NEW DELHI: An advocacy group promoting equitable access to medicines and healthcare in India has urged the Centre to urgently revise the National List of Essential Medicines (NLEM), as the omissions include critical medicines for the treatment of non-communicable diseases such as cancer and diabetes.
The NLEM is a curated list of medicines compiled by the Union Health Ministry, which prioritises medicines that satisfy the healthcare needs of Indians on the basis of safety, efficacy, and cost-effectiveness. Medicines on this list are called “scheduled drugs.”
The Working Group on Access to Medicines and Treatments, a coalition of public health experts, civil society organisations, patient groups, researchers and advocates, said the inclusion of these critical medicines under NLEM will ensure they are accessible to people and more affordable.
“A delay in revising the NLEM is a delay in fulfilling India's constitutional promise of the right to life and health," said the letter, addressed to Dr Rajiv Bahl, Chairperson, Standing National Committee on Medicines (SNCM), a government-appointed expert panel tasked with reviewing and revising the NLEM.
Hoping that the government will recognise the urgency of the matter and take swift, decisive action, the advocacy group said the lives of millions of Indians, including people with cancer and rare diseases, depend on the availability of essential, life-saving medicines within the public health system.
The July 3 letter, which was also addressed to Union Health Minister JP Nadda, Union Health Secretary Punya Salila Srivastava, and Manoj Joshi, Secretary, Department of Pharmaceuticals, said this matter must receive immediate attention, as India is committed to universal access and the right to health.
“The prolonged delay in revising the NLEM has denied millions of citizens free access to newly recognised 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,” said the co-convenor, KM Gopakumar.
The World Health Organisation (WHO) has revised its Model List of Essential Medicines twice, in 2023 and 2025, incorporating significant additions and updates, following the current NLEM being notified in 2022.
The WHO Model List of Essential Medicines (WHO List of Essential Medicines) serves as the basis for national medicine policies and ensures that life-saving treatments are accessible to all populations, regardless of economic status.
“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, Third World Network (TWN), which is part of the 65-member working group.
“Furthermore, these omissions include critical medicines for the treatment of noncommunicable diseases such as cancer and diabetes. For instance, 17 active cancer-treating agents and four supportive agents for cancer treatment are also missing from the NLEM,” she added.
Similarly, the list also includes nine monoclonal antibodies (mAbs) that are also missing from the NLEM (2022). These mAbs are critical for targeted therapies in many diseases, especially cancer.
While recognising the fact that the NLEM should be based on the public health priorities of India, bringing many of these critical medicines under the NLEM will make sure that these essential medicines are accessible to people and will also make them more affordable, thereby advancing both constitutional guarantees and India’s global commitments to health equity, the letter said.
The group said that the Supreme Court has consistently affirmed, through landmark judgments, that the Right to Life under Article 21 of the 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. Moreover, timely revision of the NLEM is integral to India’s commitment to the Sustainable Development Goals (SDGs), particularly Goal 3 on ensuring healthy lives and promoting well-being for all at all ages,” the letter added.
“We, therefore, urge 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,” they added.
“Timely action is essential to safeguard the constitutional guarantee of the Right to Life, for it ensures equitable access to essential medicines for all citizens,” the letter further said.
