Digital Health Systems Need To Consciously Involve Young People 27/05/2023 Megha Kaveri (L-R) Dr Conrad Tankou, Yifan Zhou, Sarah Tuytschaever, Joseline Carias Galeano, Sameer Pujari, and Dr Ilona Kickbusch at the event. Achieving universal health coverage by 2030, as resolved by the World Health Assembly this week, should ideally bring along with it a bouquet of possibilities through digital technologies. Digital health technologies have improved the delivery of healthcare services by improving access to COVID-19 vaccination in Canada, and by improving access to breast and cervical cancer screening in Cameroon. A nuanced panel discussion organized by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) and the International Pharmaceutical Students’ Federation (IPSF), and the commission, Governing Health Futures 2030: Growing up in a Digital World, at the sidelines of the World Health Assembly in Geneva deliberated on how to harness digital technology in service of global health. Digital health must benefit vulnerable people The COVID-19 pandemic disrupted the functioning of health systems around the world by cutting off access to much-needed regular medical care for millions of people. Not only did the pandemic push back the progress the world made in tackling diseases like HIV and tuberculosis, it also complicated people’s access to COVID-19 vaccines. Setting up an electronic documentation and information system at a clinic that provides care to vulnerable populations in Canada was one of the ways in which digital health worked wonders. As a member of a student group that worked closely with such clinics in Canada, Yifan Zhou, the chairperson of external relations at the IPSF, said that they focussed on not leaving behind vulnerable groups when designing digital solutions to solve healthcare problems. The student group also helped set up a digital model that provides appointments for vaccinations at clinics instead of walk-ins, which served as a preventative measure around COVID-19. “It’s important that digital solutions are designed for the communities that they serve. They don’t have to be really fancy, they just need to be practical to solve a problem,” Zhou pointed out. Dr Conrad Tankou, an Africa Young Innovators for Health awardee and medical doctor, added that while there is ample potential to combine the power of digital technology in healthcare, especially with the involvement of young people, there are difficulties in acquiring adequate resources to make it happen. “Clearly you need resources to be able to build the solution. And then you stumble on another situation where you need resources to carry pilots (projects). You need resources to carry out clinical trials, then you stumble on other resources, be able to get regulatory approvals and then bring it to the market,” he explained. “How do you as a young person navigate all of this?” As a possible solution to these burning questions, Tankou set up the Global Innovation and Creative space (GIC) in Africa, which brings together young professionals to collaborate on co-creating digital solutions to address healthcare problems. “The idea was to build a solution where women in remote areas can have access to screening and diagnosis [for cervical and breast cancer],” he said, adding that over time, this tool integrated other hardware technologies which enabled these women to access healthcare services from specialized healthcare service providers in cities, from their remote regions, based on their diagnosis. Legal and ethical questions Any conversation about leveraging digital technologies comes with legal and ethical concerns. Establishing governance principles rooted in the human rights of the patients and people these technologies serve is essential to take the idea forward, said Joseline Carias Galeano, general manager at RECAINSA. “We believe that in order to have digital health solutions, we need to have strong legal regulations that can secure the rights of the people.” This highlights the need for close collaborations between different sectors like academia, industry, governance, and technology. “I always feel like everyone has a piece of the puzzle,” said Sarah Tuytschaever, the digital care transformation lead at UCB. “It sounds much easier than it is, but how do we align all the incentives of these different factors and actually form that partnership?…And then when it comes to implementation, what we are always forgetting is we focus on the patient outcome.” ‘Cautiously optimistic’ While digital health is the buzzword in global health circles in the recent past, it is important to remain cautiously optimistic about its potential, said Sameer Pujari, lead for AI and digital frontier ecosystems at the World Health Organization (WHO). Highlighting the importance of scalability of the technologies used in improving healthcare and the incoming evidence even in food fortification aspects of global health, Pujari said, “There’s a lot of opportunities.. make sure that everyone who’s working on AI is cautiously optimistic and we use AI in a responsible fashion. I think that’s most important.” As the health sector evolves to include more digital tools to enhance quality, efficiency and reduce costs, it is equally crucial to ensure that it is not only gender-neutral but also demographically neutral, thus bringing in more men in healthcare delivery, which is currently dominated by women. “I urge young people to help us and to take the lead to rethink health systems and what health systems you want,” said Dr Ilona Kickbusch, senior distinguished fellow at the Geneva Graduate Institute. She added that seasoned global health leaders must consciously involve young professionals in co-designing digital health systems. “If we manage to develop a footprint for sustainable and equitable digital-first health systems, then we’ll have done our job. And we need that sooner rather than later.” Image Credits: Twitter/Governing Health Futures 2030. Air Pollution Advocates Say Time to Act Is Now 27/05/2023 Disha Shetty Elvis Ndikum Achiri of Global Youth 4 Clean Air and Climate Health Action in Cameroon shares his experience of working with communities affected by air pollution. When Elvis Ndikum Achiri, a long-time veteran of tobacco control campaigns, began collecting data on air pollution in his community in Cameroon, he was surprised to discover how many people around him, both young and old, suffered from related illnesses even though they had never smoked – including a beloved high school teacher who had recently died from asthma. Since then, Achiri has become a national advocate in the air pollution space as the coordinator for the Global Youth 4 Clean Air and Climate Health Action in Cameroon. He shared his experiences at a World Health Assembly (WHA) side event on Thursday, “Breathing Life into Clean Air Action”. The event, hosted by the Geneva Graduate Institute, brought together activists with UN agency leaders and funders of air pollution work to explore what civil society leaders are doing on the ground and how they can help drive real change. Speaking of his teacher who had passed away due to asthma, Achiri said, “When we connect the experience between the patient story and the reality of the disease, the cause, the risk factor, then we begin feeling differently [about] what is happening.” Air pollution kills seven million people annually, said Dr Maria Neira, Director of Environment, Climate Change and Health at the World Health Organization (WHO) and moderator of the event. But in addition to data, individual stories are critical in persuading the public and politicians to take action, Achiri pointed out. Solutions available, but political will is needed (left to right) Gillian Holmes, Elvis Ndikum Achiri, Nathan Borgford Parnell; and Dr Maria Neira, WHO. Background: a clean air view of Pretoria, South Africa. Some of the key takeaways from the event was that while there are solutions readily available, real change will need to involve local governments and affected communities. “There is a greater awareness particularly among governments about the connections between climate and air pollution and how it could be managed,” said Nathan Borgford-Parnell, science affairs coordinator at the Climate and Clean Air Coalition Secretariat who rued the lack of a political will. “This is the moment, and we need to capture it,” Bogford-Parnell said. “We cannot afford to let this thing go by.” ‘Urban Better’: a 3 point paradigm for healthier cities Dr Tollulah Oni, (above on screen) founder of Urban Better, outlines the 3-part paradigm of ‘Urban better including: ”the air we breathe; spaces and places; the food we eat. Dr Tollulah Oni, the director of clinical research at the University of Cambridge and the founder of Urban Better, a citizen driven campaign for clean air pointed to a fact that few people know: air pollution now the second largest cause of death in Africa. “Only a fraction, sort of 6% of children on the continent, reside within 50 kilometres of an air pollution monitoring station. So how can we change what we are not even measuring? This is what we need to tackle,” she said. In response, she created the ‘Urban Better’ initiative which aims to act on what Oni describes as the three main leverage points for healthier cities: clean air, healthy spaces and places for physical activity and access to healthy, nutritious foods. In particular, policymakers need to be thinking about public spaces that enable people to exercise and move about safelyas part of health equity, Oni said. “We say… okay, how do we think about open infrastructure as critical health infrastructure, and so we work through the air we breathe, our places and spaces, and the food we eat as three critical pathways through which we can create health in the context of climate vulnerability,” Oni said. She explains that by addressing air quality, as well as the physical “spaces and places” where people move about, the rampant rise in non-communicable diseases can be addressed. “We know that leisure physical activity has additional benefits, both physical and mental well being. In the same cities, we’re seeing that physical activity is not something that is supported,” she lamented. “But what we spend a lot less time on is looking at the built environment that needs to support but it’s currently largely poorly optimized for this. So we really need to start thinking about moving from individual awareness to a supportive environment,” she added. Citizens for clean air With respect to clean air, in particular, Urban Better has spun off youth action groups in Cape Town, Lagos and Accra, which have engaged in fact-finding around air pollution in their communities to design solutions they can advocate to local officials. The initiative also engages youths by giving them portable air quality devices that they can use to collect air quality data in their neighbourhoods as they run. The participants post the data on an interactive platform. Participants then post the data on an interactive platform and use it to generate key messages at the local level and engage with their peers and local leaders to find solutions. Professional athletes have been a part of the initiative and one of the youth made it to the climate summit COP27 last year, taking their advocacy to the global stage. “They used those data stories to generate key messaging that they then used to then re-mobilize the the peers,” Oni said. “[They were] Pushing towards increasing that demand for clean air and you can see how that connects to both inspire and conspire really trying to build this community.” In identifying pollution sources, the groups also take to the streets on bicycles and with wearable pollution monitors to identify pollution hotspots. In video clips of their findings, the same sources reappear over and over again, with dirty vehicles topping the charts from Cape Town to Lagos. Waste burning takes second place, while traditional wood-burning cookstoves and dust from roads, construction and natural sources, come third. ‘Majority Demographic’ Urban Better’s interactive data platform in action in Cape Town, South Africa. Oni spoke of the immense readiness among the youth to get involved in solutions, stressing that their potential has not yet been fully harnessed. “My experience is that there is just so much hunger and so much drive to be part of the solution,” Oni said. “We do ourselves a disservice when we simply pat ourselves on the back by engaging youth to say, ‘Oh, look how good we are, we engaged.’ “They have so much more to contribute,” Oni added. “I say this every time I speak right we’re particularly on the African continent, we really have to front and centre the majority demographic.” To curb waste-burning, look to women, youth and vulnerable groups Dr. Andriannah Mbandi, Lead, Waste, UNFCCC Climate Champions speaks remotely about how waste management is also an issue of equity. Air quality is an equity issue. Poorer communities, women and those in developing countries are the worst-affected. Solutions too, the speakers agreed, have to engage women, youth and vulnerable communities. “If you know anything about waste in Africa and a lot of developing regions, you will understand that the informal sector provides waste services and provides almost all waste management on the continent,” said Dr. Andriannah Mbandi, who leads the waste programme at UNFCCC Climate Champions. “That means if you’re looking at waste, curbing waste mismanagement, you need to look at women, youth and vulnerable groups.” Waste contributes to about 12% of greenhouse gases, 20% of methane, and 11% of black carbon globally. Open waste burning also contributes about 29% of fine particulate matter emitted annually, Mbandi said to point out the link between waste, air pollution and climate change. Need for flexibility, no magic bullet Clean air action is climate action. Integrated climate action is key. We cannot address air pollution and climate challenges separately., highlights@SergioSCleanAir of @EnvDefenseFund_ pic.twitter.com/BYBnZhbw1h — UrbanBetter.science (@UrbanBetter) May 25, 2023 Gillian Holmes, programme director at the Clean Air Fund, asked those attending what they’d recommend funders to consider in awarding grants. Oni said flexibility is the key. “We can’t have a very prescriptive and linear approach to building for investing in clean air. So we have to create the space for unintended and unanticipated urges and allow that pivoting to happen.” Sergio Sanchez, senior policy director of the Global Clean Air, Environmental Defense Fund agreed, adding that there is no catch-all solution to the problem of air pollution. Lagos Youths Cycle for Clean Air in ‘Urban Better’ event “One of the lessons is that there’s no silver bullet,” Sanchez said speaking remotely from Mexico. “It’s a long term effort. All institutions need to be aligned across the society.” The key ingredients are a strong social advocacy and political will, and that funders “be consistent and allocate the resources to cities, to countries to address this issue,” he said. Sanchez spoke on the example of Mexico City, where strong public advocacy helped trigger political action on key pollution drivers that has significantly improved air quality over the past decade. Children among the most vulnerable groups Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, in the United Kingdon. While most premature deaths from air pollution occur among older people, children are also among the most vulnerable groups. Many die or suffer through lifelong impacts from polluted air, said Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, in the United Kingdon. The impact of air pollution on children has become a major issue in the United Kingdom following the death of 9-year-old Ella Kissi-Debrah from asthma in 2013. Ella later became the first person to have air pollution listed as a cause of death following a protracted legal battle by her mother, Rosamund Adoo-Kissi-Debrah, who has since set up the Ella Roberta Foundation to advance the cause of air quality. “There’s now plenty of evidence to link air pollution with infertility, miscarriage, prematurity and intrauterine growth restriction,” said Kingdon. “A study published just last month by teams at King’s College and Imperial College London showed that air pollution directly impacts the development of a new-born brain in a negative way.” Kingdon also spoke of the links between air pollution, poverty and race. “If you grow up in poverty, you’re much more likely to be exposed to poor air quality. And in a study last month from Harvard, researchers were able to confirm the link between air pollution causing death, and poverty,” she said. The study done in the US found that Black Americans are exposed to higher levels of air pollution every year compared to White Americans, and thus likely to be more prone to its health effects. Become Air Pollution “Terminators” Dr Maria Neira, Director of Environment, Climate Change and Health at WHO. Neira, meanwhile, called upon participants in the session to become “air pollution terminators” and play a more active role in pressing policymakers. “Anything we can do to mitigate the causes of climate change will be generating massive results in terms of public health,” Neira said. “Unless our citizens understand that this is an issue we will not be able to put pressure on our politicians.” WHO first took up the air pollution issue in 2015, when it passed a landmark resolution “Health and the environment: addressing the health impact of air pollution”. The resolution identified 13 measures that member states should strive to implement, including more continuous monitoring of air pollution levels; public awareness-raising; stricter air pollution standards; and mitigation measures. Since that time, more and more member states are monitoring air quality with some 6000 monitoring sites reported in WHO’s last update. But significant gaps still exist, particularly in sub-Saharan Africa where few monitoring stations exist. Mounting scientific evidence on the adverse health effects of air pollution shows cutting PM2.5 concentrations would save the lives of millions. Despite global efforts to tackle the issue, air pollution deaths overall have not declined significantly. While there are now positive signs of transition to cleaner household fuels in South Asia and Sub Saharan Africa, ambient (outdoor) air pollution continues to rise in many developing cities, seeing rapid population growth, and along with that, soaring traffic and waste management issues due to uncontrolled sprawl. The trajectory is not only deeply worrisome from a health standpoint but also from a climate perspective, insofar as the major sources of air pollution also are climate polluters. Traffic, coal, oil and gas power generation, waste burning and fires all emit huge amounts of planet warming CO2 as well as methane, black carbon, and ozone precursors, which are short-lived climate pollutants (SLCPs). Cleaning up SLCPs would also generate quick wins for climate as their lifespan is measured in weeks to decades, as compared to centuries for CO2, pointed out Borgford-Parnell. “Here [at WHA] we are talking about addressing the causes of those diseases and air pollution is one of the big causes of the problem,” Neira concluded. “The multi-sectoral approach is needed.” Health Policy Watch was a co-sponsor of this event along with the Clean Air Fund and the Climate and Clean Air Coalition. Image Credits: Clean Air Fund , US Mission Geneva . Russia Delays World Health Assembly While North Korea Condemns ‘Satanic’ US 26/05/2023 Kerry Cullinan WHA president Chris Fearne prepares to announce the results of the secret ballot Russia’s objection to the nomination of Ukraine for the World Health Organization’s (WHO) Executive Board delayed Friday’s World Health Assembly – while the US and the Democratic People’s Republic of Korea (DPRK) also took diplomatic potshots at each other. What was supposed to be a straightforward endorsement of the 10 members put forward by member states to fill the vacancies on the 34-person board turned into a lengthy delay as officials organised a secret ballot. The European Union and Monaco objected, saying that the outcome of the vote was already clear. Meanwhile, Russia also objected to the process of the ballot, which it described as “merely procedural and not an election since the member-states cannot vote against any single candidate in the ballot”. It also took exception to New Zealand being one of two representatives to count the ballots: “New Zealand has repeatedly spoken against our delegation… We have no trust the teller will be carried out correctly.” South Africa was deemed an acceptable replacement for New Zealand, and the ballot went ahead – once again resulting in Russian humiliation with 123 member states supporting all 10 new members, 13 abstentions and six spoiled ballots (35 countries were absent). “We are encouraged by the unanimity and resolve of the World Health Assembly in standing up to Russia’s unprecedented assault on WHO governing bodies,” said Ukraine, noting that Russia continued to attack health facilities and kill civilians and health workers. One of the newly elected board members is from North Korea, something that disquietened the US. “The US takes this opportunity to reinforce the expectation of members of the executive board and calls on the government of the DPRK to respect human rights, fulfil its obligations under UN Security Council resolutions and engage in serious and sustained diplomacy,” it noted. In response, North Korea’s representative described the US as “Satanic” and its comments an “abuse” of the WHA. Russia, North Korea, Syria and Egypt all objected to the politicisation of the WHA. The Executive Board is composed of 34 persons who are technically qualified in the field of health, each designated by a member state and elected for three-year terms. (Additional reporting by Megha Kaveri) Stronger Global Roadmap to Tackle NCDs is Finally Passed 26/05/2023 Kerry Cullinan WHA76: Committee A finally passes NCD plan New global guidelines to tackle non-communicable diseases (NCDs) were finally passed by the World Health Assembly on Friday afternoon after a mammoth day-and-a-half of member states’ inputs. The guidelines update the World Health Organization’s (WHO) “Best Buys” published in 2017 and focus on the four key risk factors for NCDs – tobacco, alcohol, unhealthy diet and physical inactivity – and the four main associated diseases – cardiovascular disease, diabetes, cancer and chronic respiratory disease. Earlier in the week, Bente Mikkelsen, WHO’s Director of NCDs, explained the key changes adopted on Friday to what she described as an “implementation roadmap” to tackle NCDs, which are responsible for three-quarters of global deaths. “In 2017, we had a total of 88 interventions, and 39 of them had cost-effective estimates,” Mikkelsen told the event convened by the NCD Alliance and Vital Strategies. “We now have 90 interventions, and 58 interventions with cost-effectiveness estimates. And also very importantly, in 2017, we only looked at [evidence from] 20 countries, and today we have 62 countries grouped in all three income categories.” Twenty-eight interventions are considered to be the most cost-effective and feasible for implementation in comparison to 16 recommended in 2017.” These include taxes on sugary drinks, curbs on the marketing of unhealthy products and warning labels. Vital Strategies’ Dr Nandita Murukutla described the interventions that are “inexpensive for governments to implement, including those that target behavioural risk factors such as tobacco use, unhealthy diets, alcohol consumption and inadequate physical activity”. “The effectiveness of excise taxes, marketing restrictions and labelling policies, for instance, have been demonstrated to reduce the consumption of unhealthy products,” added Murukutla, Vice President of Global Policy and Research. “Were governments to adopt the recommendations as official policies, they could, in a unified and coordinated approach, significantly reduce the proliferation of unhealthy products and make an impact on the growing trajectory of NCDs, including heart and lung disease, diabetes, and cancers,” she added. However, NCD advocates believe that the “Best Buys” need to be further strengthened to prevent interference in health policy by industries selling products that harm people – tobacco, alcohol, ultra-processed food and fossil fuel. “The industries that produce and market these products are more interested in profit than in healthy people and healthy communities,” said José Luis Castro, President and CEO of Vital Strategies, at the WHA side event hosted by his organisation and the NCD Alliance. Castro believes that “Best Buys” should be modified to include “more explicit recommendations against corporate influence” because “corporate influence worldwide has been identified as the main reason why Best Buys’ implementation falls short”. Coalition Calls to Expand Self-Care Guidelines, Proposes WHO Resolution 26/05/2023 Alex Winston Self-Care a Foundational Component of Health System Sustainability” at the 76th World Health Assembly The United for Self-Care Coalition made calls to expand the current World Health Organization’s (WHO) guidelines on self-care during a panel event, “Self-Care a Foundational Component of Health System Sustainability,” at the 76th World Health Assembly on Wednesday. The United for Self-Care Coalition, a new coalition of like-minded groups and experts, marked their call to action with a panel hosted by coalition member the Global Self-Care Federation (GSCF) to discuss “We are in a unique moment, as we see it from a federation standpoint as it pertains to the role of self-care in overall health care systems,” GSCF Chair Manoj Raghunandanan told those in attendance. Global Self-Care Federation Chair Manoj Raghunandanan A rise in chronic conditions, an ageing population, and the COVID-19 pandemic have all impacted already-overstretched resources over the past few years, he said. For Raghunandanan, the COVID-19 pandemic has changed how people view self-care due to the amount of time spent in lock downs and, for many people, an inability to see medical practitioners in person. “The COVID-19 pandemic was the great accelerator,” Raghunandanan said. “We had a period where consumers and patients were relying upon themselves to care for themselves, to adjudicate their care to provide for themselves, and during that time, we realised that in many cases, they could be successful at doing this.” What is self-care? Self-care is defined as the ability of individuals, families and communities to promote health, prevent disease and mental health, and cope with illnesses and disability, with or without the support of health workers. United for Self-Care Coalition has called on the WHO to boost health literacy, promote digital health, enhance self-care capacity and guidance, recognise self-care as an enabler of UHC and invest in self-care. The coalition is already part of the UHC2030 platform, which aims to increase Universal Health Coverage by 2030. Democratising access to self-care interventions Many see the current WHO guidelines as simply needing to do more. Manjulaa Narasimhan, a scientist in the Department of Reproductive Health and Research at WHO Manjulaa Narasimhan, a scientist in the Department of Reproductive Health and Research at WHO, explained, “We look at things like how can we reduce the levels of violence, stigma, discrimination and coercion, that many people face even within health systems. We look at what kind of education and support they might need, including psychosocial support and other types. What kind of access to justice might people need?” Self-care practices can hold enormous potential to improve people’s quality of life, helping to manage the burden of non-communicable diseases (NCDs) while helping to develop health systems’ sustainability and reduce increasing costs. One such way forward could be increased telemedicine, health-related services and information available via electronic devices and technologies. This allows longer-distance patient-clinician contact, care, advice, reminders, education, intervention, monitoring and remote admissions. Academic Austen El-Osta gave examples to the panel, including the UK National Health Service, who, he told the audience, “bought a quarter of a million blood pressure monitors and distributed these to patients. These patients are effectively self-caring, releasing pressure from primary care and the health system. Of course, we’re all familiar with the many fantastic digital health apps and tools that we use and excellent med tech. “The big question is how do we democratise access to self-care interventions and best practices?” El–Osta said. “We have the guidelines; we’ve got some anecdotal evidence. We’ve got a lot of work on NCDs and technology. So all of these are coming together now.” Another example explored was how pharmacists could help unburden struggling health systems. Mariet Eksteen, Global Lead for Advancing Integrated Services at Advancing Pharmacy Worldwide “Often pharmacy and pharmacists are the patient’s first point of call in any healthcare inquiry that they have,” stated Mariet Eksteen, Global Lead for Advancing Integrated Services at Advancing Pharmacy Worldwide. “Pharmacists could be an exceptionally well-positioned resource to support the concept of self-care because we could assist patients with a rising level of health literacy as well as knowledge in their communities, which as a result, could also lead to increased levels of preventative care.” Why a WHO resolution is needed A WHO resolution on self-care, as opposed to guidelines, would provide the following: A framework for its integration into future economic and health policies. Promoting awareness. Political commitment. The mobilisation of resources. There would then be better support for the UH2030 goals. Sandy Garçon, the founding director of the Self-Care Trailblazer Group, echoed calls for the WHO to work on the current guidelines, stating, “There needs to be the right kind of policies, the right kind of funding, and the correct type of programming. Many countries are already moving in this direction, but we need more.” “We always welcome political and legal policy and standards framework that we can rely on to help us create that ecosystem we want,” agreed Kawaldip Sehmi, CEO of the International Alliance of Patients’ Organisations. “From patients of self-care first, then health professionals second. Now it’s time to take care of ourselves.” Image Credits: Screenshot. New Principles Offer Guide to Human Rights During Health Emergencies 26/05/2023 Alex Winston From left: Magdalena Sepúlveda Carmona, Executive Director, Global Initiative For Economic, Social And Cultural Rights; Saman Zia-Zarifi, Executive Director, Physicians For Human Rights; and Viviana Muñoz Tellez, Coordinator, Health, Intellectual Property And Biodiversity Programme, South Centre As the world continues to learn the lessons of the COVID-19 pandemic, a new set of principles aiming the help guide the future of human rights in global medical emergencies was published and discussed on Tuesday at an event of the 76th World Health Assembly (WHA). The event, titled “Beyond Panic & Neglect: Building a Human Rights Framework for Public Health Emergency Prevention, Preparedness, and Response,” looked at a new set of principles and Guidelines on Human Rights and Public Health Emergencies, which were developed through a three-year partnership between the Global Health Law Consortium (GHLC) and the International Commission of Jurists (ICJ.) The overarching human rights principles and obligations fall into eight categories: 1 – Universal enjoyment of human rights 2 – International solidarity 3 – Rule of law 4 – Equality and non-discrimination 5 – Human rights duties related to non-State actors 6 – Transparency and access to information 7 – Meaningful and effective participation 8 – Accountability and access to justice for those harmed by human rights violations and abuses Principles bring together lessons from COVID and previous pandemics, epidemics The principles, formulated by 150 individuals from other health and human rights organisations and WHO officials, draw upon lessons from past epidemics and pandemics, including cholera, dengue, ebola, HIV and zika. In addition, the experts looked at situations where an inadequate response to effective public health policies and human rights obligations led to devastating outcomes. “What was needed is a contemporary treatment that also accounted for what needed to be done to ensure a broader rights-based approach to public health emergencies, including upholding the right to health and related rights. These new principles, we believe, represent a breakthrough in the ongoing effort to ensure that human rights are protected and upheld in times of crisis.” Ian Seiderman, legal and policy director at the ICJ, told those gathered. “This event here marks our first public dialogue on the new principles and guidelines and their subject matter, focusing on the role of international human rights law in guiding approaches to public health emergencies.” The principles bring together an overarching scope of the universal enjoyment of human rights, including equality and non-discrimination, transparency and access to information and accountability and access to justice for those harmed by human rights abuses or violations. Principles coincide with pandemic treaty From left: Magdalena Sepúlveda Carmona, Executive Director, Global Initiative For Economic, Social And Cultural Rights; Saman Zia-Zarifi, Executive Director, Physicians For Human Rights; Viviana Muñoz Tellez, Coordinator, Health, Intellectual Property And Biodiversity Programme, South Centre; and moderator Gian Luca Burci, Adjunct Professor, International Law, Geneva Graduate Institute The release of the principles coincided with the release of a new “Zero+” draft of the proposed World Health Organization (WHO) pandemic accord that is currently under negotiation by member states. “We saw many governments shift from complacency and neglect to rapid action, often in panic mode to respond to a public health threat that was spreading uncontrollably,” stated Roojin Habibi, a co-founding member of the Global Health Law Consortium, who led the development of the principles. “Around the world, we saw countries deploy various measures, from mask mandates to lock downs to quarantines and isolation in response to this public health threat. “The international community must learn to move beyond cycles of panic and neglect, which leaves human rights at the margins of decision-making and policymaking. The principles developed through a consensus-based and deliberative process amongst 30 of the world’s leading thinkers in global health law and human rights provide an authoritative interpretation of international law to help guide that learning.” The WHO drafted pandemic treaty states that “all lives have equal value, and that therefore equity should be a principle, an indicator and an outcome of pandemic prevention, preparedness, and response,” and this was a point emphasised by Dr. Viviana Munoz Tellez of the South Centre, an intergovernmental organisation based in Geneva that helps developing countries promote their common interests in the international arena, who brought up the issue of vaccine inequity. “We could have averted, at minimum, about a million and a half deaths,” Tellez said. “The idea was, when we have vaccine doses, we will distribute at least 20% proportionally and highlight the more vulnerable populations that need to go first. But, unfortunately, that did not happen, mainly because the more affluent countries had advanced marketing commitments. “We had competition rather than cooperation. That was one of the big problems.” The role of the private health sector The private health sector has also come under heavy scrutiny since the pandemic. However, one aspect that the principles address observes that the state must regulate and monitor private actors. The principles themselves put no obligations directly on the remote, non-state actors. Instead, they state that across all pandemic prevention, response and recovery measures, states have the responsibility to ensure that non-state actors do not impair any of the human rights laws and must regulate and monitor ” engaged non-state actors to prevent them from impairing the enjoyment of human rights and provide for redress and accountability.” Magdalena Sepúlveda Carmona, executive director of Global Initiative For Economic, Social and Cultural Rights, stated on private actors that, “Something that started happening before the pandemic is the privatization, commercialization, and financialization of public services such as health care, water, sanitation and education. There are many ways in which private actors can be involved in health care. “We need to act now. We must ensure that everybody has access to a universal resilient health system that is affordable or at no cost for those who need it. And that is included in the principles.” The hope, the presenters said, is that the COVID-19 pandemic would bring about changes in legislation that would help the world prepare and deal with any future health emergencies. “We have to use these principles to put in place legislation, rules and regulations to say the next time this happens, we have to think about how we’re going to address this problem,” Saman Zia-Zarifi, executive director of Physicians For Human Rights told the panel. “It can’t just be that we will give money to companies to support their workers who can’t come to the office, but we will keep open the informal sector where the majority of people in most countries live and work.” The new principles allow actors to play their part in change. “These principles can act as kind of a North Star for everyone,” Zia-Zarifi stated. “They establish some clear directions of movement. They don’t tell governments what to do but give them a direction of movement and a way of thinking.” The Geneva Graduate Institute, The Global Health Centre and the International Geneva Global Health Platform, the International Commission of Jurists, the Global Health Law Consortium, the Global Initiative for Economic, Social and Cultural Rights, and Physicians for Human Rights organised the panel. Image Credits: Screenshot. Huge Support for Universal Health Coverage and NCD Measures, But WHO Replenishment Fund is Rejected 25/05/2023 Kerry Cullinan & Megha Kaveri The delegate for Barbados addressing the World Health Assembly during discussions on universal health coverage. An impossibly long list of member states lined up to address universal health coverage (UHC) and non-communicable diseases (NCDs) at the World Health Assembly on Thursday afternoon, indicating the centrality of these issues for countries. There was near-universal support for primary health services to be the backbone of UHC, with disease prevention as the other key pillar – particularly to prevent NCDs. A number of countries including Canada, the US and Norway called for sexual and reproductive services accessible to young people to be included as part of primary health. Many member countries called for the three United Nations High-Level Meetings – on UHC, tuberculosis and pandemic preparedness – in September to be aligned with the WHO’s processes, including negotiations on a pandemic accord. Huge support for WHO’s ‘Best Buys’ The WHO’s updated policy options and interventions to prevent and control NCDs – referred to as “Best Buys” – also enjoyed widespread support. A number of Caribbean countries are at the forefront of fighting NCDs and obesity, including Barbados. “Barbados is privileged to be one of the front-runner countries that WHO has identified to take part in the acceleration plan to stop obesity,” its delegate said. Barbados launched a national school nutrition policy in February “to address challenges related to poor dietary habits and lack of physical activity among schoolchildren”, while its tax on sugary drinks introduced in 2015 resulted in a 4.3% reduction in their consumption. Canada underlined the importance of integrating mental health into broader NCD prevention strategies but noted that stigma “remains a barrier to mental well-being globally, especially for younger people”. Norway called for strategies to fight NCDs to be “free from undue political and commercial influence”, something that NCD advocates lobbied for on the sidelines of the WHA. No consensus on replenishment fund However, the same spirit of agreement was absent in Committee B, with a divergence among member states’ opinions on a “replenishment mechanism” proposed by the WHO Director-General to ensure more sustainable financing of the organisation. Member-states deliberated on different possible models of sustainable funding of the WHO, delaying agreement on a single, unified formula of a “replenishment mechanism”. The US made it clear that it did not support the replenishment mechanism – a view that ultimately held sway. It, however, expressed support to have rounds of investments by donors, similar to other global health organizations like The Global Fund. “We agreed to support planning for the secretariat’s proposed new initiative for sustainable financing for WHO with the understanding that we’ve moved to a more streamlined approach of innovative fundraising through an investment round, and that we’re not approving a replenishment mechanism for WHO,” stated the US. It is also widely believed that the country pushed for inclusion of “earmarked contributions” in the draft text of the resolution, in exchange for its support to the resolution. Switzerland supported the replenishment mechanism for the WHO, saying it had “considerable potential to strengthen the strategic use of funding and to guarantee predictability of financing for WHO’s operations in order to guarantee health for all”. But, it also underlined that “earmarked contributions will remain vital to the funding of WHO for many member states” but that their use needs to be “traceable, transparent and efficient”. A decision on what mechanism should be adopted to bolster WHO’s finances is expected on Friday. World Resilience Summit Galvanises Public-Private Solutions to Feed into Pandemic Accord Negotiations 25/05/2023 Kerry Cullinan Maria van Kerkhove, Priya Basu, Mary Mahy, Iveth J. González and Benjamin Roche. GENEVA – Global health conversations are much deeper at present because everyone has been affected by COVID-19 – and this opens up the possibility of building an “all-of-society” approach before the next pandemic, said Sylvie Brand, the World Health Organization’s (WHO) Director of Epidemic and Pandemic Preparedness and Prevention. “We have seen during this pandemic that it’s not enough to have doctors and nurses at the frontline. We need to bring on board politicians, academics, the private sector, civil society, faith-based organisations – everybody has a role to play,” said Brand during her keynote address to the Resilience Summit held alongside the World Health Assembly in Geneva. “But this is not enough. We need also to make sure that we connect people because when the crisis starts, it’s very hard to build things from scratch.” Her input came after leaders from the public and private sectors had discussed three different areas related to pandemics – prevention, preparedness and response – at the invitation-only summit hosted by the World Climate Foundation and the Geneva Health Forum. Stop the zoonotic spark The pandemic prevention group, which had a strong contingent of One Health actors, felt that primary prevention had to focus on zoonotic spillover from animals to people. “You have to start with the spark that can cause the fire, addressing the interface between animals and people,” said Jonathan Epstein, Vice-President of EcoHealth Alliance. The group also called for the integration of climate change and biodiversity and health. Collaborative surveillance and data-sharing dominated the discussion at the preparedness roundtable, which also stressed the importance of building trust and understanding. “We need the foundation – global, regional, national systems – for surveillance that is intentionally collaborative, that goes beyond the health sector,” said Dr Magda Robalo Correia e Silva, the Health Minister of Guinea-Bissau. She also said that preparing for an infectious disease outbreak or a pandemic must be rooted in communities and lived experiences of the people. The panellists also touched on how preventative measures like surveillance or data sharing don’t work in isolation. “It’s an ecosystem. It cannot be the data only or the tools only or the financing of the early warning system or political support. It’s an ecosystem that starts with the doctors, nurses who are in the frontlines. That’s where the [early warning] system gets triggered,” said Dr Nino Kharaishvili, Global Solutions Director of the health systems governance at Jacobs. The group dealing with the pandemic response grappled with how data could be properly collected and shared to ensure that responses were timely and resources went to areas most in need. The World Bank’s Priya Basu, who heads the Pandemic Fund secretariat, said that applications for funding for the first round of the Fund’s disbursements were aimed at strengthening health systems in low and middle-income countries. Collaboration between government departments within countries, and between countries and donors had been a prerequisite for applicants. The huge and growing shortages of health workers and a lack of trained personnel were also a substantial challenge. “We need to deal with the global shortage of health workers and the poaching by high-income countries of health workers from low and middle-income countries. There are an estimated six million missing health workers in Africa,” said Philippe Guinot, Chief Technical Officer of IntraHealth. A sticking point in pandemic accord discussions has been around how to share pathogen sequencing. IFPMA’s Grega Kumer “The rapid sharing of SARS-COV-2’s sequencing enabled the pharmaceutical industry to start developing vaccines, treatments and diagnostics in record time. The first vaccine was approved 326 days after the virus sequence was known. This sharing of data and information mustn’t be jeopardized in the future, and the principle needs to be kept in any solutions for pandemic preparedness,” said Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). He added there had been cases where access to pathogens was either blocked or delayed because of access benefit-sharing agreements derived from the Nagoya Protocol, which led to delays in vaccine production. For instance, this has been the case for seasonal influenza, Ebola or Zika. However, Yaunqiong Hu from Médecins sans Frontières appealed for community contributions to the development of vaccines to be valued, pointing out the contributions of residents of Guinea to the development of Ebola vaccines. Meanwhile, Maria van Kerkhove, WHO’s Technical Lead on COVID-19, said that substantial capacity for surveillance had been built during the pandemic, but that transparency and data sharing were waning. But “governments don’t want to find the next pandemic because of the disincentives”, she added, citing how South Africa had been slapped with travel bans after sharing the Omicron sequencing. Misinformation undermining the ‘age of biology’ Chris Perez, head of International Programs at biotech company Concentric by Ginkgo Chris Perez, head of International Programs at biotech company Concentric by Ginkgo, told the evening plenary how his company’s tracking of aeroplane wastewater had identified COVID-19 variants in the US significantly earlier than any other tracking body. “We believe that the age of biology and the bio-economy hold the keys to enormous opportunities. across sectors for a more sustainable and resilient future for the world,” said Perez. Biological risks arise from “humans encroaching on new environments and climate change” as well as the “accidental or intentional misuse of bioengineering”, warned Perez. However, he also warned of social risks – particularly misinformation that undermined people’s faith in science. “As most people know, in the United States, the COVID-19 response was very politically charged in a challenging environment and also involved the dangers of misinformation in public health,” said Perez. “We need resilient societies and governance structures and today’s information environment can compound biological risks. Trust and the truth must be core organising principles if we are to address this.” The World Resilience Summit’s steering committee intends to draft recommendations for public-private partnerships in each of the three areas to “add value with public-private partnership solutions in the implementation of the upcoming pandemic treaty drafted by the WHO”. (With inputs from Megha Kaveri) WHA76: Countries Commit to Increased Polio Immunisation 25/05/2023 Disha Shetty Countries expressed concern at an uptick in polio cases last year and discussed ways to double down on routine immunizations – interrupted by the pandemic and conflicts – at Thursday’s World Health Assembly. Polio is currently the only official global public health emergency. Afghanistan and Pakistan are the last two remaining countries where the virus is endemic, WHO has said. In 2022, Afghanistan reported two new cases while Pakistan reported 20. Pakistan which has also reported a new case in 2023, said it, “continues to make consistent progress towards stopping the transmission of poliovirus.” The virus has been found to be in circulation across 31 countries in three regions, threatening to roll back hard fought for gains over several decades. “We are only safe once everyone is safe,” Germany said, as it highlighted the need for global cooperation. The United Kingdom asked countries to guarantee the safety of teams conducting routine immunisation, an issue in both countries where poliovirus remains endemic. Australia commended the work of the Global Polio Eradication Initiative (GPEI) in Afghanistan for operating under challenging conditions as the ruling Taliban continues to make it near impossible for women to work. “We commend GPEI in Afghanistan despite increasingly stringent bans on women working for NGOs and UN agencies. Ensuring the safety of all frontline polio workers should continue to be a high priority. The risk that women may no longer be able to perform house-to-house campaigns must be mitigated to sustain high coverage and reach zero dose children,” Australia said. The scarcity of women healthcare workers in some areas of Pakistan has also affected routine immunisation, leaving blind spots. “The Mehsud belt in southern Khyber Pakhtunkhwa remains a persistent challenge as no polio campaign has been conducted in debates since last months,” Pakistan said. To counter this issue the country said it is focusing on entry and exit points to the belt as well as areas around it where security remains a concern. Iran, which borders Afghanistan flagged concerns about the influx of migrants in recent years due to the conflict in the country and called it a challenging situation. Iran also said that it continues to face barriers when accessing vaccines, and asked for greater WHO support for its national laboratories. Canada assured its financial support to the polio campaign and highlighted the need to focus not just on countries where polio is endemic but also other countries that might need support. “We fear that other vulnerable countries that do not have the resources to organize effective campaigns are further exposed to outbreaks and the risk of outbreaks,” the country said. WHO Budget Replenishment Text Keeps Door Open to ‘Earmarked’ Donations 25/05/2023 Kerry Cullinan Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. GENEVA – The World Health Assembly is poised to decide on an “investment round” in late 2024 to boost the World Health Organization’s (WHO) finances – but not the establishment of a “replenishment fund”. Member states and donors will be able to continue to provide funds to the WHO earmarked for specific health programmes – something that the WHO’s Working Group on Sustainable Financing advised that the organisation moves away from as this skews the work of the global body. This is according to a copy of the draft text leaked to Health Policy Watch, based on member state discussions late on Wednesday. The US is widely believed to have pushed for the continued inclusion of earmarked funds as a condition of its support for the resolution. The formation of a WHO Investor Forum has also been mooted ahead of the investment round, according to those close to discussions. Members’ fees to cover 20% of budget The text also urges member states to pay their membership fees – which the assembly earlier resolved would now cover 20% of the budget (up from an estimated 14%). While the text proposes that the WHO should continue to accept, “alongside unearmarked voluntary contributions, voluntary contributions that are earmarked and/or single-year contributions from member states and other donors” it urges an increase in “transparency of reporting on voluntary earmarked contributions and on their impact and allocation”. In the lead-up to planning the investment round in the last quarter of 2024, the WHO is directed to provide member states with regular updates and to provide the Executive Board with “a full plan that includes modalities and anticipated costs” for approval. Various efforts to improve the financial viability of the WHO have hammered on the importance of the organisation having access to flexible funds – rather than funds donated by philanthropies and wealthier member states that are tied to programmes that might not be top global health priorities. Civil society condemnation Four civil society organisations condemned the new text, describing it as “nothing but the institutionalisation of the earmarked contribution that has led to the dismal functioning of the WHO at various levels, including the increasing penetration of the private philanthropic sector in the organisation”. “The draft decision goes against the very objective of the recommendation of the Working Group,” said Lauren Paremoer of the People’s Health Movement. “As per the approved budget of $6834.1 million for the 2024-25 biennium, $5685.8 million is to be funded through voluntary contributions. The institutionalisation of earmarked funding would further stabilise donor-driven priorities and compromise the credibility, independence and integrity of WHO.” Nicoletta Dentico of Society for International Development (SID) condemned “the multilateral development community’s fixation with leveraging the private sector in healthcare, using public money to de-risk investments”. Third World Network’s KM Gopakumar condemned the idea of a WHO Investors’ Forum, saying it would “seriously undermine the role of the vast majority of Member states in WHO’s governance”. “The Forum participants, consisting of a rather impenetrable network of philanthropic foundations and the private sector, would de facto control WHO’s priorities,” he added. Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. 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Air Pollution Advocates Say Time to Act Is Now 27/05/2023 Disha Shetty Elvis Ndikum Achiri of Global Youth 4 Clean Air and Climate Health Action in Cameroon shares his experience of working with communities affected by air pollution. When Elvis Ndikum Achiri, a long-time veteran of tobacco control campaigns, began collecting data on air pollution in his community in Cameroon, he was surprised to discover how many people around him, both young and old, suffered from related illnesses even though they had never smoked – including a beloved high school teacher who had recently died from asthma. Since then, Achiri has become a national advocate in the air pollution space as the coordinator for the Global Youth 4 Clean Air and Climate Health Action in Cameroon. He shared his experiences at a World Health Assembly (WHA) side event on Thursday, “Breathing Life into Clean Air Action”. The event, hosted by the Geneva Graduate Institute, brought together activists with UN agency leaders and funders of air pollution work to explore what civil society leaders are doing on the ground and how they can help drive real change. Speaking of his teacher who had passed away due to asthma, Achiri said, “When we connect the experience between the patient story and the reality of the disease, the cause, the risk factor, then we begin feeling differently [about] what is happening.” Air pollution kills seven million people annually, said Dr Maria Neira, Director of Environment, Climate Change and Health at the World Health Organization (WHO) and moderator of the event. But in addition to data, individual stories are critical in persuading the public and politicians to take action, Achiri pointed out. Solutions available, but political will is needed (left to right) Gillian Holmes, Elvis Ndikum Achiri, Nathan Borgford Parnell; and Dr Maria Neira, WHO. Background: a clean air view of Pretoria, South Africa. Some of the key takeaways from the event was that while there are solutions readily available, real change will need to involve local governments and affected communities. “There is a greater awareness particularly among governments about the connections between climate and air pollution and how it could be managed,” said Nathan Borgford-Parnell, science affairs coordinator at the Climate and Clean Air Coalition Secretariat who rued the lack of a political will. “This is the moment, and we need to capture it,” Bogford-Parnell said. “We cannot afford to let this thing go by.” ‘Urban Better’: a 3 point paradigm for healthier cities Dr Tollulah Oni, (above on screen) founder of Urban Better, outlines the 3-part paradigm of ‘Urban better including: ”the air we breathe; spaces and places; the food we eat. Dr Tollulah Oni, the director of clinical research at the University of Cambridge and the founder of Urban Better, a citizen driven campaign for clean air pointed to a fact that few people know: air pollution now the second largest cause of death in Africa. “Only a fraction, sort of 6% of children on the continent, reside within 50 kilometres of an air pollution monitoring station. So how can we change what we are not even measuring? This is what we need to tackle,” she said. In response, she created the ‘Urban Better’ initiative which aims to act on what Oni describes as the three main leverage points for healthier cities: clean air, healthy spaces and places for physical activity and access to healthy, nutritious foods. In particular, policymakers need to be thinking about public spaces that enable people to exercise and move about safelyas part of health equity, Oni said. “We say… okay, how do we think about open infrastructure as critical health infrastructure, and so we work through the air we breathe, our places and spaces, and the food we eat as three critical pathways through which we can create health in the context of climate vulnerability,” Oni said. She explains that by addressing air quality, as well as the physical “spaces and places” where people move about, the rampant rise in non-communicable diseases can be addressed. “We know that leisure physical activity has additional benefits, both physical and mental well being. In the same cities, we’re seeing that physical activity is not something that is supported,” she lamented. “But what we spend a lot less time on is looking at the built environment that needs to support but it’s currently largely poorly optimized for this. So we really need to start thinking about moving from individual awareness to a supportive environment,” she added. Citizens for clean air With respect to clean air, in particular, Urban Better has spun off youth action groups in Cape Town, Lagos and Accra, which have engaged in fact-finding around air pollution in their communities to design solutions they can advocate to local officials. The initiative also engages youths by giving them portable air quality devices that they can use to collect air quality data in their neighbourhoods as they run. The participants post the data on an interactive platform. Participants then post the data on an interactive platform and use it to generate key messages at the local level and engage with their peers and local leaders to find solutions. Professional athletes have been a part of the initiative and one of the youth made it to the climate summit COP27 last year, taking their advocacy to the global stage. “They used those data stories to generate key messaging that they then used to then re-mobilize the the peers,” Oni said. “[They were] Pushing towards increasing that demand for clean air and you can see how that connects to both inspire and conspire really trying to build this community.” In identifying pollution sources, the groups also take to the streets on bicycles and with wearable pollution monitors to identify pollution hotspots. In video clips of their findings, the same sources reappear over and over again, with dirty vehicles topping the charts from Cape Town to Lagos. Waste burning takes second place, while traditional wood-burning cookstoves and dust from roads, construction and natural sources, come third. ‘Majority Demographic’ Urban Better’s interactive data platform in action in Cape Town, South Africa. Oni spoke of the immense readiness among the youth to get involved in solutions, stressing that their potential has not yet been fully harnessed. “My experience is that there is just so much hunger and so much drive to be part of the solution,” Oni said. “We do ourselves a disservice when we simply pat ourselves on the back by engaging youth to say, ‘Oh, look how good we are, we engaged.’ “They have so much more to contribute,” Oni added. “I say this every time I speak right we’re particularly on the African continent, we really have to front and centre the majority demographic.” To curb waste-burning, look to women, youth and vulnerable groups Dr. Andriannah Mbandi, Lead, Waste, UNFCCC Climate Champions speaks remotely about how waste management is also an issue of equity. Air quality is an equity issue. Poorer communities, women and those in developing countries are the worst-affected. Solutions too, the speakers agreed, have to engage women, youth and vulnerable communities. “If you know anything about waste in Africa and a lot of developing regions, you will understand that the informal sector provides waste services and provides almost all waste management on the continent,” said Dr. Andriannah Mbandi, who leads the waste programme at UNFCCC Climate Champions. “That means if you’re looking at waste, curbing waste mismanagement, you need to look at women, youth and vulnerable groups.” Waste contributes to about 12% of greenhouse gases, 20% of methane, and 11% of black carbon globally. Open waste burning also contributes about 29% of fine particulate matter emitted annually, Mbandi said to point out the link between waste, air pollution and climate change. Need for flexibility, no magic bullet Clean air action is climate action. Integrated climate action is key. We cannot address air pollution and climate challenges separately., highlights@SergioSCleanAir of @EnvDefenseFund_ pic.twitter.com/BYBnZhbw1h — UrbanBetter.science (@UrbanBetter) May 25, 2023 Gillian Holmes, programme director at the Clean Air Fund, asked those attending what they’d recommend funders to consider in awarding grants. Oni said flexibility is the key. “We can’t have a very prescriptive and linear approach to building for investing in clean air. So we have to create the space for unintended and unanticipated urges and allow that pivoting to happen.” Sergio Sanchez, senior policy director of the Global Clean Air, Environmental Defense Fund agreed, adding that there is no catch-all solution to the problem of air pollution. Lagos Youths Cycle for Clean Air in ‘Urban Better’ event “One of the lessons is that there’s no silver bullet,” Sanchez said speaking remotely from Mexico. “It’s a long term effort. All institutions need to be aligned across the society.” The key ingredients are a strong social advocacy and political will, and that funders “be consistent and allocate the resources to cities, to countries to address this issue,” he said. Sanchez spoke on the example of Mexico City, where strong public advocacy helped trigger political action on key pollution drivers that has significantly improved air quality over the past decade. Children among the most vulnerable groups Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, in the United Kingdon. While most premature deaths from air pollution occur among older people, children are also among the most vulnerable groups. Many die or suffer through lifelong impacts from polluted air, said Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, in the United Kingdon. The impact of air pollution on children has become a major issue in the United Kingdom following the death of 9-year-old Ella Kissi-Debrah from asthma in 2013. Ella later became the first person to have air pollution listed as a cause of death following a protracted legal battle by her mother, Rosamund Adoo-Kissi-Debrah, who has since set up the Ella Roberta Foundation to advance the cause of air quality. “There’s now plenty of evidence to link air pollution with infertility, miscarriage, prematurity and intrauterine growth restriction,” said Kingdon. “A study published just last month by teams at King’s College and Imperial College London showed that air pollution directly impacts the development of a new-born brain in a negative way.” Kingdon also spoke of the links between air pollution, poverty and race. “If you grow up in poverty, you’re much more likely to be exposed to poor air quality. And in a study last month from Harvard, researchers were able to confirm the link between air pollution causing death, and poverty,” she said. The study done in the US found that Black Americans are exposed to higher levels of air pollution every year compared to White Americans, and thus likely to be more prone to its health effects. Become Air Pollution “Terminators” Dr Maria Neira, Director of Environment, Climate Change and Health at WHO. Neira, meanwhile, called upon participants in the session to become “air pollution terminators” and play a more active role in pressing policymakers. “Anything we can do to mitigate the causes of climate change will be generating massive results in terms of public health,” Neira said. “Unless our citizens understand that this is an issue we will not be able to put pressure on our politicians.” WHO first took up the air pollution issue in 2015, when it passed a landmark resolution “Health and the environment: addressing the health impact of air pollution”. The resolution identified 13 measures that member states should strive to implement, including more continuous monitoring of air pollution levels; public awareness-raising; stricter air pollution standards; and mitigation measures. Since that time, more and more member states are monitoring air quality with some 6000 monitoring sites reported in WHO’s last update. But significant gaps still exist, particularly in sub-Saharan Africa where few monitoring stations exist. Mounting scientific evidence on the adverse health effects of air pollution shows cutting PM2.5 concentrations would save the lives of millions. Despite global efforts to tackle the issue, air pollution deaths overall have not declined significantly. While there are now positive signs of transition to cleaner household fuels in South Asia and Sub Saharan Africa, ambient (outdoor) air pollution continues to rise in many developing cities, seeing rapid population growth, and along with that, soaring traffic and waste management issues due to uncontrolled sprawl. The trajectory is not only deeply worrisome from a health standpoint but also from a climate perspective, insofar as the major sources of air pollution also are climate polluters. Traffic, coal, oil and gas power generation, waste burning and fires all emit huge amounts of planet warming CO2 as well as methane, black carbon, and ozone precursors, which are short-lived climate pollutants (SLCPs). Cleaning up SLCPs would also generate quick wins for climate as their lifespan is measured in weeks to decades, as compared to centuries for CO2, pointed out Borgford-Parnell. “Here [at WHA] we are talking about addressing the causes of those diseases and air pollution is one of the big causes of the problem,” Neira concluded. “The multi-sectoral approach is needed.” Health Policy Watch was a co-sponsor of this event along with the Clean Air Fund and the Climate and Clean Air Coalition. Image Credits: Clean Air Fund , US Mission Geneva . Russia Delays World Health Assembly While North Korea Condemns ‘Satanic’ US 26/05/2023 Kerry Cullinan WHA president Chris Fearne prepares to announce the results of the secret ballot Russia’s objection to the nomination of Ukraine for the World Health Organization’s (WHO) Executive Board delayed Friday’s World Health Assembly – while the US and the Democratic People’s Republic of Korea (DPRK) also took diplomatic potshots at each other. What was supposed to be a straightforward endorsement of the 10 members put forward by member states to fill the vacancies on the 34-person board turned into a lengthy delay as officials organised a secret ballot. The European Union and Monaco objected, saying that the outcome of the vote was already clear. Meanwhile, Russia also objected to the process of the ballot, which it described as “merely procedural and not an election since the member-states cannot vote against any single candidate in the ballot”. It also took exception to New Zealand being one of two representatives to count the ballots: “New Zealand has repeatedly spoken against our delegation… We have no trust the teller will be carried out correctly.” South Africa was deemed an acceptable replacement for New Zealand, and the ballot went ahead – once again resulting in Russian humiliation with 123 member states supporting all 10 new members, 13 abstentions and six spoiled ballots (35 countries were absent). “We are encouraged by the unanimity and resolve of the World Health Assembly in standing up to Russia’s unprecedented assault on WHO governing bodies,” said Ukraine, noting that Russia continued to attack health facilities and kill civilians and health workers. One of the newly elected board members is from North Korea, something that disquietened the US. “The US takes this opportunity to reinforce the expectation of members of the executive board and calls on the government of the DPRK to respect human rights, fulfil its obligations under UN Security Council resolutions and engage in serious and sustained diplomacy,” it noted. In response, North Korea’s representative described the US as “Satanic” and its comments an “abuse” of the WHA. Russia, North Korea, Syria and Egypt all objected to the politicisation of the WHA. The Executive Board is composed of 34 persons who are technically qualified in the field of health, each designated by a member state and elected for three-year terms. (Additional reporting by Megha Kaveri) Stronger Global Roadmap to Tackle NCDs is Finally Passed 26/05/2023 Kerry Cullinan WHA76: Committee A finally passes NCD plan New global guidelines to tackle non-communicable diseases (NCDs) were finally passed by the World Health Assembly on Friday afternoon after a mammoth day-and-a-half of member states’ inputs. The guidelines update the World Health Organization’s (WHO) “Best Buys” published in 2017 and focus on the four key risk factors for NCDs – tobacco, alcohol, unhealthy diet and physical inactivity – and the four main associated diseases – cardiovascular disease, diabetes, cancer and chronic respiratory disease. Earlier in the week, Bente Mikkelsen, WHO’s Director of NCDs, explained the key changes adopted on Friday to what she described as an “implementation roadmap” to tackle NCDs, which are responsible for three-quarters of global deaths. “In 2017, we had a total of 88 interventions, and 39 of them had cost-effective estimates,” Mikkelsen told the event convened by the NCD Alliance and Vital Strategies. “We now have 90 interventions, and 58 interventions with cost-effectiveness estimates. And also very importantly, in 2017, we only looked at [evidence from] 20 countries, and today we have 62 countries grouped in all three income categories.” Twenty-eight interventions are considered to be the most cost-effective and feasible for implementation in comparison to 16 recommended in 2017.” These include taxes on sugary drinks, curbs on the marketing of unhealthy products and warning labels. Vital Strategies’ Dr Nandita Murukutla described the interventions that are “inexpensive for governments to implement, including those that target behavioural risk factors such as tobacco use, unhealthy diets, alcohol consumption and inadequate physical activity”. “The effectiveness of excise taxes, marketing restrictions and labelling policies, for instance, have been demonstrated to reduce the consumption of unhealthy products,” added Murukutla, Vice President of Global Policy and Research. “Were governments to adopt the recommendations as official policies, they could, in a unified and coordinated approach, significantly reduce the proliferation of unhealthy products and make an impact on the growing trajectory of NCDs, including heart and lung disease, diabetes, and cancers,” she added. However, NCD advocates believe that the “Best Buys” need to be further strengthened to prevent interference in health policy by industries selling products that harm people – tobacco, alcohol, ultra-processed food and fossil fuel. “The industries that produce and market these products are more interested in profit than in healthy people and healthy communities,” said José Luis Castro, President and CEO of Vital Strategies, at the WHA side event hosted by his organisation and the NCD Alliance. Castro believes that “Best Buys” should be modified to include “more explicit recommendations against corporate influence” because “corporate influence worldwide has been identified as the main reason why Best Buys’ implementation falls short”. Coalition Calls to Expand Self-Care Guidelines, Proposes WHO Resolution 26/05/2023 Alex Winston Self-Care a Foundational Component of Health System Sustainability” at the 76th World Health Assembly The United for Self-Care Coalition made calls to expand the current World Health Organization’s (WHO) guidelines on self-care during a panel event, “Self-Care a Foundational Component of Health System Sustainability,” at the 76th World Health Assembly on Wednesday. The United for Self-Care Coalition, a new coalition of like-minded groups and experts, marked their call to action with a panel hosted by coalition member the Global Self-Care Federation (GSCF) to discuss “We are in a unique moment, as we see it from a federation standpoint as it pertains to the role of self-care in overall health care systems,” GSCF Chair Manoj Raghunandanan told those in attendance. Global Self-Care Federation Chair Manoj Raghunandanan A rise in chronic conditions, an ageing population, and the COVID-19 pandemic have all impacted already-overstretched resources over the past few years, he said. For Raghunandanan, the COVID-19 pandemic has changed how people view self-care due to the amount of time spent in lock downs and, for many people, an inability to see medical practitioners in person. “The COVID-19 pandemic was the great accelerator,” Raghunandanan said. “We had a period where consumers and patients were relying upon themselves to care for themselves, to adjudicate their care to provide for themselves, and during that time, we realised that in many cases, they could be successful at doing this.” What is self-care? Self-care is defined as the ability of individuals, families and communities to promote health, prevent disease and mental health, and cope with illnesses and disability, with or without the support of health workers. United for Self-Care Coalition has called on the WHO to boost health literacy, promote digital health, enhance self-care capacity and guidance, recognise self-care as an enabler of UHC and invest in self-care. The coalition is already part of the UHC2030 platform, which aims to increase Universal Health Coverage by 2030. Democratising access to self-care interventions Many see the current WHO guidelines as simply needing to do more. Manjulaa Narasimhan, a scientist in the Department of Reproductive Health and Research at WHO Manjulaa Narasimhan, a scientist in the Department of Reproductive Health and Research at WHO, explained, “We look at things like how can we reduce the levels of violence, stigma, discrimination and coercion, that many people face even within health systems. We look at what kind of education and support they might need, including psychosocial support and other types. What kind of access to justice might people need?” Self-care practices can hold enormous potential to improve people’s quality of life, helping to manage the burden of non-communicable diseases (NCDs) while helping to develop health systems’ sustainability and reduce increasing costs. One such way forward could be increased telemedicine, health-related services and information available via electronic devices and technologies. This allows longer-distance patient-clinician contact, care, advice, reminders, education, intervention, monitoring and remote admissions. Academic Austen El-Osta gave examples to the panel, including the UK National Health Service, who, he told the audience, “bought a quarter of a million blood pressure monitors and distributed these to patients. These patients are effectively self-caring, releasing pressure from primary care and the health system. Of course, we’re all familiar with the many fantastic digital health apps and tools that we use and excellent med tech. “The big question is how do we democratise access to self-care interventions and best practices?” El–Osta said. “We have the guidelines; we’ve got some anecdotal evidence. We’ve got a lot of work on NCDs and technology. So all of these are coming together now.” Another example explored was how pharmacists could help unburden struggling health systems. Mariet Eksteen, Global Lead for Advancing Integrated Services at Advancing Pharmacy Worldwide “Often pharmacy and pharmacists are the patient’s first point of call in any healthcare inquiry that they have,” stated Mariet Eksteen, Global Lead for Advancing Integrated Services at Advancing Pharmacy Worldwide. “Pharmacists could be an exceptionally well-positioned resource to support the concept of self-care because we could assist patients with a rising level of health literacy as well as knowledge in their communities, which as a result, could also lead to increased levels of preventative care.” Why a WHO resolution is needed A WHO resolution on self-care, as opposed to guidelines, would provide the following: A framework for its integration into future economic and health policies. Promoting awareness. Political commitment. The mobilisation of resources. There would then be better support for the UH2030 goals. Sandy Garçon, the founding director of the Self-Care Trailblazer Group, echoed calls for the WHO to work on the current guidelines, stating, “There needs to be the right kind of policies, the right kind of funding, and the correct type of programming. Many countries are already moving in this direction, but we need more.” “We always welcome political and legal policy and standards framework that we can rely on to help us create that ecosystem we want,” agreed Kawaldip Sehmi, CEO of the International Alliance of Patients’ Organisations. “From patients of self-care first, then health professionals second. Now it’s time to take care of ourselves.” Image Credits: Screenshot. New Principles Offer Guide to Human Rights During Health Emergencies 26/05/2023 Alex Winston From left: Magdalena Sepúlveda Carmona, Executive Director, Global Initiative For Economic, Social And Cultural Rights; Saman Zia-Zarifi, Executive Director, Physicians For Human Rights; and Viviana Muñoz Tellez, Coordinator, Health, Intellectual Property And Biodiversity Programme, South Centre As the world continues to learn the lessons of the COVID-19 pandemic, a new set of principles aiming the help guide the future of human rights in global medical emergencies was published and discussed on Tuesday at an event of the 76th World Health Assembly (WHA). The event, titled “Beyond Panic & Neglect: Building a Human Rights Framework for Public Health Emergency Prevention, Preparedness, and Response,” looked at a new set of principles and Guidelines on Human Rights and Public Health Emergencies, which were developed through a three-year partnership between the Global Health Law Consortium (GHLC) and the International Commission of Jurists (ICJ.) The overarching human rights principles and obligations fall into eight categories: 1 – Universal enjoyment of human rights 2 – International solidarity 3 – Rule of law 4 – Equality and non-discrimination 5 – Human rights duties related to non-State actors 6 – Transparency and access to information 7 – Meaningful and effective participation 8 – Accountability and access to justice for those harmed by human rights violations and abuses Principles bring together lessons from COVID and previous pandemics, epidemics The principles, formulated by 150 individuals from other health and human rights organisations and WHO officials, draw upon lessons from past epidemics and pandemics, including cholera, dengue, ebola, HIV and zika. In addition, the experts looked at situations where an inadequate response to effective public health policies and human rights obligations led to devastating outcomes. “What was needed is a contemporary treatment that also accounted for what needed to be done to ensure a broader rights-based approach to public health emergencies, including upholding the right to health and related rights. These new principles, we believe, represent a breakthrough in the ongoing effort to ensure that human rights are protected and upheld in times of crisis.” Ian Seiderman, legal and policy director at the ICJ, told those gathered. “This event here marks our first public dialogue on the new principles and guidelines and their subject matter, focusing on the role of international human rights law in guiding approaches to public health emergencies.” The principles bring together an overarching scope of the universal enjoyment of human rights, including equality and non-discrimination, transparency and access to information and accountability and access to justice for those harmed by human rights abuses or violations. Principles coincide with pandemic treaty From left: Magdalena Sepúlveda Carmona, Executive Director, Global Initiative For Economic, Social And Cultural Rights; Saman Zia-Zarifi, Executive Director, Physicians For Human Rights; Viviana Muñoz Tellez, Coordinator, Health, Intellectual Property And Biodiversity Programme, South Centre; and moderator Gian Luca Burci, Adjunct Professor, International Law, Geneva Graduate Institute The release of the principles coincided with the release of a new “Zero+” draft of the proposed World Health Organization (WHO) pandemic accord that is currently under negotiation by member states. “We saw many governments shift from complacency and neglect to rapid action, often in panic mode to respond to a public health threat that was spreading uncontrollably,” stated Roojin Habibi, a co-founding member of the Global Health Law Consortium, who led the development of the principles. “Around the world, we saw countries deploy various measures, from mask mandates to lock downs to quarantines and isolation in response to this public health threat. “The international community must learn to move beyond cycles of panic and neglect, which leaves human rights at the margins of decision-making and policymaking. The principles developed through a consensus-based and deliberative process amongst 30 of the world’s leading thinkers in global health law and human rights provide an authoritative interpretation of international law to help guide that learning.” The WHO drafted pandemic treaty states that “all lives have equal value, and that therefore equity should be a principle, an indicator and an outcome of pandemic prevention, preparedness, and response,” and this was a point emphasised by Dr. Viviana Munoz Tellez of the South Centre, an intergovernmental organisation based in Geneva that helps developing countries promote their common interests in the international arena, who brought up the issue of vaccine inequity. “We could have averted, at minimum, about a million and a half deaths,” Tellez said. “The idea was, when we have vaccine doses, we will distribute at least 20% proportionally and highlight the more vulnerable populations that need to go first. But, unfortunately, that did not happen, mainly because the more affluent countries had advanced marketing commitments. “We had competition rather than cooperation. That was one of the big problems.” The role of the private health sector The private health sector has also come under heavy scrutiny since the pandemic. However, one aspect that the principles address observes that the state must regulate and monitor private actors. The principles themselves put no obligations directly on the remote, non-state actors. Instead, they state that across all pandemic prevention, response and recovery measures, states have the responsibility to ensure that non-state actors do not impair any of the human rights laws and must regulate and monitor ” engaged non-state actors to prevent them from impairing the enjoyment of human rights and provide for redress and accountability.” Magdalena Sepúlveda Carmona, executive director of Global Initiative For Economic, Social and Cultural Rights, stated on private actors that, “Something that started happening before the pandemic is the privatization, commercialization, and financialization of public services such as health care, water, sanitation and education. There are many ways in which private actors can be involved in health care. “We need to act now. We must ensure that everybody has access to a universal resilient health system that is affordable or at no cost for those who need it. And that is included in the principles.” The hope, the presenters said, is that the COVID-19 pandemic would bring about changes in legislation that would help the world prepare and deal with any future health emergencies. “We have to use these principles to put in place legislation, rules and regulations to say the next time this happens, we have to think about how we’re going to address this problem,” Saman Zia-Zarifi, executive director of Physicians For Human Rights told the panel. “It can’t just be that we will give money to companies to support their workers who can’t come to the office, but we will keep open the informal sector where the majority of people in most countries live and work.” The new principles allow actors to play their part in change. “These principles can act as kind of a North Star for everyone,” Zia-Zarifi stated. “They establish some clear directions of movement. They don’t tell governments what to do but give them a direction of movement and a way of thinking.” The Geneva Graduate Institute, The Global Health Centre and the International Geneva Global Health Platform, the International Commission of Jurists, the Global Health Law Consortium, the Global Initiative for Economic, Social and Cultural Rights, and Physicians for Human Rights organised the panel. Image Credits: Screenshot. Huge Support for Universal Health Coverage and NCD Measures, But WHO Replenishment Fund is Rejected 25/05/2023 Kerry Cullinan & Megha Kaveri The delegate for Barbados addressing the World Health Assembly during discussions on universal health coverage. An impossibly long list of member states lined up to address universal health coverage (UHC) and non-communicable diseases (NCDs) at the World Health Assembly on Thursday afternoon, indicating the centrality of these issues for countries. There was near-universal support for primary health services to be the backbone of UHC, with disease prevention as the other key pillar – particularly to prevent NCDs. A number of countries including Canada, the US and Norway called for sexual and reproductive services accessible to young people to be included as part of primary health. Many member countries called for the three United Nations High-Level Meetings – on UHC, tuberculosis and pandemic preparedness – in September to be aligned with the WHO’s processes, including negotiations on a pandemic accord. Huge support for WHO’s ‘Best Buys’ The WHO’s updated policy options and interventions to prevent and control NCDs – referred to as “Best Buys” – also enjoyed widespread support. A number of Caribbean countries are at the forefront of fighting NCDs and obesity, including Barbados. “Barbados is privileged to be one of the front-runner countries that WHO has identified to take part in the acceleration plan to stop obesity,” its delegate said. Barbados launched a national school nutrition policy in February “to address challenges related to poor dietary habits and lack of physical activity among schoolchildren”, while its tax on sugary drinks introduced in 2015 resulted in a 4.3% reduction in their consumption. Canada underlined the importance of integrating mental health into broader NCD prevention strategies but noted that stigma “remains a barrier to mental well-being globally, especially for younger people”. Norway called for strategies to fight NCDs to be “free from undue political and commercial influence”, something that NCD advocates lobbied for on the sidelines of the WHA. No consensus on replenishment fund However, the same spirit of agreement was absent in Committee B, with a divergence among member states’ opinions on a “replenishment mechanism” proposed by the WHO Director-General to ensure more sustainable financing of the organisation. Member-states deliberated on different possible models of sustainable funding of the WHO, delaying agreement on a single, unified formula of a “replenishment mechanism”. The US made it clear that it did not support the replenishment mechanism – a view that ultimately held sway. It, however, expressed support to have rounds of investments by donors, similar to other global health organizations like The Global Fund. “We agreed to support planning for the secretariat’s proposed new initiative for sustainable financing for WHO with the understanding that we’ve moved to a more streamlined approach of innovative fundraising through an investment round, and that we’re not approving a replenishment mechanism for WHO,” stated the US. It is also widely believed that the country pushed for inclusion of “earmarked contributions” in the draft text of the resolution, in exchange for its support to the resolution. Switzerland supported the replenishment mechanism for the WHO, saying it had “considerable potential to strengthen the strategic use of funding and to guarantee predictability of financing for WHO’s operations in order to guarantee health for all”. But, it also underlined that “earmarked contributions will remain vital to the funding of WHO for many member states” but that their use needs to be “traceable, transparent and efficient”. A decision on what mechanism should be adopted to bolster WHO’s finances is expected on Friday. World Resilience Summit Galvanises Public-Private Solutions to Feed into Pandemic Accord Negotiations 25/05/2023 Kerry Cullinan Maria van Kerkhove, Priya Basu, Mary Mahy, Iveth J. González and Benjamin Roche. GENEVA – Global health conversations are much deeper at present because everyone has been affected by COVID-19 – and this opens up the possibility of building an “all-of-society” approach before the next pandemic, said Sylvie Brand, the World Health Organization’s (WHO) Director of Epidemic and Pandemic Preparedness and Prevention. “We have seen during this pandemic that it’s not enough to have doctors and nurses at the frontline. We need to bring on board politicians, academics, the private sector, civil society, faith-based organisations – everybody has a role to play,” said Brand during her keynote address to the Resilience Summit held alongside the World Health Assembly in Geneva. “But this is not enough. We need also to make sure that we connect people because when the crisis starts, it’s very hard to build things from scratch.” Her input came after leaders from the public and private sectors had discussed three different areas related to pandemics – prevention, preparedness and response – at the invitation-only summit hosted by the World Climate Foundation and the Geneva Health Forum. Stop the zoonotic spark The pandemic prevention group, which had a strong contingent of One Health actors, felt that primary prevention had to focus on zoonotic spillover from animals to people. “You have to start with the spark that can cause the fire, addressing the interface between animals and people,” said Jonathan Epstein, Vice-President of EcoHealth Alliance. The group also called for the integration of climate change and biodiversity and health. Collaborative surveillance and data-sharing dominated the discussion at the preparedness roundtable, which also stressed the importance of building trust and understanding. “We need the foundation – global, regional, national systems – for surveillance that is intentionally collaborative, that goes beyond the health sector,” said Dr Magda Robalo Correia e Silva, the Health Minister of Guinea-Bissau. She also said that preparing for an infectious disease outbreak or a pandemic must be rooted in communities and lived experiences of the people. The panellists also touched on how preventative measures like surveillance or data sharing don’t work in isolation. “It’s an ecosystem. It cannot be the data only or the tools only or the financing of the early warning system or political support. It’s an ecosystem that starts with the doctors, nurses who are in the frontlines. That’s where the [early warning] system gets triggered,” said Dr Nino Kharaishvili, Global Solutions Director of the health systems governance at Jacobs. The group dealing with the pandemic response grappled with how data could be properly collected and shared to ensure that responses were timely and resources went to areas most in need. The World Bank’s Priya Basu, who heads the Pandemic Fund secretariat, said that applications for funding for the first round of the Fund’s disbursements were aimed at strengthening health systems in low and middle-income countries. Collaboration between government departments within countries, and between countries and donors had been a prerequisite for applicants. The huge and growing shortages of health workers and a lack of trained personnel were also a substantial challenge. “We need to deal with the global shortage of health workers and the poaching by high-income countries of health workers from low and middle-income countries. There are an estimated six million missing health workers in Africa,” said Philippe Guinot, Chief Technical Officer of IntraHealth. A sticking point in pandemic accord discussions has been around how to share pathogen sequencing. IFPMA’s Grega Kumer “The rapid sharing of SARS-COV-2’s sequencing enabled the pharmaceutical industry to start developing vaccines, treatments and diagnostics in record time. The first vaccine was approved 326 days after the virus sequence was known. This sharing of data and information mustn’t be jeopardized in the future, and the principle needs to be kept in any solutions for pandemic preparedness,” said Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). He added there had been cases where access to pathogens was either blocked or delayed because of access benefit-sharing agreements derived from the Nagoya Protocol, which led to delays in vaccine production. For instance, this has been the case for seasonal influenza, Ebola or Zika. However, Yaunqiong Hu from Médecins sans Frontières appealed for community contributions to the development of vaccines to be valued, pointing out the contributions of residents of Guinea to the development of Ebola vaccines. Meanwhile, Maria van Kerkhove, WHO’s Technical Lead on COVID-19, said that substantial capacity for surveillance had been built during the pandemic, but that transparency and data sharing were waning. But “governments don’t want to find the next pandemic because of the disincentives”, she added, citing how South Africa had been slapped with travel bans after sharing the Omicron sequencing. Misinformation undermining the ‘age of biology’ Chris Perez, head of International Programs at biotech company Concentric by Ginkgo Chris Perez, head of International Programs at biotech company Concentric by Ginkgo, told the evening plenary how his company’s tracking of aeroplane wastewater had identified COVID-19 variants in the US significantly earlier than any other tracking body. “We believe that the age of biology and the bio-economy hold the keys to enormous opportunities. across sectors for a more sustainable and resilient future for the world,” said Perez. Biological risks arise from “humans encroaching on new environments and climate change” as well as the “accidental or intentional misuse of bioengineering”, warned Perez. However, he also warned of social risks – particularly misinformation that undermined people’s faith in science. “As most people know, in the United States, the COVID-19 response was very politically charged in a challenging environment and also involved the dangers of misinformation in public health,” said Perez. “We need resilient societies and governance structures and today’s information environment can compound biological risks. Trust and the truth must be core organising principles if we are to address this.” The World Resilience Summit’s steering committee intends to draft recommendations for public-private partnerships in each of the three areas to “add value with public-private partnership solutions in the implementation of the upcoming pandemic treaty drafted by the WHO”. (With inputs from Megha Kaveri) WHA76: Countries Commit to Increased Polio Immunisation 25/05/2023 Disha Shetty Countries expressed concern at an uptick in polio cases last year and discussed ways to double down on routine immunizations – interrupted by the pandemic and conflicts – at Thursday’s World Health Assembly. Polio is currently the only official global public health emergency. Afghanistan and Pakistan are the last two remaining countries where the virus is endemic, WHO has said. In 2022, Afghanistan reported two new cases while Pakistan reported 20. Pakistan which has also reported a new case in 2023, said it, “continues to make consistent progress towards stopping the transmission of poliovirus.” The virus has been found to be in circulation across 31 countries in three regions, threatening to roll back hard fought for gains over several decades. “We are only safe once everyone is safe,” Germany said, as it highlighted the need for global cooperation. The United Kingdom asked countries to guarantee the safety of teams conducting routine immunisation, an issue in both countries where poliovirus remains endemic. Australia commended the work of the Global Polio Eradication Initiative (GPEI) in Afghanistan for operating under challenging conditions as the ruling Taliban continues to make it near impossible for women to work. “We commend GPEI in Afghanistan despite increasingly stringent bans on women working for NGOs and UN agencies. Ensuring the safety of all frontline polio workers should continue to be a high priority. The risk that women may no longer be able to perform house-to-house campaigns must be mitigated to sustain high coverage and reach zero dose children,” Australia said. The scarcity of women healthcare workers in some areas of Pakistan has also affected routine immunisation, leaving blind spots. “The Mehsud belt in southern Khyber Pakhtunkhwa remains a persistent challenge as no polio campaign has been conducted in debates since last months,” Pakistan said. To counter this issue the country said it is focusing on entry and exit points to the belt as well as areas around it where security remains a concern. Iran, which borders Afghanistan flagged concerns about the influx of migrants in recent years due to the conflict in the country and called it a challenging situation. Iran also said that it continues to face barriers when accessing vaccines, and asked for greater WHO support for its national laboratories. Canada assured its financial support to the polio campaign and highlighted the need to focus not just on countries where polio is endemic but also other countries that might need support. “We fear that other vulnerable countries that do not have the resources to organize effective campaigns are further exposed to outbreaks and the risk of outbreaks,” the country said. WHO Budget Replenishment Text Keeps Door Open to ‘Earmarked’ Donations 25/05/2023 Kerry Cullinan Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. GENEVA – The World Health Assembly is poised to decide on an “investment round” in late 2024 to boost the World Health Organization’s (WHO) finances – but not the establishment of a “replenishment fund”. Member states and donors will be able to continue to provide funds to the WHO earmarked for specific health programmes – something that the WHO’s Working Group on Sustainable Financing advised that the organisation moves away from as this skews the work of the global body. This is according to a copy of the draft text leaked to Health Policy Watch, based on member state discussions late on Wednesday. The US is widely believed to have pushed for the continued inclusion of earmarked funds as a condition of its support for the resolution. The formation of a WHO Investor Forum has also been mooted ahead of the investment round, according to those close to discussions. Members’ fees to cover 20% of budget The text also urges member states to pay their membership fees – which the assembly earlier resolved would now cover 20% of the budget (up from an estimated 14%). While the text proposes that the WHO should continue to accept, “alongside unearmarked voluntary contributions, voluntary contributions that are earmarked and/or single-year contributions from member states and other donors” it urges an increase in “transparency of reporting on voluntary earmarked contributions and on their impact and allocation”. In the lead-up to planning the investment round in the last quarter of 2024, the WHO is directed to provide member states with regular updates and to provide the Executive Board with “a full plan that includes modalities and anticipated costs” for approval. Various efforts to improve the financial viability of the WHO have hammered on the importance of the organisation having access to flexible funds – rather than funds donated by philanthropies and wealthier member states that are tied to programmes that might not be top global health priorities. Civil society condemnation Four civil society organisations condemned the new text, describing it as “nothing but the institutionalisation of the earmarked contribution that has led to the dismal functioning of the WHO at various levels, including the increasing penetration of the private philanthropic sector in the organisation”. “The draft decision goes against the very objective of the recommendation of the Working Group,” said Lauren Paremoer of the People’s Health Movement. “As per the approved budget of $6834.1 million for the 2024-25 biennium, $5685.8 million is to be funded through voluntary contributions. The institutionalisation of earmarked funding would further stabilise donor-driven priorities and compromise the credibility, independence and integrity of WHO.” Nicoletta Dentico of Society for International Development (SID) condemned “the multilateral development community’s fixation with leveraging the private sector in healthcare, using public money to de-risk investments”. Third World Network’s KM Gopakumar condemned the idea of a WHO Investors’ Forum, saying it would “seriously undermine the role of the vast majority of Member states in WHO’s governance”. “The Forum participants, consisting of a rather impenetrable network of philanthropic foundations and the private sector, would de facto control WHO’s priorities,” he added. Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. 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Russia Delays World Health Assembly While North Korea Condemns ‘Satanic’ US 26/05/2023 Kerry Cullinan WHA president Chris Fearne prepares to announce the results of the secret ballot Russia’s objection to the nomination of Ukraine for the World Health Organization’s (WHO) Executive Board delayed Friday’s World Health Assembly – while the US and the Democratic People’s Republic of Korea (DPRK) also took diplomatic potshots at each other. What was supposed to be a straightforward endorsement of the 10 members put forward by member states to fill the vacancies on the 34-person board turned into a lengthy delay as officials organised a secret ballot. The European Union and Monaco objected, saying that the outcome of the vote was already clear. Meanwhile, Russia also objected to the process of the ballot, which it described as “merely procedural and not an election since the member-states cannot vote against any single candidate in the ballot”. It also took exception to New Zealand being one of two representatives to count the ballots: “New Zealand has repeatedly spoken against our delegation… We have no trust the teller will be carried out correctly.” South Africa was deemed an acceptable replacement for New Zealand, and the ballot went ahead – once again resulting in Russian humiliation with 123 member states supporting all 10 new members, 13 abstentions and six spoiled ballots (35 countries were absent). “We are encouraged by the unanimity and resolve of the World Health Assembly in standing up to Russia’s unprecedented assault on WHO governing bodies,” said Ukraine, noting that Russia continued to attack health facilities and kill civilians and health workers. One of the newly elected board members is from North Korea, something that disquietened the US. “The US takes this opportunity to reinforce the expectation of members of the executive board and calls on the government of the DPRK to respect human rights, fulfil its obligations under UN Security Council resolutions and engage in serious and sustained diplomacy,” it noted. In response, North Korea’s representative described the US as “Satanic” and its comments an “abuse” of the WHA. Russia, North Korea, Syria and Egypt all objected to the politicisation of the WHA. The Executive Board is composed of 34 persons who are technically qualified in the field of health, each designated by a member state and elected for three-year terms. (Additional reporting by Megha Kaveri) Stronger Global Roadmap to Tackle NCDs is Finally Passed 26/05/2023 Kerry Cullinan WHA76: Committee A finally passes NCD plan New global guidelines to tackle non-communicable diseases (NCDs) were finally passed by the World Health Assembly on Friday afternoon after a mammoth day-and-a-half of member states’ inputs. The guidelines update the World Health Organization’s (WHO) “Best Buys” published in 2017 and focus on the four key risk factors for NCDs – tobacco, alcohol, unhealthy diet and physical inactivity – and the four main associated diseases – cardiovascular disease, diabetes, cancer and chronic respiratory disease. Earlier in the week, Bente Mikkelsen, WHO’s Director of NCDs, explained the key changes adopted on Friday to what she described as an “implementation roadmap” to tackle NCDs, which are responsible for three-quarters of global deaths. “In 2017, we had a total of 88 interventions, and 39 of them had cost-effective estimates,” Mikkelsen told the event convened by the NCD Alliance and Vital Strategies. “We now have 90 interventions, and 58 interventions with cost-effectiveness estimates. And also very importantly, in 2017, we only looked at [evidence from] 20 countries, and today we have 62 countries grouped in all three income categories.” Twenty-eight interventions are considered to be the most cost-effective and feasible for implementation in comparison to 16 recommended in 2017.” These include taxes on sugary drinks, curbs on the marketing of unhealthy products and warning labels. Vital Strategies’ Dr Nandita Murukutla described the interventions that are “inexpensive for governments to implement, including those that target behavioural risk factors such as tobacco use, unhealthy diets, alcohol consumption and inadequate physical activity”. “The effectiveness of excise taxes, marketing restrictions and labelling policies, for instance, have been demonstrated to reduce the consumption of unhealthy products,” added Murukutla, Vice President of Global Policy and Research. “Were governments to adopt the recommendations as official policies, they could, in a unified and coordinated approach, significantly reduce the proliferation of unhealthy products and make an impact on the growing trajectory of NCDs, including heart and lung disease, diabetes, and cancers,” she added. However, NCD advocates believe that the “Best Buys” need to be further strengthened to prevent interference in health policy by industries selling products that harm people – tobacco, alcohol, ultra-processed food and fossil fuel. “The industries that produce and market these products are more interested in profit than in healthy people and healthy communities,” said José Luis Castro, President and CEO of Vital Strategies, at the WHA side event hosted by his organisation and the NCD Alliance. Castro believes that “Best Buys” should be modified to include “more explicit recommendations against corporate influence” because “corporate influence worldwide has been identified as the main reason why Best Buys’ implementation falls short”. Coalition Calls to Expand Self-Care Guidelines, Proposes WHO Resolution 26/05/2023 Alex Winston Self-Care a Foundational Component of Health System Sustainability” at the 76th World Health Assembly The United for Self-Care Coalition made calls to expand the current World Health Organization’s (WHO) guidelines on self-care during a panel event, “Self-Care a Foundational Component of Health System Sustainability,” at the 76th World Health Assembly on Wednesday. The United for Self-Care Coalition, a new coalition of like-minded groups and experts, marked their call to action with a panel hosted by coalition member the Global Self-Care Federation (GSCF) to discuss “We are in a unique moment, as we see it from a federation standpoint as it pertains to the role of self-care in overall health care systems,” GSCF Chair Manoj Raghunandanan told those in attendance. Global Self-Care Federation Chair Manoj Raghunandanan A rise in chronic conditions, an ageing population, and the COVID-19 pandemic have all impacted already-overstretched resources over the past few years, he said. For Raghunandanan, the COVID-19 pandemic has changed how people view self-care due to the amount of time spent in lock downs and, for many people, an inability to see medical practitioners in person. “The COVID-19 pandemic was the great accelerator,” Raghunandanan said. “We had a period where consumers and patients were relying upon themselves to care for themselves, to adjudicate their care to provide for themselves, and during that time, we realised that in many cases, they could be successful at doing this.” What is self-care? Self-care is defined as the ability of individuals, families and communities to promote health, prevent disease and mental health, and cope with illnesses and disability, with or without the support of health workers. United for Self-Care Coalition has called on the WHO to boost health literacy, promote digital health, enhance self-care capacity and guidance, recognise self-care as an enabler of UHC and invest in self-care. The coalition is already part of the UHC2030 platform, which aims to increase Universal Health Coverage by 2030. Democratising access to self-care interventions Many see the current WHO guidelines as simply needing to do more. Manjulaa Narasimhan, a scientist in the Department of Reproductive Health and Research at WHO Manjulaa Narasimhan, a scientist in the Department of Reproductive Health and Research at WHO, explained, “We look at things like how can we reduce the levels of violence, stigma, discrimination and coercion, that many people face even within health systems. We look at what kind of education and support they might need, including psychosocial support and other types. What kind of access to justice might people need?” Self-care practices can hold enormous potential to improve people’s quality of life, helping to manage the burden of non-communicable diseases (NCDs) while helping to develop health systems’ sustainability and reduce increasing costs. One such way forward could be increased telemedicine, health-related services and information available via electronic devices and technologies. This allows longer-distance patient-clinician contact, care, advice, reminders, education, intervention, monitoring and remote admissions. Academic Austen El-Osta gave examples to the panel, including the UK National Health Service, who, he told the audience, “bought a quarter of a million blood pressure monitors and distributed these to patients. These patients are effectively self-caring, releasing pressure from primary care and the health system. Of course, we’re all familiar with the many fantastic digital health apps and tools that we use and excellent med tech. “The big question is how do we democratise access to self-care interventions and best practices?” El–Osta said. “We have the guidelines; we’ve got some anecdotal evidence. We’ve got a lot of work on NCDs and technology. So all of these are coming together now.” Another example explored was how pharmacists could help unburden struggling health systems. Mariet Eksteen, Global Lead for Advancing Integrated Services at Advancing Pharmacy Worldwide “Often pharmacy and pharmacists are the patient’s first point of call in any healthcare inquiry that they have,” stated Mariet Eksteen, Global Lead for Advancing Integrated Services at Advancing Pharmacy Worldwide. “Pharmacists could be an exceptionally well-positioned resource to support the concept of self-care because we could assist patients with a rising level of health literacy as well as knowledge in their communities, which as a result, could also lead to increased levels of preventative care.” Why a WHO resolution is needed A WHO resolution on self-care, as opposed to guidelines, would provide the following: A framework for its integration into future economic and health policies. Promoting awareness. Political commitment. The mobilisation of resources. There would then be better support for the UH2030 goals. Sandy Garçon, the founding director of the Self-Care Trailblazer Group, echoed calls for the WHO to work on the current guidelines, stating, “There needs to be the right kind of policies, the right kind of funding, and the correct type of programming. Many countries are already moving in this direction, but we need more.” “We always welcome political and legal policy and standards framework that we can rely on to help us create that ecosystem we want,” agreed Kawaldip Sehmi, CEO of the International Alliance of Patients’ Organisations. “From patients of self-care first, then health professionals second. Now it’s time to take care of ourselves.” Image Credits: Screenshot. New Principles Offer Guide to Human Rights During Health Emergencies 26/05/2023 Alex Winston From left: Magdalena Sepúlveda Carmona, Executive Director, Global Initiative For Economic, Social And Cultural Rights; Saman Zia-Zarifi, Executive Director, Physicians For Human Rights; and Viviana Muñoz Tellez, Coordinator, Health, Intellectual Property And Biodiversity Programme, South Centre As the world continues to learn the lessons of the COVID-19 pandemic, a new set of principles aiming the help guide the future of human rights in global medical emergencies was published and discussed on Tuesday at an event of the 76th World Health Assembly (WHA). The event, titled “Beyond Panic & Neglect: Building a Human Rights Framework for Public Health Emergency Prevention, Preparedness, and Response,” looked at a new set of principles and Guidelines on Human Rights and Public Health Emergencies, which were developed through a three-year partnership between the Global Health Law Consortium (GHLC) and the International Commission of Jurists (ICJ.) The overarching human rights principles and obligations fall into eight categories: 1 – Universal enjoyment of human rights 2 – International solidarity 3 – Rule of law 4 – Equality and non-discrimination 5 – Human rights duties related to non-State actors 6 – Transparency and access to information 7 – Meaningful and effective participation 8 – Accountability and access to justice for those harmed by human rights violations and abuses Principles bring together lessons from COVID and previous pandemics, epidemics The principles, formulated by 150 individuals from other health and human rights organisations and WHO officials, draw upon lessons from past epidemics and pandemics, including cholera, dengue, ebola, HIV and zika. In addition, the experts looked at situations where an inadequate response to effective public health policies and human rights obligations led to devastating outcomes. “What was needed is a contemporary treatment that also accounted for what needed to be done to ensure a broader rights-based approach to public health emergencies, including upholding the right to health and related rights. These new principles, we believe, represent a breakthrough in the ongoing effort to ensure that human rights are protected and upheld in times of crisis.” Ian Seiderman, legal and policy director at the ICJ, told those gathered. “This event here marks our first public dialogue on the new principles and guidelines and their subject matter, focusing on the role of international human rights law in guiding approaches to public health emergencies.” The principles bring together an overarching scope of the universal enjoyment of human rights, including equality and non-discrimination, transparency and access to information and accountability and access to justice for those harmed by human rights abuses or violations. Principles coincide with pandemic treaty From left: Magdalena Sepúlveda Carmona, Executive Director, Global Initiative For Economic, Social And Cultural Rights; Saman Zia-Zarifi, Executive Director, Physicians For Human Rights; Viviana Muñoz Tellez, Coordinator, Health, Intellectual Property And Biodiversity Programme, South Centre; and moderator Gian Luca Burci, Adjunct Professor, International Law, Geneva Graduate Institute The release of the principles coincided with the release of a new “Zero+” draft of the proposed World Health Organization (WHO) pandemic accord that is currently under negotiation by member states. “We saw many governments shift from complacency and neglect to rapid action, often in panic mode to respond to a public health threat that was spreading uncontrollably,” stated Roojin Habibi, a co-founding member of the Global Health Law Consortium, who led the development of the principles. “Around the world, we saw countries deploy various measures, from mask mandates to lock downs to quarantines and isolation in response to this public health threat. “The international community must learn to move beyond cycles of panic and neglect, which leaves human rights at the margins of decision-making and policymaking. The principles developed through a consensus-based and deliberative process amongst 30 of the world’s leading thinkers in global health law and human rights provide an authoritative interpretation of international law to help guide that learning.” The WHO drafted pandemic treaty states that “all lives have equal value, and that therefore equity should be a principle, an indicator and an outcome of pandemic prevention, preparedness, and response,” and this was a point emphasised by Dr. Viviana Munoz Tellez of the South Centre, an intergovernmental organisation based in Geneva that helps developing countries promote their common interests in the international arena, who brought up the issue of vaccine inequity. “We could have averted, at minimum, about a million and a half deaths,” Tellez said. “The idea was, when we have vaccine doses, we will distribute at least 20% proportionally and highlight the more vulnerable populations that need to go first. But, unfortunately, that did not happen, mainly because the more affluent countries had advanced marketing commitments. “We had competition rather than cooperation. That was one of the big problems.” The role of the private health sector The private health sector has also come under heavy scrutiny since the pandemic. However, one aspect that the principles address observes that the state must regulate and monitor private actors. The principles themselves put no obligations directly on the remote, non-state actors. Instead, they state that across all pandemic prevention, response and recovery measures, states have the responsibility to ensure that non-state actors do not impair any of the human rights laws and must regulate and monitor ” engaged non-state actors to prevent them from impairing the enjoyment of human rights and provide for redress and accountability.” Magdalena Sepúlveda Carmona, executive director of Global Initiative For Economic, Social and Cultural Rights, stated on private actors that, “Something that started happening before the pandemic is the privatization, commercialization, and financialization of public services such as health care, water, sanitation and education. There are many ways in which private actors can be involved in health care. “We need to act now. We must ensure that everybody has access to a universal resilient health system that is affordable or at no cost for those who need it. And that is included in the principles.” The hope, the presenters said, is that the COVID-19 pandemic would bring about changes in legislation that would help the world prepare and deal with any future health emergencies. “We have to use these principles to put in place legislation, rules and regulations to say the next time this happens, we have to think about how we’re going to address this problem,” Saman Zia-Zarifi, executive director of Physicians For Human Rights told the panel. “It can’t just be that we will give money to companies to support their workers who can’t come to the office, but we will keep open the informal sector where the majority of people in most countries live and work.” The new principles allow actors to play their part in change. “These principles can act as kind of a North Star for everyone,” Zia-Zarifi stated. “They establish some clear directions of movement. They don’t tell governments what to do but give them a direction of movement and a way of thinking.” The Geneva Graduate Institute, The Global Health Centre and the International Geneva Global Health Platform, the International Commission of Jurists, the Global Health Law Consortium, the Global Initiative for Economic, Social and Cultural Rights, and Physicians for Human Rights organised the panel. Image Credits: Screenshot. Huge Support for Universal Health Coverage and NCD Measures, But WHO Replenishment Fund is Rejected 25/05/2023 Kerry Cullinan & Megha Kaveri The delegate for Barbados addressing the World Health Assembly during discussions on universal health coverage. An impossibly long list of member states lined up to address universal health coverage (UHC) and non-communicable diseases (NCDs) at the World Health Assembly on Thursday afternoon, indicating the centrality of these issues for countries. There was near-universal support for primary health services to be the backbone of UHC, with disease prevention as the other key pillar – particularly to prevent NCDs. A number of countries including Canada, the US and Norway called for sexual and reproductive services accessible to young people to be included as part of primary health. Many member countries called for the three United Nations High-Level Meetings – on UHC, tuberculosis and pandemic preparedness – in September to be aligned with the WHO’s processes, including negotiations on a pandemic accord. Huge support for WHO’s ‘Best Buys’ The WHO’s updated policy options and interventions to prevent and control NCDs – referred to as “Best Buys” – also enjoyed widespread support. A number of Caribbean countries are at the forefront of fighting NCDs and obesity, including Barbados. “Barbados is privileged to be one of the front-runner countries that WHO has identified to take part in the acceleration plan to stop obesity,” its delegate said. Barbados launched a national school nutrition policy in February “to address challenges related to poor dietary habits and lack of physical activity among schoolchildren”, while its tax on sugary drinks introduced in 2015 resulted in a 4.3% reduction in their consumption. Canada underlined the importance of integrating mental health into broader NCD prevention strategies but noted that stigma “remains a barrier to mental well-being globally, especially for younger people”. Norway called for strategies to fight NCDs to be “free from undue political and commercial influence”, something that NCD advocates lobbied for on the sidelines of the WHA. No consensus on replenishment fund However, the same spirit of agreement was absent in Committee B, with a divergence among member states’ opinions on a “replenishment mechanism” proposed by the WHO Director-General to ensure more sustainable financing of the organisation. Member-states deliberated on different possible models of sustainable funding of the WHO, delaying agreement on a single, unified formula of a “replenishment mechanism”. The US made it clear that it did not support the replenishment mechanism – a view that ultimately held sway. It, however, expressed support to have rounds of investments by donors, similar to other global health organizations like The Global Fund. “We agreed to support planning for the secretariat’s proposed new initiative for sustainable financing for WHO with the understanding that we’ve moved to a more streamlined approach of innovative fundraising through an investment round, and that we’re not approving a replenishment mechanism for WHO,” stated the US. It is also widely believed that the country pushed for inclusion of “earmarked contributions” in the draft text of the resolution, in exchange for its support to the resolution. Switzerland supported the replenishment mechanism for the WHO, saying it had “considerable potential to strengthen the strategic use of funding and to guarantee predictability of financing for WHO’s operations in order to guarantee health for all”. But, it also underlined that “earmarked contributions will remain vital to the funding of WHO for many member states” but that their use needs to be “traceable, transparent and efficient”. A decision on what mechanism should be adopted to bolster WHO’s finances is expected on Friday. World Resilience Summit Galvanises Public-Private Solutions to Feed into Pandemic Accord Negotiations 25/05/2023 Kerry Cullinan Maria van Kerkhove, Priya Basu, Mary Mahy, Iveth J. González and Benjamin Roche. GENEVA – Global health conversations are much deeper at present because everyone has been affected by COVID-19 – and this opens up the possibility of building an “all-of-society” approach before the next pandemic, said Sylvie Brand, the World Health Organization’s (WHO) Director of Epidemic and Pandemic Preparedness and Prevention. “We have seen during this pandemic that it’s not enough to have doctors and nurses at the frontline. We need to bring on board politicians, academics, the private sector, civil society, faith-based organisations – everybody has a role to play,” said Brand during her keynote address to the Resilience Summit held alongside the World Health Assembly in Geneva. “But this is not enough. We need also to make sure that we connect people because when the crisis starts, it’s very hard to build things from scratch.” Her input came after leaders from the public and private sectors had discussed three different areas related to pandemics – prevention, preparedness and response – at the invitation-only summit hosted by the World Climate Foundation and the Geneva Health Forum. Stop the zoonotic spark The pandemic prevention group, which had a strong contingent of One Health actors, felt that primary prevention had to focus on zoonotic spillover from animals to people. “You have to start with the spark that can cause the fire, addressing the interface between animals and people,” said Jonathan Epstein, Vice-President of EcoHealth Alliance. The group also called for the integration of climate change and biodiversity and health. Collaborative surveillance and data-sharing dominated the discussion at the preparedness roundtable, which also stressed the importance of building trust and understanding. “We need the foundation – global, regional, national systems – for surveillance that is intentionally collaborative, that goes beyond the health sector,” said Dr Magda Robalo Correia e Silva, the Health Minister of Guinea-Bissau. She also said that preparing for an infectious disease outbreak or a pandemic must be rooted in communities and lived experiences of the people. The panellists also touched on how preventative measures like surveillance or data sharing don’t work in isolation. “It’s an ecosystem. It cannot be the data only or the tools only or the financing of the early warning system or political support. It’s an ecosystem that starts with the doctors, nurses who are in the frontlines. That’s where the [early warning] system gets triggered,” said Dr Nino Kharaishvili, Global Solutions Director of the health systems governance at Jacobs. The group dealing with the pandemic response grappled with how data could be properly collected and shared to ensure that responses were timely and resources went to areas most in need. The World Bank’s Priya Basu, who heads the Pandemic Fund secretariat, said that applications for funding for the first round of the Fund’s disbursements were aimed at strengthening health systems in low and middle-income countries. Collaboration between government departments within countries, and between countries and donors had been a prerequisite for applicants. The huge and growing shortages of health workers and a lack of trained personnel were also a substantial challenge. “We need to deal with the global shortage of health workers and the poaching by high-income countries of health workers from low and middle-income countries. There are an estimated six million missing health workers in Africa,” said Philippe Guinot, Chief Technical Officer of IntraHealth. A sticking point in pandemic accord discussions has been around how to share pathogen sequencing. IFPMA’s Grega Kumer “The rapid sharing of SARS-COV-2’s sequencing enabled the pharmaceutical industry to start developing vaccines, treatments and diagnostics in record time. The first vaccine was approved 326 days after the virus sequence was known. This sharing of data and information mustn’t be jeopardized in the future, and the principle needs to be kept in any solutions for pandemic preparedness,” said Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). He added there had been cases where access to pathogens was either blocked or delayed because of access benefit-sharing agreements derived from the Nagoya Protocol, which led to delays in vaccine production. For instance, this has been the case for seasonal influenza, Ebola or Zika. However, Yaunqiong Hu from Médecins sans Frontières appealed for community contributions to the development of vaccines to be valued, pointing out the contributions of residents of Guinea to the development of Ebola vaccines. Meanwhile, Maria van Kerkhove, WHO’s Technical Lead on COVID-19, said that substantial capacity for surveillance had been built during the pandemic, but that transparency and data sharing were waning. But “governments don’t want to find the next pandemic because of the disincentives”, she added, citing how South Africa had been slapped with travel bans after sharing the Omicron sequencing. Misinformation undermining the ‘age of biology’ Chris Perez, head of International Programs at biotech company Concentric by Ginkgo Chris Perez, head of International Programs at biotech company Concentric by Ginkgo, told the evening plenary how his company’s tracking of aeroplane wastewater had identified COVID-19 variants in the US significantly earlier than any other tracking body. “We believe that the age of biology and the bio-economy hold the keys to enormous opportunities. across sectors for a more sustainable and resilient future for the world,” said Perez. Biological risks arise from “humans encroaching on new environments and climate change” as well as the “accidental or intentional misuse of bioengineering”, warned Perez. However, he also warned of social risks – particularly misinformation that undermined people’s faith in science. “As most people know, in the United States, the COVID-19 response was very politically charged in a challenging environment and also involved the dangers of misinformation in public health,” said Perez. “We need resilient societies and governance structures and today’s information environment can compound biological risks. Trust and the truth must be core organising principles if we are to address this.” The World Resilience Summit’s steering committee intends to draft recommendations for public-private partnerships in each of the three areas to “add value with public-private partnership solutions in the implementation of the upcoming pandemic treaty drafted by the WHO”. (With inputs from Megha Kaveri) WHA76: Countries Commit to Increased Polio Immunisation 25/05/2023 Disha Shetty Countries expressed concern at an uptick in polio cases last year and discussed ways to double down on routine immunizations – interrupted by the pandemic and conflicts – at Thursday’s World Health Assembly. Polio is currently the only official global public health emergency. Afghanistan and Pakistan are the last two remaining countries where the virus is endemic, WHO has said. In 2022, Afghanistan reported two new cases while Pakistan reported 20. Pakistan which has also reported a new case in 2023, said it, “continues to make consistent progress towards stopping the transmission of poliovirus.” The virus has been found to be in circulation across 31 countries in three regions, threatening to roll back hard fought for gains over several decades. “We are only safe once everyone is safe,” Germany said, as it highlighted the need for global cooperation. The United Kingdom asked countries to guarantee the safety of teams conducting routine immunisation, an issue in both countries where poliovirus remains endemic. Australia commended the work of the Global Polio Eradication Initiative (GPEI) in Afghanistan for operating under challenging conditions as the ruling Taliban continues to make it near impossible for women to work. “We commend GPEI in Afghanistan despite increasingly stringent bans on women working for NGOs and UN agencies. Ensuring the safety of all frontline polio workers should continue to be a high priority. The risk that women may no longer be able to perform house-to-house campaigns must be mitigated to sustain high coverage and reach zero dose children,” Australia said. The scarcity of women healthcare workers in some areas of Pakistan has also affected routine immunisation, leaving blind spots. “The Mehsud belt in southern Khyber Pakhtunkhwa remains a persistent challenge as no polio campaign has been conducted in debates since last months,” Pakistan said. To counter this issue the country said it is focusing on entry and exit points to the belt as well as areas around it where security remains a concern. Iran, which borders Afghanistan flagged concerns about the influx of migrants in recent years due to the conflict in the country and called it a challenging situation. Iran also said that it continues to face barriers when accessing vaccines, and asked for greater WHO support for its national laboratories. Canada assured its financial support to the polio campaign and highlighted the need to focus not just on countries where polio is endemic but also other countries that might need support. “We fear that other vulnerable countries that do not have the resources to organize effective campaigns are further exposed to outbreaks and the risk of outbreaks,” the country said. WHO Budget Replenishment Text Keeps Door Open to ‘Earmarked’ Donations 25/05/2023 Kerry Cullinan Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. GENEVA – The World Health Assembly is poised to decide on an “investment round” in late 2024 to boost the World Health Organization’s (WHO) finances – but not the establishment of a “replenishment fund”. Member states and donors will be able to continue to provide funds to the WHO earmarked for specific health programmes – something that the WHO’s Working Group on Sustainable Financing advised that the organisation moves away from as this skews the work of the global body. This is according to a copy of the draft text leaked to Health Policy Watch, based on member state discussions late on Wednesday. The US is widely believed to have pushed for the continued inclusion of earmarked funds as a condition of its support for the resolution. The formation of a WHO Investor Forum has also been mooted ahead of the investment round, according to those close to discussions. Members’ fees to cover 20% of budget The text also urges member states to pay their membership fees – which the assembly earlier resolved would now cover 20% of the budget (up from an estimated 14%). While the text proposes that the WHO should continue to accept, “alongside unearmarked voluntary contributions, voluntary contributions that are earmarked and/or single-year contributions from member states and other donors” it urges an increase in “transparency of reporting on voluntary earmarked contributions and on their impact and allocation”. In the lead-up to planning the investment round in the last quarter of 2024, the WHO is directed to provide member states with regular updates and to provide the Executive Board with “a full plan that includes modalities and anticipated costs” for approval. Various efforts to improve the financial viability of the WHO have hammered on the importance of the organisation having access to flexible funds – rather than funds donated by philanthropies and wealthier member states that are tied to programmes that might not be top global health priorities. Civil society condemnation Four civil society organisations condemned the new text, describing it as “nothing but the institutionalisation of the earmarked contribution that has led to the dismal functioning of the WHO at various levels, including the increasing penetration of the private philanthropic sector in the organisation”. “The draft decision goes against the very objective of the recommendation of the Working Group,” said Lauren Paremoer of the People’s Health Movement. “As per the approved budget of $6834.1 million for the 2024-25 biennium, $5685.8 million is to be funded through voluntary contributions. The institutionalisation of earmarked funding would further stabilise donor-driven priorities and compromise the credibility, independence and integrity of WHO.” Nicoletta Dentico of Society for International Development (SID) condemned “the multilateral development community’s fixation with leveraging the private sector in healthcare, using public money to de-risk investments”. Third World Network’s KM Gopakumar condemned the idea of a WHO Investors’ Forum, saying it would “seriously undermine the role of the vast majority of Member states in WHO’s governance”. “The Forum participants, consisting of a rather impenetrable network of philanthropic foundations and the private sector, would de facto control WHO’s priorities,” he added. Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. 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Stronger Global Roadmap to Tackle NCDs is Finally Passed 26/05/2023 Kerry Cullinan WHA76: Committee A finally passes NCD plan New global guidelines to tackle non-communicable diseases (NCDs) were finally passed by the World Health Assembly on Friday afternoon after a mammoth day-and-a-half of member states’ inputs. The guidelines update the World Health Organization’s (WHO) “Best Buys” published in 2017 and focus on the four key risk factors for NCDs – tobacco, alcohol, unhealthy diet and physical inactivity – and the four main associated diseases – cardiovascular disease, diabetes, cancer and chronic respiratory disease. Earlier in the week, Bente Mikkelsen, WHO’s Director of NCDs, explained the key changes adopted on Friday to what she described as an “implementation roadmap” to tackle NCDs, which are responsible for three-quarters of global deaths. “In 2017, we had a total of 88 interventions, and 39 of them had cost-effective estimates,” Mikkelsen told the event convened by the NCD Alliance and Vital Strategies. “We now have 90 interventions, and 58 interventions with cost-effectiveness estimates. And also very importantly, in 2017, we only looked at [evidence from] 20 countries, and today we have 62 countries grouped in all three income categories.” Twenty-eight interventions are considered to be the most cost-effective and feasible for implementation in comparison to 16 recommended in 2017.” These include taxes on sugary drinks, curbs on the marketing of unhealthy products and warning labels. Vital Strategies’ Dr Nandita Murukutla described the interventions that are “inexpensive for governments to implement, including those that target behavioural risk factors such as tobacco use, unhealthy diets, alcohol consumption and inadequate physical activity”. “The effectiveness of excise taxes, marketing restrictions and labelling policies, for instance, have been demonstrated to reduce the consumption of unhealthy products,” added Murukutla, Vice President of Global Policy and Research. “Were governments to adopt the recommendations as official policies, they could, in a unified and coordinated approach, significantly reduce the proliferation of unhealthy products and make an impact on the growing trajectory of NCDs, including heart and lung disease, diabetes, and cancers,” she added. However, NCD advocates believe that the “Best Buys” need to be further strengthened to prevent interference in health policy by industries selling products that harm people – tobacco, alcohol, ultra-processed food and fossil fuel. “The industries that produce and market these products are more interested in profit than in healthy people and healthy communities,” said José Luis Castro, President and CEO of Vital Strategies, at the WHA side event hosted by his organisation and the NCD Alliance. Castro believes that “Best Buys” should be modified to include “more explicit recommendations against corporate influence” because “corporate influence worldwide has been identified as the main reason why Best Buys’ implementation falls short”. Coalition Calls to Expand Self-Care Guidelines, Proposes WHO Resolution 26/05/2023 Alex Winston Self-Care a Foundational Component of Health System Sustainability” at the 76th World Health Assembly The United for Self-Care Coalition made calls to expand the current World Health Organization’s (WHO) guidelines on self-care during a panel event, “Self-Care a Foundational Component of Health System Sustainability,” at the 76th World Health Assembly on Wednesday. The United for Self-Care Coalition, a new coalition of like-minded groups and experts, marked their call to action with a panel hosted by coalition member the Global Self-Care Federation (GSCF) to discuss “We are in a unique moment, as we see it from a federation standpoint as it pertains to the role of self-care in overall health care systems,” GSCF Chair Manoj Raghunandanan told those in attendance. Global Self-Care Federation Chair Manoj Raghunandanan A rise in chronic conditions, an ageing population, and the COVID-19 pandemic have all impacted already-overstretched resources over the past few years, he said. For Raghunandanan, the COVID-19 pandemic has changed how people view self-care due to the amount of time spent in lock downs and, for many people, an inability to see medical practitioners in person. “The COVID-19 pandemic was the great accelerator,” Raghunandanan said. “We had a period where consumers and patients were relying upon themselves to care for themselves, to adjudicate their care to provide for themselves, and during that time, we realised that in many cases, they could be successful at doing this.” What is self-care? Self-care is defined as the ability of individuals, families and communities to promote health, prevent disease and mental health, and cope with illnesses and disability, with or without the support of health workers. United for Self-Care Coalition has called on the WHO to boost health literacy, promote digital health, enhance self-care capacity and guidance, recognise self-care as an enabler of UHC and invest in self-care. The coalition is already part of the UHC2030 platform, which aims to increase Universal Health Coverage by 2030. Democratising access to self-care interventions Many see the current WHO guidelines as simply needing to do more. Manjulaa Narasimhan, a scientist in the Department of Reproductive Health and Research at WHO Manjulaa Narasimhan, a scientist in the Department of Reproductive Health and Research at WHO, explained, “We look at things like how can we reduce the levels of violence, stigma, discrimination and coercion, that many people face even within health systems. We look at what kind of education and support they might need, including psychosocial support and other types. What kind of access to justice might people need?” Self-care practices can hold enormous potential to improve people’s quality of life, helping to manage the burden of non-communicable diseases (NCDs) while helping to develop health systems’ sustainability and reduce increasing costs. One such way forward could be increased telemedicine, health-related services and information available via electronic devices and technologies. This allows longer-distance patient-clinician contact, care, advice, reminders, education, intervention, monitoring and remote admissions. Academic Austen El-Osta gave examples to the panel, including the UK National Health Service, who, he told the audience, “bought a quarter of a million blood pressure monitors and distributed these to patients. These patients are effectively self-caring, releasing pressure from primary care and the health system. Of course, we’re all familiar with the many fantastic digital health apps and tools that we use and excellent med tech. “The big question is how do we democratise access to self-care interventions and best practices?” El–Osta said. “We have the guidelines; we’ve got some anecdotal evidence. We’ve got a lot of work on NCDs and technology. So all of these are coming together now.” Another example explored was how pharmacists could help unburden struggling health systems. Mariet Eksteen, Global Lead for Advancing Integrated Services at Advancing Pharmacy Worldwide “Often pharmacy and pharmacists are the patient’s first point of call in any healthcare inquiry that they have,” stated Mariet Eksteen, Global Lead for Advancing Integrated Services at Advancing Pharmacy Worldwide. “Pharmacists could be an exceptionally well-positioned resource to support the concept of self-care because we could assist patients with a rising level of health literacy as well as knowledge in their communities, which as a result, could also lead to increased levels of preventative care.” Why a WHO resolution is needed A WHO resolution on self-care, as opposed to guidelines, would provide the following: A framework for its integration into future economic and health policies. Promoting awareness. Political commitment. The mobilisation of resources. There would then be better support for the UH2030 goals. Sandy Garçon, the founding director of the Self-Care Trailblazer Group, echoed calls for the WHO to work on the current guidelines, stating, “There needs to be the right kind of policies, the right kind of funding, and the correct type of programming. Many countries are already moving in this direction, but we need more.” “We always welcome political and legal policy and standards framework that we can rely on to help us create that ecosystem we want,” agreed Kawaldip Sehmi, CEO of the International Alliance of Patients’ Organisations. “From patients of self-care first, then health professionals second. Now it’s time to take care of ourselves.” Image Credits: Screenshot. New Principles Offer Guide to Human Rights During Health Emergencies 26/05/2023 Alex Winston From left: Magdalena Sepúlveda Carmona, Executive Director, Global Initiative For Economic, Social And Cultural Rights; Saman Zia-Zarifi, Executive Director, Physicians For Human Rights; and Viviana Muñoz Tellez, Coordinator, Health, Intellectual Property And Biodiversity Programme, South Centre As the world continues to learn the lessons of the COVID-19 pandemic, a new set of principles aiming the help guide the future of human rights in global medical emergencies was published and discussed on Tuesday at an event of the 76th World Health Assembly (WHA). The event, titled “Beyond Panic & Neglect: Building a Human Rights Framework for Public Health Emergency Prevention, Preparedness, and Response,” looked at a new set of principles and Guidelines on Human Rights and Public Health Emergencies, which were developed through a three-year partnership between the Global Health Law Consortium (GHLC) and the International Commission of Jurists (ICJ.) The overarching human rights principles and obligations fall into eight categories: 1 – Universal enjoyment of human rights 2 – International solidarity 3 – Rule of law 4 – Equality and non-discrimination 5 – Human rights duties related to non-State actors 6 – Transparency and access to information 7 – Meaningful and effective participation 8 – Accountability and access to justice for those harmed by human rights violations and abuses Principles bring together lessons from COVID and previous pandemics, epidemics The principles, formulated by 150 individuals from other health and human rights organisations and WHO officials, draw upon lessons from past epidemics and pandemics, including cholera, dengue, ebola, HIV and zika. In addition, the experts looked at situations where an inadequate response to effective public health policies and human rights obligations led to devastating outcomes. “What was needed is a contemporary treatment that also accounted for what needed to be done to ensure a broader rights-based approach to public health emergencies, including upholding the right to health and related rights. These new principles, we believe, represent a breakthrough in the ongoing effort to ensure that human rights are protected and upheld in times of crisis.” Ian Seiderman, legal and policy director at the ICJ, told those gathered. “This event here marks our first public dialogue on the new principles and guidelines and their subject matter, focusing on the role of international human rights law in guiding approaches to public health emergencies.” The principles bring together an overarching scope of the universal enjoyment of human rights, including equality and non-discrimination, transparency and access to information and accountability and access to justice for those harmed by human rights abuses or violations. Principles coincide with pandemic treaty From left: Magdalena Sepúlveda Carmona, Executive Director, Global Initiative For Economic, Social And Cultural Rights; Saman Zia-Zarifi, Executive Director, Physicians For Human Rights; Viviana Muñoz Tellez, Coordinator, Health, Intellectual Property And Biodiversity Programme, South Centre; and moderator Gian Luca Burci, Adjunct Professor, International Law, Geneva Graduate Institute The release of the principles coincided with the release of a new “Zero+” draft of the proposed World Health Organization (WHO) pandemic accord that is currently under negotiation by member states. “We saw many governments shift from complacency and neglect to rapid action, often in panic mode to respond to a public health threat that was spreading uncontrollably,” stated Roojin Habibi, a co-founding member of the Global Health Law Consortium, who led the development of the principles. “Around the world, we saw countries deploy various measures, from mask mandates to lock downs to quarantines and isolation in response to this public health threat. “The international community must learn to move beyond cycles of panic and neglect, which leaves human rights at the margins of decision-making and policymaking. The principles developed through a consensus-based and deliberative process amongst 30 of the world’s leading thinkers in global health law and human rights provide an authoritative interpretation of international law to help guide that learning.” The WHO drafted pandemic treaty states that “all lives have equal value, and that therefore equity should be a principle, an indicator and an outcome of pandemic prevention, preparedness, and response,” and this was a point emphasised by Dr. Viviana Munoz Tellez of the South Centre, an intergovernmental organisation based in Geneva that helps developing countries promote their common interests in the international arena, who brought up the issue of vaccine inequity. “We could have averted, at minimum, about a million and a half deaths,” Tellez said. “The idea was, when we have vaccine doses, we will distribute at least 20% proportionally and highlight the more vulnerable populations that need to go first. But, unfortunately, that did not happen, mainly because the more affluent countries had advanced marketing commitments. “We had competition rather than cooperation. That was one of the big problems.” The role of the private health sector The private health sector has also come under heavy scrutiny since the pandemic. However, one aspect that the principles address observes that the state must regulate and monitor private actors. The principles themselves put no obligations directly on the remote, non-state actors. Instead, they state that across all pandemic prevention, response and recovery measures, states have the responsibility to ensure that non-state actors do not impair any of the human rights laws and must regulate and monitor ” engaged non-state actors to prevent them from impairing the enjoyment of human rights and provide for redress and accountability.” Magdalena Sepúlveda Carmona, executive director of Global Initiative For Economic, Social and Cultural Rights, stated on private actors that, “Something that started happening before the pandemic is the privatization, commercialization, and financialization of public services such as health care, water, sanitation and education. There are many ways in which private actors can be involved in health care. “We need to act now. We must ensure that everybody has access to a universal resilient health system that is affordable or at no cost for those who need it. And that is included in the principles.” The hope, the presenters said, is that the COVID-19 pandemic would bring about changes in legislation that would help the world prepare and deal with any future health emergencies. “We have to use these principles to put in place legislation, rules and regulations to say the next time this happens, we have to think about how we’re going to address this problem,” Saman Zia-Zarifi, executive director of Physicians For Human Rights told the panel. “It can’t just be that we will give money to companies to support their workers who can’t come to the office, but we will keep open the informal sector where the majority of people in most countries live and work.” The new principles allow actors to play their part in change. “These principles can act as kind of a North Star for everyone,” Zia-Zarifi stated. “They establish some clear directions of movement. They don’t tell governments what to do but give them a direction of movement and a way of thinking.” The Geneva Graduate Institute, The Global Health Centre and the International Geneva Global Health Platform, the International Commission of Jurists, the Global Health Law Consortium, the Global Initiative for Economic, Social and Cultural Rights, and Physicians for Human Rights organised the panel. Image Credits: Screenshot. Huge Support for Universal Health Coverage and NCD Measures, But WHO Replenishment Fund is Rejected 25/05/2023 Kerry Cullinan & Megha Kaveri The delegate for Barbados addressing the World Health Assembly during discussions on universal health coverage. An impossibly long list of member states lined up to address universal health coverage (UHC) and non-communicable diseases (NCDs) at the World Health Assembly on Thursday afternoon, indicating the centrality of these issues for countries. There was near-universal support for primary health services to be the backbone of UHC, with disease prevention as the other key pillar – particularly to prevent NCDs. A number of countries including Canada, the US and Norway called for sexual and reproductive services accessible to young people to be included as part of primary health. Many member countries called for the three United Nations High-Level Meetings – on UHC, tuberculosis and pandemic preparedness – in September to be aligned with the WHO’s processes, including negotiations on a pandemic accord. Huge support for WHO’s ‘Best Buys’ The WHO’s updated policy options and interventions to prevent and control NCDs – referred to as “Best Buys” – also enjoyed widespread support. A number of Caribbean countries are at the forefront of fighting NCDs and obesity, including Barbados. “Barbados is privileged to be one of the front-runner countries that WHO has identified to take part in the acceleration plan to stop obesity,” its delegate said. Barbados launched a national school nutrition policy in February “to address challenges related to poor dietary habits and lack of physical activity among schoolchildren”, while its tax on sugary drinks introduced in 2015 resulted in a 4.3% reduction in their consumption. Canada underlined the importance of integrating mental health into broader NCD prevention strategies but noted that stigma “remains a barrier to mental well-being globally, especially for younger people”. Norway called for strategies to fight NCDs to be “free from undue political and commercial influence”, something that NCD advocates lobbied for on the sidelines of the WHA. No consensus on replenishment fund However, the same spirit of agreement was absent in Committee B, with a divergence among member states’ opinions on a “replenishment mechanism” proposed by the WHO Director-General to ensure more sustainable financing of the organisation. Member-states deliberated on different possible models of sustainable funding of the WHO, delaying agreement on a single, unified formula of a “replenishment mechanism”. The US made it clear that it did not support the replenishment mechanism – a view that ultimately held sway. It, however, expressed support to have rounds of investments by donors, similar to other global health organizations like The Global Fund. “We agreed to support planning for the secretariat’s proposed new initiative for sustainable financing for WHO with the understanding that we’ve moved to a more streamlined approach of innovative fundraising through an investment round, and that we’re not approving a replenishment mechanism for WHO,” stated the US. It is also widely believed that the country pushed for inclusion of “earmarked contributions” in the draft text of the resolution, in exchange for its support to the resolution. Switzerland supported the replenishment mechanism for the WHO, saying it had “considerable potential to strengthen the strategic use of funding and to guarantee predictability of financing for WHO’s operations in order to guarantee health for all”. But, it also underlined that “earmarked contributions will remain vital to the funding of WHO for many member states” but that their use needs to be “traceable, transparent and efficient”. A decision on what mechanism should be adopted to bolster WHO’s finances is expected on Friday. World Resilience Summit Galvanises Public-Private Solutions to Feed into Pandemic Accord Negotiations 25/05/2023 Kerry Cullinan Maria van Kerkhove, Priya Basu, Mary Mahy, Iveth J. González and Benjamin Roche. GENEVA – Global health conversations are much deeper at present because everyone has been affected by COVID-19 – and this opens up the possibility of building an “all-of-society” approach before the next pandemic, said Sylvie Brand, the World Health Organization’s (WHO) Director of Epidemic and Pandemic Preparedness and Prevention. “We have seen during this pandemic that it’s not enough to have doctors and nurses at the frontline. We need to bring on board politicians, academics, the private sector, civil society, faith-based organisations – everybody has a role to play,” said Brand during her keynote address to the Resilience Summit held alongside the World Health Assembly in Geneva. “But this is not enough. We need also to make sure that we connect people because when the crisis starts, it’s very hard to build things from scratch.” Her input came after leaders from the public and private sectors had discussed three different areas related to pandemics – prevention, preparedness and response – at the invitation-only summit hosted by the World Climate Foundation and the Geneva Health Forum. Stop the zoonotic spark The pandemic prevention group, which had a strong contingent of One Health actors, felt that primary prevention had to focus on zoonotic spillover from animals to people. “You have to start with the spark that can cause the fire, addressing the interface between animals and people,” said Jonathan Epstein, Vice-President of EcoHealth Alliance. The group also called for the integration of climate change and biodiversity and health. Collaborative surveillance and data-sharing dominated the discussion at the preparedness roundtable, which also stressed the importance of building trust and understanding. “We need the foundation – global, regional, national systems – for surveillance that is intentionally collaborative, that goes beyond the health sector,” said Dr Magda Robalo Correia e Silva, the Health Minister of Guinea-Bissau. She also said that preparing for an infectious disease outbreak or a pandemic must be rooted in communities and lived experiences of the people. The panellists also touched on how preventative measures like surveillance or data sharing don’t work in isolation. “It’s an ecosystem. It cannot be the data only or the tools only or the financing of the early warning system or political support. It’s an ecosystem that starts with the doctors, nurses who are in the frontlines. That’s where the [early warning] system gets triggered,” said Dr Nino Kharaishvili, Global Solutions Director of the health systems governance at Jacobs. The group dealing with the pandemic response grappled with how data could be properly collected and shared to ensure that responses were timely and resources went to areas most in need. The World Bank’s Priya Basu, who heads the Pandemic Fund secretariat, said that applications for funding for the first round of the Fund’s disbursements were aimed at strengthening health systems in low and middle-income countries. Collaboration between government departments within countries, and between countries and donors had been a prerequisite for applicants. The huge and growing shortages of health workers and a lack of trained personnel were also a substantial challenge. “We need to deal with the global shortage of health workers and the poaching by high-income countries of health workers from low and middle-income countries. There are an estimated six million missing health workers in Africa,” said Philippe Guinot, Chief Technical Officer of IntraHealth. A sticking point in pandemic accord discussions has been around how to share pathogen sequencing. IFPMA’s Grega Kumer “The rapid sharing of SARS-COV-2’s sequencing enabled the pharmaceutical industry to start developing vaccines, treatments and diagnostics in record time. The first vaccine was approved 326 days after the virus sequence was known. This sharing of data and information mustn’t be jeopardized in the future, and the principle needs to be kept in any solutions for pandemic preparedness,” said Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). He added there had been cases where access to pathogens was either blocked or delayed because of access benefit-sharing agreements derived from the Nagoya Protocol, which led to delays in vaccine production. For instance, this has been the case for seasonal influenza, Ebola or Zika. However, Yaunqiong Hu from Médecins sans Frontières appealed for community contributions to the development of vaccines to be valued, pointing out the contributions of residents of Guinea to the development of Ebola vaccines. Meanwhile, Maria van Kerkhove, WHO’s Technical Lead on COVID-19, said that substantial capacity for surveillance had been built during the pandemic, but that transparency and data sharing were waning. But “governments don’t want to find the next pandemic because of the disincentives”, she added, citing how South Africa had been slapped with travel bans after sharing the Omicron sequencing. Misinformation undermining the ‘age of biology’ Chris Perez, head of International Programs at biotech company Concentric by Ginkgo Chris Perez, head of International Programs at biotech company Concentric by Ginkgo, told the evening plenary how his company’s tracking of aeroplane wastewater had identified COVID-19 variants in the US significantly earlier than any other tracking body. “We believe that the age of biology and the bio-economy hold the keys to enormous opportunities. across sectors for a more sustainable and resilient future for the world,” said Perez. Biological risks arise from “humans encroaching on new environments and climate change” as well as the “accidental or intentional misuse of bioengineering”, warned Perez. However, he also warned of social risks – particularly misinformation that undermined people’s faith in science. “As most people know, in the United States, the COVID-19 response was very politically charged in a challenging environment and also involved the dangers of misinformation in public health,” said Perez. “We need resilient societies and governance structures and today’s information environment can compound biological risks. Trust and the truth must be core organising principles if we are to address this.” The World Resilience Summit’s steering committee intends to draft recommendations for public-private partnerships in each of the three areas to “add value with public-private partnership solutions in the implementation of the upcoming pandemic treaty drafted by the WHO”. (With inputs from Megha Kaveri) WHA76: Countries Commit to Increased Polio Immunisation 25/05/2023 Disha Shetty Countries expressed concern at an uptick in polio cases last year and discussed ways to double down on routine immunizations – interrupted by the pandemic and conflicts – at Thursday’s World Health Assembly. Polio is currently the only official global public health emergency. Afghanistan and Pakistan are the last two remaining countries where the virus is endemic, WHO has said. In 2022, Afghanistan reported two new cases while Pakistan reported 20. Pakistan which has also reported a new case in 2023, said it, “continues to make consistent progress towards stopping the transmission of poliovirus.” The virus has been found to be in circulation across 31 countries in three regions, threatening to roll back hard fought for gains over several decades. “We are only safe once everyone is safe,” Germany said, as it highlighted the need for global cooperation. The United Kingdom asked countries to guarantee the safety of teams conducting routine immunisation, an issue in both countries where poliovirus remains endemic. Australia commended the work of the Global Polio Eradication Initiative (GPEI) in Afghanistan for operating under challenging conditions as the ruling Taliban continues to make it near impossible for women to work. “We commend GPEI in Afghanistan despite increasingly stringent bans on women working for NGOs and UN agencies. Ensuring the safety of all frontline polio workers should continue to be a high priority. The risk that women may no longer be able to perform house-to-house campaigns must be mitigated to sustain high coverage and reach zero dose children,” Australia said. The scarcity of women healthcare workers in some areas of Pakistan has also affected routine immunisation, leaving blind spots. “The Mehsud belt in southern Khyber Pakhtunkhwa remains a persistent challenge as no polio campaign has been conducted in debates since last months,” Pakistan said. To counter this issue the country said it is focusing on entry and exit points to the belt as well as areas around it where security remains a concern. Iran, which borders Afghanistan flagged concerns about the influx of migrants in recent years due to the conflict in the country and called it a challenging situation. Iran also said that it continues to face barriers when accessing vaccines, and asked for greater WHO support for its national laboratories. Canada assured its financial support to the polio campaign and highlighted the need to focus not just on countries where polio is endemic but also other countries that might need support. “We fear that other vulnerable countries that do not have the resources to organize effective campaigns are further exposed to outbreaks and the risk of outbreaks,” the country said. WHO Budget Replenishment Text Keeps Door Open to ‘Earmarked’ Donations 25/05/2023 Kerry Cullinan Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. GENEVA – The World Health Assembly is poised to decide on an “investment round” in late 2024 to boost the World Health Organization’s (WHO) finances – but not the establishment of a “replenishment fund”. Member states and donors will be able to continue to provide funds to the WHO earmarked for specific health programmes – something that the WHO’s Working Group on Sustainable Financing advised that the organisation moves away from as this skews the work of the global body. This is according to a copy of the draft text leaked to Health Policy Watch, based on member state discussions late on Wednesday. The US is widely believed to have pushed for the continued inclusion of earmarked funds as a condition of its support for the resolution. The formation of a WHO Investor Forum has also been mooted ahead of the investment round, according to those close to discussions. Members’ fees to cover 20% of budget The text also urges member states to pay their membership fees – which the assembly earlier resolved would now cover 20% of the budget (up from an estimated 14%). While the text proposes that the WHO should continue to accept, “alongside unearmarked voluntary contributions, voluntary contributions that are earmarked and/or single-year contributions from member states and other donors” it urges an increase in “transparency of reporting on voluntary earmarked contributions and on their impact and allocation”. In the lead-up to planning the investment round in the last quarter of 2024, the WHO is directed to provide member states with regular updates and to provide the Executive Board with “a full plan that includes modalities and anticipated costs” for approval. Various efforts to improve the financial viability of the WHO have hammered on the importance of the organisation having access to flexible funds – rather than funds donated by philanthropies and wealthier member states that are tied to programmes that might not be top global health priorities. Civil society condemnation Four civil society organisations condemned the new text, describing it as “nothing but the institutionalisation of the earmarked contribution that has led to the dismal functioning of the WHO at various levels, including the increasing penetration of the private philanthropic sector in the organisation”. “The draft decision goes against the very objective of the recommendation of the Working Group,” said Lauren Paremoer of the People’s Health Movement. “As per the approved budget of $6834.1 million for the 2024-25 biennium, $5685.8 million is to be funded through voluntary contributions. The institutionalisation of earmarked funding would further stabilise donor-driven priorities and compromise the credibility, independence and integrity of WHO.” Nicoletta Dentico of Society for International Development (SID) condemned “the multilateral development community’s fixation with leveraging the private sector in healthcare, using public money to de-risk investments”. Third World Network’s KM Gopakumar condemned the idea of a WHO Investors’ Forum, saying it would “seriously undermine the role of the vast majority of Member states in WHO’s governance”. “The Forum participants, consisting of a rather impenetrable network of philanthropic foundations and the private sector, would de facto control WHO’s priorities,” he added. Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. 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Coalition Calls to Expand Self-Care Guidelines, Proposes WHO Resolution 26/05/2023 Alex Winston Self-Care a Foundational Component of Health System Sustainability” at the 76th World Health Assembly The United for Self-Care Coalition made calls to expand the current World Health Organization’s (WHO) guidelines on self-care during a panel event, “Self-Care a Foundational Component of Health System Sustainability,” at the 76th World Health Assembly on Wednesday. The United for Self-Care Coalition, a new coalition of like-minded groups and experts, marked their call to action with a panel hosted by coalition member the Global Self-Care Federation (GSCF) to discuss “We are in a unique moment, as we see it from a federation standpoint as it pertains to the role of self-care in overall health care systems,” GSCF Chair Manoj Raghunandanan told those in attendance. Global Self-Care Federation Chair Manoj Raghunandanan A rise in chronic conditions, an ageing population, and the COVID-19 pandemic have all impacted already-overstretched resources over the past few years, he said. For Raghunandanan, the COVID-19 pandemic has changed how people view self-care due to the amount of time spent in lock downs and, for many people, an inability to see medical practitioners in person. “The COVID-19 pandemic was the great accelerator,” Raghunandanan said. “We had a period where consumers and patients were relying upon themselves to care for themselves, to adjudicate their care to provide for themselves, and during that time, we realised that in many cases, they could be successful at doing this.” What is self-care? Self-care is defined as the ability of individuals, families and communities to promote health, prevent disease and mental health, and cope with illnesses and disability, with or without the support of health workers. United for Self-Care Coalition has called on the WHO to boost health literacy, promote digital health, enhance self-care capacity and guidance, recognise self-care as an enabler of UHC and invest in self-care. The coalition is already part of the UHC2030 platform, which aims to increase Universal Health Coverage by 2030. Democratising access to self-care interventions Many see the current WHO guidelines as simply needing to do more. Manjulaa Narasimhan, a scientist in the Department of Reproductive Health and Research at WHO Manjulaa Narasimhan, a scientist in the Department of Reproductive Health and Research at WHO, explained, “We look at things like how can we reduce the levels of violence, stigma, discrimination and coercion, that many people face even within health systems. We look at what kind of education and support they might need, including psychosocial support and other types. What kind of access to justice might people need?” Self-care practices can hold enormous potential to improve people’s quality of life, helping to manage the burden of non-communicable diseases (NCDs) while helping to develop health systems’ sustainability and reduce increasing costs. One such way forward could be increased telemedicine, health-related services and information available via electronic devices and technologies. This allows longer-distance patient-clinician contact, care, advice, reminders, education, intervention, monitoring and remote admissions. Academic Austen El-Osta gave examples to the panel, including the UK National Health Service, who, he told the audience, “bought a quarter of a million blood pressure monitors and distributed these to patients. These patients are effectively self-caring, releasing pressure from primary care and the health system. Of course, we’re all familiar with the many fantastic digital health apps and tools that we use and excellent med tech. “The big question is how do we democratise access to self-care interventions and best practices?” El–Osta said. “We have the guidelines; we’ve got some anecdotal evidence. We’ve got a lot of work on NCDs and technology. So all of these are coming together now.” Another example explored was how pharmacists could help unburden struggling health systems. Mariet Eksteen, Global Lead for Advancing Integrated Services at Advancing Pharmacy Worldwide “Often pharmacy and pharmacists are the patient’s first point of call in any healthcare inquiry that they have,” stated Mariet Eksteen, Global Lead for Advancing Integrated Services at Advancing Pharmacy Worldwide. “Pharmacists could be an exceptionally well-positioned resource to support the concept of self-care because we could assist patients with a rising level of health literacy as well as knowledge in their communities, which as a result, could also lead to increased levels of preventative care.” Why a WHO resolution is needed A WHO resolution on self-care, as opposed to guidelines, would provide the following: A framework for its integration into future economic and health policies. Promoting awareness. Political commitment. The mobilisation of resources. There would then be better support for the UH2030 goals. Sandy Garçon, the founding director of the Self-Care Trailblazer Group, echoed calls for the WHO to work on the current guidelines, stating, “There needs to be the right kind of policies, the right kind of funding, and the correct type of programming. Many countries are already moving in this direction, but we need more.” “We always welcome political and legal policy and standards framework that we can rely on to help us create that ecosystem we want,” agreed Kawaldip Sehmi, CEO of the International Alliance of Patients’ Organisations. “From patients of self-care first, then health professionals second. Now it’s time to take care of ourselves.” Image Credits: Screenshot. New Principles Offer Guide to Human Rights During Health Emergencies 26/05/2023 Alex Winston From left: Magdalena Sepúlveda Carmona, Executive Director, Global Initiative For Economic, Social And Cultural Rights; Saman Zia-Zarifi, Executive Director, Physicians For Human Rights; and Viviana Muñoz Tellez, Coordinator, Health, Intellectual Property And Biodiversity Programme, South Centre As the world continues to learn the lessons of the COVID-19 pandemic, a new set of principles aiming the help guide the future of human rights in global medical emergencies was published and discussed on Tuesday at an event of the 76th World Health Assembly (WHA). The event, titled “Beyond Panic & Neglect: Building a Human Rights Framework for Public Health Emergency Prevention, Preparedness, and Response,” looked at a new set of principles and Guidelines on Human Rights and Public Health Emergencies, which were developed through a three-year partnership between the Global Health Law Consortium (GHLC) and the International Commission of Jurists (ICJ.) The overarching human rights principles and obligations fall into eight categories: 1 – Universal enjoyment of human rights 2 – International solidarity 3 – Rule of law 4 – Equality and non-discrimination 5 – Human rights duties related to non-State actors 6 – Transparency and access to information 7 – Meaningful and effective participation 8 – Accountability and access to justice for those harmed by human rights violations and abuses Principles bring together lessons from COVID and previous pandemics, epidemics The principles, formulated by 150 individuals from other health and human rights organisations and WHO officials, draw upon lessons from past epidemics and pandemics, including cholera, dengue, ebola, HIV and zika. In addition, the experts looked at situations where an inadequate response to effective public health policies and human rights obligations led to devastating outcomes. “What was needed is a contemporary treatment that also accounted for what needed to be done to ensure a broader rights-based approach to public health emergencies, including upholding the right to health and related rights. These new principles, we believe, represent a breakthrough in the ongoing effort to ensure that human rights are protected and upheld in times of crisis.” Ian Seiderman, legal and policy director at the ICJ, told those gathered. “This event here marks our first public dialogue on the new principles and guidelines and their subject matter, focusing on the role of international human rights law in guiding approaches to public health emergencies.” The principles bring together an overarching scope of the universal enjoyment of human rights, including equality and non-discrimination, transparency and access to information and accountability and access to justice for those harmed by human rights abuses or violations. Principles coincide with pandemic treaty From left: Magdalena Sepúlveda Carmona, Executive Director, Global Initiative For Economic, Social And Cultural Rights; Saman Zia-Zarifi, Executive Director, Physicians For Human Rights; Viviana Muñoz Tellez, Coordinator, Health, Intellectual Property And Biodiversity Programme, South Centre; and moderator Gian Luca Burci, Adjunct Professor, International Law, Geneva Graduate Institute The release of the principles coincided with the release of a new “Zero+” draft of the proposed World Health Organization (WHO) pandemic accord that is currently under negotiation by member states. “We saw many governments shift from complacency and neglect to rapid action, often in panic mode to respond to a public health threat that was spreading uncontrollably,” stated Roojin Habibi, a co-founding member of the Global Health Law Consortium, who led the development of the principles. “Around the world, we saw countries deploy various measures, from mask mandates to lock downs to quarantines and isolation in response to this public health threat. “The international community must learn to move beyond cycles of panic and neglect, which leaves human rights at the margins of decision-making and policymaking. The principles developed through a consensus-based and deliberative process amongst 30 of the world’s leading thinkers in global health law and human rights provide an authoritative interpretation of international law to help guide that learning.” The WHO drafted pandemic treaty states that “all lives have equal value, and that therefore equity should be a principle, an indicator and an outcome of pandemic prevention, preparedness, and response,” and this was a point emphasised by Dr. Viviana Munoz Tellez of the South Centre, an intergovernmental organisation based in Geneva that helps developing countries promote their common interests in the international arena, who brought up the issue of vaccine inequity. “We could have averted, at minimum, about a million and a half deaths,” Tellez said. “The idea was, when we have vaccine doses, we will distribute at least 20% proportionally and highlight the more vulnerable populations that need to go first. But, unfortunately, that did not happen, mainly because the more affluent countries had advanced marketing commitments. “We had competition rather than cooperation. That was one of the big problems.” The role of the private health sector The private health sector has also come under heavy scrutiny since the pandemic. However, one aspect that the principles address observes that the state must regulate and monitor private actors. The principles themselves put no obligations directly on the remote, non-state actors. Instead, they state that across all pandemic prevention, response and recovery measures, states have the responsibility to ensure that non-state actors do not impair any of the human rights laws and must regulate and monitor ” engaged non-state actors to prevent them from impairing the enjoyment of human rights and provide for redress and accountability.” Magdalena Sepúlveda Carmona, executive director of Global Initiative For Economic, Social and Cultural Rights, stated on private actors that, “Something that started happening before the pandemic is the privatization, commercialization, and financialization of public services such as health care, water, sanitation and education. There are many ways in which private actors can be involved in health care. “We need to act now. We must ensure that everybody has access to a universal resilient health system that is affordable or at no cost for those who need it. And that is included in the principles.” The hope, the presenters said, is that the COVID-19 pandemic would bring about changes in legislation that would help the world prepare and deal with any future health emergencies. “We have to use these principles to put in place legislation, rules and regulations to say the next time this happens, we have to think about how we’re going to address this problem,” Saman Zia-Zarifi, executive director of Physicians For Human Rights told the panel. “It can’t just be that we will give money to companies to support their workers who can’t come to the office, but we will keep open the informal sector where the majority of people in most countries live and work.” The new principles allow actors to play their part in change. “These principles can act as kind of a North Star for everyone,” Zia-Zarifi stated. “They establish some clear directions of movement. They don’t tell governments what to do but give them a direction of movement and a way of thinking.” The Geneva Graduate Institute, The Global Health Centre and the International Geneva Global Health Platform, the International Commission of Jurists, the Global Health Law Consortium, the Global Initiative for Economic, Social and Cultural Rights, and Physicians for Human Rights organised the panel. Image Credits: Screenshot. Huge Support for Universal Health Coverage and NCD Measures, But WHO Replenishment Fund is Rejected 25/05/2023 Kerry Cullinan & Megha Kaveri The delegate for Barbados addressing the World Health Assembly during discussions on universal health coverage. An impossibly long list of member states lined up to address universal health coverage (UHC) and non-communicable diseases (NCDs) at the World Health Assembly on Thursday afternoon, indicating the centrality of these issues for countries. There was near-universal support for primary health services to be the backbone of UHC, with disease prevention as the other key pillar – particularly to prevent NCDs. A number of countries including Canada, the US and Norway called for sexual and reproductive services accessible to young people to be included as part of primary health. Many member countries called for the three United Nations High-Level Meetings – on UHC, tuberculosis and pandemic preparedness – in September to be aligned with the WHO’s processes, including negotiations on a pandemic accord. Huge support for WHO’s ‘Best Buys’ The WHO’s updated policy options and interventions to prevent and control NCDs – referred to as “Best Buys” – also enjoyed widespread support. A number of Caribbean countries are at the forefront of fighting NCDs and obesity, including Barbados. “Barbados is privileged to be one of the front-runner countries that WHO has identified to take part in the acceleration plan to stop obesity,” its delegate said. Barbados launched a national school nutrition policy in February “to address challenges related to poor dietary habits and lack of physical activity among schoolchildren”, while its tax on sugary drinks introduced in 2015 resulted in a 4.3% reduction in their consumption. Canada underlined the importance of integrating mental health into broader NCD prevention strategies but noted that stigma “remains a barrier to mental well-being globally, especially for younger people”. Norway called for strategies to fight NCDs to be “free from undue political and commercial influence”, something that NCD advocates lobbied for on the sidelines of the WHA. No consensus on replenishment fund However, the same spirit of agreement was absent in Committee B, with a divergence among member states’ opinions on a “replenishment mechanism” proposed by the WHO Director-General to ensure more sustainable financing of the organisation. Member-states deliberated on different possible models of sustainable funding of the WHO, delaying agreement on a single, unified formula of a “replenishment mechanism”. The US made it clear that it did not support the replenishment mechanism – a view that ultimately held sway. It, however, expressed support to have rounds of investments by donors, similar to other global health organizations like The Global Fund. “We agreed to support planning for the secretariat’s proposed new initiative for sustainable financing for WHO with the understanding that we’ve moved to a more streamlined approach of innovative fundraising through an investment round, and that we’re not approving a replenishment mechanism for WHO,” stated the US. It is also widely believed that the country pushed for inclusion of “earmarked contributions” in the draft text of the resolution, in exchange for its support to the resolution. Switzerland supported the replenishment mechanism for the WHO, saying it had “considerable potential to strengthen the strategic use of funding and to guarantee predictability of financing for WHO’s operations in order to guarantee health for all”. But, it also underlined that “earmarked contributions will remain vital to the funding of WHO for many member states” but that their use needs to be “traceable, transparent and efficient”. A decision on what mechanism should be adopted to bolster WHO’s finances is expected on Friday. World Resilience Summit Galvanises Public-Private Solutions to Feed into Pandemic Accord Negotiations 25/05/2023 Kerry Cullinan Maria van Kerkhove, Priya Basu, Mary Mahy, Iveth J. González and Benjamin Roche. GENEVA – Global health conversations are much deeper at present because everyone has been affected by COVID-19 – and this opens up the possibility of building an “all-of-society” approach before the next pandemic, said Sylvie Brand, the World Health Organization’s (WHO) Director of Epidemic and Pandemic Preparedness and Prevention. “We have seen during this pandemic that it’s not enough to have doctors and nurses at the frontline. We need to bring on board politicians, academics, the private sector, civil society, faith-based organisations – everybody has a role to play,” said Brand during her keynote address to the Resilience Summit held alongside the World Health Assembly in Geneva. “But this is not enough. We need also to make sure that we connect people because when the crisis starts, it’s very hard to build things from scratch.” Her input came after leaders from the public and private sectors had discussed three different areas related to pandemics – prevention, preparedness and response – at the invitation-only summit hosted by the World Climate Foundation and the Geneva Health Forum. Stop the zoonotic spark The pandemic prevention group, which had a strong contingent of One Health actors, felt that primary prevention had to focus on zoonotic spillover from animals to people. “You have to start with the spark that can cause the fire, addressing the interface between animals and people,” said Jonathan Epstein, Vice-President of EcoHealth Alliance. The group also called for the integration of climate change and biodiversity and health. Collaborative surveillance and data-sharing dominated the discussion at the preparedness roundtable, which also stressed the importance of building trust and understanding. “We need the foundation – global, regional, national systems – for surveillance that is intentionally collaborative, that goes beyond the health sector,” said Dr Magda Robalo Correia e Silva, the Health Minister of Guinea-Bissau. She also said that preparing for an infectious disease outbreak or a pandemic must be rooted in communities and lived experiences of the people. The panellists also touched on how preventative measures like surveillance or data sharing don’t work in isolation. “It’s an ecosystem. It cannot be the data only or the tools only or the financing of the early warning system or political support. It’s an ecosystem that starts with the doctors, nurses who are in the frontlines. That’s where the [early warning] system gets triggered,” said Dr Nino Kharaishvili, Global Solutions Director of the health systems governance at Jacobs. The group dealing with the pandemic response grappled with how data could be properly collected and shared to ensure that responses were timely and resources went to areas most in need. The World Bank’s Priya Basu, who heads the Pandemic Fund secretariat, said that applications for funding for the first round of the Fund’s disbursements were aimed at strengthening health systems in low and middle-income countries. Collaboration between government departments within countries, and between countries and donors had been a prerequisite for applicants. The huge and growing shortages of health workers and a lack of trained personnel were also a substantial challenge. “We need to deal with the global shortage of health workers and the poaching by high-income countries of health workers from low and middle-income countries. There are an estimated six million missing health workers in Africa,” said Philippe Guinot, Chief Technical Officer of IntraHealth. A sticking point in pandemic accord discussions has been around how to share pathogen sequencing. IFPMA’s Grega Kumer “The rapid sharing of SARS-COV-2’s sequencing enabled the pharmaceutical industry to start developing vaccines, treatments and diagnostics in record time. The first vaccine was approved 326 days after the virus sequence was known. This sharing of data and information mustn’t be jeopardized in the future, and the principle needs to be kept in any solutions for pandemic preparedness,” said Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). He added there had been cases where access to pathogens was either blocked or delayed because of access benefit-sharing agreements derived from the Nagoya Protocol, which led to delays in vaccine production. For instance, this has been the case for seasonal influenza, Ebola or Zika. However, Yaunqiong Hu from Médecins sans Frontières appealed for community contributions to the development of vaccines to be valued, pointing out the contributions of residents of Guinea to the development of Ebola vaccines. Meanwhile, Maria van Kerkhove, WHO’s Technical Lead on COVID-19, said that substantial capacity for surveillance had been built during the pandemic, but that transparency and data sharing were waning. But “governments don’t want to find the next pandemic because of the disincentives”, she added, citing how South Africa had been slapped with travel bans after sharing the Omicron sequencing. Misinformation undermining the ‘age of biology’ Chris Perez, head of International Programs at biotech company Concentric by Ginkgo Chris Perez, head of International Programs at biotech company Concentric by Ginkgo, told the evening plenary how his company’s tracking of aeroplane wastewater had identified COVID-19 variants in the US significantly earlier than any other tracking body. “We believe that the age of biology and the bio-economy hold the keys to enormous opportunities. across sectors for a more sustainable and resilient future for the world,” said Perez. Biological risks arise from “humans encroaching on new environments and climate change” as well as the “accidental or intentional misuse of bioengineering”, warned Perez. However, he also warned of social risks – particularly misinformation that undermined people’s faith in science. “As most people know, in the United States, the COVID-19 response was very politically charged in a challenging environment and also involved the dangers of misinformation in public health,” said Perez. “We need resilient societies and governance structures and today’s information environment can compound biological risks. Trust and the truth must be core organising principles if we are to address this.” The World Resilience Summit’s steering committee intends to draft recommendations for public-private partnerships in each of the three areas to “add value with public-private partnership solutions in the implementation of the upcoming pandemic treaty drafted by the WHO”. (With inputs from Megha Kaveri) WHA76: Countries Commit to Increased Polio Immunisation 25/05/2023 Disha Shetty Countries expressed concern at an uptick in polio cases last year and discussed ways to double down on routine immunizations – interrupted by the pandemic and conflicts – at Thursday’s World Health Assembly. Polio is currently the only official global public health emergency. Afghanistan and Pakistan are the last two remaining countries where the virus is endemic, WHO has said. In 2022, Afghanistan reported two new cases while Pakistan reported 20. Pakistan which has also reported a new case in 2023, said it, “continues to make consistent progress towards stopping the transmission of poliovirus.” The virus has been found to be in circulation across 31 countries in three regions, threatening to roll back hard fought for gains over several decades. “We are only safe once everyone is safe,” Germany said, as it highlighted the need for global cooperation. The United Kingdom asked countries to guarantee the safety of teams conducting routine immunisation, an issue in both countries where poliovirus remains endemic. Australia commended the work of the Global Polio Eradication Initiative (GPEI) in Afghanistan for operating under challenging conditions as the ruling Taliban continues to make it near impossible for women to work. “We commend GPEI in Afghanistan despite increasingly stringent bans on women working for NGOs and UN agencies. Ensuring the safety of all frontline polio workers should continue to be a high priority. The risk that women may no longer be able to perform house-to-house campaigns must be mitigated to sustain high coverage and reach zero dose children,” Australia said. The scarcity of women healthcare workers in some areas of Pakistan has also affected routine immunisation, leaving blind spots. “The Mehsud belt in southern Khyber Pakhtunkhwa remains a persistent challenge as no polio campaign has been conducted in debates since last months,” Pakistan said. To counter this issue the country said it is focusing on entry and exit points to the belt as well as areas around it where security remains a concern. Iran, which borders Afghanistan flagged concerns about the influx of migrants in recent years due to the conflict in the country and called it a challenging situation. Iran also said that it continues to face barriers when accessing vaccines, and asked for greater WHO support for its national laboratories. Canada assured its financial support to the polio campaign and highlighted the need to focus not just on countries where polio is endemic but also other countries that might need support. “We fear that other vulnerable countries that do not have the resources to organize effective campaigns are further exposed to outbreaks and the risk of outbreaks,” the country said. WHO Budget Replenishment Text Keeps Door Open to ‘Earmarked’ Donations 25/05/2023 Kerry Cullinan Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. GENEVA – The World Health Assembly is poised to decide on an “investment round” in late 2024 to boost the World Health Organization’s (WHO) finances – but not the establishment of a “replenishment fund”. Member states and donors will be able to continue to provide funds to the WHO earmarked for specific health programmes – something that the WHO’s Working Group on Sustainable Financing advised that the organisation moves away from as this skews the work of the global body. This is according to a copy of the draft text leaked to Health Policy Watch, based on member state discussions late on Wednesday. The US is widely believed to have pushed for the continued inclusion of earmarked funds as a condition of its support for the resolution. The formation of a WHO Investor Forum has also been mooted ahead of the investment round, according to those close to discussions. Members’ fees to cover 20% of budget The text also urges member states to pay their membership fees – which the assembly earlier resolved would now cover 20% of the budget (up from an estimated 14%). While the text proposes that the WHO should continue to accept, “alongside unearmarked voluntary contributions, voluntary contributions that are earmarked and/or single-year contributions from member states and other donors” it urges an increase in “transparency of reporting on voluntary earmarked contributions and on their impact and allocation”. In the lead-up to planning the investment round in the last quarter of 2024, the WHO is directed to provide member states with regular updates and to provide the Executive Board with “a full plan that includes modalities and anticipated costs” for approval. Various efforts to improve the financial viability of the WHO have hammered on the importance of the organisation having access to flexible funds – rather than funds donated by philanthropies and wealthier member states that are tied to programmes that might not be top global health priorities. Civil society condemnation Four civil society organisations condemned the new text, describing it as “nothing but the institutionalisation of the earmarked contribution that has led to the dismal functioning of the WHO at various levels, including the increasing penetration of the private philanthropic sector in the organisation”. “The draft decision goes against the very objective of the recommendation of the Working Group,” said Lauren Paremoer of the People’s Health Movement. “As per the approved budget of $6834.1 million for the 2024-25 biennium, $5685.8 million is to be funded through voluntary contributions. The institutionalisation of earmarked funding would further stabilise donor-driven priorities and compromise the credibility, independence and integrity of WHO.” Nicoletta Dentico of Society for International Development (SID) condemned “the multilateral development community’s fixation with leveraging the private sector in healthcare, using public money to de-risk investments”. Third World Network’s KM Gopakumar condemned the idea of a WHO Investors’ Forum, saying it would “seriously undermine the role of the vast majority of Member states in WHO’s governance”. “The Forum participants, consisting of a rather impenetrable network of philanthropic foundations and the private sector, would de facto control WHO’s priorities,” he added. Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. 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New Principles Offer Guide to Human Rights During Health Emergencies 26/05/2023 Alex Winston From left: Magdalena Sepúlveda Carmona, Executive Director, Global Initiative For Economic, Social And Cultural Rights; Saman Zia-Zarifi, Executive Director, Physicians For Human Rights; and Viviana Muñoz Tellez, Coordinator, Health, Intellectual Property And Biodiversity Programme, South Centre As the world continues to learn the lessons of the COVID-19 pandemic, a new set of principles aiming the help guide the future of human rights in global medical emergencies was published and discussed on Tuesday at an event of the 76th World Health Assembly (WHA). The event, titled “Beyond Panic & Neglect: Building a Human Rights Framework for Public Health Emergency Prevention, Preparedness, and Response,” looked at a new set of principles and Guidelines on Human Rights and Public Health Emergencies, which were developed through a three-year partnership between the Global Health Law Consortium (GHLC) and the International Commission of Jurists (ICJ.) The overarching human rights principles and obligations fall into eight categories: 1 – Universal enjoyment of human rights 2 – International solidarity 3 – Rule of law 4 – Equality and non-discrimination 5 – Human rights duties related to non-State actors 6 – Transparency and access to information 7 – Meaningful and effective participation 8 – Accountability and access to justice for those harmed by human rights violations and abuses Principles bring together lessons from COVID and previous pandemics, epidemics The principles, formulated by 150 individuals from other health and human rights organisations and WHO officials, draw upon lessons from past epidemics and pandemics, including cholera, dengue, ebola, HIV and zika. In addition, the experts looked at situations where an inadequate response to effective public health policies and human rights obligations led to devastating outcomes. “What was needed is a contemporary treatment that also accounted for what needed to be done to ensure a broader rights-based approach to public health emergencies, including upholding the right to health and related rights. These new principles, we believe, represent a breakthrough in the ongoing effort to ensure that human rights are protected and upheld in times of crisis.” Ian Seiderman, legal and policy director at the ICJ, told those gathered. “This event here marks our first public dialogue on the new principles and guidelines and their subject matter, focusing on the role of international human rights law in guiding approaches to public health emergencies.” The principles bring together an overarching scope of the universal enjoyment of human rights, including equality and non-discrimination, transparency and access to information and accountability and access to justice for those harmed by human rights abuses or violations. Principles coincide with pandemic treaty From left: Magdalena Sepúlveda Carmona, Executive Director, Global Initiative For Economic, Social And Cultural Rights; Saman Zia-Zarifi, Executive Director, Physicians For Human Rights; Viviana Muñoz Tellez, Coordinator, Health, Intellectual Property And Biodiversity Programme, South Centre; and moderator Gian Luca Burci, Adjunct Professor, International Law, Geneva Graduate Institute The release of the principles coincided with the release of a new “Zero+” draft of the proposed World Health Organization (WHO) pandemic accord that is currently under negotiation by member states. “We saw many governments shift from complacency and neglect to rapid action, often in panic mode to respond to a public health threat that was spreading uncontrollably,” stated Roojin Habibi, a co-founding member of the Global Health Law Consortium, who led the development of the principles. “Around the world, we saw countries deploy various measures, from mask mandates to lock downs to quarantines and isolation in response to this public health threat. “The international community must learn to move beyond cycles of panic and neglect, which leaves human rights at the margins of decision-making and policymaking. The principles developed through a consensus-based and deliberative process amongst 30 of the world’s leading thinkers in global health law and human rights provide an authoritative interpretation of international law to help guide that learning.” The WHO drafted pandemic treaty states that “all lives have equal value, and that therefore equity should be a principle, an indicator and an outcome of pandemic prevention, preparedness, and response,” and this was a point emphasised by Dr. Viviana Munoz Tellez of the South Centre, an intergovernmental organisation based in Geneva that helps developing countries promote their common interests in the international arena, who brought up the issue of vaccine inequity. “We could have averted, at minimum, about a million and a half deaths,” Tellez said. “The idea was, when we have vaccine doses, we will distribute at least 20% proportionally and highlight the more vulnerable populations that need to go first. But, unfortunately, that did not happen, mainly because the more affluent countries had advanced marketing commitments. “We had competition rather than cooperation. That was one of the big problems.” The role of the private health sector The private health sector has also come under heavy scrutiny since the pandemic. However, one aspect that the principles address observes that the state must regulate and monitor private actors. The principles themselves put no obligations directly on the remote, non-state actors. Instead, they state that across all pandemic prevention, response and recovery measures, states have the responsibility to ensure that non-state actors do not impair any of the human rights laws and must regulate and monitor ” engaged non-state actors to prevent them from impairing the enjoyment of human rights and provide for redress and accountability.” Magdalena Sepúlveda Carmona, executive director of Global Initiative For Economic, Social and Cultural Rights, stated on private actors that, “Something that started happening before the pandemic is the privatization, commercialization, and financialization of public services such as health care, water, sanitation and education. There are many ways in which private actors can be involved in health care. “We need to act now. We must ensure that everybody has access to a universal resilient health system that is affordable or at no cost for those who need it. And that is included in the principles.” The hope, the presenters said, is that the COVID-19 pandemic would bring about changes in legislation that would help the world prepare and deal with any future health emergencies. “We have to use these principles to put in place legislation, rules and regulations to say the next time this happens, we have to think about how we’re going to address this problem,” Saman Zia-Zarifi, executive director of Physicians For Human Rights told the panel. “It can’t just be that we will give money to companies to support their workers who can’t come to the office, but we will keep open the informal sector where the majority of people in most countries live and work.” The new principles allow actors to play their part in change. “These principles can act as kind of a North Star for everyone,” Zia-Zarifi stated. “They establish some clear directions of movement. They don’t tell governments what to do but give them a direction of movement and a way of thinking.” The Geneva Graduate Institute, The Global Health Centre and the International Geneva Global Health Platform, the International Commission of Jurists, the Global Health Law Consortium, the Global Initiative for Economic, Social and Cultural Rights, and Physicians for Human Rights organised the panel. Image Credits: Screenshot. Huge Support for Universal Health Coverage and NCD Measures, But WHO Replenishment Fund is Rejected 25/05/2023 Kerry Cullinan & Megha Kaveri The delegate for Barbados addressing the World Health Assembly during discussions on universal health coverage. An impossibly long list of member states lined up to address universal health coverage (UHC) and non-communicable diseases (NCDs) at the World Health Assembly on Thursday afternoon, indicating the centrality of these issues for countries. There was near-universal support for primary health services to be the backbone of UHC, with disease prevention as the other key pillar – particularly to prevent NCDs. A number of countries including Canada, the US and Norway called for sexual and reproductive services accessible to young people to be included as part of primary health. Many member countries called for the three United Nations High-Level Meetings – on UHC, tuberculosis and pandemic preparedness – in September to be aligned with the WHO’s processes, including negotiations on a pandemic accord. Huge support for WHO’s ‘Best Buys’ The WHO’s updated policy options and interventions to prevent and control NCDs – referred to as “Best Buys” – also enjoyed widespread support. A number of Caribbean countries are at the forefront of fighting NCDs and obesity, including Barbados. “Barbados is privileged to be one of the front-runner countries that WHO has identified to take part in the acceleration plan to stop obesity,” its delegate said. Barbados launched a national school nutrition policy in February “to address challenges related to poor dietary habits and lack of physical activity among schoolchildren”, while its tax on sugary drinks introduced in 2015 resulted in a 4.3% reduction in their consumption. Canada underlined the importance of integrating mental health into broader NCD prevention strategies but noted that stigma “remains a barrier to mental well-being globally, especially for younger people”. Norway called for strategies to fight NCDs to be “free from undue political and commercial influence”, something that NCD advocates lobbied for on the sidelines of the WHA. No consensus on replenishment fund However, the same spirit of agreement was absent in Committee B, with a divergence among member states’ opinions on a “replenishment mechanism” proposed by the WHO Director-General to ensure more sustainable financing of the organisation. Member-states deliberated on different possible models of sustainable funding of the WHO, delaying agreement on a single, unified formula of a “replenishment mechanism”. The US made it clear that it did not support the replenishment mechanism – a view that ultimately held sway. It, however, expressed support to have rounds of investments by donors, similar to other global health organizations like The Global Fund. “We agreed to support planning for the secretariat’s proposed new initiative for sustainable financing for WHO with the understanding that we’ve moved to a more streamlined approach of innovative fundraising through an investment round, and that we’re not approving a replenishment mechanism for WHO,” stated the US. It is also widely believed that the country pushed for inclusion of “earmarked contributions” in the draft text of the resolution, in exchange for its support to the resolution. Switzerland supported the replenishment mechanism for the WHO, saying it had “considerable potential to strengthen the strategic use of funding and to guarantee predictability of financing for WHO’s operations in order to guarantee health for all”. But, it also underlined that “earmarked contributions will remain vital to the funding of WHO for many member states” but that their use needs to be “traceable, transparent and efficient”. A decision on what mechanism should be adopted to bolster WHO’s finances is expected on Friday. World Resilience Summit Galvanises Public-Private Solutions to Feed into Pandemic Accord Negotiations 25/05/2023 Kerry Cullinan Maria van Kerkhove, Priya Basu, Mary Mahy, Iveth J. González and Benjamin Roche. GENEVA – Global health conversations are much deeper at present because everyone has been affected by COVID-19 – and this opens up the possibility of building an “all-of-society” approach before the next pandemic, said Sylvie Brand, the World Health Organization’s (WHO) Director of Epidemic and Pandemic Preparedness and Prevention. “We have seen during this pandemic that it’s not enough to have doctors and nurses at the frontline. We need to bring on board politicians, academics, the private sector, civil society, faith-based organisations – everybody has a role to play,” said Brand during her keynote address to the Resilience Summit held alongside the World Health Assembly in Geneva. “But this is not enough. We need also to make sure that we connect people because when the crisis starts, it’s very hard to build things from scratch.” Her input came after leaders from the public and private sectors had discussed three different areas related to pandemics – prevention, preparedness and response – at the invitation-only summit hosted by the World Climate Foundation and the Geneva Health Forum. Stop the zoonotic spark The pandemic prevention group, which had a strong contingent of One Health actors, felt that primary prevention had to focus on zoonotic spillover from animals to people. “You have to start with the spark that can cause the fire, addressing the interface between animals and people,” said Jonathan Epstein, Vice-President of EcoHealth Alliance. The group also called for the integration of climate change and biodiversity and health. Collaborative surveillance and data-sharing dominated the discussion at the preparedness roundtable, which also stressed the importance of building trust and understanding. “We need the foundation – global, regional, national systems – for surveillance that is intentionally collaborative, that goes beyond the health sector,” said Dr Magda Robalo Correia e Silva, the Health Minister of Guinea-Bissau. She also said that preparing for an infectious disease outbreak or a pandemic must be rooted in communities and lived experiences of the people. The panellists also touched on how preventative measures like surveillance or data sharing don’t work in isolation. “It’s an ecosystem. It cannot be the data only or the tools only or the financing of the early warning system or political support. It’s an ecosystem that starts with the doctors, nurses who are in the frontlines. That’s where the [early warning] system gets triggered,” said Dr Nino Kharaishvili, Global Solutions Director of the health systems governance at Jacobs. The group dealing with the pandemic response grappled with how data could be properly collected and shared to ensure that responses were timely and resources went to areas most in need. The World Bank’s Priya Basu, who heads the Pandemic Fund secretariat, said that applications for funding for the first round of the Fund’s disbursements were aimed at strengthening health systems in low and middle-income countries. Collaboration between government departments within countries, and between countries and donors had been a prerequisite for applicants. The huge and growing shortages of health workers and a lack of trained personnel were also a substantial challenge. “We need to deal with the global shortage of health workers and the poaching by high-income countries of health workers from low and middle-income countries. There are an estimated six million missing health workers in Africa,” said Philippe Guinot, Chief Technical Officer of IntraHealth. A sticking point in pandemic accord discussions has been around how to share pathogen sequencing. IFPMA’s Grega Kumer “The rapid sharing of SARS-COV-2’s sequencing enabled the pharmaceutical industry to start developing vaccines, treatments and diagnostics in record time. The first vaccine was approved 326 days after the virus sequence was known. This sharing of data and information mustn’t be jeopardized in the future, and the principle needs to be kept in any solutions for pandemic preparedness,” said Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). He added there had been cases where access to pathogens was either blocked or delayed because of access benefit-sharing agreements derived from the Nagoya Protocol, which led to delays in vaccine production. For instance, this has been the case for seasonal influenza, Ebola or Zika. However, Yaunqiong Hu from Médecins sans Frontières appealed for community contributions to the development of vaccines to be valued, pointing out the contributions of residents of Guinea to the development of Ebola vaccines. Meanwhile, Maria van Kerkhove, WHO’s Technical Lead on COVID-19, said that substantial capacity for surveillance had been built during the pandemic, but that transparency and data sharing were waning. But “governments don’t want to find the next pandemic because of the disincentives”, she added, citing how South Africa had been slapped with travel bans after sharing the Omicron sequencing. Misinformation undermining the ‘age of biology’ Chris Perez, head of International Programs at biotech company Concentric by Ginkgo Chris Perez, head of International Programs at biotech company Concentric by Ginkgo, told the evening plenary how his company’s tracking of aeroplane wastewater had identified COVID-19 variants in the US significantly earlier than any other tracking body. “We believe that the age of biology and the bio-economy hold the keys to enormous opportunities. across sectors for a more sustainable and resilient future for the world,” said Perez. Biological risks arise from “humans encroaching on new environments and climate change” as well as the “accidental or intentional misuse of bioengineering”, warned Perez. However, he also warned of social risks – particularly misinformation that undermined people’s faith in science. “As most people know, in the United States, the COVID-19 response was very politically charged in a challenging environment and also involved the dangers of misinformation in public health,” said Perez. “We need resilient societies and governance structures and today’s information environment can compound biological risks. Trust and the truth must be core organising principles if we are to address this.” The World Resilience Summit’s steering committee intends to draft recommendations for public-private partnerships in each of the three areas to “add value with public-private partnership solutions in the implementation of the upcoming pandemic treaty drafted by the WHO”. (With inputs from Megha Kaveri) WHA76: Countries Commit to Increased Polio Immunisation 25/05/2023 Disha Shetty Countries expressed concern at an uptick in polio cases last year and discussed ways to double down on routine immunizations – interrupted by the pandemic and conflicts – at Thursday’s World Health Assembly. Polio is currently the only official global public health emergency. Afghanistan and Pakistan are the last two remaining countries where the virus is endemic, WHO has said. In 2022, Afghanistan reported two new cases while Pakistan reported 20. Pakistan which has also reported a new case in 2023, said it, “continues to make consistent progress towards stopping the transmission of poliovirus.” The virus has been found to be in circulation across 31 countries in three regions, threatening to roll back hard fought for gains over several decades. “We are only safe once everyone is safe,” Germany said, as it highlighted the need for global cooperation. The United Kingdom asked countries to guarantee the safety of teams conducting routine immunisation, an issue in both countries where poliovirus remains endemic. Australia commended the work of the Global Polio Eradication Initiative (GPEI) in Afghanistan for operating under challenging conditions as the ruling Taliban continues to make it near impossible for women to work. “We commend GPEI in Afghanistan despite increasingly stringent bans on women working for NGOs and UN agencies. Ensuring the safety of all frontline polio workers should continue to be a high priority. The risk that women may no longer be able to perform house-to-house campaigns must be mitigated to sustain high coverage and reach zero dose children,” Australia said. The scarcity of women healthcare workers in some areas of Pakistan has also affected routine immunisation, leaving blind spots. “The Mehsud belt in southern Khyber Pakhtunkhwa remains a persistent challenge as no polio campaign has been conducted in debates since last months,” Pakistan said. To counter this issue the country said it is focusing on entry and exit points to the belt as well as areas around it where security remains a concern. Iran, which borders Afghanistan flagged concerns about the influx of migrants in recent years due to the conflict in the country and called it a challenging situation. Iran also said that it continues to face barriers when accessing vaccines, and asked for greater WHO support for its national laboratories. Canada assured its financial support to the polio campaign and highlighted the need to focus not just on countries where polio is endemic but also other countries that might need support. “We fear that other vulnerable countries that do not have the resources to organize effective campaigns are further exposed to outbreaks and the risk of outbreaks,” the country said. WHO Budget Replenishment Text Keeps Door Open to ‘Earmarked’ Donations 25/05/2023 Kerry Cullinan Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. GENEVA – The World Health Assembly is poised to decide on an “investment round” in late 2024 to boost the World Health Organization’s (WHO) finances – but not the establishment of a “replenishment fund”. Member states and donors will be able to continue to provide funds to the WHO earmarked for specific health programmes – something that the WHO’s Working Group on Sustainable Financing advised that the organisation moves away from as this skews the work of the global body. This is according to a copy of the draft text leaked to Health Policy Watch, based on member state discussions late on Wednesday. The US is widely believed to have pushed for the continued inclusion of earmarked funds as a condition of its support for the resolution. The formation of a WHO Investor Forum has also been mooted ahead of the investment round, according to those close to discussions. Members’ fees to cover 20% of budget The text also urges member states to pay their membership fees – which the assembly earlier resolved would now cover 20% of the budget (up from an estimated 14%). While the text proposes that the WHO should continue to accept, “alongside unearmarked voluntary contributions, voluntary contributions that are earmarked and/or single-year contributions from member states and other donors” it urges an increase in “transparency of reporting on voluntary earmarked contributions and on their impact and allocation”. In the lead-up to planning the investment round in the last quarter of 2024, the WHO is directed to provide member states with regular updates and to provide the Executive Board with “a full plan that includes modalities and anticipated costs” for approval. Various efforts to improve the financial viability of the WHO have hammered on the importance of the organisation having access to flexible funds – rather than funds donated by philanthropies and wealthier member states that are tied to programmes that might not be top global health priorities. Civil society condemnation Four civil society organisations condemned the new text, describing it as “nothing but the institutionalisation of the earmarked contribution that has led to the dismal functioning of the WHO at various levels, including the increasing penetration of the private philanthropic sector in the organisation”. “The draft decision goes against the very objective of the recommendation of the Working Group,” said Lauren Paremoer of the People’s Health Movement. “As per the approved budget of $6834.1 million for the 2024-25 biennium, $5685.8 million is to be funded through voluntary contributions. The institutionalisation of earmarked funding would further stabilise donor-driven priorities and compromise the credibility, independence and integrity of WHO.” Nicoletta Dentico of Society for International Development (SID) condemned “the multilateral development community’s fixation with leveraging the private sector in healthcare, using public money to de-risk investments”. Third World Network’s KM Gopakumar condemned the idea of a WHO Investors’ Forum, saying it would “seriously undermine the role of the vast majority of Member states in WHO’s governance”. “The Forum participants, consisting of a rather impenetrable network of philanthropic foundations and the private sector, would de facto control WHO’s priorities,” he added. Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Huge Support for Universal Health Coverage and NCD Measures, But WHO Replenishment Fund is Rejected 25/05/2023 Kerry Cullinan & Megha Kaveri The delegate for Barbados addressing the World Health Assembly during discussions on universal health coverage. An impossibly long list of member states lined up to address universal health coverage (UHC) and non-communicable diseases (NCDs) at the World Health Assembly on Thursday afternoon, indicating the centrality of these issues for countries. There was near-universal support for primary health services to be the backbone of UHC, with disease prevention as the other key pillar – particularly to prevent NCDs. A number of countries including Canada, the US and Norway called for sexual and reproductive services accessible to young people to be included as part of primary health. Many member countries called for the three United Nations High-Level Meetings – on UHC, tuberculosis and pandemic preparedness – in September to be aligned with the WHO’s processes, including negotiations on a pandemic accord. Huge support for WHO’s ‘Best Buys’ The WHO’s updated policy options and interventions to prevent and control NCDs – referred to as “Best Buys” – also enjoyed widespread support. A number of Caribbean countries are at the forefront of fighting NCDs and obesity, including Barbados. “Barbados is privileged to be one of the front-runner countries that WHO has identified to take part in the acceleration plan to stop obesity,” its delegate said. Barbados launched a national school nutrition policy in February “to address challenges related to poor dietary habits and lack of physical activity among schoolchildren”, while its tax on sugary drinks introduced in 2015 resulted in a 4.3% reduction in their consumption. Canada underlined the importance of integrating mental health into broader NCD prevention strategies but noted that stigma “remains a barrier to mental well-being globally, especially for younger people”. Norway called for strategies to fight NCDs to be “free from undue political and commercial influence”, something that NCD advocates lobbied for on the sidelines of the WHA. No consensus on replenishment fund However, the same spirit of agreement was absent in Committee B, with a divergence among member states’ opinions on a “replenishment mechanism” proposed by the WHO Director-General to ensure more sustainable financing of the organisation. Member-states deliberated on different possible models of sustainable funding of the WHO, delaying agreement on a single, unified formula of a “replenishment mechanism”. The US made it clear that it did not support the replenishment mechanism – a view that ultimately held sway. It, however, expressed support to have rounds of investments by donors, similar to other global health organizations like The Global Fund. “We agreed to support planning for the secretariat’s proposed new initiative for sustainable financing for WHO with the understanding that we’ve moved to a more streamlined approach of innovative fundraising through an investment round, and that we’re not approving a replenishment mechanism for WHO,” stated the US. It is also widely believed that the country pushed for inclusion of “earmarked contributions” in the draft text of the resolution, in exchange for its support to the resolution. Switzerland supported the replenishment mechanism for the WHO, saying it had “considerable potential to strengthen the strategic use of funding and to guarantee predictability of financing for WHO’s operations in order to guarantee health for all”. But, it also underlined that “earmarked contributions will remain vital to the funding of WHO for many member states” but that their use needs to be “traceable, transparent and efficient”. A decision on what mechanism should be adopted to bolster WHO’s finances is expected on Friday. World Resilience Summit Galvanises Public-Private Solutions to Feed into Pandemic Accord Negotiations 25/05/2023 Kerry Cullinan Maria van Kerkhove, Priya Basu, Mary Mahy, Iveth J. González and Benjamin Roche. GENEVA – Global health conversations are much deeper at present because everyone has been affected by COVID-19 – and this opens up the possibility of building an “all-of-society” approach before the next pandemic, said Sylvie Brand, the World Health Organization’s (WHO) Director of Epidemic and Pandemic Preparedness and Prevention. “We have seen during this pandemic that it’s not enough to have doctors and nurses at the frontline. We need to bring on board politicians, academics, the private sector, civil society, faith-based organisations – everybody has a role to play,” said Brand during her keynote address to the Resilience Summit held alongside the World Health Assembly in Geneva. “But this is not enough. We need also to make sure that we connect people because when the crisis starts, it’s very hard to build things from scratch.” Her input came after leaders from the public and private sectors had discussed three different areas related to pandemics – prevention, preparedness and response – at the invitation-only summit hosted by the World Climate Foundation and the Geneva Health Forum. Stop the zoonotic spark The pandemic prevention group, which had a strong contingent of One Health actors, felt that primary prevention had to focus on zoonotic spillover from animals to people. “You have to start with the spark that can cause the fire, addressing the interface between animals and people,” said Jonathan Epstein, Vice-President of EcoHealth Alliance. The group also called for the integration of climate change and biodiversity and health. Collaborative surveillance and data-sharing dominated the discussion at the preparedness roundtable, which also stressed the importance of building trust and understanding. “We need the foundation – global, regional, national systems – for surveillance that is intentionally collaborative, that goes beyond the health sector,” said Dr Magda Robalo Correia e Silva, the Health Minister of Guinea-Bissau. She also said that preparing for an infectious disease outbreak or a pandemic must be rooted in communities and lived experiences of the people. The panellists also touched on how preventative measures like surveillance or data sharing don’t work in isolation. “It’s an ecosystem. It cannot be the data only or the tools only or the financing of the early warning system or political support. It’s an ecosystem that starts with the doctors, nurses who are in the frontlines. That’s where the [early warning] system gets triggered,” said Dr Nino Kharaishvili, Global Solutions Director of the health systems governance at Jacobs. The group dealing with the pandemic response grappled with how data could be properly collected and shared to ensure that responses were timely and resources went to areas most in need. The World Bank’s Priya Basu, who heads the Pandemic Fund secretariat, said that applications for funding for the first round of the Fund’s disbursements were aimed at strengthening health systems in low and middle-income countries. Collaboration between government departments within countries, and between countries and donors had been a prerequisite for applicants. The huge and growing shortages of health workers and a lack of trained personnel were also a substantial challenge. “We need to deal with the global shortage of health workers and the poaching by high-income countries of health workers from low and middle-income countries. There are an estimated six million missing health workers in Africa,” said Philippe Guinot, Chief Technical Officer of IntraHealth. A sticking point in pandemic accord discussions has been around how to share pathogen sequencing. IFPMA’s Grega Kumer “The rapid sharing of SARS-COV-2’s sequencing enabled the pharmaceutical industry to start developing vaccines, treatments and diagnostics in record time. The first vaccine was approved 326 days after the virus sequence was known. This sharing of data and information mustn’t be jeopardized in the future, and the principle needs to be kept in any solutions for pandemic preparedness,” said Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). He added there had been cases where access to pathogens was either blocked or delayed because of access benefit-sharing agreements derived from the Nagoya Protocol, which led to delays in vaccine production. For instance, this has been the case for seasonal influenza, Ebola or Zika. However, Yaunqiong Hu from Médecins sans Frontières appealed for community contributions to the development of vaccines to be valued, pointing out the contributions of residents of Guinea to the development of Ebola vaccines. Meanwhile, Maria van Kerkhove, WHO’s Technical Lead on COVID-19, said that substantial capacity for surveillance had been built during the pandemic, but that transparency and data sharing were waning. But “governments don’t want to find the next pandemic because of the disincentives”, she added, citing how South Africa had been slapped with travel bans after sharing the Omicron sequencing. Misinformation undermining the ‘age of biology’ Chris Perez, head of International Programs at biotech company Concentric by Ginkgo Chris Perez, head of International Programs at biotech company Concentric by Ginkgo, told the evening plenary how his company’s tracking of aeroplane wastewater had identified COVID-19 variants in the US significantly earlier than any other tracking body. “We believe that the age of biology and the bio-economy hold the keys to enormous opportunities. across sectors for a more sustainable and resilient future for the world,” said Perez. Biological risks arise from “humans encroaching on new environments and climate change” as well as the “accidental or intentional misuse of bioengineering”, warned Perez. However, he also warned of social risks – particularly misinformation that undermined people’s faith in science. “As most people know, in the United States, the COVID-19 response was very politically charged in a challenging environment and also involved the dangers of misinformation in public health,” said Perez. “We need resilient societies and governance structures and today’s information environment can compound biological risks. Trust and the truth must be core organising principles if we are to address this.” The World Resilience Summit’s steering committee intends to draft recommendations for public-private partnerships in each of the three areas to “add value with public-private partnership solutions in the implementation of the upcoming pandemic treaty drafted by the WHO”. (With inputs from Megha Kaveri) WHA76: Countries Commit to Increased Polio Immunisation 25/05/2023 Disha Shetty Countries expressed concern at an uptick in polio cases last year and discussed ways to double down on routine immunizations – interrupted by the pandemic and conflicts – at Thursday’s World Health Assembly. Polio is currently the only official global public health emergency. Afghanistan and Pakistan are the last two remaining countries where the virus is endemic, WHO has said. In 2022, Afghanistan reported two new cases while Pakistan reported 20. Pakistan which has also reported a new case in 2023, said it, “continues to make consistent progress towards stopping the transmission of poliovirus.” The virus has been found to be in circulation across 31 countries in three regions, threatening to roll back hard fought for gains over several decades. “We are only safe once everyone is safe,” Germany said, as it highlighted the need for global cooperation. The United Kingdom asked countries to guarantee the safety of teams conducting routine immunisation, an issue in both countries where poliovirus remains endemic. Australia commended the work of the Global Polio Eradication Initiative (GPEI) in Afghanistan for operating under challenging conditions as the ruling Taliban continues to make it near impossible for women to work. “We commend GPEI in Afghanistan despite increasingly stringent bans on women working for NGOs and UN agencies. Ensuring the safety of all frontline polio workers should continue to be a high priority. The risk that women may no longer be able to perform house-to-house campaigns must be mitigated to sustain high coverage and reach zero dose children,” Australia said. The scarcity of women healthcare workers in some areas of Pakistan has also affected routine immunisation, leaving blind spots. “The Mehsud belt in southern Khyber Pakhtunkhwa remains a persistent challenge as no polio campaign has been conducted in debates since last months,” Pakistan said. To counter this issue the country said it is focusing on entry and exit points to the belt as well as areas around it where security remains a concern. Iran, which borders Afghanistan flagged concerns about the influx of migrants in recent years due to the conflict in the country and called it a challenging situation. Iran also said that it continues to face barriers when accessing vaccines, and asked for greater WHO support for its national laboratories. Canada assured its financial support to the polio campaign and highlighted the need to focus not just on countries where polio is endemic but also other countries that might need support. “We fear that other vulnerable countries that do not have the resources to organize effective campaigns are further exposed to outbreaks and the risk of outbreaks,” the country said. WHO Budget Replenishment Text Keeps Door Open to ‘Earmarked’ Donations 25/05/2023 Kerry Cullinan Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. GENEVA – The World Health Assembly is poised to decide on an “investment round” in late 2024 to boost the World Health Organization’s (WHO) finances – but not the establishment of a “replenishment fund”. Member states and donors will be able to continue to provide funds to the WHO earmarked for specific health programmes – something that the WHO’s Working Group on Sustainable Financing advised that the organisation moves away from as this skews the work of the global body. This is according to a copy of the draft text leaked to Health Policy Watch, based on member state discussions late on Wednesday. The US is widely believed to have pushed for the continued inclusion of earmarked funds as a condition of its support for the resolution. The formation of a WHO Investor Forum has also been mooted ahead of the investment round, according to those close to discussions. Members’ fees to cover 20% of budget The text also urges member states to pay their membership fees – which the assembly earlier resolved would now cover 20% of the budget (up from an estimated 14%). While the text proposes that the WHO should continue to accept, “alongside unearmarked voluntary contributions, voluntary contributions that are earmarked and/or single-year contributions from member states and other donors” it urges an increase in “transparency of reporting on voluntary earmarked contributions and on their impact and allocation”. In the lead-up to planning the investment round in the last quarter of 2024, the WHO is directed to provide member states with regular updates and to provide the Executive Board with “a full plan that includes modalities and anticipated costs” for approval. Various efforts to improve the financial viability of the WHO have hammered on the importance of the organisation having access to flexible funds – rather than funds donated by philanthropies and wealthier member states that are tied to programmes that might not be top global health priorities. Civil society condemnation Four civil society organisations condemned the new text, describing it as “nothing but the institutionalisation of the earmarked contribution that has led to the dismal functioning of the WHO at various levels, including the increasing penetration of the private philanthropic sector in the organisation”. “The draft decision goes against the very objective of the recommendation of the Working Group,” said Lauren Paremoer of the People’s Health Movement. “As per the approved budget of $6834.1 million for the 2024-25 biennium, $5685.8 million is to be funded through voluntary contributions. The institutionalisation of earmarked funding would further stabilise donor-driven priorities and compromise the credibility, independence and integrity of WHO.” Nicoletta Dentico of Society for International Development (SID) condemned “the multilateral development community’s fixation with leveraging the private sector in healthcare, using public money to de-risk investments”. Third World Network’s KM Gopakumar condemned the idea of a WHO Investors’ Forum, saying it would “seriously undermine the role of the vast majority of Member states in WHO’s governance”. “The Forum participants, consisting of a rather impenetrable network of philanthropic foundations and the private sector, would de facto control WHO’s priorities,” he added. Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
World Resilience Summit Galvanises Public-Private Solutions to Feed into Pandemic Accord Negotiations 25/05/2023 Kerry Cullinan Maria van Kerkhove, Priya Basu, Mary Mahy, Iveth J. González and Benjamin Roche. GENEVA – Global health conversations are much deeper at present because everyone has been affected by COVID-19 – and this opens up the possibility of building an “all-of-society” approach before the next pandemic, said Sylvie Brand, the World Health Organization’s (WHO) Director of Epidemic and Pandemic Preparedness and Prevention. “We have seen during this pandemic that it’s not enough to have doctors and nurses at the frontline. We need to bring on board politicians, academics, the private sector, civil society, faith-based organisations – everybody has a role to play,” said Brand during her keynote address to the Resilience Summit held alongside the World Health Assembly in Geneva. “But this is not enough. We need also to make sure that we connect people because when the crisis starts, it’s very hard to build things from scratch.” Her input came after leaders from the public and private sectors had discussed three different areas related to pandemics – prevention, preparedness and response – at the invitation-only summit hosted by the World Climate Foundation and the Geneva Health Forum. Stop the zoonotic spark The pandemic prevention group, which had a strong contingent of One Health actors, felt that primary prevention had to focus on zoonotic spillover from animals to people. “You have to start with the spark that can cause the fire, addressing the interface between animals and people,” said Jonathan Epstein, Vice-President of EcoHealth Alliance. The group also called for the integration of climate change and biodiversity and health. Collaborative surveillance and data-sharing dominated the discussion at the preparedness roundtable, which also stressed the importance of building trust and understanding. “We need the foundation – global, regional, national systems – for surveillance that is intentionally collaborative, that goes beyond the health sector,” said Dr Magda Robalo Correia e Silva, the Health Minister of Guinea-Bissau. She also said that preparing for an infectious disease outbreak or a pandemic must be rooted in communities and lived experiences of the people. The panellists also touched on how preventative measures like surveillance or data sharing don’t work in isolation. “It’s an ecosystem. It cannot be the data only or the tools only or the financing of the early warning system or political support. It’s an ecosystem that starts with the doctors, nurses who are in the frontlines. That’s where the [early warning] system gets triggered,” said Dr Nino Kharaishvili, Global Solutions Director of the health systems governance at Jacobs. The group dealing with the pandemic response grappled with how data could be properly collected and shared to ensure that responses were timely and resources went to areas most in need. The World Bank’s Priya Basu, who heads the Pandemic Fund secretariat, said that applications for funding for the first round of the Fund’s disbursements were aimed at strengthening health systems in low and middle-income countries. Collaboration between government departments within countries, and between countries and donors had been a prerequisite for applicants. The huge and growing shortages of health workers and a lack of trained personnel were also a substantial challenge. “We need to deal with the global shortage of health workers and the poaching by high-income countries of health workers from low and middle-income countries. There are an estimated six million missing health workers in Africa,” said Philippe Guinot, Chief Technical Officer of IntraHealth. A sticking point in pandemic accord discussions has been around how to share pathogen sequencing. IFPMA’s Grega Kumer “The rapid sharing of SARS-COV-2’s sequencing enabled the pharmaceutical industry to start developing vaccines, treatments and diagnostics in record time. The first vaccine was approved 326 days after the virus sequence was known. This sharing of data and information mustn’t be jeopardized in the future, and the principle needs to be kept in any solutions for pandemic preparedness,” said Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). He added there had been cases where access to pathogens was either blocked or delayed because of access benefit-sharing agreements derived from the Nagoya Protocol, which led to delays in vaccine production. For instance, this has been the case for seasonal influenza, Ebola or Zika. However, Yaunqiong Hu from Médecins sans Frontières appealed for community contributions to the development of vaccines to be valued, pointing out the contributions of residents of Guinea to the development of Ebola vaccines. Meanwhile, Maria van Kerkhove, WHO’s Technical Lead on COVID-19, said that substantial capacity for surveillance had been built during the pandemic, but that transparency and data sharing were waning. But “governments don’t want to find the next pandemic because of the disincentives”, she added, citing how South Africa had been slapped with travel bans after sharing the Omicron sequencing. Misinformation undermining the ‘age of biology’ Chris Perez, head of International Programs at biotech company Concentric by Ginkgo Chris Perez, head of International Programs at biotech company Concentric by Ginkgo, told the evening plenary how his company’s tracking of aeroplane wastewater had identified COVID-19 variants in the US significantly earlier than any other tracking body. “We believe that the age of biology and the bio-economy hold the keys to enormous opportunities. across sectors for a more sustainable and resilient future for the world,” said Perez. Biological risks arise from “humans encroaching on new environments and climate change” as well as the “accidental or intentional misuse of bioengineering”, warned Perez. However, he also warned of social risks – particularly misinformation that undermined people’s faith in science. “As most people know, in the United States, the COVID-19 response was very politically charged in a challenging environment and also involved the dangers of misinformation in public health,” said Perez. “We need resilient societies and governance structures and today’s information environment can compound biological risks. Trust and the truth must be core organising principles if we are to address this.” The World Resilience Summit’s steering committee intends to draft recommendations for public-private partnerships in each of the three areas to “add value with public-private partnership solutions in the implementation of the upcoming pandemic treaty drafted by the WHO”. (With inputs from Megha Kaveri) WHA76: Countries Commit to Increased Polio Immunisation 25/05/2023 Disha Shetty Countries expressed concern at an uptick in polio cases last year and discussed ways to double down on routine immunizations – interrupted by the pandemic and conflicts – at Thursday’s World Health Assembly. Polio is currently the only official global public health emergency. Afghanistan and Pakistan are the last two remaining countries where the virus is endemic, WHO has said. In 2022, Afghanistan reported two new cases while Pakistan reported 20. Pakistan which has also reported a new case in 2023, said it, “continues to make consistent progress towards stopping the transmission of poliovirus.” The virus has been found to be in circulation across 31 countries in three regions, threatening to roll back hard fought for gains over several decades. “We are only safe once everyone is safe,” Germany said, as it highlighted the need for global cooperation. The United Kingdom asked countries to guarantee the safety of teams conducting routine immunisation, an issue in both countries where poliovirus remains endemic. Australia commended the work of the Global Polio Eradication Initiative (GPEI) in Afghanistan for operating under challenging conditions as the ruling Taliban continues to make it near impossible for women to work. “We commend GPEI in Afghanistan despite increasingly stringent bans on women working for NGOs and UN agencies. Ensuring the safety of all frontline polio workers should continue to be a high priority. The risk that women may no longer be able to perform house-to-house campaigns must be mitigated to sustain high coverage and reach zero dose children,” Australia said. The scarcity of women healthcare workers in some areas of Pakistan has also affected routine immunisation, leaving blind spots. “The Mehsud belt in southern Khyber Pakhtunkhwa remains a persistent challenge as no polio campaign has been conducted in debates since last months,” Pakistan said. To counter this issue the country said it is focusing on entry and exit points to the belt as well as areas around it where security remains a concern. Iran, which borders Afghanistan flagged concerns about the influx of migrants in recent years due to the conflict in the country and called it a challenging situation. Iran also said that it continues to face barriers when accessing vaccines, and asked for greater WHO support for its national laboratories. Canada assured its financial support to the polio campaign and highlighted the need to focus not just on countries where polio is endemic but also other countries that might need support. “We fear that other vulnerable countries that do not have the resources to organize effective campaigns are further exposed to outbreaks and the risk of outbreaks,” the country said. WHO Budget Replenishment Text Keeps Door Open to ‘Earmarked’ Donations 25/05/2023 Kerry Cullinan Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. GENEVA – The World Health Assembly is poised to decide on an “investment round” in late 2024 to boost the World Health Organization’s (WHO) finances – but not the establishment of a “replenishment fund”. Member states and donors will be able to continue to provide funds to the WHO earmarked for specific health programmes – something that the WHO’s Working Group on Sustainable Financing advised that the organisation moves away from as this skews the work of the global body. This is according to a copy of the draft text leaked to Health Policy Watch, based on member state discussions late on Wednesday. The US is widely believed to have pushed for the continued inclusion of earmarked funds as a condition of its support for the resolution. The formation of a WHO Investor Forum has also been mooted ahead of the investment round, according to those close to discussions. Members’ fees to cover 20% of budget The text also urges member states to pay their membership fees – which the assembly earlier resolved would now cover 20% of the budget (up from an estimated 14%). While the text proposes that the WHO should continue to accept, “alongside unearmarked voluntary contributions, voluntary contributions that are earmarked and/or single-year contributions from member states and other donors” it urges an increase in “transparency of reporting on voluntary earmarked contributions and on their impact and allocation”. In the lead-up to planning the investment round in the last quarter of 2024, the WHO is directed to provide member states with regular updates and to provide the Executive Board with “a full plan that includes modalities and anticipated costs” for approval. Various efforts to improve the financial viability of the WHO have hammered on the importance of the organisation having access to flexible funds – rather than funds donated by philanthropies and wealthier member states that are tied to programmes that might not be top global health priorities. Civil society condemnation Four civil society organisations condemned the new text, describing it as “nothing but the institutionalisation of the earmarked contribution that has led to the dismal functioning of the WHO at various levels, including the increasing penetration of the private philanthropic sector in the organisation”. “The draft decision goes against the very objective of the recommendation of the Working Group,” said Lauren Paremoer of the People’s Health Movement. “As per the approved budget of $6834.1 million for the 2024-25 biennium, $5685.8 million is to be funded through voluntary contributions. The institutionalisation of earmarked funding would further stabilise donor-driven priorities and compromise the credibility, independence and integrity of WHO.” Nicoletta Dentico of Society for International Development (SID) condemned “the multilateral development community’s fixation with leveraging the private sector in healthcare, using public money to de-risk investments”. Third World Network’s KM Gopakumar condemned the idea of a WHO Investors’ Forum, saying it would “seriously undermine the role of the vast majority of Member states in WHO’s governance”. “The Forum participants, consisting of a rather impenetrable network of philanthropic foundations and the private sector, would de facto control WHO’s priorities,” he added. Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
WHA76: Countries Commit to Increased Polio Immunisation 25/05/2023 Disha Shetty Countries expressed concern at an uptick in polio cases last year and discussed ways to double down on routine immunizations – interrupted by the pandemic and conflicts – at Thursday’s World Health Assembly. Polio is currently the only official global public health emergency. Afghanistan and Pakistan are the last two remaining countries where the virus is endemic, WHO has said. In 2022, Afghanistan reported two new cases while Pakistan reported 20. Pakistan which has also reported a new case in 2023, said it, “continues to make consistent progress towards stopping the transmission of poliovirus.” The virus has been found to be in circulation across 31 countries in three regions, threatening to roll back hard fought for gains over several decades. “We are only safe once everyone is safe,” Germany said, as it highlighted the need for global cooperation. The United Kingdom asked countries to guarantee the safety of teams conducting routine immunisation, an issue in both countries where poliovirus remains endemic. Australia commended the work of the Global Polio Eradication Initiative (GPEI) in Afghanistan for operating under challenging conditions as the ruling Taliban continues to make it near impossible for women to work. “We commend GPEI in Afghanistan despite increasingly stringent bans on women working for NGOs and UN agencies. Ensuring the safety of all frontline polio workers should continue to be a high priority. The risk that women may no longer be able to perform house-to-house campaigns must be mitigated to sustain high coverage and reach zero dose children,” Australia said. The scarcity of women healthcare workers in some areas of Pakistan has also affected routine immunisation, leaving blind spots. “The Mehsud belt in southern Khyber Pakhtunkhwa remains a persistent challenge as no polio campaign has been conducted in debates since last months,” Pakistan said. To counter this issue the country said it is focusing on entry and exit points to the belt as well as areas around it where security remains a concern. Iran, which borders Afghanistan flagged concerns about the influx of migrants in recent years due to the conflict in the country and called it a challenging situation. Iran also said that it continues to face barriers when accessing vaccines, and asked for greater WHO support for its national laboratories. Canada assured its financial support to the polio campaign and highlighted the need to focus not just on countries where polio is endemic but also other countries that might need support. “We fear that other vulnerable countries that do not have the resources to organize effective campaigns are further exposed to outbreaks and the risk of outbreaks,” the country said. WHO Budget Replenishment Text Keeps Door Open to ‘Earmarked’ Donations 25/05/2023 Kerry Cullinan Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. GENEVA – The World Health Assembly is poised to decide on an “investment round” in late 2024 to boost the World Health Organization’s (WHO) finances – but not the establishment of a “replenishment fund”. Member states and donors will be able to continue to provide funds to the WHO earmarked for specific health programmes – something that the WHO’s Working Group on Sustainable Financing advised that the organisation moves away from as this skews the work of the global body. This is according to a copy of the draft text leaked to Health Policy Watch, based on member state discussions late on Wednesday. The US is widely believed to have pushed for the continued inclusion of earmarked funds as a condition of its support for the resolution. The formation of a WHO Investor Forum has also been mooted ahead of the investment round, according to those close to discussions. Members’ fees to cover 20% of budget The text also urges member states to pay their membership fees – which the assembly earlier resolved would now cover 20% of the budget (up from an estimated 14%). While the text proposes that the WHO should continue to accept, “alongside unearmarked voluntary contributions, voluntary contributions that are earmarked and/or single-year contributions from member states and other donors” it urges an increase in “transparency of reporting on voluntary earmarked contributions and on their impact and allocation”. In the lead-up to planning the investment round in the last quarter of 2024, the WHO is directed to provide member states with regular updates and to provide the Executive Board with “a full plan that includes modalities and anticipated costs” for approval. Various efforts to improve the financial viability of the WHO have hammered on the importance of the organisation having access to flexible funds – rather than funds donated by philanthropies and wealthier member states that are tied to programmes that might not be top global health priorities. Civil society condemnation Four civil society organisations condemned the new text, describing it as “nothing but the institutionalisation of the earmarked contribution that has led to the dismal functioning of the WHO at various levels, including the increasing penetration of the private philanthropic sector in the organisation”. “The draft decision goes against the very objective of the recommendation of the Working Group,” said Lauren Paremoer of the People’s Health Movement. “As per the approved budget of $6834.1 million for the 2024-25 biennium, $5685.8 million is to be funded through voluntary contributions. The institutionalisation of earmarked funding would further stabilise donor-driven priorities and compromise the credibility, independence and integrity of WHO.” Nicoletta Dentico of Society for International Development (SID) condemned “the multilateral development community’s fixation with leveraging the private sector in healthcare, using public money to de-risk investments”. Third World Network’s KM Gopakumar condemned the idea of a WHO Investors’ Forum, saying it would “seriously undermine the role of the vast majority of Member states in WHO’s governance”. “The Forum participants, consisting of a rather impenetrable network of philanthropic foundations and the private sector, would de facto control WHO’s priorities,” he added. Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. 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WHO Budget Replenishment Text Keeps Door Open to ‘Earmarked’ Donations 25/05/2023 Kerry Cullinan Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. GENEVA – The World Health Assembly is poised to decide on an “investment round” in late 2024 to boost the World Health Organization’s (WHO) finances – but not the establishment of a “replenishment fund”. Member states and donors will be able to continue to provide funds to the WHO earmarked for specific health programmes – something that the WHO’s Working Group on Sustainable Financing advised that the organisation moves away from as this skews the work of the global body. This is according to a copy of the draft text leaked to Health Policy Watch, based on member state discussions late on Wednesday. The US is widely believed to have pushed for the continued inclusion of earmarked funds as a condition of its support for the resolution. The formation of a WHO Investor Forum has also been mooted ahead of the investment round, according to those close to discussions. Members’ fees to cover 20% of budget The text also urges member states to pay their membership fees – which the assembly earlier resolved would now cover 20% of the budget (up from an estimated 14%). While the text proposes that the WHO should continue to accept, “alongside unearmarked voluntary contributions, voluntary contributions that are earmarked and/or single-year contributions from member states and other donors” it urges an increase in “transparency of reporting on voluntary earmarked contributions and on their impact and allocation”. In the lead-up to planning the investment round in the last quarter of 2024, the WHO is directed to provide member states with regular updates and to provide the Executive Board with “a full plan that includes modalities and anticipated costs” for approval. Various efforts to improve the financial viability of the WHO have hammered on the importance of the organisation having access to flexible funds – rather than funds donated by philanthropies and wealthier member states that are tied to programmes that might not be top global health priorities. Civil society condemnation Four civil society organisations condemned the new text, describing it as “nothing but the institutionalisation of the earmarked contribution that has led to the dismal functioning of the WHO at various levels, including the increasing penetration of the private philanthropic sector in the organisation”. “The draft decision goes against the very objective of the recommendation of the Working Group,” said Lauren Paremoer of the People’s Health Movement. “As per the approved budget of $6834.1 million for the 2024-25 biennium, $5685.8 million is to be funded through voluntary contributions. The institutionalisation of earmarked funding would further stabilise donor-driven priorities and compromise the credibility, independence and integrity of WHO.” Nicoletta Dentico of Society for International Development (SID) condemned “the multilateral development community’s fixation with leveraging the private sector in healthcare, using public money to de-risk investments”. Third World Network’s KM Gopakumar condemned the idea of a WHO Investors’ Forum, saying it would “seriously undermine the role of the vast majority of Member states in WHO’s governance”. “The Forum participants, consisting of a rather impenetrable network of philanthropic foundations and the private sector, would de facto control WHO’s priorities,” he added. Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus. Posts navigation Older postsNewer posts