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team of professionals, namely the KEML Review TWG, to spearhead the effort of reviewing and ensuring that the KEML is based on the most current information, both globally and nationally. The KEML Review TWG convened a series of meetings and discussions with a variety of medical specialists as well as internal and external validation meetings to obtain this final product. The Ministry of Health wishes to acknowledge all the efforts of those who provided inputs into this review, as well as the technical and financial support of USAID through the MTaPS program. In this KEML 2019, medicines are listed by 33 major therapeutic categories. Within each category, medicines appear in alphabetical order and with the appropriate dosage forms indicated, the required strength and size, and the healthcare level of use. The listing does not imply preference for one medicine over another. For each medicine, the lowest level of use is indicated to guide procurement and patient management at various levels. Medicines which had been listed in KEML 2016 for handling by specialists have been incorporated under the various healthcare levels. This is in recognition of the advancements within our health care settings. A new categorization of antibiotics into Access, Watch and Reserve (AWaRe) classes has been introduced to guide the rational use of antibiotics in line with global guidance provided by the World Health Organisation. x Executive Summary KEML 2019 ensures the past efforts of reviewing the Kenya Essential Medicines List, and ensures that medicines required at all the healthcare levels are included to guide efforts to improve access, in line with the Ministry of Health's aims under the Universal Health Coverage (UHC) initiative. The Ministry of Health through the NMTC constituted a multidisciplinary team of professionals, namely the KEML Review TWG, to spearhead the effort of reviewing and ensuring that the KEML is based on the most current information, both globally and nationally. The KEML Review TWG convened a series of meetings and discussions with a variety of medical specialists as well as internal and external validation meetings to obtain this final product. The Ministry of Health wishes to acknowledge all the efforts of those who provided inputs into this review, as well as the technical and financial support of USAID through the MTaPS program. In this KEML 2019, medicines are listed by 33 major therapeutic categories. Within each category, medicines appear in alphabetical order and with the appropriate dosage forms indicated, the required strength and size, and the healthcare level of use. The listing does not imply preference for one medicine over another. For each medicine, the lowest level of use is indicated to guide procurement and patient management at various levels. Medicines which had been listed in KEML 2016 for handling by specialists have been incorporated under the various healthcare levels. This is in recognition of the advancements within our health care settings. A new categorization of antibiotics into Access, Watch and Reserve (AWaRe) classes has been introduced to guide the rational use of antibiotics in line wretinol..........................................................................34 Access antibiotics have activity against a wide range of commonly encountered susceptible pathogens while showing low potential for development of resistance. These are antibiotics of choice for treatment of the top most common infectious diseases in a country. They should be available at all times, be affordable and quality-assured. In the WHO EML, they are listed as essential first-choice or second-choice empirical treatment options for specific infectious diseases. 4 Watch antibiotics have higher resistance potential or higher toxicity concerns. and treated ribavirin......................................................................14 riboflavin....................................................................34 rifabutin......................................................................10 They should be prioritized as key targets of national and local stewardship programs and monitoring. In the WHO EML, they are listed as essential first-choice or second-choice empirical treatment options recommended only for a limited number of specific infectious diseases. Unlike Access antibiotics which have lower priority for AMR stewardship activities, use of Watch antibiotics should be actively monitored.4 Reserve antibiotics should be reserved for treatment of confirmed or suspected infections due to multi drug-resistant organisms rifampicin...............................................................9, 10 risperidone.................................................................31 ritonavir......................................................................13 rotavirus vaccine.......................................................29 rubella vaccine ..........................................................29 salbutamol .................................................................33 salicylic acid...............................................................23 saquinavir (SQV) ......................................................13 selenium sulfide........................................................23 senna.......................................................................3, 26 silver sulfadiazine.....................................................23 simvastatin.................................................................23 sodium calcium edetate .................................................4 sodium chloride........................................................33 sodium fluoride ........................................................34 sodium hydrogen carbonate...................................33 sodium lactate ...........................................................33 sodium nitrite..............................................................4 sodium nitroprusside...................................................22 sodium stibogluconate or   meglumine antimoniate ......................................14 sodium thiosulfate................................................4, 23 spectinomycin .............................................................8 spironolactone...............................................22, 24, 25 stavudine (d4T).........................................................12 streptokinase................................................................23 streptomycin..............................................................10 succimer.........................................................................4 sulfadiazine ...............................................................16 sulfadoxine + pyrimethamine.................................16 sulfamethoxazole + trimethoprim .....................9, 16 sulfasalazine........................................................ 25, 35 suramin sodium........................................................ 17 surfactant .................................................................... 35 suxamethonium........................................................ 29 tamoxifen..................................................................... 19 tenofovir disoproxil fumarate................................ 12 terbinafine.................................................................. 23 testosterone.................................................................. 26 tetanus vaccine.......................................................... 29 tetracaine.................................................................... 30 tetracycline ................................................................ 30 thiamine ..................................................................... 34 thioguanine.................................................................. 19 timolol ........................................................................ 30 tranexamic acid......................................................... 20 triclabendazole............................................................ 6 trimethoprim............................................................... 9 tropicamide ............................................................... 24 tuberculin, purified protein derivative (PPD)..... 28 typhoid vaccine ........................................................ 29 urea ............................................................................. 23 valproic acid (sodium valproate) ...................... 5, 32 vancomycin ................................................................... 9 varicella vaccine ....................................................... 29 vecuronium ............................................................... 29 verapamil................................................................... 21 vinblastine................................................................... 19 vincristine.................................................................... 19 warfarin...................................................................... 20 water for injection .................................................... 33 whole blood............................................................... 20 xylometazoline.......................................................... 34 yellow fever vaccine ................................................ 29 zidovudine (ZDV or AZT)...................................... 12 zinc sulfate................................................................. 261. 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