Advocacy Group Urges India to Revise Essential Medicines List as 17 Cancer Drugs and 9 Monoclonal Antibodies Remain Excluded
Key Insights
A coalition of 65 public health organizations has called for urgent revision of India's National List of Essential Medicines (NLEM), which has not been updated since 2022.
The WHO has revised its Model List of Essential Medicines twice since then, now listing 523 medicines compared to India's 384, leaving over 100 WHO-listed drugs excluded.
Among the omissions are 17 active cancer (search)-treating agents, four supportive cancer care agents, and nine monoclonal antibodies critical for targeted cancer therapies.
A coalition of public health experts, civil society organizations, patient groups, researchers, and advocates has formally petitioned the Indian government to urgently revise the National List of Essential Medicines (NLEM), warning that critical drugs for cancer (search), diabetes (search), and other non-communicable diseases remain excluded from the list, denying millions of citizens affordable access to life-saving treatments.
The Working Group on Access to Medicines and Treatments (search), a 65-member coalition, addressed its July 3 letter to Dr. Rajiv Bahl, Chairperson of the Standing National Committee on Medicines (SNCM) — the government-appointed expert panel tasked with reviewing and revising the NLEM. Copies were also sent to Union Health Minister JP Nadda, Union Health Secretary Punya Salila Srivastava, and Manoj Joshi, Secretary of the Department of Pharmaceuticals.
A Growing Gap Between WHO and India's Essential Medicines Lists
The NLEM is a curated list compiled by the Union Health Ministry that prioritizes medicines based on safety, efficacy, and cost-effectiveness. Medicines on this list, designated as "scheduled drugs," are subject to price controls and are meant to be available within the public health system.
The current NLEM was notified in 2022 and contains 384 medicines. In contrast, the World Health Organization's Model List of Essential Medicines, 2025 includes 523 medicines, following two revisions — in 2023 and 2025 — that incorporated significant additions and updates.
"The WHO List of Essential Medicines, 2025 has a total of 523 medicines, but the number of medicines listed in NLEM, 2022 is 384," said Chetali Rao, Senior Researcher and Legal Advisor at Third World Network (search) (TWN), which is part of the working group.
Cancer (search) and Diabetes (search) Drugs Among Key Omissions
The coalition's letter specifically identifies 17 active cancer (search)-treating agents missing from the NLEM: Abiraterone, Anastrozole, Bevacizumab, Blinatumomab, Cladribine, Dasatinib, Erlotinib, Everolimus, Fludarabine, Ibrutinib, Nilotinib, Pegaspargase, Pembrolizumab, Procarbazine, Realgar-Indigo naturalis formulation, Tioguanine, and Vinorelbine.
Additionally, four supportive agents for cancer (search) treatment — Aprepitant, Octreotide, Pegfilgrastim, and Rasburicase — are absent from the list. The group also highlighted that nine monoclonal antibodies proven critical for targeted therapies, particularly in cancer, remain excluded from the 2022 NLEM.
"These omissions include critical medicines for the treatment of noncommunicable diseases such as cancer (search) and diabetes (search)," Rao added.
Constitutional and Human Rights Concerns
KM Gopakumar, co-convenor of the working group, emphasized the legal and ethical stakes: "The prolonged delay in revising the NLEM has denied millions of citizens free access to newly recognized essential medicines within the public health system, while also restricting affordable access in the private sector. Such a delay carries profound constitutional and human rights implications."
The coalition's letter invoked the Supreme Court's consistent affirmation that the Right to Life under Article 21 of the Indian Constitution encompasses health rights and the right to access medical treatment. "In this light, the continued non-revision of the NLEM is not a mere administrative lapse but a potential violation of this fundamental right," the letter stated.
The group further argued that timely revision of the NLEM is integral to India's commitment to the Sustainable Development Goals, particularly Goal 3 on ensuring healthy lives and promoting well-being for all at all ages.
Call for Transparent, Time-Bound Revision Process
While acknowledging that the NLEM should be based on India's public health priorities, the coalition stressed that bringing these critical medicines under the NLEM would ensure accessibility and affordability, advancing both constitutional guarantees and India's global commitments to health equity.
The letter urged "the immediate initiation of a transparent, time-bound, and conflict-of-interest-free process to revise the NLEM, ensuring that it reflects the latest evidence, public health priorities, and the WHO Model List of Essential Medicines."
"A delay in revising the NLEM is a delay in fulfilling India's constitutional promise of the right to life and health," the letter concluded, expressing hope that the government would recognize the urgency and take swift, decisive action, noting that the lives of millions of Indians, including people with cancer (search) and rare diseases, depend on the availability of essential, life-saving medicines within the public health system.