In May, the Fiji National Medicines and Therapeutics Committee (NMTC) together with the Essential Medicines Authority and World Health Organization (WHO) held a two-day Essential Medicines List (EML) review workshop in Suva, Fiji.

The key objectives of the meeting were to identify potential gaps in the EML, including possible items for deletion or addition, and to review the level of healthcare facility access for all items, which is very relevant to the current focus on strengthening primary healthcare services in Fiji.

Mieke Hutchinson-Kern attended the meeting to present recommendations made by the Partnership Program team as part of a project to update the Fiji Antibiotic Guidelines and review the Essential Medicines List in 2019.

EMLs are foundational to the management and supply of safe and effective medicines in a health system but keeping the EML up to date is challenging; it requires managing the complex and often competing demands of increased heath service usage, expansion of clinical services, newer (and often more expensive) medicines being used internationally and limited resources.

This workshop brought together representatives from across clinical specialties, disciplines and geographic regions. There were initial presentations from the Primary Healthcare team on the current work to expand primary healthcare services and the role of the EML in supporting access to necessary medicines and the Essential Medicines Authority team who outlined the requirements and process for requesting a change to the EML and the factors considered by the NMTC in their decision-making. There were also presentations from WHO on the selection of essential medicines, Beyond Essential Systems on inventory data to support decision making, and the Partnership Program on recommended EML changes from guidelines published 2015-2019. The remainder of the workshop was focussed on in-depth reviews of all medicines on the EML.

While there is still more work ahead for the team in Fiji to further review and then implement the recommendations from the workshop, this was a fantastic opportunity to systematically appraise each medicine on the EML (as often the focus is only on adding new agents) and to include perspectives from clinicians who use the medicines on the EML in their day-to-day practice in the care of their patients.