World Health Assembly Approves New Strategic Plan With Focus on “Triple Billion” Targets
The World Health Organization (WHO) convened its 71st World Health Assembly (WHA) from 21 to 26 May at its headquarters in Geneva. During the week-long event, ministers of health and other delegates from the WHO’s 194 member states met to discuss a variety of pressing global health issues and to finalise the organisation’s 13th General Programme of Work (GPW 13).
The WHA is the global health organisation’s top decision-making body. Approved by the assembly last week, GPW 13 will serve as the WHO’s five-year strategic guide for planning, monitoring, and evaluation of its work from 2019-2023.
The programme is strongly informed by the UN’s 2030 Agenda for Sustainable Development, and in particular Sustainable Development Goal (SDG) 3 on good health and well-being. In order to accelerate progress towards SDG targets, GPW 13 focuses on three interconnected areas: achieving universal health coverage, addressing health emergencies, and promoting healthier populations.
Achieving the “triple billion” targets
Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO, said that “everything WHO did going forward would be evaluated in light of the ‘triple billion’ targets,” wherein WHO aims to ensure that by 2023: one billion more people benefit from universal health coverage (UHC); one billion more people have better protection from health emergencies; and one billion more people enjoy better health and well-being.
Universal health coverage, the first of the three targets, depends in large part on access to medicine. Referencing SDG 3.8, GPW 13 defines UHC to include protection from financial risk, as well as “access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.”
The programme also notes the need for access to other health products, including diagnostics, medical devices, and blood and blood products.
In order to mitigate the financial hardship caused by out-of-pocket payments for medicine, the WHO will help to ensure policies are in place that allow fair pricing and access. The WHO reported that in 2010, nearly 100 million people were pushed into extreme poverty due to out-of-pocket payment for health services.
GPW 13 also emphasises the need for access to generic medicines as well as quality-assurance through regulation. Recent years have seen an increase in substandard and falsified medical products that undermine the safety and efficacy of medicines and vaccines.
Decisions adopted on access to medicine, IP, and innovation
In addition to the WHO’s plans delineated in GPW 13, the assembly adopted two decisions, one related to access to medicine and vaccines, the other related to innovation and intellectual property (IP).
First, having considered a March report by the Director-General, the assembly requested the WHO head draft a roadmap report, in consultation with member states, outlining the organisation’s programming work on access to medicines and vaccines. The roadmap is to include activities, actions, and deliverables for the 2019-2023 work period.
The March report recommends a number of key actions where the WHO could have the greatest potential impact on access to safe, effective, and quality medicines.
These include enhanced collaboration on IP and trade policies with the World Intellectual Property Organization (WIPO) and the World Trade Organization (WTO); and the expansion of the Medicines Patent Pool to include all medicines from the WHO Model List of Essential Medicines.
The report further proposes the implementation of IP laws that are in line with the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement), and that make adequate use of its flexibilities, including non-voluntary licenses.
However, member states continue to differ as to the appropriate balance between protection of IP rights and access to medicine and vaccines, in particular through the use of non-voluntary licenses, considered by some as an instrument of last resort to be used under extremely limited circumstances.
The assembly’s second decision relates to the WHO’s 2008 Global Strategy and Plan of Action on Public Heath, Innovation and Intellectual Property (GSPA).
After considering the Director-General’s report on the overall programme review of GSPA for the period 2018–2022, the assembly urged member states and the WHO head to implement the report’s recommendations consistent with the GSPA. (See Bridges Weekly, 5 February 2015)
These recommendations include prioritising research and development (R&D) and building research capacity; promoting transparency and collaboration with R&D; and promoting health technology transfers in line with the SDGs and TRIPS Agreement.
The report also emphasised the importance of developing sustainable financing mechanisms for research and the need to manage IP to contribute to innovation and public health. As mentioned by some member states during the assembly, existing WHO financial resources do not cover the budget that is required to implement the GSPA-related recommendations.
ICTSD Reporting; “WHA agrees on drafting of roadmap for access to medicines and vaccines; US blasts compulsory licences,” INTELLECTUAL PROPERTY WATCH, 24 May 2018.