The WHO aims to use the EU’s digital COVID-19 certificate to develop a global certificate network.

The World Health Organization (WHO) is establishing a global digital health certification network based on the European Union’s COVID-19 certificate to “facilitate global mobility and protect citizens across the world from ongoing and future health threats, including pandemics”, the body announced on Monday.

The EU’s digital COVID-19 certificate (DCC), which recorded vaccinations, tests and recovery, “facilitated safe travel for citizens, and it has also been key to support Europe’s hard-hit tourism industry”, according to the European Commission.

But when the DCC was first introduced in mid-2021, it was viewed with suspicion by non-EU members who feared it was a measure to exclude non-Europeans and in the early days a number of EU countries did not recognise vaccines used in other countries, such Covishield, India’s generic version of the AstraZeneca vaccine.

When a ​​vaccine was not centrally authorised by the EU, “each member state has the option to recognise it,” EU spokesperson Stefan de Keersmaecker told Health Policy Watch. 

However, the DCC open-source platform became widely used by non-EU countries to issue and validate certificates. But the DCC regulation is set to expire on 30 June and the WHO hopes to step into the gap with a global solution. 

“Building on the EU’s highly successful digital certification network, WHO aims to offer all WHO member states access to an open-source digital health tool, which is based on the principles of equity, innovation, transparency and data protection and privacy,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, on Monday.

The WHO will work in partnership with the EC to develop the global digital health certificate, guided by the EU Global Health Strategy and WHO Global strategy on digital health.

Thierry Breton, European Commissioner for Internal Market, said: “With 80 countries and territories connected to the EU Digital COVID-19 Certificate, the EU has set a global standard. The EU certificate has not only been an important tool in our fight against the pandemic, but has also facilitated international travel and tourism. I am pleased that the WHO will build on the privacy-preserving principles and cutting-edge technology of the EU certificate to create a global tool against future pandemics.”

Image Credits: Lukas/ Unsplash.

Humanity produces around 460 million metric tonnes of plastic a year, and this will triple by 2060 if no urgent action is taken.

A zero-draft of a global, legally binding instrument on plastic pollution will be released before the next meeting of the Intergovernmental Negotiating Committee (INC) in November.

This follows last week’s second INC meeting in Paris attended by delegates from 169 Member States and over 900 observers from NGOs. 

“I am encouraged by progress at INC-2 and the mandate to prepare a zero draft of the international legally binding instrument on plastic pollution,” said Inger Andersen, Executive Director of the UN Environment Programme (UNEP), urging member states to  “maintain this momentum”. 

“Plastic has been the default option in design for too long. It is time to redesign products to use less plastic, particularly unnecessary and problematic plastics, to redesign product packaging and shipping to use less plastic, to redesign systems and products for reuse and recyclability and to redesign the broader system for justice,” she added. “The INC has the power to deliver this transformation, bringing major opportunities for everyone.” 

The announcement was made shortly before World Environment Day, observed on Monday, and focused on the plastic pollution crisis amid the negotiations.

More than 430 million tonnes of plastic are produced annually, two-thirds of which are short-lived products that soon become waste, filling the ocean and often working their way into the human food chain, according to UNEP.

Plastics are accumulating in the world’s soils at a worrying rate, according to a report in UNEP’s Foresight Brief, which highlights how plastics used extensively in farming – from plastic-coated fertilizers to mulch film – are contaminating the soil and potentially threatening food security. Microplastics are also impacting human health when transferred to people through the food chain.

Overall, 46% of plastic waste is landfilled, while 22% is mismanaged and becomes litter. Unlike other materials, plastic does not biodegrade. This pollution chokes marine wildlife, damages soil and poisons groundwater, and can cause serious health impacts.

Action against plastics in Latin America and the Caribbean

The Caribbean sea is the second most polluted in the world, behind the Mediterranean, which is heavily polluted by sewage, oil and chemicals along with plastics.

In 2020, 3.7 million tonnes of plastic pollution entered the ocean from countries in the Latin America and the Caribbean Region (LAC), threatening the health and livelihoods of over 200 million people living on or near the coast.

In response, 27 of the 33 LAC member countries have passed national or local laws for the reduction, prohibition, or elimination of single-use plastics. However, the rates of recycling and waste recovery are typically less than 10% in the region.

Examples of this include bans on plastic bags, the earliest of which was introduced in Antigua and Barbuda in 2016.

Chile banned the use of plastic bags in 2018 and, in 2021, its Single-Use Plastics Law entered into force which prohibits food sellers from handing out straws, stirrers or chopsticks.

In its push to make the Galápagos Islands plastic-free, Ecuador phased out plastic bags, straws and polythene containers and bottles in 2018.

In 2019, Argentina established national guidelines to manage all aspects of plastics – production, use, waste management, and pollution reduction. It has also banned the production, importation and marketing of personal care products that contain plastic microbeads.

In Mexico, 31 of the country’s 32 states have established bans and restrictions on different single-use plastic and polystyrene, as well as on microplastics in personal care products. 

The Mexican government is developing a National Action Plan on Marine Litter and Plastic Pollution and developing its first National Inventory of Sources of Plastic Pollution, as a foundation for the Plan.

Panama banned plastic bags in 2019 and also launched the Panama National Marine Litter Action Plan 2022 – 2027 to eliminate the generation of marine litter.

In 2020, Panama regulated single-use plastics and a year later, it banned 11 plastic products including disposable plates, bags, laundry covers and egg packaging.

In 2019, Saint Lucia banned the importation of single-use plastic and Styrofoam, and in 2021 banned businesses from manufacturing, distributing or selling the prohibited items.

In March 2022, Belize, which has the second-largest barrier reef in the world, implemented a ban on single-use plastic and styrofoam items.
While Brazil has yet to implement its 2019 National Plan to Combat Waste in the Sea, the State of Rio de Janeiro banned plastic bags in 2018.

Colombia’s National Plan for the Sustainable Management of Single-Use Plastics aims to replace all single-use plastics with reusable, recyclable, or compostable products by 2030. In 2022, the country approved a bill to ban 14 types of plastic, including plastic bags, straws and fruit and vegetable packaging.

In 2021, Costa Rica introduced its National Marine Waste Plan 2021 – 2030 to reduce land-based waste streams that reach the sea.

Path to plastics pollution negotiations in Kenya

The INC Secretariat is inviting submissions from observers by 15 August and member states by 15 September on elements not discussed at last week’s meeting, such as the principles and scope of the agreement.

“My appeal to you at the beginning of this session was that you make Paris count. You have done so, by providing us with a mandate for a zero draft and intersessional work,” said Jyoti Mathur-Filipp, Executive Secretary of the INC secretariat. “The momentum you have built up here in Paris will guide our work in the intersessional period and at our future sessions. I look forward to continuing our important work together and to welcoming you all to Nairobi for our third session in November.” 

Image Credits: United Nations Environment Programme, Florian Fussstetter/ UNEP.

Global Health Policy Lab launch event on 24 May, 2023 in Geneva
Global Health Policy Lab launch event on 24 May, 2023 in Geneva

A new collaboration called the “Global Health Policy Lab” (GHPL) aims to develop digital tools that strengthen the available global capacity to identify, benchmark, disseminate and assess the impact of relevant health laws and policies within the field of global health.

The lab, a partnership between the Harvard Health Systems Innovation Lab and the Charité Center for Global Health was announced on the sidelines of the World Health Assembly in Geneva last month. The partners will work to make science and evidence-based policy-making a “universal reality,” they said, with the end goal of improving access and quality of care across the globe.

“Policy design is painful, but policy implementation is even more painful,” said Dr. Rifat Atun, Director of the Harvard Health Systems Innovation Lab at Harvard School of Public Health. “We are therefore committed to innovate on how these challenges are addressed: with rigorous learning and collaboration, democratization and dissemination through machine learning and AI.”

Part of the collaboration will include building an accessible “Digital Repositorium” of health laws and policies, which will be disseminated through a yearly report that includes analysis of health policy trends, challenges, opportunities and threats.

Foundational to the lab is digitalization and use of new technologies to drive better care.

Digital Health Aim of WHO Since 2020

The World Health Organization set a Global Strategy on Digital Health in 2020 at the World Health Assembly. WHO’s vision is “for digital health to be supportive of equitable and universal access to quality health services,” the organization said.

The WHO program includes three critical objectives:

1 – Supporting the implementation of digital solution to inform medical decision making.

2 – To bring together experts around the world via digital communication to share best practices and knowledge.

3 – Linking countries with the specific health innovations that best meet their needs.

Similarly, according to Ricardo Baptista Leite, founding chair of the initiative, “We will harness the power of technology to foster innovation and knowledge that ultimately provides policy makers at all levels (multilateral, national, state, regional and local) with tools and competencies capable of accelerating the translation of science-based recommendations into concrete laws, policies, awareness campaigns and other political interventions that ultimately can contribute to a healthier population at a global scale.”

He said GHPL plans to play a “differentiating and disruptive role in how data and science
effectively translate into new approaches and solutions that lead to improved health
outcomes for all.”

AI: Challenges and Opportunities

On the other hand, some doctors and scientists have identified challenges to using AI in healthcare and health policy making. A paper published this year in the peer-reviewed journal Biomed Matter Devices highlighted the drawbacks of artificial intelligence and their potential solutions in the healthcare sector. Included in the list of obstacles is data collecting, technological development, clinical application and ethical and societal concerns.

The GHPL is supported by the Virchow Foundation for Global Health by providing the legal and collaborative framework for the initiative. The World Health Summit with its conference and activity platform is also a project partner.

“The gap in the translation between scientific knowledge, on one hand, and political action,
on the other hand, is still weak and leaves a lot to do,” said Dr. Axel Pries, President of the World Health Summit. “Science is inherently global, and governments on a national level have to work together much more to address these broad challenges. We believe this initiative will highly contribute to this goal.”

Image Credits: Courtesy Global Health Policy Lab.

There is growing evidence that using e-cigarettes doubles the chance of starting to smoke cigarettes later in life for never-smoker adolescents.

Electronic cigarettes are a trap to recruit children, not part of harm reduction, said Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organization (WHO) at the global body’s weekly media conference.

“When the tobacco industry introduced electronic cigarettes and vaping, one narrative they really tried to sell is that this is part of harm reduction. It’s not true. It actually is a trap, meaning kids are being recruited at the early age of 10,11,12 to do vaping and e-cigarettes,” said Tedros in one of the sharpest rebukes of the industry yet.

Children are attracted to e-cigarettes and vaping because think that it’s cool, and it comes in different colours and flavours, he added.

“Then they get hooked for life and most actually move into regular cigarette smoking,” said Tedros, who also stressed that e-cigarette and vaping were also harmful to health in themselves.

He appealed to WHO member states to regulate e-cigarettes and vaping to protect their citizens.

Earlier in the week, the WHO marked World No Tobacco Day by appealing to member states to assist local tobacco farmers in  to move to food crops by ending tobacco-growing subsidies.

Meanwhile, the US Food and Drug Administration issued warning letters to 30 retailers, for illegally selling unauthorized tobacco products. 

“The unauthorized products were various types of Puff and Hyde brand disposable e-cigarettes, which were two of the most commonly reported brands used by youth e-cigarette users in 2022,” according to the FDA.

“Protecting our nation’s youth from tobacco products – including disposable e-cigarettes – is a top priority for the FDA,” said FDA Commissioner Robert M. Califf, M.D. “We’re committed to holding all players in the supply chain – not just manufacturers but also retailers and distributors – accountable to the law.”

Bogus claims about pandemic treaty

Tedros also hailed the long list of resolutions adopted over the past 10 days by the World Health Assembly, the highest decision-making body of the WHO.

He described the decision to increase member states’ fees – assessed contributions – to cover 20% of the WHO’s budget and support for an investment drive as  “landmark agreements in our shared efforts towards a stronger, more effective and empowered WHO”.

However, he once again appealed for an end to disinformation that the pandemic accord and changes to the International Health Regulations currently being negotiated would threaten nations’ sovereignty.

Right-wing Swiss members of Freiheitstrychler protest against the WHO in Geneva

“This accord is a generational opportunity that we must seize. We are the generation that lived through the COVID-19 pandemic so we must be the generation that learns the lessons and makes the changes to keep future generations safer,” stressed Tedros.

“The two processes are being negotiated by member states for member states and will, if enacted, be implemented in member states in accordance with their own national laws,” said Tedros. 

“All member states will retain their own sovereignty to set their own domestic health policies. The idea that tthis accord or the amended international health regulations will cede sovereignty to WHO is simply bogus.”

Last Saturday, members of the right-wing Frieheitstrychler (“freedom bell-ringers”) held a protest outside the United Nations in Geneva in protest against the WHO and the pandemic treaty. Ringing cowbells, some of the protestors carried posters condemning the pandemic treaty and claiming that the WHO was trying to take power from member states.

Image Credits: WHO, Megha Kaveri.

Africa
Medical teams in Tanzania react to the country’s first-ever Marburg virus case.

Tanzania declared the end of its Marburg Virus Disease outbreak on Friday, two months after the outbreak was first detected in the north-western Kagera region. 

Nine cases (eight confirmed and one probable) and six deaths were recorded in the outbreak, which was declared on 21 March after laboratory analysis confirmed that the cause of deaths and illnesses that were reported earlier in the region was Marburg.

The last confirmed case tested negative for a second time on 19 April, setting off the 42-day waiting period before the end of the outbreak could be declared.

Marburg is from the same virus family as Ebola, and very virulent and causes haemorrhagic fever. Around 88% of cases dies.

Symptoms start almost immediately, with high fever, severe headache, and severe malaise. Many patients develop severe haemorrhagic symptoms within seven days.

The virus is transmitted to people from fruit bats and spreads between people through direct contact with the bodily fluids of infected people, surfaces and materials. 

There are no vaccines or antiviral treatments approved to treat the virus. However, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improve survival.

In Africa, previous outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Ghana, Kenya, Equatorial Guinea, South Africa and Uganda.

The World Health Organization (WHO) assisted Tanzania to train responders, which had been slow to identify the disease because of a lack of laboratory facilities in the remote area where the first cases were found.

“With the investments being made to prepare for and tackle health emergencies in the region, we are responding even faster and more effectively to save lives, livelihoods and safeguard health,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

The WHO office in Tanzania also assisted the country’s efforts by deploying outbreak response experts to reinforce surveillance, testing, infection prevention and control, contact tracing, treatment and community engagement. 

Additionally, with partners, WHO shipped nearly three tons of supplies of personal protective equipment and is also working with the Ministry of Health to support survivors of the disease.

“Thanks to these efforts, Tanzania has been able to end this outbreak and limit the potentially devastating impacts of a highly infectious disease,” Dr Moeti said.

“The outbreak in Equatorial Guinea is also expected to be declared over next week if no further cases are detected,” WHO Director General Dr Tedros Adhanom Ghebreyesus told a media briefing on Friday.

Marburg was first identified in Marburg, Germany in 1967. Since then, there have been a limited number of outbreaks reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda.

In 2023, two separate Marburg outbreaks have been reported in two countries, Equatorial Guinea and the United Republic of Tanzania.

Image Credits: WHO, WHO.

A protest against the Anti-Homosexuality law in New York.

Two different court challenges of Uganda’s draconian Anti-Homosexuality Bill have been launched over the past week.

The first involves 10 Ugandans and a human rights organisation, which have petitioned the country’s Constitutional Court to prevent the Anti-Homosexuality Act signed into law on Monday from being implemented.

According to the petition, the law is unconstitutional as it violates a number of constitutional rights, including the rights of children as it allows for prison sentences for LGBTQ children, and it was introduced without public participation. According to the rules of the Ugandan Parliament,  every bill should be considered for at least 45 days at the committee level but this law was went through Parliament in about 30 days, without public engagement.

The Attorney General has 10 days to respond to the petition, which has been filed by a Member of Parliament, academics and activists alongside the Human Rights Awareness and Promotion Forum (HRAPF). 

MP Fox Odoi-Oywelowo, academics Professor Sylvia Tamale and Dr Busingye Kambymba and journalist Andrew Mwenda have joined forces with activists Frank Mugisha, Jacqueline Nabagesera, Richard Smith Lusimbo and Eris Ndawula to oppose the law.

The second petition filed with the Constitutional Court involves nine Ugandans, some of the same as in the first petition. It includes the only two MPs to vote against the bill in parliament, Fox Odoi-Oywelowo and Paul Kwizera Bucyana; Jane Nasiimbwa, who has a queer child, human rights activists Pepe Onziema and Frank Mugisha; feminist lawyer Linda Mutesi and feminist activist Jackline Kemigisa, diplomat Kintu Nyago, and journalist Andrew Mwenda.

 

Kemigisha, writing in openDemocracy this week, said she is “petitioning against this law simply because I am a Black African, and it is anti-Black to class queer Ugandans as non-humans deserving of life in prison or even death”.

“Queerness is well documented in our historical societies, including in the royal court of the Buganda kingdom, the nucleus around which colonialists cobbled present-day Uganda. To disown queer Ugandans is to disown both our past and our present,” she added.

The draconian law introduces the death penalty for “aggravated homosexuality”, prison terms for up to 20 years and fines for a wide range of people who provide services to LGBTQ people, including landlords.

Since Parliament passed the law earlier this month, there has been an increase in evictions as well as violence against people suspected of being LGBTQ.

Oxycontin

A US court’s decision to provide legal immunity to a family that made billions by marketing opioids as “non addictive painkillers” in exchange for a $6 billion settlement has evoked sharp criticism from politicians and health advocates. 

The US Court of Appeals ruled on Tuesday that the Sackler family will enjoy protection from current and future civil suits related to the role played by their company, Purdue Pharma, in the country’s opioid crisis. 

Purdue Pharma declared bankruptcy in 2019 and this order came as part of the court review in the bankruptcy process. The court added that the $6 billion paid as settlement will be used to address opioid addiction issues across the country. 

Democrat Senator Elizabeth Warren called for plugging the loophole in the existing bankruptcy laws that allows bad actors behind bankrupt companies to claim legal immunity even when they have not filed for personal bankruptcy.  

“Purdue and the Sackler family destroyed thousands of lives in their relentless pursuit of profit. They cravenly sought to hide behind our country’s broken bankruptcy code to escape justice and shield their blood money,” tweeted William Tong, the Attorney-General of Connecticut. 

“Since 2012, members of the Sackler family have donated over $10 million to the Federalist Society, the group rigging the courts in favor of extreme right-wing conservatives and corporate interests. It’s not a justice system if it’s also an auction,” tweeted Melanie D’Arrigo, the executive director of the New York for Health campaign. 

Settlement to address opioid crisis

The amount to be paid by the Sackler family as a settlement will be used to address the growing opioid crisis in the US, the court said. The money will be paid over a set period of time, and is expected to fund rehabilitation programmes run by the government. Around $750 million will be distributed amongst individual victims and families affected by the opioid crisis. 

As per the terms of the settlement, the family has also allowed their name to be taken off buildings, scholarships and fellowships. Several institutions including The Louvre have already dissociated themselves from the Sackler family in response to the company’s role in America’s opioid crisis. 

The Sackler family welcomed the decision in a statement and added that the decision will be instrumental in bringing relief to the people and the communities in need: “The Sackler families believe the long-awaited implementation of this resolution is critical to providing substantial resources for people and communities in need. We are pleased with the court’s decision to allow the agreement to move forward and look forward to it taking effect as soon as possible.”

While the latest order protects the families from civil suits, it does not provide immunity from criminal charges. 

Purdue Pharma and its role in the opioid crisis

Purdue Pharma was founded by the Sackler brothers, Mortimer, Richard and Raymond, and is blamed for fuelling the opioid crisis in the US. Since the 1990s, the company has produced OxyContin, a prescription-only extended-release painkiller.

The company is accused of funding research that severely understated the effects of opioid addiction and of misleading doctors. The Sackler family still holds controlling shares in the company. 

Almost immediately after the drug’s launch, its abuse began in remote pockets of the US, which then rapidly spread across the country. The drug’s warning label cautioned users from grinding it and snorting or mixing it in water and injecting it since doing so will bypass the “extended-release mechanism” and lead to rapid release and absorption of the drug; and this warning ended up as an instruction manual for vulnerable users.

Over time, several reports of OxyContin users dying after consuming the drug came to light and Purdue maintained that the usage of the drug was the responsibility of the individual. The company has previously pleaded guilty to charges related to opioid marketing, but the Sackler family has denied any wrongdoing in this regard. 

According to the US CDC, nearly 75% of the deaths caused by drug overdose in the US in 2020 involved an opioid. Between 1999 and 2020, more than 564,000 people were killed due to opioid overdose, including nearly 69,000 deaths in 2020. The first wave of the US opioid crisis began in the 1990s and overdose deaths involving prescription opioids have been on the rise since 1999.  

In 2019, after being bombarded with hundreds of lawsuits for their involvement in the opioid business, Purdue filed for bankruptcy. The Sackler family, however, did not file for personal bankruptcy. Their wealth is estimated to be around $11 billion, with a substantial amount stashed in offshore accounts. 

The company will now cease to exist and its assets will be transferred to a new company “Knoa”, which will be independently monitored. The new company will manufacture opioid reversal drugs and addiction treatments on a no-profit basis. It will continue to manufacture and sell OxyContin and use its profits to fund the settlement plan. 

Image Credits: US Drug Enforcement Administration.

Sprina Robu Chacha, a former tobacco farmer from Kenya

On World No Tobacco Day on Wednesday, the World Health Organization (WHO) appealed to governments to end tobacco growing subsidies and use the savings to support farmers to switch to “more sustainable crops that improve food security and nutrition”.

Over three million hectares of land in over 120 countries are being used to grow tobacco while over 300 million people globally are faced with acute food insecurity, according to the WHO.

“Tobacco is responsible for eight million deaths a year, yet governments across the world spend millions supporting tobacco farms,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “By choosing to grow food instead of tobacco, we prioritize health, preserve ecosystems, and strengthen food security for all.”

A new WHO report, “Grow food, not tobacco,” highlights the ills of tobacco growing and the benefits of switching to more sustainable food crops for farmers, communities, economies, the environment, and the world at large. 

The report also exposes the tobacco industry for trapping farmers in a vicious cycle of debt, propagating tobacco growing by exaggerating its economic benefits and lobbying through farming front groups.

Kenyan farmer Sprina Robi Chacha recalls how the WHO helped her to move from farming tobacco, as her parents had, to growing iron beans.

“Tobacco is a very delicate crop and it takes a lot of work,” said Chacha in a video produced by WHO. “It requires poisonous pesticide that the chemical companies supply in the form of a loan.”

Chacha said that her children had to stay out of school to assist to harvest the tobacco. In contrast, farming beans was not that labour-intensive, the beans replenished the soil and she was able to feed her family with the crop.

WHO, the Food and Agriculture Organization and the World Food Programme support the Tobacco Free Farms initiative that will provide help to more than 5000 farmers in Kenya and Zambia to grow sustainable food crops instead of tobacco

Harm to farmers

Tobacco farming causes diseases to the farmers themselves and more than one million child labourers are estimated to be working on tobacco farms, missing their opportunity for an education.

“Tobacco is not only a massive threat to food insecurity, but health overall, including the health of tobacco farmers. Farmers are exposed to chemical pesticides, tobacco smoke and as much nicotine as found in 50 cigarettes – leading to illnesses like chronic lung conditions and nicotine poisoning,” said Dr Ruediger Krech, Director of Health Promotion at WHO.

Tobacco growing is a global problem. While most of the tobacco farms are in Asia and South America, the latest data shows that, since 2005, there has been a nearly 20% increase in tobacco farming land across Africa.

FDA warns retailers

Meanwhile, the US Food and Drug Administration issued warning letters to 30 retailers, for illegally selling unauthorized tobacco products on Wednesday. 

“The unauthorized products were various types of Puff and Hyde brand disposable e-cigarettes, which were two of the most commonly reported brands used by youth e-cigarette users in 2022.,” according to the FDA.

“Protecting our nation’s youth from tobacco products – including disposable e-cigarettes – is a top priority for the FDA,” said FDA Commissioner Robert M. Califf, M.D. “We’re committed to holding all players in the supply chain – not just manufacturers but also retailers and distributors – accountable to the law.”

Lisa McClennon, incoming WHO internal auditor, addresses the Executive Board.

Lisa McClennon has been appointed Director of Internal Oversight Services (IOS), the office in charge of investigating all misconduct including sexual abuse and fraud, at the World Health Organization (WHO), the global body’s Executive Board heard on Wednesday.

McClennon has been IOS Head of Investigations since November 2021, and led investigations into the sex abuse scandal in the Democratic Republic of Congo (DRC) during the Ebola outbreak in 2018.

Prior to joining the WHO, she worked at the US Agency for International Development, where she was Deputy Assistant Inspector General for Investigations for six years.

Announcing the appointment, WHO Director-General Dr Tedros Adhanom Gebreyesus said McClennon would assume her new position – generally referred to as the Internal Auditor –  on 1 July, taking over from David Webb, who is due to retire in December.

“Lisa, in her previous capacity, has done an excellent job in investigations, leading our efforts to fast-track and clear the backlog,” said Tedros. “We’re happy to see her transition to this role, and confident her leadership will be critical to driving results.”

In a brief address, McClennon thanked the Executive Board for its support and confidence in her leadership.

“While the road ahead of us is long, the good news is that we are on it together. You have my commitment to be focused, to be collaborative, transparent, and results-oriented,” she told the board.

US board representative Loyce Pace welcomed the appointment: “This is exciting, late-breaking news for today for us because of course this this role is just so critically important,” said Pace. “We’re confident in her ability to do this work.”

Hot seat

McClennon has already faced some heat about the length of time WHO takes to investigate sexual abuse investigations following foot-dragging claims in relation to UK doctor Dr Rosie James’s sexual harassment by Dr Temo Waqanivalu at the World Health Summit in Berlin last October.

“We are fast, we’re rigorous, we’re thorough. We take a contemporary and survivor-centric approach to the matters that are referred to us in this effort,” she told Health Policy Watch in a recent interview. 

“This increased effort and focus in increased resources towards this matter began over a year ago, and we have been able to clear up several cases that had perhaps languished in the past.”

Over the past few months, several employees have been fired in sexual harassment cases.

Loyce Pace, Assistant Secretary in the Office of Global Affairs for the U.S. Department of Health & Human Services.

Earlier in the meeting, US representative Pace had appealed to the WHO to address any claims of harassment and bullying within its ranks. 

“I want to take the time to highlight not only the sexual misconduct cases and what we expect to be cleared from among those that have increased in number, but we want to be sure that we’re also focused on harassment and other forms of abuse like bullying that happens at all levels of the organisation, and we continue to hear those cases,” said Pace.

“Of course, those cases arguably come forward because WHO is doing a better job creating space for staff and others to report on those, but let’s be sure we continue to address the issue and not just identify the issue moving forward.”

Lack of swift action is a persistent problem 

Meanwhile, a report of the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme released ahead of the World Health Assembly, which concluded on Tuesday, had raised concerns about delays in disciplinary action, noting, “delays in post-investigation disciplinary actions have generated frustration and marred confidence in the system.”

The committee had asked the WHO to provide the Human Resources department with additional expertise and capacity so they could act swiftly.

Apart from the allegations of sexual misconduct during the management of Ebola crisis in the DRC, the committee is also monitoring an investigation taking place in Syria that it was briefed about in November 2022. 

The committee “recommended that the investigation be conducted in collaboration with other UN entities, as relevant and findings be carefully communicated to donors.” 

But the oversight committee’s report also noted the seniority of the perpetrators. “The Committee was struck by the number of males in D-1 and P-5 leadership roles that are included on the dashboard as perpetrators. The IOAC is deeply concerned that the seniority of the perpetrators combined with a lack of swift disciplinary action is indicative of an ongoing culture of impunity across the Organization,” it said in its report. 

Need to include more women in WHO

While member states applauded the rising number of women at the WHO, they called for more efforts to improve inclusivity.

“We should have a zero tolerance when it comes to harassment, both sexual and at work, and that we need to maintain a perspective of greater inclusion through the participation of the women in the WHO,” Peru said.

The Executive Board finished its business on Wednesday and will not meet tomorrow as scheduled.

Indigenous Peoples
The 76th World Health Assembly approved a milestone decision on the health of indigenous populations, but a global plan will not be presented until year.

In a milestone decision at the 76th World Health Assembly (WHA76), a resolution aimed at addressing health challenges faced by indigenous peoples worldwide has been approved. With it, the Director-General of the WHO has been directed to develop a comprehensive global action plan dedicated to improving their health outcomes by 2026.

Indigenous peoples, encompassing a rich tapestry of diverse population groups and communities around the world, have long endured significant disparities in health compared to non-indigenous populations, WHO says. 

They face lower life expectancy rates and a higher prevalence of various diseases and adverse health conditions, including diabetes, maternal and infant mortality, and malnutrition, cardiovascular illnesses, HIV/AIDS and others. Disability rates are sometimes 20-33% higher than those of the general population, the WHA resolution notes.

In the United States, indigenous populations reportedly have higher rates of asthma, heart disease, diabetes, obesity, and dementia than the general U.S. population and these chronic medical conditions put individuals at more risk for illness and injury as the climate changes.

Calls for ethical engagement with indigenous communities

Rural Amazonia communities at risk in Peru (MMV/Damien Schumann).

The WHA resolution calls on countries and other actors to ensure “full, effective and equal participation of Indigenous Peoples” in the development of strategies and action plans concerning their communities. 

The same principles hold for WHO’s development of a Global Plan of Action for the Health of Indigenous Peoples, the resolution states. It should include consultation with “Member States, Indigenous Peoples, relevant United Nations and multilateral system agencies, as well as civil society, academia and other stakeholders.”

In addition, the resolution also mandates the WHO to extend support to Member States, upon their request, with respect to efforts to enhance indigenous health.  Such support may include sharing expertise, resources, and best practices to facilitate the implementation of national health plans, strategies, or other measures tailored specifically for indigenous population, the resolution states. 

The resolution also recommended the integration of improvement of indigenous peoples’ health within the framework of the WHO’s next five year work plan, or the 14th WHO General Programme of Work, 2024-2029.

Member States also are asked to actively develop knowledge about the health situation of indigenous peoples, following the principles of free, prior, and informed consent. The resolution notes that by engaging with indigenous communities respectfully and ethically, countries can gain a deeper understanding of their unique health challenges, paving the way for more targeted interventions and policies.

And the resolution encourages WHO Member States to “invest in and implement national health plans, strategies, or measures” that specifically address the health needs of indigenous populations. This includes “attraction, training, recruitment, and retention of indigenous peoples as health workers,” recognizing and valuing their traditional knowledge and practices. 

A significant milestone

The resolution was co-sponsored by an eclectic collection of 15 developed and developing nations with large indigenous populations, along with the European Union. They included: Australia, Bolivia, Brazil, Canada, Cuba, New Zealand, Vanuatu, Mexico, Colombia and Ecuador, along with several other Latin American nations. 

During their deliberations, WHO member states described the resolution as a significant milestone in the global pursuit of health equity and the protection of indigenous rights. 

Countries also shared their experiences to date, in efforts to improve the health of indigenous communities. “Our institutions are trying to adapt it to the specific needs of healthcare for indigenous peoples through amending legislation, through providing better health programs, and through ensuring that indigenous health is a cross-cutting issue in all our policies,” Chile told the WHA.

In another remark, the United Nations Population Fund (UNFPA) delegate told the committee that sexual and reproductive health needs and rights of indigenous peoples must be upheld. 

Addressing structural racism, sexism and discrimination, ensuring access to disaggregated data and working in partnership with civil society, are also key to advancing the rights of Indigenous Peoples, the UNFPA delegate said.

Image Credits: (MMV/Damien Schumann).