World Health Organization (WHO)

The World Health Organisation (WHO) is an important partner for contacts with regulatory authorities, particularly those with whom the European Medicines Agency (EMA) does not have a confidentiality arrangement. Collaboration with the WHO is specifically highlighted in the legislation establishing the Agency, with reference to scientific harmonisation, technical cooperation and international collaboration on pharmacovigilance.

Confidentiality arrangement

A confidentiality arrangement between the EMA, the European Commission's Directorate-General for Health and Food Safety (DG SANTE) and the World Health Organization (WHO) has been in place since 1 September 2015. This complements cooperation between these organisations in the context of global networks and initiatives.

The arrangement covers certain non-public information on the safety, quality and efficacy of medicines already authorised or under review in the European Union (EU), or pre-qualified or under review by the WHO:

• Letter on the working arrangement to exchange non-public information on medical products between the European Commission's Directorate General for Health and Food Safety (DG SANTE), European Medicines Agency and the Worl...
• World Health organization's (WHO) confirmation letter on the working arrangement to exchange non-public information on medical products between the European Commission's Directorate General for Health and Food Safety (DG...

Under the arrangement, EMA, the European Commission and the WHO may share a range of information including:

• post-authorisation pharmacovigilance data, particularly related to adverse drug reactions as well as safety concerns arising from periodic safety update reports, and post-authorisation obligations and commitments;
• information in applications for scientific advice, orphan medicine designation, marketing authorisation or post-authorisation activities of significant public health interest, and applications for agreement of paediatric investigation plans;
• data related to inspections, manufacturing facilities and clinical research activities and related reports.

This should accelerate patients' access to new and innovative medicines, avoid duplication of assessments and improve the authorisation and safety of medicines by involving the best expertise from both sides.

Transfer of data on suspected adverse reactions

As of 2017, EMA operates a regular transfer of data on suspected adverse drug reactions occurring in the EU to WHO's Uppsala Monitoring Centre (UMC). 

The data comes from the EudraVigilance system and contributes to WHO's global database of individual case safety reports, VigiBase. The UMC manages VigiBase on behalf of the WHO Programme on International Drug Monitoring.

EU Member States, EMA and other countries and stakeholders consult VigiBase when investigating risks with medicines.

The framework allowing EMA to make all suspected adverse reaction reports occurring in the EU promptly available to WHO is a legal requirement under Article 28c of Regulation (EC ) No 726/2004. 

EMA, WHO and the UMC updated the conditions for data transfer in 2020, in line with EU legislation on personal data protection and the EudraVigilance access policy. These conditions have been reviewed by EMA, WHO and UMC in 2022 and remain valid.

For more information, see the exchange of letters:

• Letter from EMA on conditions for making available reports of suspected adverse reactions by EMA to WHO/UMC
• Response from WHO to letter from EMA on conditions for making available reports of suspected adverse reactions by EMA to WHO/UMC
• Response from UMC to letter from EMA on conditions for making available reports of suspected adverse reactions by EMA to WHO/UMC

Facilitating access to medicines in low- and middle-income countries

EMA cooperates with the WHO to provide scientific advice and/or scientific opinions on Medicines for use outside the European Union under the 'EU-M4all' procedure. To be eligible, medicines must be intended for use to prevent or treat diseases of major public health interest, including vaccines used in the WHO Expanded Programme on Immunization. For more information, see:

• Obtaining and maintaining a scientific opinion on a medicine for use outside the European Union

EMA participates since 2015 as a Stringent Regulatory Authority (SRA) in the WHO-led Collaborative Registration Procedure using Stringent Regulatory Authorities (SRA CRP), which facilitates the registration of medicines in non-EU countries where regulatory resources may be limited.

This allows marketing authorisation holders of centrally authorised medicines or holders of EU-M4all opinions to share full assessment reports and inspection reports with the authorities in non-EU countries where they seek authorisation. The aim is to accelerate authorisation based on the SRA assessment while allowing competent authorities which might have limited regulatory resources to fulfil their regulatory responsibilities and make their own decisions.

An analysis of public health impact and participant experience during a pilot found the SRA CRP enables faster access to quality-assured, safe and effective medicines for patients in need. It reduces the time from submission to authorisation, avoids duplication and decreases workload in resource-limited countries, leading to greater efficiency in regulatory processes. For more information, see:

• WHO collaborative registration procedure using stringent regulatory authorities’ medicine evaluation: reliance in action?

Other areas of cooperation

EMA and WHO regularly participate in a range of collaborative activities including:

• the development of International non-proprietary names;
• monitoring of the safety of medicines in cooperation with WHO's Uppsala Monitoring Centre and the WHO Programme on International Drug Monitoring;
• good clinical practice and good manufacturing practice inspections and guidance;
• strengthening of regulatory systems in WHO member countries;
• vaccines;
• pandemic and seasonal influenza activities;
• possible pathways for the development, evaluation and approval of medicines to fight Ebola;

EMA, the European Commission and the WHO have a long history of multilateral scientific and technical collaboration including in the context of the International Council on Harmonisation and the International Pharmaceutical Regulators Forum.

EMA contributes to a number of WHO initiatives including Make Medicines Child Size and the Paediatric Medicines Regulators' Network. This is a network of national medicines regulatory authorities set up by the WHO in 2010, which promotes the quality and availability of medicines for children and contributes to capacity-building.

As part of the WHO certification scheme, EMA issues certificates of medicinal products to confirm their marketing-authorisation status if they have been authorised through the centralised procedure, or to confirm that a centralised marketing-authorisation application has been submitted in accordance with the WHO certification scheme. The purpose of this certification scheme is to support the work of health authorities outside the European Union, in particular those in developing countries. For more information, see Certification of medicinal products.