The addition of direct oral anticoagulants to the WHO list of essential medicines provides an opportunity to improve access and care for African patients with atrial fibrillation.
The inclusion of DOACs in the WHO essential medicines list is a critical step toward improving stroke prevention in African patients with atrial fibrillation, provided access and affordability barriers are addressed.
Atrial fibrillation (AF) is a major cause of adverse cardiovascular outcomes, and its prevalence is fast rising in Africa. The advent of direct oral anticoagulants (DOACs) has been a major revolution for the prevention of AF-related stroke and systemic embolism given the significant advantage over vitamin K antagonists in terms of both efficacy, safety, and adherence. However, due to their high cost, equitable access to DOACs has been a challenge, especially in low- and middle-income countries. Therefore, the recent addition of DOACs to the 21st WHO list of essential medicines comes as good news. African governments should take this opportunity to scale up the accessibility to DOACs for African patients with AF. This could be achieved through advocacy, appropriate training of health professionals, task shifting, patient education, strategic partnership to increase availability and quality of low-cost generic drugs, and appropriate medico-economic studies.
Noubiap et al. (2022) conducted an editorial in Atrial fibrillation. Direct oral anticoagulants (DOACs) vs. Vitamin K antagonists was evaluated. The addition of direct oral anticoagulants to the WHO list of essential medicines provides an opportunity to improve access and care for African patients with atrial fibrillation.