Greetings - Please place these medications on the Essential Medicines listing. Lives will be saved. Sincerely,

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1 Kathy Clark Sent: 11 August :42 Hydrocortisone and fludrocortisone Follow Up Flag: Follow up Greetings - Cortisol oral preparations (hydrocortisone and fludrocortisone) are the essential replacement for a variety of childhood and adult disorders. These medications are life saving for any child born with congenital adrenal hyperplasia and for children or adults who acquire adrenal loss from Addison's Disease. Without these very inexpensive medications, these children would not survive. With replacement, they can lead normal productive lives. Please place these medications on the Essential Medicines listing. Lives will be saved. Sincerely, Kathy Clark RN CS MSN Pediatric Nurse Practitioner Pediatric Endocrinology University of Michigan (734) FAX (734)

2 Heino Meyer-Bahlburg Sent: 11 August :52 Hydrocortisone and Fludrocortisone Follow Up Flag: Follow up Dear Sir/Madam: As a specialist in the psychological evaluation and care of children, adolescents and adults with adrenal disorders, I strongly support the application to the WHO for the inclusion of hydrocortisone and fludrocortisone in WHO's Essential Drug List. These medications are essential for the survival of patients with congenital adrenal hyperplasia or other syndromes of adrenal insufficiency, and many of such patients die unnecessarily or suffer brain damage because of lack of access to these drugs. Sincerely, Heino F. L. Meyer-Bahlburg, Dr. rer. nat. Director, Program of Developmental Psychoendocrinology Professor of Clinical Psychology (in Psychiatry) New York State Psychiatric Institute & Department of Psychiatry, Columbia University 1051 Riverside Drive, Unit 15 New York, NY 10032, USA 1

3 Eapen, Santhosh Sent: 11 August :57 Adding Hydrocortisone and Fludrocortisone to essential drug list. Dear Sir/Madam: I am a pediatric endocrinologist and I am writing this letter to request that hydrocortisone and fludrocortisone be added to the essential drug list. These medicines are essential life saving therapy for patients with adrenal failure due to Addison s disease or salt-losing congenital adrenal hyperplasia. These conditions are easily treatable and availability of these medicines can prevent significant morbidity and mortality. Sincerely, Santhosh Eapen Pediatric Endocrinologist K. Hovnanian Children s Hospital Neptune, New Jersey.

4 Boniface - MD, Anne [ Sent: 11 August :44 Addition of hydrocortisone and fludrocortisone to Essential Medications list Dear Committee: I would like to add my support for the addition of these life-saving medications to your Essential Medications list. I won t belabor the reasons why this would be appropriate anything I say would be redundant, given what you have already received. I will just add that one of the most rewarding experiences in my personal or professional life has been to see a very sick, limp, lifeless infant or child completely turn around within a day, once glucocorticoid + mineralocorticoid treatment is begun. I cannot imagine the pain that would be caused by watching one of these children die due to lack of a cheap, readily available medication. I thank you for the work you do everyday for children and their families. Anne Boniface, MD, CDE Director, Pediatric Endocrinology Eastern Maine Medical Center Bangor, ME USA

5 shireen scott [ Sent: 11 August :36 Cc: Kate Hansen Who considering new Medications Follow Up Flag: Follow up Dear Sirs and Madames, Please take a short journey with me to Haiti, considered the poorest country in the Western Hemispere. You are a mom who has given birth to a baby who has very confusing looking genitals and you aren't sure if you have a boy or a girl and this baby just isn't thriving, you are afraid to show your baby to others and want to keep the baby away from peering eyes. There is a very real concern that the people of Haiti will think you have a curse on your family and that your baby could be taken from you to be used in a Voodoo Sacrifice. Voodoo is a religion in Haiti and the people of Haiti have alot of fears and superstitions. Check this information out for yourselves. This baby, as luck would have it is brought to the USA at 3 months of age on a Medical Visa, she was close to death and weighed 7 pounds. She was given the life-saving medications of Hydrocortisone and Fludrocortisone. This little girl will be 4 years old this month and is doing great I would know this because she is now my Precious Grandaughter spectively Submitted, hireen Scott Re S 1

6 The Hacketts Sent: 12 August :39 Inclusion of Hydrocortisone and Fludrocortisone in WHO's Essential Drug List Dear Sir or Madame, My name is Tara and my daughter Addy was born with a serious endocrine disorder, Salt-Wasting Congenital Adrenal Hyperplasia. Addy loves to sing, paint, play baseball, and hide-and-seek. She is a vivacious little three year old! Hydrocortisone and Fludrocortisone have kept her alive. Please add these drugs to the Essential Drug List for the many children all around the world who are born with this life threatening form of Congenital Adrenal Hyperplasia. It sends chills down my spine to think that these simple medications are not available to so many. Children with CAH die everyday, while hydrocortisone and fludrocortisone make it possible for children like her to live a very normal, very happy life. Thank you for your consideration, Tara Hackett

7 Amanda hopper Sent: 12 August :56 RE: Who Essential Drug List To Whom it May Concern: My husband and I have been raising our niece for the last eight years, she was born with CAH. She has been taking Hydrocortisone and Floudrocortisone since she has been living with us, with out these drugs she would not be here with us to bring us so much joy. Please, except these two drugs so that children who need them can get them. Amanda Hopper 725 S Jefferson St Moscow, Idaho 83843