, and tirzepatide were added to the list for use as glucose-lowering therapy in adults with type 2 diabetes and comorbidities, including obesity.
Rationale for Addition of GLP-1 Drugs to the EML
• High global disease burden: Over 800 million people live with diabetes, and half remain untreated, while more than one billion people are affected by obesity with rapidly rising rates, especially in low and middle-income countries.
• Dual therapeutic benefit: GLP-1 receptor agonists lower blood glucose effectively in type 2 diabetes and simultaneously help in reducing weight, making them valuable in tackling diabetes and obesity together.
• Management of comorbidities: These medicines show proven benefits in patients with cardiovascular disease and chronic kidney disease, which are common and serious complications of diabetes.
• Urgency of access: Despite being effective, these medicines are priced very high, limiting availability. Including them in the EML is expected to push governments and health systems towards improving affordability and wider access.
GLP-1
• GLP-1 (glucagon-like peptide-1) is a naturally occurring hormone that helps regulate blood sugar and appetite by signaling the brain to increase feelings of fullness, slowing stomach emptying, and stimulating the pancreas to release insulin, thereby lowering blood sugar levels.
• It functions both as an incretin hormone and a neurotransmitter, and is secreted from the small intestine and the hindbrain after a meal.
• It travels to the pancreas, where it regulates blood sugar by increasing insulin and decreasing glucagon. This is referred to as the incretin effect.
- This effect is blood glucose-dependent, meaning it occurs only when blood glucose levels are elevated.
- It also influences centres in the brain associated with hunger and satiety, effectively signalling that we have eaten enough and should stop.
• GLP-1 binds to receptors located in many organs throughout the body.
• It also produces beneficial effects in organs such as the kidney, liver, and cardiovascular system.
• However, its effects on the pancreas and brain are the most important for controlling blood glucose levels and body weight.