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WHO Prequalification Program

The World Health Organization Prequalification Programme ensures that medicines used by international procurement agencies meet acceptable standards of quality, safety, and efficacy for priority diseases in low- and middle-income countries.

270 Days

Target Assessment

90+

Countries Served

eCTD/CTD

Accepted Formats

WHO GMP

Inspection Required

Programme Overview

The WHO Prequalification Programme (WHO-PQ) was established in 2001 to ensure that medicines procured by international agencies — including UNICEF, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and PEPFAR — meet acceptable standards of quality, safety, and efficacy. The programme operates as a service provided by WHO to facilitate access to quality-assured priority medicines in resource-limited settings where national regulatory capacity may be insufficient to independently verify product quality.

WHO-PQ evaluates and prequalifies Finished Pharmaceutical Products (FPPs) and Active Pharmaceutical Ingredients (APIs) through a rigorous assessment process that includes scientific dossier review, GMP inspection of manufacturing sites, and ongoing quality surveillance. Prequalification status is not a one-time achievement — products are subject to regular requalification, annual reporting requirements, and post-marketing surveillance to maintain their prequalified status.

Submission Format

WHO accepts submissions in both eCTD and CTD formats. While eCTD is preferred and encouraged for new submissions, the traditional paper-based CTD format remains acceptable. Applicants are strongly encouraged to transition to eCTD submissions to facilitate more efficient assessment and lifecycle management.

Priority Disease Areas

WHO-PQ focuses on medicines for three major infectious diseases that disproportionately affect populations in low- and middle-income countries. These priority areas align with global health initiatives and procurement programmes.

HIV/AIDS

Prequalification of antiretroviral (ARV) medicines including first-line, second-line, and third-line treatment regimens. Covers single-entity and fixed-dose combination products for adult and paediatric populations. WHO-PQ ARVs are critical for PEPFAR and Global Fund procurement.

Key Prequalified Products

Tenofovir, Lamivudine, Dolutegravir, Efavirenz, Lopinavir/Ritonavir, Abacavir, and numerous FDCs

Tuberculosis

Prequalification of anti-tuberculosis medicines for drug-susceptible and drug-resistant TB. Includes first-line agents (Rifampicin, Isoniazid, Pyrazinamide, Ethambutol), second-line agents (Bedaquiline, Delamanid, Linezolid), and fixed-dose combinations for DOTS programmes.

Key Prequalified Products

Rifampicin/Isoniazid FDC, Bedaquiline, Delamanid, Pretomanid, Linezolid, RHZE combinations

Malaria

Prequalification of artemisinin-based combination therapies (ACTs) and other antimalarial medicines. Covers treatment of P. falciparum and P. vivax malaria, including paediatric formulations. WHO-PQ antimalarials are essential for national malaria control programmes and Global Fund procurement.

Key Prequalified Products

Artemether/Lumefantrine, Artesunate/Amodiaquine, Dihydroartemisinin/Piperaquine, Injectable Artesunate

FPP Prequalification Requirements

Finished Pharmaceutical Products (FPPs) submitted for WHO prequalification must meet stringent quality, safety, and efficacy standards. The following documentation is required for a complete prequalification dossier:

Quality Documentation (Module 3)

Complete chemistry, manufacturing, and controls data for the finished pharmaceutical product, including drug substance and drug product specifications, manufacturing process descriptions, batch analyses, stability data, and comparator dissolution profiles.

Bioequivalence Studies (Module 5)

Comparative bioavailability studies demonstrating bioequivalence to the WHO-designated comparator product. Studies must comply with WHO guidelines on registration requirements for multisource pharmaceutical products and must be conducted at WHO-prequalified or GLP-compliant bioanalytical laboratories.

Product Information

Summary of Product Characteristics (SmPC), patient information leaflet, and labelling in compliance with WHO requirements. Information must align with the approved comparator product labelling and include all relevant safety information.

GMP Compliance

Evidence of compliance with WHO Good Manufacturing Practice standards. Manufacturing sites must be inspected and found compliant by WHO or a stringent regulatory authority (SRA). The inspection report must be current (within the past 3 years).

Clinical Efficacy Data (if required)

For certain product categories, particularly fixed-dose combinations and novel formulations, WHO may require additional clinical evidence beyond bioequivalence to support prequalification.

API Prequalification Requirements

Active Pharmaceutical Ingredients (APIs) can be independently prequalified by WHO, providing a quality assurance framework for drug substance manufacturers. API prequalification is particularly important for ensuring supply chain integrity when FPP manufacturers source active ingredients from multiple suppliers across different countries.

Complete Master File documentation for the Active Pharmaceutical Ingredient

Drug substance characterisation including physicochemical properties, polymorphism, and particle size

Detailed manufacturing process description with critical process parameters and in-process controls

Impurity profile analysis including identified and unidentified impurities against ICH Q3A limits

Stability data under ICH conditions (long-term, accelerated, and stress testing)

Specifications and validated analytical methods for identity, assay, and impurity testing

Evidence of GMP compliance at the API manufacturing site (WHO or SRA inspection)

Procurement Agencies

UNICEF Supply Division

Procures medicines and health supplies for maternal, newborn, and child health programmes in over 150 countries. UNICEF mandates WHO prequalification status for all pharmaceutical products it procures.

The Global Fund

The Global Fund to Fight AIDS, Tuberculosis and Malaria requires that all pharmaceutical products purchased with its funds are either WHO-prequalified or approved by a stringent regulatory authority (SRA). This ensures quality and safety of medicines reaching patient populations.

PEPFAR (U.S. President's Emergency Plan)

The largest global initiative for combating HIV/AIDS. PEPFAR requires that ARV medicines procured through its programme hold either WHO-PQ status or US FDA tentative/full approval.

Unitaid & GAVI

International health financing organisations that rely on WHO prequalification as a benchmark for procurement eligibility. Their investments catalyse market access for quality-assured health products in low- and middle-income countries.

Key Reference Documents

WHO Technical Report Series (TRS)

Published WHO Expert Committee recommendations on specifications for pharmaceutical preparations

WHO Guidelines on Bioequivalence

Multisource (generic) pharmaceutical product registration requirements including BE study guidelines

WHO Prequalification: Medicines Assessment

Procedures and guidance for the assessment of medicines submitted for WHO prequalification

WHO GMP Guidelines (TRS 986, Annex 2)

Good Manufacturing Practice standards required for WHO prequalification of manufacturing sites

ICH CTD/eCTD Guidelines

WHO accepts submissions structured per the ICH Common Technical Document format

WHO Model List of Essential Medicines

Core list of medicines addressing priority health needs, many of which are eligible for prequalification

Reference Document

WHO Prequalification Technical Documentation

Technical guidance for medicines prequalification assessment and submission requirements

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