Medicines for treatment of older people in guidelines and essential medicines lists, WHO African Region

To assess the geriatric medicine content in national standard treatment guidelines and essential medicines lists across the 47 Member States of the World Health Organization (WHO) African Region.

Until 28 June 2025, we searched for national guidelines and lists in the Global Essential Medicines database and the WHO Repository of National Essential Medicines Lists. We examined each document for a geriatric medicine chapter and guidance on the management of frailty, falls, palliative care, osteoporosis, parkinsonism, incontinence, delirium, dementia and polypharmacy. We obtained country-level data from the World Bank and WHO. Using χ² -tests, we determined associations between country-level metrics and geriatric medicine content.

We obtained a standard treatment guideline or essential medicines list from all 47 countries. Six (13%) documents contained a geriatric medicine chapter (five in English, one in French). Guidance on parkinsonism was the most common (42 documents; 89%), while guidance on frailty was the least common (three documents; 6%). Guidance on dementia was associated with current and predicted percentage population aged 65 years or older (P-value: 0.05), while guidance on palliative care was associated with healthy life expectancy both at birth and at age 60 years (P-value: 0.02 and P-value: 0.02, respectively).

Countries in the African Region with a higher proportion of people older than 65 years were more likely to include geriatric medicine content in their standard treatment guidelines and essential medicines lists. There is considerable potential for expanding guidance on management of common geriatric conditions, such as frailty, incontinence and polypharmacy.