July 2005

In November 2003, a small group of people living with AIDS, drug users, women and gay men met with the Director General of the World Health
Organization Dr. Jong Wook-Lee and the new head of the HIV/AIDS Department, Dr. Jim Kim. This was the first meeting in the history of the epidemic between a Director General and a delegation of PLWHAs from around the world.

One of the priorities for the activists at that meeting was the inclusion of methadone on the WHO’s Model List of Essential Medicines, since this drug is life saving for those struggling with addiction and is a key adjunctive therapy with antiretroviral treatment for drug users. Right after the meeting a follow up letter urged WHO to “consider the inclusion of methadone hydrochloride into the List of Essential Drugs as part of the AIDS kit that will be crucial for making antiretroviral therapy (ARV) treatment available for the majority of HIV-positive people in Asia and Central and Eastern European countries” (the letter is attached for easy reference)

It is my pleasure to inform you that methadone (and buprenorphine as a medicine with a similar clinical performance within a pharmacological class) are on the WHO Model (Complementary) List of Essential Medicines! Yesterday the report was finally approved and in several days the report of the WHO Expert Committee and WHO Model List of Essential Medicines will be in the public domain.

“Complementary” list is used for medicines when specialized diagnostic or monitoring facilities and/or specialist medical care and/or specialist
training are needed. Another achievement is the introduction of a new section in the WHO Model List of Essential Medicines, namely – Medicines used for substance dependence (programmes). This is an opening for other medicines used for treatment of substance dependence, including alcohol.

In November 2003, Dr. Kim said he would push to get methadone on the Essential Drug list. It took 18 months to do it, but he fulfilled his promise.

Mauro Guarinieri

Chair, Board of Directors, Global Network of People Living with HIV/AIDS (GNP)