World Health Assembly Concludes with Focus on Means to Achieve Health-Related SDGs
The 70th World Health Assembly reached a close last week with a host of decisions adopted by World Health Organization (WHO) member states on matters relating to public health, as well as the election of a new Director-General, former Ethiopian health minister Tedros Adhanom Ghebreyesus.
Discussions at the nine-day annual gathering in Geneva of the WHO’s main decision-making body assessed the contribution that could be made by the organisation to the 2030 Agenda for Sustainable Development.
Delegates also sought strategies to address antimicrobial resistance adequately and respond to non-communicable diseases (NCDs), while providing for universal healthcare, facilitating access to medicines, and ensuring emergency preparedness, among other pressing policy objectives. In addition, a programme budget for the 2018/2019 biennium was approved, including a three percent increase in member assessed contributions.
Universal healthcare at the fore
Tedros Adhanom Ghebreyesus will begin his five-year term on 1 July, succeeding Margaret Chan as Director-General of the WHO. Tedros was elected on the second day of the WHA. (See Bridges Weekly, 24 May 2017)
As his country’s health minister, Tedros led a widespread reform effort of the Ethiopian national health system, including on infrastructure and insurance coverage. He also chaired the Global Fund to Fight AIDS, Tuberculosis and Malaria and the Roll Back Malaria partnership.
In an acceptance speech given on 23 May, Tedros promised to foster a balance between building effective partnerships with relevant stakeholders, while at the same time providing strong leadership, and focusing “resources on the most vulnerable people in the most fragile contexts, while serving everybody.”
He also emphasised the provision of universal health coverage as a priority, as he had previously done over the course of his campaign. “All roads lead to universal health coverage,” Tedros stated, noting that half of the global population currently lacks access to healthcare and universal health coverage.
“The path forward is really clear: the Sustainable Development Goals (SDGs) give the WHO the opportunity to dramatically increase access to healthcare,” he added, emphasising a need to overcome barriers to quality of care and improve access to medicines in a manner tailored to the individual needs of countries.
The Assembly reviewed a report identifying health-related SDG targets, including in relation to issues such as universal health coverage, as well as maternal and child health, infectious diseases, NCDs, and management of health risks. The report also examines advances in implementing the 2030 Agenda at the regional and national levels, where 60 WHO country offices have already worked in some capacity with public sector officials in order to bring national health policies in line with the SDGs.
Delegates requested reporting on progress towards achieving the SDGs from the Director-General to member states every two years.
The rise of antimicrobial resistance – cases where antibiotics, anti-virals, and anti-malarials are prevented from effectively combating microorganisms that have been exposed to antimicrobial drugs – has meant that certain treatments have become ineffective in countering the spread of infections.
The WHA acknowledged the threat posed by antimicrobial resistance, effectively heightening the risk factors of medical procedures that rely on effective antimicrobials. A sum of US$23.2 million was added into the 2018/2019 budget designated for tackling antimicrobial resistance.
Several delegates highlighted the need for accessible antibiotics, and for technical and financial aid in ensuring improved accessibility, warning that overly expensive products can incentivise the use of counterfeit medicines. Some also reportedly raised the issue of “delinking” the costs of developing these medicines from the prices at which medicines are later sold to consumers.
Among other decisions, the Assembly agreed to adopt new terminology of “substandard and falsified medical products” for products that do not meet domestic or international quality standards or that misrepresent their source or makeup.
This step is intended to foster a common definition of what these products entail, compared to the earlier term “substandard/spurious/falsely-labelled/falsified/counterfeit medical products.” Proponents say that the change could facilitate efforts to review data.
Emergency preparedness and response
A critical part of the WHO mandate is to develop treatments; strengthen national public health systems and capacity, including the institution of early warning alert systems and training programmes for rapid response times; and build effective coordination in the international system in order to address the need for greater emergency preparedness in the case of large-scale outbreaks including pandemic influenza, Ebola fever, and Zika.
Efforts towards streamlined international collaboration are in line with the International Health Regulations, which entered into force in 2007 and are still awaiting full implementation – calls for which were reiterated at the Assembly. These regulations aim to help address public health threats that could extend from national to international levels.
During the WHA, delegates reaffirmed the need to support domestic and international seasonal influenza virus surveillance, including through the Global Influenza Surveillance and Response System, to swiftly identify influenza viruses with pandemic potential.
They also underlined the valuable function of the Pandemic Influenza Preparedness (PIP) Framework as an international instrument to provide for the equitable sharing of vaccines and risk analysis in response to influenza viruses that could lead to pandemics, agreeing that the model could possibly be employed to combat other pathogens.
The WHO Secretariat was asked to, in consultation with member states, look into incorporating seasonal influenza under the Framework and amending the definition of PIP biological materials to include genetic sequence data. The new budget passed during the WHA adds US$69.1 million in investments in the Health Emergencies Programme.
The Global Vector Control Response (GVCR) 2017-2030, which seeks to mitigate and control the threat of vector-borne diseases with a targeted 75 percent global reduction in mortality by 2030, was also welcomed by delegates, and a draft resolution was approved. Vector-borne diseases include malaria, dengue, yellow fever, and Zika, and account for around 17 percent of all infectious diseases, particularly affecting poorer populations.
The Assembly resolved to tackle non-communicable diseases (NCDs), otherwise known as chronic diseases, with an updated set of interventions and policy options to support countries in meeting global goals in the prevention and management of NCDs.
Among others, these measures include the possibility of tax increases on tobacco and alcoholic or sugary beverages, in order to limit exposure to factors that raise the risk of developing NCDs. The policy options also include the use of plain packaging for tobacco products, a measure that has been adopted by various countries in recent years.
Plain packaging has also drawn scrutiny for its potential implications for trade in such products, with a state-to-state dispute currently underway at the WTO regarding Australia’s packaging policy. A panel ruling is expected this year. A separate investor-state arbitration case between tobacco company Philip Morris and Uruguay over the latter’s plain packaging regulations was dismissed by a tribunal last year. (See Bridges Weekly, 1 May 2014 and 14 July 2016)
The Conference of the Parties (COP) to the WHO Framework Convention on Tobacco Control was asked to deliver updates on meeting outcomes to future Assemblies, and the WHO Director-General was in turn asked to inform the COP of tobacco-related WHA resolutions in a coordinated process of information exchange. The next session of the COP is set to be held in Geneva in October 2018.
In addition, the interventions provide for drug therapy for diabetes, cervical cancer screening for women, and counselling for sufferers or individuals at-risk for cardiovascular diseases.
NCDs are the leading cause of death globally and include cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. The WHO is currently preparing for the third UN General Assembly High-level meeting on the prevention and control of NCDs, scheduled for 2018.
ICTSD reporting; “World Health Assembly Adopts Resolution Supporting Tax on Tobacco, Alcohol, Sugar,” IP-WATCH, 2 June 2017; “World Health Assembly Adopts Resolution To Fight Sepsis; Antimicrobial Resistance Major Threat,” IP-WATCH, 26 May 2017; “A Summary Of Key IP-Related Actions Taken By The 70th World Health Assembly,” IP-WATCH, 31 May 2017.
This article first appeared in Bridges Weekly, 8 June 2017.