Ukraine Health Emergency Takes Center Stage at World Health Assembly – Once Again 24/05/2023 Stefan Anderson Two residents stand in the ruins of homes in Borodianka in the Kyiv region. Three days into the World Health Assembly (WHA), the health emergency caused by Russia’s fifteen-month invasion of Ukraine looks set to become a dominant issue at the World Health Organization’s (WHO) top decision-making body for a second consecutive year. Over 140 Russian missiles and drones have rained down on Ukraine’s energy, civilian and medical infrastructure since the start of this month. The consequences of the onslaught continue to affect millions of civilians, jeopardizing their access to physical and mental health care and forcing nearly 10 million to flee their homes since the start of the war. Supply chains for essential medicines have been disrupted, hospitals destroyed, and the medical facilities that remain operational are forced to fight to keep the lights on amid regular power outages due to attacks on Ukraine’s power grid. One in five ambulances in Ukraine’s medical fleet has been damaged or destroyed. More than 1,256 health facilities have been damaged and 177 more reduced to rubble, Ukraine told WHA delegates on Tuesday. The World Health Organization has independently confirmed 974 attacks on medical facilities and the deaths of over 100 healthcare workers since the start of the war. Will there be enough time to discuss other humanitarian emergencies? The overwhelming focus on the health crisis in Ukraine by delegates in Geneva is well-founded. But amid a flurry of ongoing humanitarian crises and the re-emergence of familiar battles litigated at the WHA last year, the question of whether enough time will be left to discuss the plight of millions of civilians outside of Ukraine has grown in importance. The World Health Organization currently counts 13 ongoing crises as “grade 3” emergencies, the UN health body’s highest internal threat level. These include the extended droughts in the Horn of Africa, the humanitarian situation in Afghanistan, and ongoing conflicts in Yemen, Syria and Ethiopia. A deadly civil war featuring regular attacks on hospitals and civilians also recently erupted in Sudan, threatening the stability of the wider region as hundreds of thousands flee the country. Civilian casualties in armed conflicts increased by 53% year-on-year since 2022, according to a report presented by the Swiss Presidency of the UN Security Council on Tuesday, raising concerns that an over-focus on Ukraine could leave civilians in less represented conflicts by the wayside. Over 90% of deaths from explosive weapons detonated in populated areas documented in the report were civilians. The draft resolution submitted by Ukraine and its allies on Monday is near-identical – even sharing the same title – to the one passed by the WHA in 2022 which described the Ukrainian health crisis as “stemming from Russian aggression.” Russia responded by submitting its own resolution – described by Ukraine as a “recycled” version of Russia’s 2022 proposal shot down by the WHA – calling on countries to “refrain from the politicization of global health cooperation” and to “respect their obligations under international and humanitarian rights law.” Syria, the counter-resolution’s co-sponsor, called on WHA delegates to “avoid escalating crises” and support the Russian draft to “help further stability in Ukraine and neighbour countries.” North Korea, Nicaragua and Belarus are currently the only other WHO member states to voice their support for the Russian resolution. Vote to show WHA will not stand for attacks on health infrastructure, Ukraine says Operating theatre in a Ukrainian hospital destroyed by a Russian airstrike. On Tuesday, the Ukrainian delegation called on the WHO’s 194 member states to support its resolution condemning Russian “aggression”. It also asked states to vote down the Russian counter-resolution, which it said is based on a “distorted, alternative reality.” “The Russian text is nothing short of a desperate attempt to put the aggressor on par with the victim and avoid responsibility for their attacks on the health care system in Ukraine,” its delegate said. “[Voting down the resolution] will send a clear signal that provoking a health emergency of outstanding proportions and destroying medical structures on a massive scale is not tolerated by this assembly.” Russian diplomats, meanwhile, protested statements by Ukranian allies such as Poland and the United States condemning Russian actions in Ukraine, which its delegates argue “don’t have any relationship to the mandate of the WHO.” Russia’s interventions have so far been shot down by WHA President Dr Christopher Fearne and other committee chairs due to the scale of the health crisis caused by the war. The Ukrainian health crisis is “clearly a health matter relevant to this assembly,” Fearne said in response to a Russian protest on Monday. “Russia has no respect for human life,” an Estonian delegate said. “Suspend the Russian Federation from the decision-making [of WHO] until it has restored full respect to international law and human rights.” Russia circulates document accusing Ukraine of attacking its own health care system Confirmed attacks on health care in Ukraine, according to the WHO. An average of two attacks on health care a day were reported in the first year of the Russian invasion. These include strikes on hospitals, shootings of ambulances, torturing of medics and looting of medical facilities. This has not stopped Russia from attempting to mount a diplomatic counter-offensive. In a bid to garner support for its draft resolution, Russian diplomats circulated pamphlets in WHA accusing Ukraine of attacking its own hospitals and health care facilities. The delegate for the United Kingdom, referring to the move in a heated debate Tuesday afternoon, compared the Russian efforts to the “theater of the absurd.” “We are aware that like last year, Russia has passed around pamphlets to our fellow delegates which allege that Ukraine has been attacking its own health system,” UK diplomats told the assembly. “We are confident … delegates here today won’t be fooled by such disinformation.” Russia has not openly voiced such accusations in its own statements at the WHA. Its draft resolution, however, expresses “serious concern” that the WHO Surveillance System for Attacks on Health Care (SSA) – the UN health body’s database documenting attacks on medical facilities and staff – does not accurately reflect “all the incidents with attacks on health care facilities.” It also calls on the WHO to improve its collection of “data on attacks on health care facilities, health workers, health transports and patients” – an odd request from a country accused of perpetrating nearly 1,000 attacks on Ukrainian health care. Human Rights Watch and other groups documented repeated “unlawful” Russian and Syrian attacks on “schools, hospitals, and other civilian objects” throughout the Syrian civil war. Attacks on Ukranian health facilities are not the first Attacks on hospitals, health workers and civilians by Russian forces in their intervention in Syria’s civil war have been well-documented by rights groups. Bashar al-Assad, the Syrian President and key co-sponsor of the Russian resolution, repeatedly used chemical weapons to attack civilians in his bid to retain power. The Russian resolution also calls for countries to “refrain from deliberately placing military objects and equipment” in the vicinity of civilians and civilian infrastructure or in “densely populated areas.” The language of the Russian text appears to mirror the findings of a report by Amnesty International published in August, which accused Ukrainian forces of repeatedly putting “civilians in harm’s way” by stationing soldiers nearby and staging military operations from populated areas. Russian officials portrayed the report as a vindication of its actions in Ukraine. The Russian ambassador to the United Nations, Vasily Nebenzya, claimed the report proved Russia does not use “the tactics Ukrainian armed forces are using” such as “using civilian objects as military cover.” An independent review of the report later found Amnesty’s claims that Ukraine had violated international law were “not sufficiently substantiated”. The review also called some of the language used by Amnesty “legally questionable,” particularly with respect to the report’s implication that Ukrainian forces were “primarily or equally to blame for the death of civilians” resulting from Russian attacks. The International Criminal Court in the Hague issued a warrant for the arrest of Russian President Vladimir Putin for the war crime of abducting and deporting thousands of Ukrainian children to Russia in March. Image Credits: Matteo Minasi/ UNOCHA, Christian Treibert. Cholera Vaccine Shortage to Continue Through 2025 23/05/2023 Stefan Anderson Floods and cyclones increase the risk of Cholera outbreaks. As a wave of cholera outbreaks spreads around the world, Gavi, the Vaccine Alliance said it expects the global shortage of oral cholera vaccines to continue until the end of 2025. Supply of oral cholera vaccines for preventative use could catch up to demand by 2026, but “urgent action is needed,” according to a vaccine production roadmap published by Gavi, the World Health Organization (WHO) and other global health partners on Monday. There are currently still enough vaccine supplies to respond to emergencies, Gavi said. “The good news is we have doses to meet all emergency demand despite the rise in outbreaks, and that is expected to continue,” said Dr Derrick Sim, head of vaccine markets and health security at Gavi, adding that the global resurgence of cholera “underscores the need to prevent outbreaks before they occur.” The past ten years have seen a steady increase in the availability of oral cholera vaccines. Global production rose from 4 million doses in 2012 to 35 million by 2022, with a similar number of vaccines expected to be produced this year. “Every vaccine dose delivered to a person in need today is the result of years of planning,” Sim said. “The ultimate solution to both sustainable oral cholera vaccine supply and cholera control lies in our collective ability to step-up up our efforts on prevention programmes.” But the recent spike in cholera outbreaks driven by climate shocks, war and humanitarian crises have caused a surge in demand for the vaccines for emergency response, limiting the availability of supplies for preventative use. Between 2021 and 2022, 48 million oral cholera vaccines were needed for emergency response, 10 million more than in the entire previous decade. “The outlook is bleak,” WHO incident manager for the global cholera response Henry Gray said at a press briefing on Friday. “We’re not able to provide enough vaccines.” Only 8 million of 18 million doses requested by WHO have been made available so far in 2023, Gray added. The WHO has warned that climate change is a major threat to global health, and that cholera is one of the diseases that is most likely to be affected. Extreme weather events, such as floods and droughts, increase the risk of cholera outbreaks by contaminating water supplies with sewage, waste and bacteria. People displaced by climate shocks are also less likely to have access to clean water and sanitation, increasing their risk of infection. The ongoing cholera outbreak in Malawi, which began at the end of the cyclone season in March last year, is the deadliest in the country’s history, according to the WHO. In response to a shortage of oral cholera vaccines last year, WHO advised countries to ration supplies during outbreaks by giving just one of the two-dose vaccine to patients. The WHO still ran out of vaccines by the end of the year. Image Credits: World Health Organization (WHO). Climate Crisis Threatens Countries Still Reeling from COVID-19 23/05/2023 Disha Shetty World Health Assembly discusses resolution on preparing for the next pandemic and emergency situations on May 23. The messiness of the COVID-19 vaccine distribution and the growing challenge of climate change emerged as key challenges at the World Health Assembly (WHA) on Tuesday in discussions on resolutions on preparing for future pandemics in Geneva. Representing 47 countries in the African region, Tanzania underscored the importance of greater equity and access to technology as countries battle multiple emergencies concurrently. While conflict in several African countries remains an ongoing issue, climate change has worsened droughts and floods, increasing pressures on fragile health systems, the country pointed out. Tanzania stressed that even though COVID-19 is no longer an official global health emergency, many African countries are still recovering and progress has been slow. A small island nation, Bahamas also told the assembly that it was facing multiple challenges concurrently, with climate change posing a particular problem. Bangladesh, currently being battered by climate change and is at the forefront of climate adaptation, highlighted the need for public-private partnerships as various solutions are explored. Speaking on behalf of all countries in Southeast Asia, Bangladesh said, “Southeast Asia is of the view that during pandemics and public health emergencies, the health of the people should prevail and be prioritized over commercial interests.” However, the needs across WHO member states are often vastly different. Bahrain, on the other hand, pointed out that it is dealing with an influx of migrants due to conflicts in the region. Finland, which in recent years had adopted a feminist foreign policy approach, pointed out to the disproportionate impact on women and girls in any disaster and focussed on the need to pay attention to that. “Finland considers it important that people living in conflict situations in particular, women and girls and persons with disabilities are put at the center of the roadmap. They are often the ones hit the hardest in conflict situations,” the country said. The overwhelming majority of the countries taking part at the WHA agreed that there is a need to strengthen WHO’s presence in their region by investing in more staff at both regional and national levels. In the context of pandemic preparedness, Germany rued Taiwan’s exclusion from the Assembly despite the island seeking an observer status. “Not only, but especially in health emergencies, we must not leave any blind spots on the map and ensure inclusivity. Therefore, we also have to take into consideration and use the experience of all parties and all partners including Taiwan,” Germany said. China, at whose behest Taiwan was excluded, promised the assembly its full cooperation and financial support in its work. “The Chinese government is willing to further provide the necessary human technological and financial support to who knows operations in the global health emergency response,” the country said. WHO Director General Dr Tedros Adhanom Ghebreyesus has urged countries to play an active role in negotiating future pandemic preparedness, and across regions countries engaged bringing in diverse perspectives. WHO Member-states Greenlight $6.83b Budget for 2024-25; Countries Demand More Transparency 22/05/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. World Health Organization member-states greenlighted a budget of $6.83 billion for 2024-25 for the global health agency – an 11% increase over the 2022-23 budget. Implicit in the budget is member-state implementation of a stepwise increase in assessed contributions. The groundbreaking reform, which aims to have one-half of WHO’s spending financed more sustainably by fixed member state contributions by 2030, was approved in principle at the May 2022 World Health Assembly (WHA). But it still required a nod from member states for the increased assessments to be applied this year. And that was not a foregone conclusion until a closed door meeting last week between member states, observed former WHO chief legal counsel Gian Luca Burci at a WHA preview event on Sunday. The WHO budget for the previous biennium 2022-23 was $6.12 billion. The gradual increase in country assessments aims to correct WHO’s current over-dependence on earmarked “voluntary contributions” – money that is donated by a member state or philanthropy. Such voluntary contributions now make up around 84% of the WHO’s total budget. WHO Director General Dr Tedros Adhanom Ghebreyesus, along with other senior officials, have long complained that such designated funding makes strategic planning hard to control. “WHO’s over-reliance on voluntary contributions, with a large proportion earmarked for specific areas of work results, in an ongoing misalignment between organizational priorities and the ability to finance them,” the WHO had mentioned in a statement during WHA 2022. Focus shifts towards countries Budget allocated to WHO offices this year compared to the previous allocation. Roughly $2 billion of the 2024-25 budget will go towards furthering WHO’s goal of Universal Health Coverage, and around $1.35 billion will be channeled into a “more effective and efficient WHO”. The latter includes greater support to countries, including co-financing for United Nations Resident Coordinators. While WHO will continue to maintain its own country offices in over 100 developing countries, the UN-wide Resident Coordinator system, aims to improve coordination between UN-affiliated tasks at country level. But the new 2024-25 budget allocation to countries and regions is, in fact, only marginally larger than the allocation of $1.25 billion from the previous 2022-23 biennium. Countries welcomed the gradual increase in country allocations, however modest. But , African member-states re-asserted demands that at least 75% of the budget should go to offices outside of the Geneva headquarters. “We wish to see the efforts to continue increasing the share of countries and regions from the program budget according to an agreed phased timeline for 2024 to 2027 with an aspiration to reach at least 75% budget allocation to countries and regions,” said the delegate from Ethiopia, speaking on behalf of the group of 47 sub-Saharan African member states. Of the $6.83 billion budget allocation, a little over 50% will be spent towards achieving the WHO’s triple billion targets of universal health coverage ($1.96 billion), protecting people from health emergencies ($1.21 billion). The third pillar aiming to ensure “healthier lives and well-being” for 1 billion people received the least funding with only $0.43 billion for the two years. Polio eradication, meanwhile, received an allocation of $0.69 billion, 23% higher than the previous biennium. Polio, which had resurfaced sporadically in Africa and North America over the past year, along with the typical Asian hotspots of Afghanistan and Pakistan, remains the only public health emergency of international concern (PHEIC) designated by the WHO as of Monday. WHO’s Special Programmes (for Research and Training in Tropical Diseases, the Special Programme of Research, Development and Research Training in Human Reproduction, and the Pandemic Influenza Preparedness Framework) received an allocation of $0.17 billion as against the allocation of $0.19 billion the previous time. Main ask: flexible funding and transparency in spending Member states, meanwhile, rallied to emphasize on the need to continue working for a flexible funding mechanism that prioritizes the causes of spending based on specific situations. “The lack of flexible funds remains a continued concern. We hope to witness an increase in flexible funds over the long run by steadily introducing replenishment mechanisms, which are currently being discussed,” the delegate for the Republic of Korea noted. Calls for greater transparency in WHO spending also rang across the room. Countries ranging from the Philippines, to Namibia and Brazil demanded that WHO disclose more specific details about projects and programmes in which it is engaged at country-level. “Improvements in transparency, accountability and administrative measures are essential. In the absence of clear improvements in those areas, it will be impossible to adopt, let alone justify any increase in assessed contributions,” the delegate for Brazil told the floor. “The practice of complete disclosure of information on expenditures of member states to member states in order to ensure transparency is not only indispensable, but also something customarily adopted by the UN agencies, and it is high time the WHO follows this path.” Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus, WHO. Egypt to Produce Insulin for Africa in New Collaboration with Eli Lilly 22/05/2023 Kerry Cullinan Dr Loyce Pace, with WHO’s Dr Bente Mikkelsen, Africa CDC’s Dr Jean Kaseya and EVA Pharma CEO Riad Armanious. GENEVA – Within months, insulin manufactured in Egypt will be available for distribution in sub-Saharan Africa, thanks to a collaboration between Eli Lilly and a local manufacturer that aims to produce one million doses of insulin by 2030. Eli Lilly is providing Egypt’s EVA Pharma with the active pharmaceutical ingredients (API) of insulin at a “significantly reduced price” to enable cheaper, faster production of the life-saving medication that is used to treat diabetes, one of the fastest-growing health problems on the continent. Eli Lilly will also provide a pro-bono technology transfer to enable EVA Pharma to formulate, fill and finish insulin vials and cartridges as part of its global commitment to enable 30 million insulin doses by 2030. Dr Bente Mikkelsen, WHO and Dr Jean Kaseya, Africa CDC Dr Bente Mikkelsen, Director of the Non-communicable Disease (NCD) Programme at the World Health Organization (WHO), welcomed the initiative, which was announced at a special event on the sidelines of the World Health Assembly (WHA) in Geneva. “If we can control diabetes, we can reach the SDG targets on NCDs,” said Mikkelsen. “We need to focus on early diagnosis and treatment and universal health coverage as 74% of global deaths are due to NCDs.” An estimated 3-4 million Africans are living with diabetes today – although less than 50% are aware of their status,” said Eli Lilly’s Leigh Ann Pusey, speaking at another event later on Monday. However, if current projections hold, some 54 million Africans are likely to suffer from diabetes by 2045, “That’s a 144% increase,” she said, representing the largest projected increase in diabetes rates globally, with Egypt particularly affected. EVA Pharma CEO Riad Armanious EVA Pharma CEO Riad Armanious said that his company had signed the agreement with Eli Lilly in December and his company had been building the manufacturing capacity to make insulin over the past five months. “We celebrating the completion of the biologics facility next week, then we will need regulatory approval but we expect to start manufacturing before the end of the year,” Armanious told Health Policy Watch. Voicing his support for the initiative, Dr Jean Kaseya, Director General of the Africa Centres for Disease Control and Prevention, revealed that his father had died of diabetes because he could not get insulin. “Only 30% of the therapeutics used in Africa are produced on the continent,” said Kaseya, adding that he was convening a meeting of local manufacturing with African leaders in July. Dr Loyce Pace, US Assistant Secretary for Global Affairs in the Department of Health and Human Services, said that people in the US also faced challenges getting access to insulin and that her country was committed to being a “real partner” in improving the global supply of insulin. Pace revealed that her own mother-in-law had died of diabetes in The Gambia because she was unable to get insulin. Image Credits: WHO. Ukraine Allies Call on World Health Assembly to Condemn Russian ‘Aggression’ 22/05/2023 Stefan Anderson World Health Assembly delegates minutes after votes on competing resolutions on the health crisis in Ukraine last year. Europe, the United States, Ukraine and its allies have submitted a draft resolution to the World Health Assembly (WHA) calling on the 194 member states of the World Health Organization (WHO) to condemn the health crisis caused by Russia’s “continued aggression against Ukraine.” The EU-led draft, published on Monday, is a near-identical replica of the resolution condemning Russian “aggression” passed by the WHA last year. They even share the same title. The resolution urges Russia to “immediately cease any attacks on hospitals and other health care facilities,” and to protect “civilians, health and humanitarian workers.” At least 8,500 civilians have been killed since Russia invaded Ukraine in February last year, and over 14,000 more have been injured, the UN Office of the High Commissioner for Human Rights said in its April status report. Russia responded by submitting a draft resolution of its own. The resolution, co-sponsored by Syria, makes no mention of Russia’s role in the health crisis in Ukraine. A similar effort to push through a counter-resolution failed last year. The Russian draft expresses “grave concern at the deteriorating humanitarian situation in and around Ukraine” and demands “all parties concerned to respect their obligations under international humanitarian and human rights law.” It also strongly condemns “attacks directed against civilians and health objects.” The WHO surveillance system for attacks on health care (SSA) lists 974 confirmed attacks on health facilities in Ukraine since the start of the war – an onslaught WHO Europe Director Dr Hans Kluge called “the largest attack on health care on European soil since the Second World War.” Over 100 health care workers have died in the attacks. Syrian President Bashar al-Assad, the Russian bill’s co-sponsor, has repeatedly used chemical weapons against his own people throughout the Syrian civil war. WHO tip-toes a fine line, but Ukraine health crisis in bounds The Russian delegation protested a US statement in support of Ukraine, calling on the chair to “ask people to speak about health.” The WHO has had a hard go of its attempts to remain politically neutral amid Russia’s invasion of Ukraine. Earlier this month, a year-long pressure campaign from EU states succeeded in forcing the closure of WHO’s non-communicable diseases office in Moscow. The announcement of its closure was accompanied by the news that the office will be relocated to Copenhagen next year. The use of the word “invasion” in a WHO status report on the organization’s emergency response in Ukraine caused a clash at this year’s Executive Board meeting, where Director-General Dr Tedros Adhanom Ghebreyesus vehemently defended his choice in response to Russian allegations that the report had been politicized. “I couldn’t find any other word that would represent it because it’s the truth,” Tedros said. “What could I say?” Interventions in plenary sessions calling out Russia’s role in the health crisis in Ukraine have so far been upheld by WHA President Dr Christopher Fearne despite repeated Russian protests. “We are not in New York, we are in the world health assembly,” the Russian delegation said in response to a statement by the United States that its invasion of Ukraine violated the charter of the United Nations. “We are ready to discuss the entire agenda, but not … any issues of aggression, or whatever these countries are saying.” Fearne called the health crisis in Ukraine “clearly a health matter relevant to this assembly”. “In fact,” he added, “we are to discuss it later on this week.” Image Credits: Health Policy Watch . Taiwan Excluded as World Health Assembly Opening Focuses on Pandemic Preparedness, and Funding 22/05/2023 Disha Shetty Dr Tedros Adhanom Ghebreyesus, director-general of the WHO. The 76th World Health Assembly turned political even before formal the proceedings began, with the decision to exclude Taiwan. The island was seeking an observer status, something that it had held previously between 2009 and 2016, with the support of the United States and others. But its inclusion was strongly opposed by China which maintains the island is its province and not an independent country. Pakistan backed China’s right to territorial integrity. The two countries said they did not object to the inclusion of experts from Taiwan in technical meetings and exchanges related to pandemic preparedness. As Taiwan’s bid failed, Dr Jui-Yuan Hsueh, Taiwan’s Minister of Health and Welfare, said the call was taken by WHA due to political considerations and pressure from China. In his keynote address, WHO Director-General Dr Tedros Adhanom Ghebreyesus listed the key priority for this year’s assembly, urging countries to work towards WHO’s triple billion targets and pick up the pace on achieving the health-related sustainable development goals (SGDs). Tedros also said the pandemic accord that the WHA will be negotiating this year will be an important step for future preparedness and requested countries to engage with the process. But Taiwan’s exclusion will have an impact on the pandemic accord, according to Health Minister Hsueh: “Without WHO membership, Taiwan is also unable to provide various surveillance data to the global influenza surveillance and the response system, which could alert the world to the next pandemic. Taiwan is willing and it should also be included in the pandemic accord that is under negotiation,”. Tedros also made it clear that finding ways to fund the various programmes of the WHO will be a priority. Despite South Asia currently being under another intense heatwave second year in a row, climate change was mentioned only briefly by Tedros. With COVID-19 no longer an official global health emergency, polio remains the only one global emergency. “After an all-time low of five wild poliovirus cases in 2021, we saw an increase last year, with 20 cases in Pakistan, two in Afghanistan and eight in Mozambique,” he said, adding that WHO is committed to polio eradication. “Last year, three million children previously inaccessible in Afghanistan received polio vaccines for the first time. And in October, donors pledged US$2.6 billion to support the push for eradication,” he said. Tedros also mentioned the work being done to roll out new vaccines for tuberculosis as quickly as possible. “It was done for COVID; it can be done for TB,” he said. He also acknowledged the need to bolster disaster response and funding, appealing to member countries to support funding efforts in 2024 so the health body was in the best possible shape to respond. In discussions, members drew attention to multiple emergencies in the Horn of Africa, Palestine, Syria, Ukraine and Yemen, among others. Additional reporting by Megha Kaveri What Can We Learn from the History of Health? New Podcast 22/05/2023 Editorial team It is often said that those who fail to learn from history are doomed to repeat it. So what, if anything, can we learn from the history of health? In this brand new season of the Global Health Matters podcast, host Garry Aslanyan takes a step back in time to look at why “history matters” and to discuss the value and merits of understanding global health history and the evolution of global health, particularly concerning the establishment of the World Health Organization (WHO), which this year celebrates its 75th anniversary. “All institutions have long histories,” guest Sanjoy Bhattacharya, head of the School of History and Professor of Medical and Global Health History at the University of Leeds in the UK, told Aslanyan.” And those long histories have determined negotiations between complex partnerships, complex organisations, and how we operate today is deeply determined by those long-term negotiations, which is historical. So history matters.” Speaking on the history of global health in terms of colonialism and colonial powers, Professor of Global Development Studies and Global Health at the University of Toronto in Canada, Anne-Emanuelle Birn, said, “In the 19th century, the arena that has evolved or erupted, transformed into global health history, began in a very particular context, that of imperialism, particularly European, but also North American imperialism and the growth of the colonial enterprise. “Health and medicine played a very important role, so one of the earliest precursors to global health history, or global health, was colonial medicine.” By the middle of the 20th century, after two world wars ravaged the world, there was renewed hope which saw the formation of several new international cooperation organization, such as the United Nations. In this arena, the World Health Organization was founded in April 1948, aiming to work worldwide to promote health and coordinate responses to health emergencies. “You have this transition, and it really takes off after the founding of the World Health Organization, this idea of international health, health between countries, through sometimes collective decision-making but also very much influenced by the world order, in that case, the Cold War,” Birn said. “For me, WHO is not just Geneva,” Bhattacharya said. “if you look at a bottom-up history of WHO, where you center the regional offices, I would submit that you actually get a much more decolonised and democratic history of international and global health than you would if you looked at Geneva and say that everything that is happening in global or international health is happening because of things that are happening in Geneva.” Taking a look at a very recent example of COVID-19, Birn points out that as much as coordinated international efforts can combat the quick spread of disease and introduce appropriate measures, at the same time, every country is in its own unique situation based on cultural and social factors. “With the COVID-19 pandemic, there was an expectation in certain quarters that history would help to address, resolve, shed light on the course of the pandemic,” Birn said. “There’s no way historical perspectives can resolve social, political, and other forms of tensions that the response to COVID-19 continues to engender, arguably. History can’t predict or liberate, and every pandemic has occurred in particular social, political, and cultural configurations. So there’s no recipe, right? The expectation was that history would provide a recipe.” “There are multiple historical narratives about any aspect of global pandemics,” Bhattacharya added. “So if you’re saying was COVID influenced by any historical narratives, then the problem then became that there wasn’t one historical narrative.” Looking into the past can sometimes provide the lessons or answers we seek, but as Bhattacharya pointed out, it is essential to know which or whose history one is learning. “History matters, but we must always ask which history matters because there are multiple histories.” This is part I of a two-part series. Image Credits: Global Health Matters Podcast via TDR. On 75th Anniversary World Health Assembly Must Confront New and Growing Threats 21/05/2023 Elaine Ruth Fletcher Member states attending the World Health Assembly’s high-level opening on Sunday, 21 May in Geneva. The World Health Assembly opened its annual meeting of member states Sunday on a celebratory note marking the 75th anniversary of the World Health Organization’s foundation in 1948. Eradicating smallpox, eliminating polio in most countries worldwide, and dramatic reductions in deaths from once-deadly childhood diseases preventable by clean water, basic medicines and vaccines are among a few of the historic accomplishments the Organization will be celebrating as this year’s 76th WHA session begins, said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in opening remarks at the WHA. “Smallpox is history and polio is on the brink. And epidemics of malaria, HIV and tuberculosis have all been pushed back,” said Dr Tedros. Thanks to the Framework Convention on Tobacco Control, smoking rates have declined in dozens of countries worldwide, with strict policies on tobacco advertising and taxes on tobacco products. He was speaking Sunday at a WHA preview event at the Geneva Graduate Institute’s Global Health Center, just before the official WHA curtain-raiser; the latter featured a lineup of high-level figures from around the world, including India’s Prime Minister Narendra Modi and former New Zealand Prime Minister Jacinda Ardern. Pandemic treaty negotiations set against regional conflicts The number of people living in zones of combined conflict and health emergencies has doubled since 2015 – Kate Dodson, UN Foundation But against those successes, this year’s WHA is taking place against the background of complex, ongoing negotiations over an ambitious new pandemic treaty and, in parallel, talks over revisions to the 2005 International Health Regulations that aim to supplement and replace archaic rules on international emergency response. The WHA also is taking place in a second year of war between Russia and the Ukraine – whose bitter dispute was the subject of competing WHA resolutions last year – and which will likely again surface in debates by the global health body this year. And the Ukraine-Russia war is only one of multiple conflicts destroying lives and global health. As this year’s WHA considers a new “Health for Peace Initiative”, some 39 million people are – or almost one in 20 of the world’s population – living in fragile and complex settings that combine conflict with health emergencies. “That’s an increase of 25% since just last year, and double since 2015,” noted Kate Dodson, vice president for global health at the United Nations Foundation, a co-sponsor of the Graduate School WHA opener. And while this week’s WHA session is set to approve update guidance to countries on “best buys” for reducing non-communicable diseases, NCD disease rates are soaring worldwide, with heart disease having increased by 60% in the last 30 years, according to data published by the World Heart Summit, also convening this weekend in Geneva. Meanwhile, the WHO remains financially challenged. For the first time ever, this year’s WHA is supposed to approve stepped up rates of annual contributions by member states to the global health organization. It will also debate a January Executive Board recommendation to establish a “replenishment fund” for voluntary contributions by donors and member states that could be used in a more flexible way by the Organization than “earmarked” donations that make up the bulk of its budget today. Challenges moving far beyond the health sector Non-communicable diseases now account for 70% of deaths globally – WHO Director General Dr Tedros Adhanom Ghebreyesus at the opening of the 76th WHA. Overall, as it enters its 76th year of existence, the Organization is increasingly challenged by the need to respond coherently to an increasingly broad and complex portfolio of emerging disease threats – over which it often has little influence or control. Those include obesity, heart disease and hypertension stimulated by sedentary lifestyles and fast food diets; antimicrobial resistance from misuse and overuse of antibiotics in both the human and animal health sector; the climate crisis and air pollution; and as COVID-19 demonstrated to the world – vast disparities in access to health care including vital medicines and vaccines. “Non communicable diseases now account for some 70% of deaths globally,” noted Tedros in his opening WHA address. “Antimicrobial resistance threatens to unwind centuries of medical progress. Vast disparities in access to health resources exist between and within countries and communities. And the existential threat of climate change is jeopardizing the very habitability of our planet. “WHO has grown enormously but our resources have not,” Tedros added. “There is the challenge of being a technical scientific organization in a political, and increasingly politicized, environment.” “These are daunting and complex challenges. We will not solve them at the World Health Assembly and we will not solve them in our lifetimes, but we’re building a path that our children and grandchildren will walk down and that they will continue to build,” Tedros said. “The challenges of today are very different to those we faced in 1948. But the vision is the same.” 1969 International Health Regulations only covered four diseases In 1969 the International Health Regulations only covered four disease – former WHO official David Heymann (on left) speaking at WHO preview event at the Geneva Graduate Institute “When the [WHO] International Health Regulations were developed back in 1969, their goal was really to stop disease at borders,” pointed out David Heymann, a former high-ranking WHO official, at the Geneva Graduate Institute’s WHA preview event Sunday morning. “If a country reported one in four infections, cholera, yellow fever, plague or smallpox, then countries that were receiving passengers from those countries could request a vaccination certificate. There were pre-determined measures to stop disease transmission, and at that time, WHO was the exclusive owner of much of the information because countries reported to WHO, WHO did a risk assessment, and provided its recommendations.” While the IHR finally underwent a major update in 2005, greatly broadening the scope of what was to be reported – and empowering WHO to declare a “Public Health Emergency of International Concern (PHEIC),” the regulations have failed to keep up with the pace of change in the real world, he pointed out. The biggest failure, he contends, was in “the most important part of the IHR, which was the requirement of countries to establish core capacity in public health to be able to detect, respond and prevent national disease spread and death, and eventually prevent international spread by this rapid reaction.” In terms of risk assessments as well, as the digital transformation accelerated the spread of information, WHO was no longer the exclusive arbiter of risks from pathogens that appeared. “As we saw in the COVID pandemic, countries really preferred doing their own risk assessments. They had access to data which they had never had before – all respectable medical journals were publishing peer reviewed information in front of their paywall. So any government advisory group could get that and could make recommendations to their own government as to what to do. As a result, WHO lost its authoritative position in making recommendations, countries devised their own policies, and what ensued was “confusion, utter confusion” over global response, Heymann contended. “The [IHR] regulations to me, they’re really a vestige of the past.” Negotiations over pandemic accord will be on sidelines of formal WHA Gian Luca Burci, former WHO chief legal counsel describes the workings of the World Health Assembly – and what to expect at this session. This year’s WHA is set against the backdrop of ongoing negotiations over IHR revisions as well as the development of a new pandemic accord. Both are mired in controversial debates by member states over language on reporting outbreaks- including proposals for requiring countries to report emerging pathogen threats within hours. With respect to the pandemic accord, while all countries have paid lip service to the need to ensure more equitable distribution of drugs and vaccines in the next pandemic – they are at odds about draft language that would commit them, in advance, to set aside of fixed quantities of health tools for developing nations. Insofar as those negotiations are only due to conclude by May 2024, the most meaningful talks are likely to be in the corridors and on the sidelines of the WHA – rather than in the formal chambers of the meeting, being held at Geneva’s UN headquarters, said Gian Luca Burci, former chief WHO legal counsel at Sunday’s Graduate Institute session. “For [WHA] action, there is nothing specific on the IHR, Burci observed. With regards to the pandemic accord, the only main formal item explicitly on the agenda is the potential treaty’s cost.” “But there will be a Secretariat Briefing on the negotiations, and I’m sure there will be a lot of discussions, a lot of side conversations among delegates looking to break some of the deadlocks, and so forth.” Meanwhile, WHO continues to move ahead with voluntary initiatives aimed at improving outbreak detection and response. For example, just ahead of the WHA’s opening, WHO announced the launch of a new International Pathogen Surveillance Network, that aims to detect and report infectious disease threats in real time, making better use of digital and genomic tools that many countries still lack. WHO and partners are launching the International Pathogen Surveillance Network, a global network to help protect people from infectious disease threats through better use of pathogen genomics https://t.co/riuOjqB8Ju pic.twitter.com/vXqJZk6dzs — World Health Organization (WHO) (@WHO) May 20, 2023 The new network represents an ambitious effort to fill a critical gap in WHO’s existing system of disease outbreak alerts – which can right now be delayed by weeks or even months if countries resist disclosure. But without revisions to the IHR, such networks will remain purely voluntary. So the key question, as always remains: will all countries join, collaborate and cooperate – and who will support the improved capacity of low income countries for detecting and reporting new threats? WHO Calls on Countries to “Drastically Reduce” Climate Emissions to Improve Global Health 19/05/2023 Megha Kaveri Fossil fuel combustion is a leadng source of global warming as well as of health harmful air pollution emissions. The World Health Organization (WHO) has called for focused action to address global warming and climate change to promote health outcomes. Recommendations include concerted efforts to reduce carbon emissions, build climate-resilient and sustainable health systems and protect health from the impacts of climate change. There is also a decline in the treatment coverage for tuberculosis between 2019 and 2021, and a stall in the world’s progress to tackle non-communicable diseases (NCDs) like hypertension and adult obesity. “Climate and Health” is featured as a separate chapter in the latest edition of the World Health Statistics Report, published by the WHO on Friday. This underlines its importance as a major driver of health outcomes in coming years, WHO officials said. The 131-page annual compilation of health statistics, while providing a birds-eye view on the progress made on global health metrics, also highlights how the world is not on track to achieve the targets set out in the Sustainable Development Goals (SDGs) 2030. “The world is off track to reach the sustainable development goals,” said Dr Samira Asma, assistant director-general for data, analytics and delivery for impact at the WHO during a press briefing on Thursday. “Unless we pick up the pace, we risk losing countless lives that could have been saved, as well as failing to improve the quality of life for all”. Spotlight on climate change “For the first time, we have a dedicated section on climate change, recognizing its crucial role in shaping the global landscape,” Asma said, underlining the role climate plays in global health. The global average temperature during 2021 was around 1.20°C higher than levels observed during the pre-industrial years. The report added that it’s unlikely the world will be able to limit the rise in average temperature to the 1.5°C level agreed in the 2015-Paris Agreement, so as to avoid “irreversible and catastrophic changes to our natural and human systems”. “In order to stay within the 1.5˚C global warming limit set out in the 2015 Paris climate agreement, the world will need to drastically reduce emissions through large-scale transformation across social and economic systems,” the report emphasized. WHO’s spotlight on climate change and its connection to health comes at the heels of the Annual to Decadal Climate update released by the World Meteorological Organization (WMO) on Wednesday. The WMO report stated that the world is likely to breach the 1.5°C limit set by the Paris Agreement before 2027 – although if drastic mitigation measures were taken now they could still bring temperatures down again later. Apart urgent measures to reduce carbon emissions, countries should also concentrate on building climate-resilient and environmentally sustainable health systems to mitigate the effects of climate change on health. “At the global level, the health sector generates 4-5% of the global greenhouse gas emissions. Adopting sustainable practices brings benefits like improved accessibility, reliable services, and lower costs,” Dr Haidong Wang, the WHO unit head of monitoring, forecasting & inequalities, said. “Climate change has challenges to countries already dealing with non-communicable disease burdens. It may also lead to resurgence of infectious diseases”. Infectious diseases and NCDs The report revealed that in the past few years, the progress made by the world in combating infectious diseases like TB, HIV and malaria, and NCDs, have been reversed. Around 10.6 million people were diagnosed with TB in 2021, which is a 4.5% increase in numbers when compared with 2020. The global TB incidence rate increased by 3.6% between 2020 and 2021, reversing the progress made in the past two decades. “Tuberculosis treatment coverage dropped from 69% in 2019 to 61% in 2021,” Wang pointed out. The situation around NCDs are equally grim. Probability of dying from the four major NCDs (ages 30–69 years), projection versus SDGtarget, WHO regions and global, 2000–2048. If targeted efforts are not taken by countries, the objectives set out in the SDGs around tackling NCDs will remain unachieved. “The share of deaths caused annually by NCDs has grown to nearly three quarters of all deaths and, if the trend continues, is projected to reach about 86% globally by WHO’s 100th anniversary in 2048,” the report cautions. “The United Nations projects that total annual deaths will reach nearly 90 million globally in 2048; consequently, 77 million of these will be NCD deaths – a nearly 90% increase in absolute numbers over 2019”. COVID-19 pandemic: A medley of crises It is known that the COVID-19 pandemic caused unprecedented damage to health systems across the world. Not only did it kill millions of lives, it also caused considerable backsliding in decades-long efforts taken to address diseases like tuberculosis and HIV, and even changed the pattern of care-seeking across the world. “So the COVID-19 pandemic wasn’t just a health emergency, it was also a statistical crisis across the world,” Dr Dr Stephen MacFeely, WHOs director of data and analytics said. He added that several countries suspended longstanding surveys due to pandemic-related restrictions, making it impossible to acquire real data on issues like population and housing. “This shock interrupted the flow of data from already weak and fragile data systems.” Emphasizing on the need to have robust, disaggregated, good quality data for monitoring and surveillance purposes, MacFeely said that WHO will be launching a “Data Dot Portal”, as part of the agency’s World Health Data Hub project, to serve as a “one-stop shop for health data”. The portal will be launching at the end of next week, as curtains fall on the 76th World Health Assembly, after being in development for nearly four years. Image Credits: Chris LeBoutillier, World Health Organization. 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.
Cholera Vaccine Shortage to Continue Through 2025 23/05/2023 Stefan Anderson Floods and cyclones increase the risk of Cholera outbreaks. As a wave of cholera outbreaks spreads around the world, Gavi, the Vaccine Alliance said it expects the global shortage of oral cholera vaccines to continue until the end of 2025. Supply of oral cholera vaccines for preventative use could catch up to demand by 2026, but “urgent action is needed,” according to a vaccine production roadmap published by Gavi, the World Health Organization (WHO) and other global health partners on Monday. There are currently still enough vaccine supplies to respond to emergencies, Gavi said. “The good news is we have doses to meet all emergency demand despite the rise in outbreaks, and that is expected to continue,” said Dr Derrick Sim, head of vaccine markets and health security at Gavi, adding that the global resurgence of cholera “underscores the need to prevent outbreaks before they occur.” The past ten years have seen a steady increase in the availability of oral cholera vaccines. Global production rose from 4 million doses in 2012 to 35 million by 2022, with a similar number of vaccines expected to be produced this year. “Every vaccine dose delivered to a person in need today is the result of years of planning,” Sim said. “The ultimate solution to both sustainable oral cholera vaccine supply and cholera control lies in our collective ability to step-up up our efforts on prevention programmes.” But the recent spike in cholera outbreaks driven by climate shocks, war and humanitarian crises have caused a surge in demand for the vaccines for emergency response, limiting the availability of supplies for preventative use. Between 2021 and 2022, 48 million oral cholera vaccines were needed for emergency response, 10 million more than in the entire previous decade. “The outlook is bleak,” WHO incident manager for the global cholera response Henry Gray said at a press briefing on Friday. “We’re not able to provide enough vaccines.” Only 8 million of 18 million doses requested by WHO have been made available so far in 2023, Gray added. The WHO has warned that climate change is a major threat to global health, and that cholera is one of the diseases that is most likely to be affected. Extreme weather events, such as floods and droughts, increase the risk of cholera outbreaks by contaminating water supplies with sewage, waste and bacteria. People displaced by climate shocks are also less likely to have access to clean water and sanitation, increasing their risk of infection. The ongoing cholera outbreak in Malawi, which began at the end of the cyclone season in March last year, is the deadliest in the country’s history, according to the WHO. In response to a shortage of oral cholera vaccines last year, WHO advised countries to ration supplies during outbreaks by giving just one of the two-dose vaccine to patients. The WHO still ran out of vaccines by the end of the year. Image Credits: World Health Organization (WHO). Climate Crisis Threatens Countries Still Reeling from COVID-19 23/05/2023 Disha Shetty World Health Assembly discusses resolution on preparing for the next pandemic and emergency situations on May 23. The messiness of the COVID-19 vaccine distribution and the growing challenge of climate change emerged as key challenges at the World Health Assembly (WHA) on Tuesday in discussions on resolutions on preparing for future pandemics in Geneva. Representing 47 countries in the African region, Tanzania underscored the importance of greater equity and access to technology as countries battle multiple emergencies concurrently. While conflict in several African countries remains an ongoing issue, climate change has worsened droughts and floods, increasing pressures on fragile health systems, the country pointed out. Tanzania stressed that even though COVID-19 is no longer an official global health emergency, many African countries are still recovering and progress has been slow. A small island nation, Bahamas also told the assembly that it was facing multiple challenges concurrently, with climate change posing a particular problem. Bangladesh, currently being battered by climate change and is at the forefront of climate adaptation, highlighted the need for public-private partnerships as various solutions are explored. Speaking on behalf of all countries in Southeast Asia, Bangladesh said, “Southeast Asia is of the view that during pandemics and public health emergencies, the health of the people should prevail and be prioritized over commercial interests.” However, the needs across WHO member states are often vastly different. Bahrain, on the other hand, pointed out that it is dealing with an influx of migrants due to conflicts in the region. Finland, which in recent years had adopted a feminist foreign policy approach, pointed out to the disproportionate impact on women and girls in any disaster and focussed on the need to pay attention to that. “Finland considers it important that people living in conflict situations in particular, women and girls and persons with disabilities are put at the center of the roadmap. They are often the ones hit the hardest in conflict situations,” the country said. The overwhelming majority of the countries taking part at the WHA agreed that there is a need to strengthen WHO’s presence in their region by investing in more staff at both regional and national levels. In the context of pandemic preparedness, Germany rued Taiwan’s exclusion from the Assembly despite the island seeking an observer status. “Not only, but especially in health emergencies, we must not leave any blind spots on the map and ensure inclusivity. Therefore, we also have to take into consideration and use the experience of all parties and all partners including Taiwan,” Germany said. China, at whose behest Taiwan was excluded, promised the assembly its full cooperation and financial support in its work. “The Chinese government is willing to further provide the necessary human technological and financial support to who knows operations in the global health emergency response,” the country said. WHO Director General Dr Tedros Adhanom Ghebreyesus has urged countries to play an active role in negotiating future pandemic preparedness, and across regions countries engaged bringing in diverse perspectives. WHO Member-states Greenlight $6.83b Budget for 2024-25; Countries Demand More Transparency 22/05/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. World Health Organization member-states greenlighted a budget of $6.83 billion for 2024-25 for the global health agency – an 11% increase over the 2022-23 budget. Implicit in the budget is member-state implementation of a stepwise increase in assessed contributions. The groundbreaking reform, which aims to have one-half of WHO’s spending financed more sustainably by fixed member state contributions by 2030, was approved in principle at the May 2022 World Health Assembly (WHA). But it still required a nod from member states for the increased assessments to be applied this year. And that was not a foregone conclusion until a closed door meeting last week between member states, observed former WHO chief legal counsel Gian Luca Burci at a WHA preview event on Sunday. The WHO budget for the previous biennium 2022-23 was $6.12 billion. The gradual increase in country assessments aims to correct WHO’s current over-dependence on earmarked “voluntary contributions” – money that is donated by a member state or philanthropy. Such voluntary contributions now make up around 84% of the WHO’s total budget. WHO Director General Dr Tedros Adhanom Ghebreyesus, along with other senior officials, have long complained that such designated funding makes strategic planning hard to control. “WHO’s over-reliance on voluntary contributions, with a large proportion earmarked for specific areas of work results, in an ongoing misalignment between organizational priorities and the ability to finance them,” the WHO had mentioned in a statement during WHA 2022. Focus shifts towards countries Budget allocated to WHO offices this year compared to the previous allocation. Roughly $2 billion of the 2024-25 budget will go towards furthering WHO’s goal of Universal Health Coverage, and around $1.35 billion will be channeled into a “more effective and efficient WHO”. The latter includes greater support to countries, including co-financing for United Nations Resident Coordinators. While WHO will continue to maintain its own country offices in over 100 developing countries, the UN-wide Resident Coordinator system, aims to improve coordination between UN-affiliated tasks at country level. But the new 2024-25 budget allocation to countries and regions is, in fact, only marginally larger than the allocation of $1.25 billion from the previous 2022-23 biennium. Countries welcomed the gradual increase in country allocations, however modest. But , African member-states re-asserted demands that at least 75% of the budget should go to offices outside of the Geneva headquarters. “We wish to see the efforts to continue increasing the share of countries and regions from the program budget according to an agreed phased timeline for 2024 to 2027 with an aspiration to reach at least 75% budget allocation to countries and regions,” said the delegate from Ethiopia, speaking on behalf of the group of 47 sub-Saharan African member states. Of the $6.83 billion budget allocation, a little over 50% will be spent towards achieving the WHO’s triple billion targets of universal health coverage ($1.96 billion), protecting people from health emergencies ($1.21 billion). The third pillar aiming to ensure “healthier lives and well-being” for 1 billion people received the least funding with only $0.43 billion for the two years. Polio eradication, meanwhile, received an allocation of $0.69 billion, 23% higher than the previous biennium. Polio, which had resurfaced sporadically in Africa and North America over the past year, along with the typical Asian hotspots of Afghanistan and Pakistan, remains the only public health emergency of international concern (PHEIC) designated by the WHO as of Monday. WHO’s Special Programmes (for Research and Training in Tropical Diseases, the Special Programme of Research, Development and Research Training in Human Reproduction, and the Pandemic Influenza Preparedness Framework) received an allocation of $0.17 billion as against the allocation of $0.19 billion the previous time. Main ask: flexible funding and transparency in spending Member states, meanwhile, rallied to emphasize on the need to continue working for a flexible funding mechanism that prioritizes the causes of spending based on specific situations. “The lack of flexible funds remains a continued concern. We hope to witness an increase in flexible funds over the long run by steadily introducing replenishment mechanisms, which are currently being discussed,” the delegate for the Republic of Korea noted. Calls for greater transparency in WHO spending also rang across the room. Countries ranging from the Philippines, to Namibia and Brazil demanded that WHO disclose more specific details about projects and programmes in which it is engaged at country-level. “Improvements in transparency, accountability and administrative measures are essential. In the absence of clear improvements in those areas, it will be impossible to adopt, let alone justify any increase in assessed contributions,” the delegate for Brazil told the floor. “The practice of complete disclosure of information on expenditures of member states to member states in order to ensure transparency is not only indispensable, but also something customarily adopted by the UN agencies, and it is high time the WHO follows this path.” Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus, WHO. Egypt to Produce Insulin for Africa in New Collaboration with Eli Lilly 22/05/2023 Kerry Cullinan Dr Loyce Pace, with WHO’s Dr Bente Mikkelsen, Africa CDC’s Dr Jean Kaseya and EVA Pharma CEO Riad Armanious. GENEVA – Within months, insulin manufactured in Egypt will be available for distribution in sub-Saharan Africa, thanks to a collaboration between Eli Lilly and a local manufacturer that aims to produce one million doses of insulin by 2030. Eli Lilly is providing Egypt’s EVA Pharma with the active pharmaceutical ingredients (API) of insulin at a “significantly reduced price” to enable cheaper, faster production of the life-saving medication that is used to treat diabetes, one of the fastest-growing health problems on the continent. Eli Lilly will also provide a pro-bono technology transfer to enable EVA Pharma to formulate, fill and finish insulin vials and cartridges as part of its global commitment to enable 30 million insulin doses by 2030. Dr Bente Mikkelsen, WHO and Dr Jean Kaseya, Africa CDC Dr Bente Mikkelsen, Director of the Non-communicable Disease (NCD) Programme at the World Health Organization (WHO), welcomed the initiative, which was announced at a special event on the sidelines of the World Health Assembly (WHA) in Geneva. “If we can control diabetes, we can reach the SDG targets on NCDs,” said Mikkelsen. “We need to focus on early diagnosis and treatment and universal health coverage as 74% of global deaths are due to NCDs.” An estimated 3-4 million Africans are living with diabetes today – although less than 50% are aware of their status,” said Eli Lilly’s Leigh Ann Pusey, speaking at another event later on Monday. However, if current projections hold, some 54 million Africans are likely to suffer from diabetes by 2045, “That’s a 144% increase,” she said, representing the largest projected increase in diabetes rates globally, with Egypt particularly affected. EVA Pharma CEO Riad Armanious EVA Pharma CEO Riad Armanious said that his company had signed the agreement with Eli Lilly in December and his company had been building the manufacturing capacity to make insulin over the past five months. “We celebrating the completion of the biologics facility next week, then we will need regulatory approval but we expect to start manufacturing before the end of the year,” Armanious told Health Policy Watch. Voicing his support for the initiative, Dr Jean Kaseya, Director General of the Africa Centres for Disease Control and Prevention, revealed that his father had died of diabetes because he could not get insulin. “Only 30% of the therapeutics used in Africa are produced on the continent,” said Kaseya, adding that he was convening a meeting of local manufacturing with African leaders in July. Dr Loyce Pace, US Assistant Secretary for Global Affairs in the Department of Health and Human Services, said that people in the US also faced challenges getting access to insulin and that her country was committed to being a “real partner” in improving the global supply of insulin. Pace revealed that her own mother-in-law had died of diabetes in The Gambia because she was unable to get insulin. Image Credits: WHO. Ukraine Allies Call on World Health Assembly to Condemn Russian ‘Aggression’ 22/05/2023 Stefan Anderson World Health Assembly delegates minutes after votes on competing resolutions on the health crisis in Ukraine last year. Europe, the United States, Ukraine and its allies have submitted a draft resolution to the World Health Assembly (WHA) calling on the 194 member states of the World Health Organization (WHO) to condemn the health crisis caused by Russia’s “continued aggression against Ukraine.” The EU-led draft, published on Monday, is a near-identical replica of the resolution condemning Russian “aggression” passed by the WHA last year. They even share the same title. The resolution urges Russia to “immediately cease any attacks on hospitals and other health care facilities,” and to protect “civilians, health and humanitarian workers.” At least 8,500 civilians have been killed since Russia invaded Ukraine in February last year, and over 14,000 more have been injured, the UN Office of the High Commissioner for Human Rights said in its April status report. Russia responded by submitting a draft resolution of its own. The resolution, co-sponsored by Syria, makes no mention of Russia’s role in the health crisis in Ukraine. A similar effort to push through a counter-resolution failed last year. The Russian draft expresses “grave concern at the deteriorating humanitarian situation in and around Ukraine” and demands “all parties concerned to respect their obligations under international humanitarian and human rights law.” It also strongly condemns “attacks directed against civilians and health objects.” The WHO surveillance system for attacks on health care (SSA) lists 974 confirmed attacks on health facilities in Ukraine since the start of the war – an onslaught WHO Europe Director Dr Hans Kluge called “the largest attack on health care on European soil since the Second World War.” Over 100 health care workers have died in the attacks. Syrian President Bashar al-Assad, the Russian bill’s co-sponsor, has repeatedly used chemical weapons against his own people throughout the Syrian civil war. WHO tip-toes a fine line, but Ukraine health crisis in bounds The Russian delegation protested a US statement in support of Ukraine, calling on the chair to “ask people to speak about health.” The WHO has had a hard go of its attempts to remain politically neutral amid Russia’s invasion of Ukraine. Earlier this month, a year-long pressure campaign from EU states succeeded in forcing the closure of WHO’s non-communicable diseases office in Moscow. The announcement of its closure was accompanied by the news that the office will be relocated to Copenhagen next year. The use of the word “invasion” in a WHO status report on the organization’s emergency response in Ukraine caused a clash at this year’s Executive Board meeting, where Director-General Dr Tedros Adhanom Ghebreyesus vehemently defended his choice in response to Russian allegations that the report had been politicized. “I couldn’t find any other word that would represent it because it’s the truth,” Tedros said. “What could I say?” Interventions in plenary sessions calling out Russia’s role in the health crisis in Ukraine have so far been upheld by WHA President Dr Christopher Fearne despite repeated Russian protests. “We are not in New York, we are in the world health assembly,” the Russian delegation said in response to a statement by the United States that its invasion of Ukraine violated the charter of the United Nations. “We are ready to discuss the entire agenda, but not … any issues of aggression, or whatever these countries are saying.” Fearne called the health crisis in Ukraine “clearly a health matter relevant to this assembly”. “In fact,” he added, “we are to discuss it later on this week.” Image Credits: Health Policy Watch . Taiwan Excluded as World Health Assembly Opening Focuses on Pandemic Preparedness, and Funding 22/05/2023 Disha Shetty Dr Tedros Adhanom Ghebreyesus, director-general of the WHO. The 76th World Health Assembly turned political even before formal the proceedings began, with the decision to exclude Taiwan. The island was seeking an observer status, something that it had held previously between 2009 and 2016, with the support of the United States and others. But its inclusion was strongly opposed by China which maintains the island is its province and not an independent country. Pakistan backed China’s right to territorial integrity. The two countries said they did not object to the inclusion of experts from Taiwan in technical meetings and exchanges related to pandemic preparedness. As Taiwan’s bid failed, Dr Jui-Yuan Hsueh, Taiwan’s Minister of Health and Welfare, said the call was taken by WHA due to political considerations and pressure from China. In his keynote address, WHO Director-General Dr Tedros Adhanom Ghebreyesus listed the key priority for this year’s assembly, urging countries to work towards WHO’s triple billion targets and pick up the pace on achieving the health-related sustainable development goals (SGDs). Tedros also said the pandemic accord that the WHA will be negotiating this year will be an important step for future preparedness and requested countries to engage with the process. But Taiwan’s exclusion will have an impact on the pandemic accord, according to Health Minister Hsueh: “Without WHO membership, Taiwan is also unable to provide various surveillance data to the global influenza surveillance and the response system, which could alert the world to the next pandemic. Taiwan is willing and it should also be included in the pandemic accord that is under negotiation,”. Tedros also made it clear that finding ways to fund the various programmes of the WHO will be a priority. Despite South Asia currently being under another intense heatwave second year in a row, climate change was mentioned only briefly by Tedros. With COVID-19 no longer an official global health emergency, polio remains the only one global emergency. “After an all-time low of five wild poliovirus cases in 2021, we saw an increase last year, with 20 cases in Pakistan, two in Afghanistan and eight in Mozambique,” he said, adding that WHO is committed to polio eradication. “Last year, three million children previously inaccessible in Afghanistan received polio vaccines for the first time. And in October, donors pledged US$2.6 billion to support the push for eradication,” he said. Tedros also mentioned the work being done to roll out new vaccines for tuberculosis as quickly as possible. “It was done for COVID; it can be done for TB,” he said. He also acknowledged the need to bolster disaster response and funding, appealing to member countries to support funding efforts in 2024 so the health body was in the best possible shape to respond. In discussions, members drew attention to multiple emergencies in the Horn of Africa, Palestine, Syria, Ukraine and Yemen, among others. Additional reporting by Megha Kaveri What Can We Learn from the History of Health? New Podcast 22/05/2023 Editorial team It is often said that those who fail to learn from history are doomed to repeat it. So what, if anything, can we learn from the history of health? In this brand new season of the Global Health Matters podcast, host Garry Aslanyan takes a step back in time to look at why “history matters” and to discuss the value and merits of understanding global health history and the evolution of global health, particularly concerning the establishment of the World Health Organization (WHO), which this year celebrates its 75th anniversary. “All institutions have long histories,” guest Sanjoy Bhattacharya, head of the School of History and Professor of Medical and Global Health History at the University of Leeds in the UK, told Aslanyan.” And those long histories have determined negotiations between complex partnerships, complex organisations, and how we operate today is deeply determined by those long-term negotiations, which is historical. So history matters.” Speaking on the history of global health in terms of colonialism and colonial powers, Professor of Global Development Studies and Global Health at the University of Toronto in Canada, Anne-Emanuelle Birn, said, “In the 19th century, the arena that has evolved or erupted, transformed into global health history, began in a very particular context, that of imperialism, particularly European, but also North American imperialism and the growth of the colonial enterprise. “Health and medicine played a very important role, so one of the earliest precursors to global health history, or global health, was colonial medicine.” By the middle of the 20th century, after two world wars ravaged the world, there was renewed hope which saw the formation of several new international cooperation organization, such as the United Nations. In this arena, the World Health Organization was founded in April 1948, aiming to work worldwide to promote health and coordinate responses to health emergencies. “You have this transition, and it really takes off after the founding of the World Health Organization, this idea of international health, health between countries, through sometimes collective decision-making but also very much influenced by the world order, in that case, the Cold War,” Birn said. “For me, WHO is not just Geneva,” Bhattacharya said. “if you look at a bottom-up history of WHO, where you center the regional offices, I would submit that you actually get a much more decolonised and democratic history of international and global health than you would if you looked at Geneva and say that everything that is happening in global or international health is happening because of things that are happening in Geneva.” Taking a look at a very recent example of COVID-19, Birn points out that as much as coordinated international efforts can combat the quick spread of disease and introduce appropriate measures, at the same time, every country is in its own unique situation based on cultural and social factors. “With the COVID-19 pandemic, there was an expectation in certain quarters that history would help to address, resolve, shed light on the course of the pandemic,” Birn said. “There’s no way historical perspectives can resolve social, political, and other forms of tensions that the response to COVID-19 continues to engender, arguably. History can’t predict or liberate, and every pandemic has occurred in particular social, political, and cultural configurations. So there’s no recipe, right? The expectation was that history would provide a recipe.” “There are multiple historical narratives about any aspect of global pandemics,” Bhattacharya added. “So if you’re saying was COVID influenced by any historical narratives, then the problem then became that there wasn’t one historical narrative.” Looking into the past can sometimes provide the lessons or answers we seek, but as Bhattacharya pointed out, it is essential to know which or whose history one is learning. “History matters, but we must always ask which history matters because there are multiple histories.” This is part I of a two-part series. Image Credits: Global Health Matters Podcast via TDR. On 75th Anniversary World Health Assembly Must Confront New and Growing Threats 21/05/2023 Elaine Ruth Fletcher Member states attending the World Health Assembly’s high-level opening on Sunday, 21 May in Geneva. The World Health Assembly opened its annual meeting of member states Sunday on a celebratory note marking the 75th anniversary of the World Health Organization’s foundation in 1948. Eradicating smallpox, eliminating polio in most countries worldwide, and dramatic reductions in deaths from once-deadly childhood diseases preventable by clean water, basic medicines and vaccines are among a few of the historic accomplishments the Organization will be celebrating as this year’s 76th WHA session begins, said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in opening remarks at the WHA. “Smallpox is history and polio is on the brink. And epidemics of malaria, HIV and tuberculosis have all been pushed back,” said Dr Tedros. Thanks to the Framework Convention on Tobacco Control, smoking rates have declined in dozens of countries worldwide, with strict policies on tobacco advertising and taxes on tobacco products. He was speaking Sunday at a WHA preview event at the Geneva Graduate Institute’s Global Health Center, just before the official WHA curtain-raiser; the latter featured a lineup of high-level figures from around the world, including India’s Prime Minister Narendra Modi and former New Zealand Prime Minister Jacinda Ardern. Pandemic treaty negotiations set against regional conflicts The number of people living in zones of combined conflict and health emergencies has doubled since 2015 – Kate Dodson, UN Foundation But against those successes, this year’s WHA is taking place against the background of complex, ongoing negotiations over an ambitious new pandemic treaty and, in parallel, talks over revisions to the 2005 International Health Regulations that aim to supplement and replace archaic rules on international emergency response. The WHA also is taking place in a second year of war between Russia and the Ukraine – whose bitter dispute was the subject of competing WHA resolutions last year – and which will likely again surface in debates by the global health body this year. And the Ukraine-Russia war is only one of multiple conflicts destroying lives and global health. As this year’s WHA considers a new “Health for Peace Initiative”, some 39 million people are – or almost one in 20 of the world’s population – living in fragile and complex settings that combine conflict with health emergencies. “That’s an increase of 25% since just last year, and double since 2015,” noted Kate Dodson, vice president for global health at the United Nations Foundation, a co-sponsor of the Graduate School WHA opener. And while this week’s WHA session is set to approve update guidance to countries on “best buys” for reducing non-communicable diseases, NCD disease rates are soaring worldwide, with heart disease having increased by 60% in the last 30 years, according to data published by the World Heart Summit, also convening this weekend in Geneva. Meanwhile, the WHO remains financially challenged. For the first time ever, this year’s WHA is supposed to approve stepped up rates of annual contributions by member states to the global health organization. It will also debate a January Executive Board recommendation to establish a “replenishment fund” for voluntary contributions by donors and member states that could be used in a more flexible way by the Organization than “earmarked” donations that make up the bulk of its budget today. Challenges moving far beyond the health sector Non-communicable diseases now account for 70% of deaths globally – WHO Director General Dr Tedros Adhanom Ghebreyesus at the opening of the 76th WHA. Overall, as it enters its 76th year of existence, the Organization is increasingly challenged by the need to respond coherently to an increasingly broad and complex portfolio of emerging disease threats – over which it often has little influence or control. Those include obesity, heart disease and hypertension stimulated by sedentary lifestyles and fast food diets; antimicrobial resistance from misuse and overuse of antibiotics in both the human and animal health sector; the climate crisis and air pollution; and as COVID-19 demonstrated to the world – vast disparities in access to health care including vital medicines and vaccines. “Non communicable diseases now account for some 70% of deaths globally,” noted Tedros in his opening WHA address. “Antimicrobial resistance threatens to unwind centuries of medical progress. Vast disparities in access to health resources exist between and within countries and communities. And the existential threat of climate change is jeopardizing the very habitability of our planet. “WHO has grown enormously but our resources have not,” Tedros added. “There is the challenge of being a technical scientific organization in a political, and increasingly politicized, environment.” “These are daunting and complex challenges. We will not solve them at the World Health Assembly and we will not solve them in our lifetimes, but we’re building a path that our children and grandchildren will walk down and that they will continue to build,” Tedros said. “The challenges of today are very different to those we faced in 1948. But the vision is the same.” 1969 International Health Regulations only covered four diseases In 1969 the International Health Regulations only covered four disease – former WHO official David Heymann (on left) speaking at WHO preview event at the Geneva Graduate Institute “When the [WHO] International Health Regulations were developed back in 1969, their goal was really to stop disease at borders,” pointed out David Heymann, a former high-ranking WHO official, at the Geneva Graduate Institute’s WHA preview event Sunday morning. “If a country reported one in four infections, cholera, yellow fever, plague or smallpox, then countries that were receiving passengers from those countries could request a vaccination certificate. There were pre-determined measures to stop disease transmission, and at that time, WHO was the exclusive owner of much of the information because countries reported to WHO, WHO did a risk assessment, and provided its recommendations.” While the IHR finally underwent a major update in 2005, greatly broadening the scope of what was to be reported – and empowering WHO to declare a “Public Health Emergency of International Concern (PHEIC),” the regulations have failed to keep up with the pace of change in the real world, he pointed out. The biggest failure, he contends, was in “the most important part of the IHR, which was the requirement of countries to establish core capacity in public health to be able to detect, respond and prevent national disease spread and death, and eventually prevent international spread by this rapid reaction.” In terms of risk assessments as well, as the digital transformation accelerated the spread of information, WHO was no longer the exclusive arbiter of risks from pathogens that appeared. “As we saw in the COVID pandemic, countries really preferred doing their own risk assessments. They had access to data which they had never had before – all respectable medical journals were publishing peer reviewed information in front of their paywall. So any government advisory group could get that and could make recommendations to their own government as to what to do. As a result, WHO lost its authoritative position in making recommendations, countries devised their own policies, and what ensued was “confusion, utter confusion” over global response, Heymann contended. “The [IHR] regulations to me, they’re really a vestige of the past.” Negotiations over pandemic accord will be on sidelines of formal WHA Gian Luca Burci, former WHO chief legal counsel describes the workings of the World Health Assembly – and what to expect at this session. This year’s WHA is set against the backdrop of ongoing negotiations over IHR revisions as well as the development of a new pandemic accord. Both are mired in controversial debates by member states over language on reporting outbreaks- including proposals for requiring countries to report emerging pathogen threats within hours. With respect to the pandemic accord, while all countries have paid lip service to the need to ensure more equitable distribution of drugs and vaccines in the next pandemic – they are at odds about draft language that would commit them, in advance, to set aside of fixed quantities of health tools for developing nations. Insofar as those negotiations are only due to conclude by May 2024, the most meaningful talks are likely to be in the corridors and on the sidelines of the WHA – rather than in the formal chambers of the meeting, being held at Geneva’s UN headquarters, said Gian Luca Burci, former chief WHO legal counsel at Sunday’s Graduate Institute session. “For [WHA] action, there is nothing specific on the IHR, Burci observed. With regards to the pandemic accord, the only main formal item explicitly on the agenda is the potential treaty’s cost.” “But there will be a Secretariat Briefing on the negotiations, and I’m sure there will be a lot of discussions, a lot of side conversations among delegates looking to break some of the deadlocks, and so forth.” Meanwhile, WHO continues to move ahead with voluntary initiatives aimed at improving outbreak detection and response. For example, just ahead of the WHA’s opening, WHO announced the launch of a new International Pathogen Surveillance Network, that aims to detect and report infectious disease threats in real time, making better use of digital and genomic tools that many countries still lack. WHO and partners are launching the International Pathogen Surveillance Network, a global network to help protect people from infectious disease threats through better use of pathogen genomics https://t.co/riuOjqB8Ju pic.twitter.com/vXqJZk6dzs — World Health Organization (WHO) (@WHO) May 20, 2023 The new network represents an ambitious effort to fill a critical gap in WHO’s existing system of disease outbreak alerts – which can right now be delayed by weeks or even months if countries resist disclosure. But without revisions to the IHR, such networks will remain purely voluntary. So the key question, as always remains: will all countries join, collaborate and cooperate – and who will support the improved capacity of low income countries for detecting and reporting new threats? WHO Calls on Countries to “Drastically Reduce” Climate Emissions to Improve Global Health 19/05/2023 Megha Kaveri Fossil fuel combustion is a leadng source of global warming as well as of health harmful air pollution emissions. The World Health Organization (WHO) has called for focused action to address global warming and climate change to promote health outcomes. Recommendations include concerted efforts to reduce carbon emissions, build climate-resilient and sustainable health systems and protect health from the impacts of climate change. There is also a decline in the treatment coverage for tuberculosis between 2019 and 2021, and a stall in the world’s progress to tackle non-communicable diseases (NCDs) like hypertension and adult obesity. “Climate and Health” is featured as a separate chapter in the latest edition of the World Health Statistics Report, published by the WHO on Friday. This underlines its importance as a major driver of health outcomes in coming years, WHO officials said. The 131-page annual compilation of health statistics, while providing a birds-eye view on the progress made on global health metrics, also highlights how the world is not on track to achieve the targets set out in the Sustainable Development Goals (SDGs) 2030. “The world is off track to reach the sustainable development goals,” said Dr Samira Asma, assistant director-general for data, analytics and delivery for impact at the WHO during a press briefing on Thursday. “Unless we pick up the pace, we risk losing countless lives that could have been saved, as well as failing to improve the quality of life for all”. Spotlight on climate change “For the first time, we have a dedicated section on climate change, recognizing its crucial role in shaping the global landscape,” Asma said, underlining the role climate plays in global health. The global average temperature during 2021 was around 1.20°C higher than levels observed during the pre-industrial years. The report added that it’s unlikely the world will be able to limit the rise in average temperature to the 1.5°C level agreed in the 2015-Paris Agreement, so as to avoid “irreversible and catastrophic changes to our natural and human systems”. “In order to stay within the 1.5˚C global warming limit set out in the 2015 Paris climate agreement, the world will need to drastically reduce emissions through large-scale transformation across social and economic systems,” the report emphasized. WHO’s spotlight on climate change and its connection to health comes at the heels of the Annual to Decadal Climate update released by the World Meteorological Organization (WMO) on Wednesday. The WMO report stated that the world is likely to breach the 1.5°C limit set by the Paris Agreement before 2027 – although if drastic mitigation measures were taken now they could still bring temperatures down again later. Apart urgent measures to reduce carbon emissions, countries should also concentrate on building climate-resilient and environmentally sustainable health systems to mitigate the effects of climate change on health. “At the global level, the health sector generates 4-5% of the global greenhouse gas emissions. Adopting sustainable practices brings benefits like improved accessibility, reliable services, and lower costs,” Dr Haidong Wang, the WHO unit head of monitoring, forecasting & inequalities, said. “Climate change has challenges to countries already dealing with non-communicable disease burdens. It may also lead to resurgence of infectious diseases”. Infectious diseases and NCDs The report revealed that in the past few years, the progress made by the world in combating infectious diseases like TB, HIV and malaria, and NCDs, have been reversed. Around 10.6 million people were diagnosed with TB in 2021, which is a 4.5% increase in numbers when compared with 2020. The global TB incidence rate increased by 3.6% between 2020 and 2021, reversing the progress made in the past two decades. “Tuberculosis treatment coverage dropped from 69% in 2019 to 61% in 2021,” Wang pointed out. The situation around NCDs are equally grim. Probability of dying from the four major NCDs (ages 30–69 years), projection versus SDGtarget, WHO regions and global, 2000–2048. If targeted efforts are not taken by countries, the objectives set out in the SDGs around tackling NCDs will remain unachieved. “The share of deaths caused annually by NCDs has grown to nearly three quarters of all deaths and, if the trend continues, is projected to reach about 86% globally by WHO’s 100th anniversary in 2048,” the report cautions. “The United Nations projects that total annual deaths will reach nearly 90 million globally in 2048; consequently, 77 million of these will be NCD deaths – a nearly 90% increase in absolute numbers over 2019”. COVID-19 pandemic: A medley of crises It is known that the COVID-19 pandemic caused unprecedented damage to health systems across the world. Not only did it kill millions of lives, it also caused considerable backsliding in decades-long efforts taken to address diseases like tuberculosis and HIV, and even changed the pattern of care-seeking across the world. “So the COVID-19 pandemic wasn’t just a health emergency, it was also a statistical crisis across the world,” Dr Dr Stephen MacFeely, WHOs director of data and analytics said. He added that several countries suspended longstanding surveys due to pandemic-related restrictions, making it impossible to acquire real data on issues like population and housing. “This shock interrupted the flow of data from already weak and fragile data systems.” Emphasizing on the need to have robust, disaggregated, good quality data for monitoring and surveillance purposes, MacFeely said that WHO will be launching a “Data Dot Portal”, as part of the agency’s World Health Data Hub project, to serve as a “one-stop shop for health data”. The portal will be launching at the end of next week, as curtains fall on the 76th World Health Assembly, after being in development for nearly four years. Image Credits: Chris LeBoutillier, World Health Organization. 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.
Climate Crisis Threatens Countries Still Reeling from COVID-19 23/05/2023 Disha Shetty World Health Assembly discusses resolution on preparing for the next pandemic and emergency situations on May 23. The messiness of the COVID-19 vaccine distribution and the growing challenge of climate change emerged as key challenges at the World Health Assembly (WHA) on Tuesday in discussions on resolutions on preparing for future pandemics in Geneva. Representing 47 countries in the African region, Tanzania underscored the importance of greater equity and access to technology as countries battle multiple emergencies concurrently. While conflict in several African countries remains an ongoing issue, climate change has worsened droughts and floods, increasing pressures on fragile health systems, the country pointed out. Tanzania stressed that even though COVID-19 is no longer an official global health emergency, many African countries are still recovering and progress has been slow. A small island nation, Bahamas also told the assembly that it was facing multiple challenges concurrently, with climate change posing a particular problem. Bangladesh, currently being battered by climate change and is at the forefront of climate adaptation, highlighted the need for public-private partnerships as various solutions are explored. Speaking on behalf of all countries in Southeast Asia, Bangladesh said, “Southeast Asia is of the view that during pandemics and public health emergencies, the health of the people should prevail and be prioritized over commercial interests.” However, the needs across WHO member states are often vastly different. Bahrain, on the other hand, pointed out that it is dealing with an influx of migrants due to conflicts in the region. Finland, which in recent years had adopted a feminist foreign policy approach, pointed out to the disproportionate impact on women and girls in any disaster and focussed on the need to pay attention to that. “Finland considers it important that people living in conflict situations in particular, women and girls and persons with disabilities are put at the center of the roadmap. They are often the ones hit the hardest in conflict situations,” the country said. The overwhelming majority of the countries taking part at the WHA agreed that there is a need to strengthen WHO’s presence in their region by investing in more staff at both regional and national levels. In the context of pandemic preparedness, Germany rued Taiwan’s exclusion from the Assembly despite the island seeking an observer status. “Not only, but especially in health emergencies, we must not leave any blind spots on the map and ensure inclusivity. Therefore, we also have to take into consideration and use the experience of all parties and all partners including Taiwan,” Germany said. China, at whose behest Taiwan was excluded, promised the assembly its full cooperation and financial support in its work. “The Chinese government is willing to further provide the necessary human technological and financial support to who knows operations in the global health emergency response,” the country said. WHO Director General Dr Tedros Adhanom Ghebreyesus has urged countries to play an active role in negotiating future pandemic preparedness, and across regions countries engaged bringing in diverse perspectives. WHO Member-states Greenlight $6.83b Budget for 2024-25; Countries Demand More Transparency 22/05/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. World Health Organization member-states greenlighted a budget of $6.83 billion for 2024-25 for the global health agency – an 11% increase over the 2022-23 budget. Implicit in the budget is member-state implementation of a stepwise increase in assessed contributions. The groundbreaking reform, which aims to have one-half of WHO’s spending financed more sustainably by fixed member state contributions by 2030, was approved in principle at the May 2022 World Health Assembly (WHA). But it still required a nod from member states for the increased assessments to be applied this year. And that was not a foregone conclusion until a closed door meeting last week between member states, observed former WHO chief legal counsel Gian Luca Burci at a WHA preview event on Sunday. The WHO budget for the previous biennium 2022-23 was $6.12 billion. The gradual increase in country assessments aims to correct WHO’s current over-dependence on earmarked “voluntary contributions” – money that is donated by a member state or philanthropy. Such voluntary contributions now make up around 84% of the WHO’s total budget. WHO Director General Dr Tedros Adhanom Ghebreyesus, along with other senior officials, have long complained that such designated funding makes strategic planning hard to control. “WHO’s over-reliance on voluntary contributions, with a large proportion earmarked for specific areas of work results, in an ongoing misalignment between organizational priorities and the ability to finance them,” the WHO had mentioned in a statement during WHA 2022. Focus shifts towards countries Budget allocated to WHO offices this year compared to the previous allocation. Roughly $2 billion of the 2024-25 budget will go towards furthering WHO’s goal of Universal Health Coverage, and around $1.35 billion will be channeled into a “more effective and efficient WHO”. The latter includes greater support to countries, including co-financing for United Nations Resident Coordinators. While WHO will continue to maintain its own country offices in over 100 developing countries, the UN-wide Resident Coordinator system, aims to improve coordination between UN-affiliated tasks at country level. But the new 2024-25 budget allocation to countries and regions is, in fact, only marginally larger than the allocation of $1.25 billion from the previous 2022-23 biennium. Countries welcomed the gradual increase in country allocations, however modest. But , African member-states re-asserted demands that at least 75% of the budget should go to offices outside of the Geneva headquarters. “We wish to see the efforts to continue increasing the share of countries and regions from the program budget according to an agreed phased timeline for 2024 to 2027 with an aspiration to reach at least 75% budget allocation to countries and regions,” said the delegate from Ethiopia, speaking on behalf of the group of 47 sub-Saharan African member states. Of the $6.83 billion budget allocation, a little over 50% will be spent towards achieving the WHO’s triple billion targets of universal health coverage ($1.96 billion), protecting people from health emergencies ($1.21 billion). The third pillar aiming to ensure “healthier lives and well-being” for 1 billion people received the least funding with only $0.43 billion for the two years. Polio eradication, meanwhile, received an allocation of $0.69 billion, 23% higher than the previous biennium. Polio, which had resurfaced sporadically in Africa and North America over the past year, along with the typical Asian hotspots of Afghanistan and Pakistan, remains the only public health emergency of international concern (PHEIC) designated by the WHO as of Monday. WHO’s Special Programmes (for Research and Training in Tropical Diseases, the Special Programme of Research, Development and Research Training in Human Reproduction, and the Pandemic Influenza Preparedness Framework) received an allocation of $0.17 billion as against the allocation of $0.19 billion the previous time. Main ask: flexible funding and transparency in spending Member states, meanwhile, rallied to emphasize on the need to continue working for a flexible funding mechanism that prioritizes the causes of spending based on specific situations. “The lack of flexible funds remains a continued concern. We hope to witness an increase in flexible funds over the long run by steadily introducing replenishment mechanisms, which are currently being discussed,” the delegate for the Republic of Korea noted. Calls for greater transparency in WHO spending also rang across the room. Countries ranging from the Philippines, to Namibia and Brazil demanded that WHO disclose more specific details about projects and programmes in which it is engaged at country-level. “Improvements in transparency, accountability and administrative measures are essential. In the absence of clear improvements in those areas, it will be impossible to adopt, let alone justify any increase in assessed contributions,” the delegate for Brazil told the floor. “The practice of complete disclosure of information on expenditures of member states to member states in order to ensure transparency is not only indispensable, but also something customarily adopted by the UN agencies, and it is high time the WHO follows this path.” Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus, WHO. Egypt to Produce Insulin for Africa in New Collaboration with Eli Lilly 22/05/2023 Kerry Cullinan Dr Loyce Pace, with WHO’s Dr Bente Mikkelsen, Africa CDC’s Dr Jean Kaseya and EVA Pharma CEO Riad Armanious. GENEVA – Within months, insulin manufactured in Egypt will be available for distribution in sub-Saharan Africa, thanks to a collaboration between Eli Lilly and a local manufacturer that aims to produce one million doses of insulin by 2030. Eli Lilly is providing Egypt’s EVA Pharma with the active pharmaceutical ingredients (API) of insulin at a “significantly reduced price” to enable cheaper, faster production of the life-saving medication that is used to treat diabetes, one of the fastest-growing health problems on the continent. Eli Lilly will also provide a pro-bono technology transfer to enable EVA Pharma to formulate, fill and finish insulin vials and cartridges as part of its global commitment to enable 30 million insulin doses by 2030. Dr Bente Mikkelsen, WHO and Dr Jean Kaseya, Africa CDC Dr Bente Mikkelsen, Director of the Non-communicable Disease (NCD) Programme at the World Health Organization (WHO), welcomed the initiative, which was announced at a special event on the sidelines of the World Health Assembly (WHA) in Geneva. “If we can control diabetes, we can reach the SDG targets on NCDs,” said Mikkelsen. “We need to focus on early diagnosis and treatment and universal health coverage as 74% of global deaths are due to NCDs.” An estimated 3-4 million Africans are living with diabetes today – although less than 50% are aware of their status,” said Eli Lilly’s Leigh Ann Pusey, speaking at another event later on Monday. However, if current projections hold, some 54 million Africans are likely to suffer from diabetes by 2045, “That’s a 144% increase,” she said, representing the largest projected increase in diabetes rates globally, with Egypt particularly affected. EVA Pharma CEO Riad Armanious EVA Pharma CEO Riad Armanious said that his company had signed the agreement with Eli Lilly in December and his company had been building the manufacturing capacity to make insulin over the past five months. “We celebrating the completion of the biologics facility next week, then we will need regulatory approval but we expect to start manufacturing before the end of the year,” Armanious told Health Policy Watch. Voicing his support for the initiative, Dr Jean Kaseya, Director General of the Africa Centres for Disease Control and Prevention, revealed that his father had died of diabetes because he could not get insulin. “Only 30% of the therapeutics used in Africa are produced on the continent,” said Kaseya, adding that he was convening a meeting of local manufacturing with African leaders in July. Dr Loyce Pace, US Assistant Secretary for Global Affairs in the Department of Health and Human Services, said that people in the US also faced challenges getting access to insulin and that her country was committed to being a “real partner” in improving the global supply of insulin. Pace revealed that her own mother-in-law had died of diabetes in The Gambia because she was unable to get insulin. Image Credits: WHO. Ukraine Allies Call on World Health Assembly to Condemn Russian ‘Aggression’ 22/05/2023 Stefan Anderson World Health Assembly delegates minutes after votes on competing resolutions on the health crisis in Ukraine last year. Europe, the United States, Ukraine and its allies have submitted a draft resolution to the World Health Assembly (WHA) calling on the 194 member states of the World Health Organization (WHO) to condemn the health crisis caused by Russia’s “continued aggression against Ukraine.” The EU-led draft, published on Monday, is a near-identical replica of the resolution condemning Russian “aggression” passed by the WHA last year. They even share the same title. The resolution urges Russia to “immediately cease any attacks on hospitals and other health care facilities,” and to protect “civilians, health and humanitarian workers.” At least 8,500 civilians have been killed since Russia invaded Ukraine in February last year, and over 14,000 more have been injured, the UN Office of the High Commissioner for Human Rights said in its April status report. Russia responded by submitting a draft resolution of its own. The resolution, co-sponsored by Syria, makes no mention of Russia’s role in the health crisis in Ukraine. A similar effort to push through a counter-resolution failed last year. The Russian draft expresses “grave concern at the deteriorating humanitarian situation in and around Ukraine” and demands “all parties concerned to respect their obligations under international humanitarian and human rights law.” It also strongly condemns “attacks directed against civilians and health objects.” The WHO surveillance system for attacks on health care (SSA) lists 974 confirmed attacks on health facilities in Ukraine since the start of the war – an onslaught WHO Europe Director Dr Hans Kluge called “the largest attack on health care on European soil since the Second World War.” Over 100 health care workers have died in the attacks. Syrian President Bashar al-Assad, the Russian bill’s co-sponsor, has repeatedly used chemical weapons against his own people throughout the Syrian civil war. WHO tip-toes a fine line, but Ukraine health crisis in bounds The Russian delegation protested a US statement in support of Ukraine, calling on the chair to “ask people to speak about health.” The WHO has had a hard go of its attempts to remain politically neutral amid Russia’s invasion of Ukraine. Earlier this month, a year-long pressure campaign from EU states succeeded in forcing the closure of WHO’s non-communicable diseases office in Moscow. The announcement of its closure was accompanied by the news that the office will be relocated to Copenhagen next year. The use of the word “invasion” in a WHO status report on the organization’s emergency response in Ukraine caused a clash at this year’s Executive Board meeting, where Director-General Dr Tedros Adhanom Ghebreyesus vehemently defended his choice in response to Russian allegations that the report had been politicized. “I couldn’t find any other word that would represent it because it’s the truth,” Tedros said. “What could I say?” Interventions in plenary sessions calling out Russia’s role in the health crisis in Ukraine have so far been upheld by WHA President Dr Christopher Fearne despite repeated Russian protests. “We are not in New York, we are in the world health assembly,” the Russian delegation said in response to a statement by the United States that its invasion of Ukraine violated the charter of the United Nations. “We are ready to discuss the entire agenda, but not … any issues of aggression, or whatever these countries are saying.” Fearne called the health crisis in Ukraine “clearly a health matter relevant to this assembly”. “In fact,” he added, “we are to discuss it later on this week.” Image Credits: Health Policy Watch . Taiwan Excluded as World Health Assembly Opening Focuses on Pandemic Preparedness, and Funding 22/05/2023 Disha Shetty Dr Tedros Adhanom Ghebreyesus, director-general of the WHO. The 76th World Health Assembly turned political even before formal the proceedings began, with the decision to exclude Taiwan. The island was seeking an observer status, something that it had held previously between 2009 and 2016, with the support of the United States and others. But its inclusion was strongly opposed by China which maintains the island is its province and not an independent country. Pakistan backed China’s right to territorial integrity. The two countries said they did not object to the inclusion of experts from Taiwan in technical meetings and exchanges related to pandemic preparedness. As Taiwan’s bid failed, Dr Jui-Yuan Hsueh, Taiwan’s Minister of Health and Welfare, said the call was taken by WHA due to political considerations and pressure from China. In his keynote address, WHO Director-General Dr Tedros Adhanom Ghebreyesus listed the key priority for this year’s assembly, urging countries to work towards WHO’s triple billion targets and pick up the pace on achieving the health-related sustainable development goals (SGDs). Tedros also said the pandemic accord that the WHA will be negotiating this year will be an important step for future preparedness and requested countries to engage with the process. But Taiwan’s exclusion will have an impact on the pandemic accord, according to Health Minister Hsueh: “Without WHO membership, Taiwan is also unable to provide various surveillance data to the global influenza surveillance and the response system, which could alert the world to the next pandemic. Taiwan is willing and it should also be included in the pandemic accord that is under negotiation,”. Tedros also made it clear that finding ways to fund the various programmes of the WHO will be a priority. Despite South Asia currently being under another intense heatwave second year in a row, climate change was mentioned only briefly by Tedros. With COVID-19 no longer an official global health emergency, polio remains the only one global emergency. “After an all-time low of five wild poliovirus cases in 2021, we saw an increase last year, with 20 cases in Pakistan, two in Afghanistan and eight in Mozambique,” he said, adding that WHO is committed to polio eradication. “Last year, three million children previously inaccessible in Afghanistan received polio vaccines for the first time. And in October, donors pledged US$2.6 billion to support the push for eradication,” he said. Tedros also mentioned the work being done to roll out new vaccines for tuberculosis as quickly as possible. “It was done for COVID; it can be done for TB,” he said. He also acknowledged the need to bolster disaster response and funding, appealing to member countries to support funding efforts in 2024 so the health body was in the best possible shape to respond. In discussions, members drew attention to multiple emergencies in the Horn of Africa, Palestine, Syria, Ukraine and Yemen, among others. Additional reporting by Megha Kaveri What Can We Learn from the History of Health? New Podcast 22/05/2023 Editorial team It is often said that those who fail to learn from history are doomed to repeat it. So what, if anything, can we learn from the history of health? In this brand new season of the Global Health Matters podcast, host Garry Aslanyan takes a step back in time to look at why “history matters” and to discuss the value and merits of understanding global health history and the evolution of global health, particularly concerning the establishment of the World Health Organization (WHO), which this year celebrates its 75th anniversary. “All institutions have long histories,” guest Sanjoy Bhattacharya, head of the School of History and Professor of Medical and Global Health History at the University of Leeds in the UK, told Aslanyan.” And those long histories have determined negotiations between complex partnerships, complex organisations, and how we operate today is deeply determined by those long-term negotiations, which is historical. So history matters.” Speaking on the history of global health in terms of colonialism and colonial powers, Professor of Global Development Studies and Global Health at the University of Toronto in Canada, Anne-Emanuelle Birn, said, “In the 19th century, the arena that has evolved or erupted, transformed into global health history, began in a very particular context, that of imperialism, particularly European, but also North American imperialism and the growth of the colonial enterprise. “Health and medicine played a very important role, so one of the earliest precursors to global health history, or global health, was colonial medicine.” By the middle of the 20th century, after two world wars ravaged the world, there was renewed hope which saw the formation of several new international cooperation organization, such as the United Nations. In this arena, the World Health Organization was founded in April 1948, aiming to work worldwide to promote health and coordinate responses to health emergencies. “You have this transition, and it really takes off after the founding of the World Health Organization, this idea of international health, health between countries, through sometimes collective decision-making but also very much influenced by the world order, in that case, the Cold War,” Birn said. “For me, WHO is not just Geneva,” Bhattacharya said. “if you look at a bottom-up history of WHO, where you center the regional offices, I would submit that you actually get a much more decolonised and democratic history of international and global health than you would if you looked at Geneva and say that everything that is happening in global or international health is happening because of things that are happening in Geneva.” Taking a look at a very recent example of COVID-19, Birn points out that as much as coordinated international efforts can combat the quick spread of disease and introduce appropriate measures, at the same time, every country is in its own unique situation based on cultural and social factors. “With the COVID-19 pandemic, there was an expectation in certain quarters that history would help to address, resolve, shed light on the course of the pandemic,” Birn said. “There’s no way historical perspectives can resolve social, political, and other forms of tensions that the response to COVID-19 continues to engender, arguably. History can’t predict or liberate, and every pandemic has occurred in particular social, political, and cultural configurations. So there’s no recipe, right? The expectation was that history would provide a recipe.” “There are multiple historical narratives about any aspect of global pandemics,” Bhattacharya added. “So if you’re saying was COVID influenced by any historical narratives, then the problem then became that there wasn’t one historical narrative.” Looking into the past can sometimes provide the lessons or answers we seek, but as Bhattacharya pointed out, it is essential to know which or whose history one is learning. “History matters, but we must always ask which history matters because there are multiple histories.” This is part I of a two-part series. Image Credits: Global Health Matters Podcast via TDR. On 75th Anniversary World Health Assembly Must Confront New and Growing Threats 21/05/2023 Elaine Ruth Fletcher Member states attending the World Health Assembly’s high-level opening on Sunday, 21 May in Geneva. The World Health Assembly opened its annual meeting of member states Sunday on a celebratory note marking the 75th anniversary of the World Health Organization’s foundation in 1948. Eradicating smallpox, eliminating polio in most countries worldwide, and dramatic reductions in deaths from once-deadly childhood diseases preventable by clean water, basic medicines and vaccines are among a few of the historic accomplishments the Organization will be celebrating as this year’s 76th WHA session begins, said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in opening remarks at the WHA. “Smallpox is history and polio is on the brink. And epidemics of malaria, HIV and tuberculosis have all been pushed back,” said Dr Tedros. Thanks to the Framework Convention on Tobacco Control, smoking rates have declined in dozens of countries worldwide, with strict policies on tobacco advertising and taxes on tobacco products. He was speaking Sunday at a WHA preview event at the Geneva Graduate Institute’s Global Health Center, just before the official WHA curtain-raiser; the latter featured a lineup of high-level figures from around the world, including India’s Prime Minister Narendra Modi and former New Zealand Prime Minister Jacinda Ardern. Pandemic treaty negotiations set against regional conflicts The number of people living in zones of combined conflict and health emergencies has doubled since 2015 – Kate Dodson, UN Foundation But against those successes, this year’s WHA is taking place against the background of complex, ongoing negotiations over an ambitious new pandemic treaty and, in parallel, talks over revisions to the 2005 International Health Regulations that aim to supplement and replace archaic rules on international emergency response. The WHA also is taking place in a second year of war between Russia and the Ukraine – whose bitter dispute was the subject of competing WHA resolutions last year – and which will likely again surface in debates by the global health body this year. And the Ukraine-Russia war is only one of multiple conflicts destroying lives and global health. As this year’s WHA considers a new “Health for Peace Initiative”, some 39 million people are – or almost one in 20 of the world’s population – living in fragile and complex settings that combine conflict with health emergencies. “That’s an increase of 25% since just last year, and double since 2015,” noted Kate Dodson, vice president for global health at the United Nations Foundation, a co-sponsor of the Graduate School WHA opener. And while this week’s WHA session is set to approve update guidance to countries on “best buys” for reducing non-communicable diseases, NCD disease rates are soaring worldwide, with heart disease having increased by 60% in the last 30 years, according to data published by the World Heart Summit, also convening this weekend in Geneva. Meanwhile, the WHO remains financially challenged. For the first time ever, this year’s WHA is supposed to approve stepped up rates of annual contributions by member states to the global health organization. It will also debate a January Executive Board recommendation to establish a “replenishment fund” for voluntary contributions by donors and member states that could be used in a more flexible way by the Organization than “earmarked” donations that make up the bulk of its budget today. Challenges moving far beyond the health sector Non-communicable diseases now account for 70% of deaths globally – WHO Director General Dr Tedros Adhanom Ghebreyesus at the opening of the 76th WHA. Overall, as it enters its 76th year of existence, the Organization is increasingly challenged by the need to respond coherently to an increasingly broad and complex portfolio of emerging disease threats – over which it often has little influence or control. Those include obesity, heart disease and hypertension stimulated by sedentary lifestyles and fast food diets; antimicrobial resistance from misuse and overuse of antibiotics in both the human and animal health sector; the climate crisis and air pollution; and as COVID-19 demonstrated to the world – vast disparities in access to health care including vital medicines and vaccines. “Non communicable diseases now account for some 70% of deaths globally,” noted Tedros in his opening WHA address. “Antimicrobial resistance threatens to unwind centuries of medical progress. Vast disparities in access to health resources exist between and within countries and communities. And the existential threat of climate change is jeopardizing the very habitability of our planet. “WHO has grown enormously but our resources have not,” Tedros added. “There is the challenge of being a technical scientific organization in a political, and increasingly politicized, environment.” “These are daunting and complex challenges. We will not solve them at the World Health Assembly and we will not solve them in our lifetimes, but we’re building a path that our children and grandchildren will walk down and that they will continue to build,” Tedros said. “The challenges of today are very different to those we faced in 1948. But the vision is the same.” 1969 International Health Regulations only covered four diseases In 1969 the International Health Regulations only covered four disease – former WHO official David Heymann (on left) speaking at WHO preview event at the Geneva Graduate Institute “When the [WHO] International Health Regulations were developed back in 1969, their goal was really to stop disease at borders,” pointed out David Heymann, a former high-ranking WHO official, at the Geneva Graduate Institute’s WHA preview event Sunday morning. “If a country reported one in four infections, cholera, yellow fever, plague or smallpox, then countries that were receiving passengers from those countries could request a vaccination certificate. There were pre-determined measures to stop disease transmission, and at that time, WHO was the exclusive owner of much of the information because countries reported to WHO, WHO did a risk assessment, and provided its recommendations.” While the IHR finally underwent a major update in 2005, greatly broadening the scope of what was to be reported – and empowering WHO to declare a “Public Health Emergency of International Concern (PHEIC),” the regulations have failed to keep up with the pace of change in the real world, he pointed out. The biggest failure, he contends, was in “the most important part of the IHR, which was the requirement of countries to establish core capacity in public health to be able to detect, respond and prevent national disease spread and death, and eventually prevent international spread by this rapid reaction.” In terms of risk assessments as well, as the digital transformation accelerated the spread of information, WHO was no longer the exclusive arbiter of risks from pathogens that appeared. “As we saw in the COVID pandemic, countries really preferred doing their own risk assessments. They had access to data which they had never had before – all respectable medical journals were publishing peer reviewed information in front of their paywall. So any government advisory group could get that and could make recommendations to their own government as to what to do. As a result, WHO lost its authoritative position in making recommendations, countries devised their own policies, and what ensued was “confusion, utter confusion” over global response, Heymann contended. “The [IHR] regulations to me, they’re really a vestige of the past.” Negotiations over pandemic accord will be on sidelines of formal WHA Gian Luca Burci, former WHO chief legal counsel describes the workings of the World Health Assembly – and what to expect at this session. This year’s WHA is set against the backdrop of ongoing negotiations over IHR revisions as well as the development of a new pandemic accord. Both are mired in controversial debates by member states over language on reporting outbreaks- including proposals for requiring countries to report emerging pathogen threats within hours. With respect to the pandemic accord, while all countries have paid lip service to the need to ensure more equitable distribution of drugs and vaccines in the next pandemic – they are at odds about draft language that would commit them, in advance, to set aside of fixed quantities of health tools for developing nations. Insofar as those negotiations are only due to conclude by May 2024, the most meaningful talks are likely to be in the corridors and on the sidelines of the WHA – rather than in the formal chambers of the meeting, being held at Geneva’s UN headquarters, said Gian Luca Burci, former chief WHO legal counsel at Sunday’s Graduate Institute session. “For [WHA] action, there is nothing specific on the IHR, Burci observed. With regards to the pandemic accord, the only main formal item explicitly on the agenda is the potential treaty’s cost.” “But there will be a Secretariat Briefing on the negotiations, and I’m sure there will be a lot of discussions, a lot of side conversations among delegates looking to break some of the deadlocks, and so forth.” Meanwhile, WHO continues to move ahead with voluntary initiatives aimed at improving outbreak detection and response. For example, just ahead of the WHA’s opening, WHO announced the launch of a new International Pathogen Surveillance Network, that aims to detect and report infectious disease threats in real time, making better use of digital and genomic tools that many countries still lack. WHO and partners are launching the International Pathogen Surveillance Network, a global network to help protect people from infectious disease threats through better use of pathogen genomics https://t.co/riuOjqB8Ju pic.twitter.com/vXqJZk6dzs — World Health Organization (WHO) (@WHO) May 20, 2023 The new network represents an ambitious effort to fill a critical gap in WHO’s existing system of disease outbreak alerts – which can right now be delayed by weeks or even months if countries resist disclosure. But without revisions to the IHR, such networks will remain purely voluntary. So the key question, as always remains: will all countries join, collaborate and cooperate – and who will support the improved capacity of low income countries for detecting and reporting new threats? WHO Calls on Countries to “Drastically Reduce” Climate Emissions to Improve Global Health 19/05/2023 Megha Kaveri Fossil fuel combustion is a leadng source of global warming as well as of health harmful air pollution emissions. The World Health Organization (WHO) has called for focused action to address global warming and climate change to promote health outcomes. Recommendations include concerted efforts to reduce carbon emissions, build climate-resilient and sustainable health systems and protect health from the impacts of climate change. There is also a decline in the treatment coverage for tuberculosis between 2019 and 2021, and a stall in the world’s progress to tackle non-communicable diseases (NCDs) like hypertension and adult obesity. “Climate and Health” is featured as a separate chapter in the latest edition of the World Health Statistics Report, published by the WHO on Friday. This underlines its importance as a major driver of health outcomes in coming years, WHO officials said. The 131-page annual compilation of health statistics, while providing a birds-eye view on the progress made on global health metrics, also highlights how the world is not on track to achieve the targets set out in the Sustainable Development Goals (SDGs) 2030. “The world is off track to reach the sustainable development goals,” said Dr Samira Asma, assistant director-general for data, analytics and delivery for impact at the WHO during a press briefing on Thursday. “Unless we pick up the pace, we risk losing countless lives that could have been saved, as well as failing to improve the quality of life for all”. Spotlight on climate change “For the first time, we have a dedicated section on climate change, recognizing its crucial role in shaping the global landscape,” Asma said, underlining the role climate plays in global health. The global average temperature during 2021 was around 1.20°C higher than levels observed during the pre-industrial years. The report added that it’s unlikely the world will be able to limit the rise in average temperature to the 1.5°C level agreed in the 2015-Paris Agreement, so as to avoid “irreversible and catastrophic changes to our natural and human systems”. “In order to stay within the 1.5˚C global warming limit set out in the 2015 Paris climate agreement, the world will need to drastically reduce emissions through large-scale transformation across social and economic systems,” the report emphasized. WHO’s spotlight on climate change and its connection to health comes at the heels of the Annual to Decadal Climate update released by the World Meteorological Organization (WMO) on Wednesday. The WMO report stated that the world is likely to breach the 1.5°C limit set by the Paris Agreement before 2027 – although if drastic mitigation measures were taken now they could still bring temperatures down again later. Apart urgent measures to reduce carbon emissions, countries should also concentrate on building climate-resilient and environmentally sustainable health systems to mitigate the effects of climate change on health. “At the global level, the health sector generates 4-5% of the global greenhouse gas emissions. Adopting sustainable practices brings benefits like improved accessibility, reliable services, and lower costs,” Dr Haidong Wang, the WHO unit head of monitoring, forecasting & inequalities, said. “Climate change has challenges to countries already dealing with non-communicable disease burdens. It may also lead to resurgence of infectious diseases”. Infectious diseases and NCDs The report revealed that in the past few years, the progress made by the world in combating infectious diseases like TB, HIV and malaria, and NCDs, have been reversed. Around 10.6 million people were diagnosed with TB in 2021, which is a 4.5% increase in numbers when compared with 2020. The global TB incidence rate increased by 3.6% between 2020 and 2021, reversing the progress made in the past two decades. “Tuberculosis treatment coverage dropped from 69% in 2019 to 61% in 2021,” Wang pointed out. The situation around NCDs are equally grim. Probability of dying from the four major NCDs (ages 30–69 years), projection versus SDGtarget, WHO regions and global, 2000–2048. If targeted efforts are not taken by countries, the objectives set out in the SDGs around tackling NCDs will remain unachieved. “The share of deaths caused annually by NCDs has grown to nearly three quarters of all deaths and, if the trend continues, is projected to reach about 86% globally by WHO’s 100th anniversary in 2048,” the report cautions. “The United Nations projects that total annual deaths will reach nearly 90 million globally in 2048; consequently, 77 million of these will be NCD deaths – a nearly 90% increase in absolute numbers over 2019”. COVID-19 pandemic: A medley of crises It is known that the COVID-19 pandemic caused unprecedented damage to health systems across the world. Not only did it kill millions of lives, it also caused considerable backsliding in decades-long efforts taken to address diseases like tuberculosis and HIV, and even changed the pattern of care-seeking across the world. “So the COVID-19 pandemic wasn’t just a health emergency, it was also a statistical crisis across the world,” Dr Dr Stephen MacFeely, WHOs director of data and analytics said. He added that several countries suspended longstanding surveys due to pandemic-related restrictions, making it impossible to acquire real data on issues like population and housing. “This shock interrupted the flow of data from already weak and fragile data systems.” Emphasizing on the need to have robust, disaggregated, good quality data for monitoring and surveillance purposes, MacFeely said that WHO will be launching a “Data Dot Portal”, as part of the agency’s World Health Data Hub project, to serve as a “one-stop shop for health data”. The portal will be launching at the end of next week, as curtains fall on the 76th World Health Assembly, after being in development for nearly four years. Image Credits: Chris LeBoutillier, World Health Organization. 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.
WHO Member-states Greenlight $6.83b Budget for 2024-25; Countries Demand More Transparency 22/05/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the plenary session on Monday. World Health Organization member-states greenlighted a budget of $6.83 billion for 2024-25 for the global health agency – an 11% increase over the 2022-23 budget. Implicit in the budget is member-state implementation of a stepwise increase in assessed contributions. The groundbreaking reform, which aims to have one-half of WHO’s spending financed more sustainably by fixed member state contributions by 2030, was approved in principle at the May 2022 World Health Assembly (WHA). But it still required a nod from member states for the increased assessments to be applied this year. And that was not a foregone conclusion until a closed door meeting last week between member states, observed former WHO chief legal counsel Gian Luca Burci at a WHA preview event on Sunday. The WHO budget for the previous biennium 2022-23 was $6.12 billion. The gradual increase in country assessments aims to correct WHO’s current over-dependence on earmarked “voluntary contributions” – money that is donated by a member state or philanthropy. Such voluntary contributions now make up around 84% of the WHO’s total budget. WHO Director General Dr Tedros Adhanom Ghebreyesus, along with other senior officials, have long complained that such designated funding makes strategic planning hard to control. “WHO’s over-reliance on voluntary contributions, with a large proportion earmarked for specific areas of work results, in an ongoing misalignment between organizational priorities and the ability to finance them,” the WHO had mentioned in a statement during WHA 2022. Focus shifts towards countries Budget allocated to WHO offices this year compared to the previous allocation. Roughly $2 billion of the 2024-25 budget will go towards furthering WHO’s goal of Universal Health Coverage, and around $1.35 billion will be channeled into a “more effective and efficient WHO”. The latter includes greater support to countries, including co-financing for United Nations Resident Coordinators. While WHO will continue to maintain its own country offices in over 100 developing countries, the UN-wide Resident Coordinator system, aims to improve coordination between UN-affiliated tasks at country level. But the new 2024-25 budget allocation to countries and regions is, in fact, only marginally larger than the allocation of $1.25 billion from the previous 2022-23 biennium. Countries welcomed the gradual increase in country allocations, however modest. But , African member-states re-asserted demands that at least 75% of the budget should go to offices outside of the Geneva headquarters. “We wish to see the efforts to continue increasing the share of countries and regions from the program budget according to an agreed phased timeline for 2024 to 2027 with an aspiration to reach at least 75% budget allocation to countries and regions,” said the delegate from Ethiopia, speaking on behalf of the group of 47 sub-Saharan African member states. Of the $6.83 billion budget allocation, a little over 50% will be spent towards achieving the WHO’s triple billion targets of universal health coverage ($1.96 billion), protecting people from health emergencies ($1.21 billion). The third pillar aiming to ensure “healthier lives and well-being” for 1 billion people received the least funding with only $0.43 billion for the two years. Polio eradication, meanwhile, received an allocation of $0.69 billion, 23% higher than the previous biennium. Polio, which had resurfaced sporadically in Africa and North America over the past year, along with the typical Asian hotspots of Afghanistan and Pakistan, remains the only public health emergency of international concern (PHEIC) designated by the WHO as of Monday. WHO’s Special Programmes (for Research and Training in Tropical Diseases, the Special Programme of Research, Development and Research Training in Human Reproduction, and the Pandemic Influenza Preparedness Framework) received an allocation of $0.17 billion as against the allocation of $0.19 billion the previous time. Main ask: flexible funding and transparency in spending Member states, meanwhile, rallied to emphasize on the need to continue working for a flexible funding mechanism that prioritizes the causes of spending based on specific situations. “The lack of flexible funds remains a continued concern. We hope to witness an increase in flexible funds over the long run by steadily introducing replenishment mechanisms, which are currently being discussed,” the delegate for the Republic of Korea noted. Calls for greater transparency in WHO spending also rang across the room. Countries ranging from the Philippines, to Namibia and Brazil demanded that WHO disclose more specific details about projects and programmes in which it is engaged at country-level. “Improvements in transparency, accountability and administrative measures are essential. In the absence of clear improvements in those areas, it will be impossible to adopt, let alone justify any increase in assessed contributions,” the delegate for Brazil told the floor. “The practice of complete disclosure of information on expenditures of member states to member states in order to ensure transparency is not only indispensable, but also something customarily adopted by the UN agencies, and it is high time the WHO follows this path.” Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus, WHO. Egypt to Produce Insulin for Africa in New Collaboration with Eli Lilly 22/05/2023 Kerry Cullinan Dr Loyce Pace, with WHO’s Dr Bente Mikkelsen, Africa CDC’s Dr Jean Kaseya and EVA Pharma CEO Riad Armanious. GENEVA – Within months, insulin manufactured in Egypt will be available for distribution in sub-Saharan Africa, thanks to a collaboration between Eli Lilly and a local manufacturer that aims to produce one million doses of insulin by 2030. Eli Lilly is providing Egypt’s EVA Pharma with the active pharmaceutical ingredients (API) of insulin at a “significantly reduced price” to enable cheaper, faster production of the life-saving medication that is used to treat diabetes, one of the fastest-growing health problems on the continent. Eli Lilly will also provide a pro-bono technology transfer to enable EVA Pharma to formulate, fill and finish insulin vials and cartridges as part of its global commitment to enable 30 million insulin doses by 2030. Dr Bente Mikkelsen, WHO and Dr Jean Kaseya, Africa CDC Dr Bente Mikkelsen, Director of the Non-communicable Disease (NCD) Programme at the World Health Organization (WHO), welcomed the initiative, which was announced at a special event on the sidelines of the World Health Assembly (WHA) in Geneva. “If we can control diabetes, we can reach the SDG targets on NCDs,” said Mikkelsen. “We need to focus on early diagnosis and treatment and universal health coverage as 74% of global deaths are due to NCDs.” An estimated 3-4 million Africans are living with diabetes today – although less than 50% are aware of their status,” said Eli Lilly’s Leigh Ann Pusey, speaking at another event later on Monday. However, if current projections hold, some 54 million Africans are likely to suffer from diabetes by 2045, “That’s a 144% increase,” she said, representing the largest projected increase in diabetes rates globally, with Egypt particularly affected. EVA Pharma CEO Riad Armanious EVA Pharma CEO Riad Armanious said that his company had signed the agreement with Eli Lilly in December and his company had been building the manufacturing capacity to make insulin over the past five months. “We celebrating the completion of the biologics facility next week, then we will need regulatory approval but we expect to start manufacturing before the end of the year,” Armanious told Health Policy Watch. Voicing his support for the initiative, Dr Jean Kaseya, Director General of the Africa Centres for Disease Control and Prevention, revealed that his father had died of diabetes because he could not get insulin. “Only 30% of the therapeutics used in Africa are produced on the continent,” said Kaseya, adding that he was convening a meeting of local manufacturing with African leaders in July. Dr Loyce Pace, US Assistant Secretary for Global Affairs in the Department of Health and Human Services, said that people in the US also faced challenges getting access to insulin and that her country was committed to being a “real partner” in improving the global supply of insulin. Pace revealed that her own mother-in-law had died of diabetes in The Gambia because she was unable to get insulin. Image Credits: WHO. Ukraine Allies Call on World Health Assembly to Condemn Russian ‘Aggression’ 22/05/2023 Stefan Anderson World Health Assembly delegates minutes after votes on competing resolutions on the health crisis in Ukraine last year. Europe, the United States, Ukraine and its allies have submitted a draft resolution to the World Health Assembly (WHA) calling on the 194 member states of the World Health Organization (WHO) to condemn the health crisis caused by Russia’s “continued aggression against Ukraine.” The EU-led draft, published on Monday, is a near-identical replica of the resolution condemning Russian “aggression” passed by the WHA last year. They even share the same title. The resolution urges Russia to “immediately cease any attacks on hospitals and other health care facilities,” and to protect “civilians, health and humanitarian workers.” At least 8,500 civilians have been killed since Russia invaded Ukraine in February last year, and over 14,000 more have been injured, the UN Office of the High Commissioner for Human Rights said in its April status report. Russia responded by submitting a draft resolution of its own. The resolution, co-sponsored by Syria, makes no mention of Russia’s role in the health crisis in Ukraine. A similar effort to push through a counter-resolution failed last year. The Russian draft expresses “grave concern at the deteriorating humanitarian situation in and around Ukraine” and demands “all parties concerned to respect their obligations under international humanitarian and human rights law.” It also strongly condemns “attacks directed against civilians and health objects.” The WHO surveillance system for attacks on health care (SSA) lists 974 confirmed attacks on health facilities in Ukraine since the start of the war – an onslaught WHO Europe Director Dr Hans Kluge called “the largest attack on health care on European soil since the Second World War.” Over 100 health care workers have died in the attacks. Syrian President Bashar al-Assad, the Russian bill’s co-sponsor, has repeatedly used chemical weapons against his own people throughout the Syrian civil war. WHO tip-toes a fine line, but Ukraine health crisis in bounds The Russian delegation protested a US statement in support of Ukraine, calling on the chair to “ask people to speak about health.” The WHO has had a hard go of its attempts to remain politically neutral amid Russia’s invasion of Ukraine. Earlier this month, a year-long pressure campaign from EU states succeeded in forcing the closure of WHO’s non-communicable diseases office in Moscow. The announcement of its closure was accompanied by the news that the office will be relocated to Copenhagen next year. The use of the word “invasion” in a WHO status report on the organization’s emergency response in Ukraine caused a clash at this year’s Executive Board meeting, where Director-General Dr Tedros Adhanom Ghebreyesus vehemently defended his choice in response to Russian allegations that the report had been politicized. “I couldn’t find any other word that would represent it because it’s the truth,” Tedros said. “What could I say?” Interventions in plenary sessions calling out Russia’s role in the health crisis in Ukraine have so far been upheld by WHA President Dr Christopher Fearne despite repeated Russian protests. “We are not in New York, we are in the world health assembly,” the Russian delegation said in response to a statement by the United States that its invasion of Ukraine violated the charter of the United Nations. “We are ready to discuss the entire agenda, but not … any issues of aggression, or whatever these countries are saying.” Fearne called the health crisis in Ukraine “clearly a health matter relevant to this assembly”. “In fact,” he added, “we are to discuss it later on this week.” Image Credits: Health Policy Watch . Taiwan Excluded as World Health Assembly Opening Focuses on Pandemic Preparedness, and Funding 22/05/2023 Disha Shetty Dr Tedros Adhanom Ghebreyesus, director-general of the WHO. The 76th World Health Assembly turned political even before formal the proceedings began, with the decision to exclude Taiwan. The island was seeking an observer status, something that it had held previously between 2009 and 2016, with the support of the United States and others. But its inclusion was strongly opposed by China which maintains the island is its province and not an independent country. Pakistan backed China’s right to territorial integrity. The two countries said they did not object to the inclusion of experts from Taiwan in technical meetings and exchanges related to pandemic preparedness. As Taiwan’s bid failed, Dr Jui-Yuan Hsueh, Taiwan’s Minister of Health and Welfare, said the call was taken by WHA due to political considerations and pressure from China. In his keynote address, WHO Director-General Dr Tedros Adhanom Ghebreyesus listed the key priority for this year’s assembly, urging countries to work towards WHO’s triple billion targets and pick up the pace on achieving the health-related sustainable development goals (SGDs). Tedros also said the pandemic accord that the WHA will be negotiating this year will be an important step for future preparedness and requested countries to engage with the process. But Taiwan’s exclusion will have an impact on the pandemic accord, according to Health Minister Hsueh: “Without WHO membership, Taiwan is also unable to provide various surveillance data to the global influenza surveillance and the response system, which could alert the world to the next pandemic. Taiwan is willing and it should also be included in the pandemic accord that is under negotiation,”. Tedros also made it clear that finding ways to fund the various programmes of the WHO will be a priority. Despite South Asia currently being under another intense heatwave second year in a row, climate change was mentioned only briefly by Tedros. With COVID-19 no longer an official global health emergency, polio remains the only one global emergency. “After an all-time low of five wild poliovirus cases in 2021, we saw an increase last year, with 20 cases in Pakistan, two in Afghanistan and eight in Mozambique,” he said, adding that WHO is committed to polio eradication. “Last year, three million children previously inaccessible in Afghanistan received polio vaccines for the first time. And in October, donors pledged US$2.6 billion to support the push for eradication,” he said. Tedros also mentioned the work being done to roll out new vaccines for tuberculosis as quickly as possible. “It was done for COVID; it can be done for TB,” he said. He also acknowledged the need to bolster disaster response and funding, appealing to member countries to support funding efforts in 2024 so the health body was in the best possible shape to respond. In discussions, members drew attention to multiple emergencies in the Horn of Africa, Palestine, Syria, Ukraine and Yemen, among others. Additional reporting by Megha Kaveri What Can We Learn from the History of Health? New Podcast 22/05/2023 Editorial team It is often said that those who fail to learn from history are doomed to repeat it. So what, if anything, can we learn from the history of health? In this brand new season of the Global Health Matters podcast, host Garry Aslanyan takes a step back in time to look at why “history matters” and to discuss the value and merits of understanding global health history and the evolution of global health, particularly concerning the establishment of the World Health Organization (WHO), which this year celebrates its 75th anniversary. “All institutions have long histories,” guest Sanjoy Bhattacharya, head of the School of History and Professor of Medical and Global Health History at the University of Leeds in the UK, told Aslanyan.” And those long histories have determined negotiations between complex partnerships, complex organisations, and how we operate today is deeply determined by those long-term negotiations, which is historical. So history matters.” Speaking on the history of global health in terms of colonialism and colonial powers, Professor of Global Development Studies and Global Health at the University of Toronto in Canada, Anne-Emanuelle Birn, said, “In the 19th century, the arena that has evolved or erupted, transformed into global health history, began in a very particular context, that of imperialism, particularly European, but also North American imperialism and the growth of the colonial enterprise. “Health and medicine played a very important role, so one of the earliest precursors to global health history, or global health, was colonial medicine.” By the middle of the 20th century, after two world wars ravaged the world, there was renewed hope which saw the formation of several new international cooperation organization, such as the United Nations. In this arena, the World Health Organization was founded in April 1948, aiming to work worldwide to promote health and coordinate responses to health emergencies. “You have this transition, and it really takes off after the founding of the World Health Organization, this idea of international health, health between countries, through sometimes collective decision-making but also very much influenced by the world order, in that case, the Cold War,” Birn said. “For me, WHO is not just Geneva,” Bhattacharya said. “if you look at a bottom-up history of WHO, where you center the regional offices, I would submit that you actually get a much more decolonised and democratic history of international and global health than you would if you looked at Geneva and say that everything that is happening in global or international health is happening because of things that are happening in Geneva.” Taking a look at a very recent example of COVID-19, Birn points out that as much as coordinated international efforts can combat the quick spread of disease and introduce appropriate measures, at the same time, every country is in its own unique situation based on cultural and social factors. “With the COVID-19 pandemic, there was an expectation in certain quarters that history would help to address, resolve, shed light on the course of the pandemic,” Birn said. “There’s no way historical perspectives can resolve social, political, and other forms of tensions that the response to COVID-19 continues to engender, arguably. History can’t predict or liberate, and every pandemic has occurred in particular social, political, and cultural configurations. So there’s no recipe, right? The expectation was that history would provide a recipe.” “There are multiple historical narratives about any aspect of global pandemics,” Bhattacharya added. “So if you’re saying was COVID influenced by any historical narratives, then the problem then became that there wasn’t one historical narrative.” Looking into the past can sometimes provide the lessons or answers we seek, but as Bhattacharya pointed out, it is essential to know which or whose history one is learning. “History matters, but we must always ask which history matters because there are multiple histories.” This is part I of a two-part series. Image Credits: Global Health Matters Podcast via TDR. On 75th Anniversary World Health Assembly Must Confront New and Growing Threats 21/05/2023 Elaine Ruth Fletcher Member states attending the World Health Assembly’s high-level opening on Sunday, 21 May in Geneva. The World Health Assembly opened its annual meeting of member states Sunday on a celebratory note marking the 75th anniversary of the World Health Organization’s foundation in 1948. Eradicating smallpox, eliminating polio in most countries worldwide, and dramatic reductions in deaths from once-deadly childhood diseases preventable by clean water, basic medicines and vaccines are among a few of the historic accomplishments the Organization will be celebrating as this year’s 76th WHA session begins, said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in opening remarks at the WHA. “Smallpox is history and polio is on the brink. And epidemics of malaria, HIV and tuberculosis have all been pushed back,” said Dr Tedros. Thanks to the Framework Convention on Tobacco Control, smoking rates have declined in dozens of countries worldwide, with strict policies on tobacco advertising and taxes on tobacco products. He was speaking Sunday at a WHA preview event at the Geneva Graduate Institute’s Global Health Center, just before the official WHA curtain-raiser; the latter featured a lineup of high-level figures from around the world, including India’s Prime Minister Narendra Modi and former New Zealand Prime Minister Jacinda Ardern. Pandemic treaty negotiations set against regional conflicts The number of people living in zones of combined conflict and health emergencies has doubled since 2015 – Kate Dodson, UN Foundation But against those successes, this year’s WHA is taking place against the background of complex, ongoing negotiations over an ambitious new pandemic treaty and, in parallel, talks over revisions to the 2005 International Health Regulations that aim to supplement and replace archaic rules on international emergency response. The WHA also is taking place in a second year of war between Russia and the Ukraine – whose bitter dispute was the subject of competing WHA resolutions last year – and which will likely again surface in debates by the global health body this year. And the Ukraine-Russia war is only one of multiple conflicts destroying lives and global health. As this year’s WHA considers a new “Health for Peace Initiative”, some 39 million people are – or almost one in 20 of the world’s population – living in fragile and complex settings that combine conflict with health emergencies. “That’s an increase of 25% since just last year, and double since 2015,” noted Kate Dodson, vice president for global health at the United Nations Foundation, a co-sponsor of the Graduate School WHA opener. And while this week’s WHA session is set to approve update guidance to countries on “best buys” for reducing non-communicable diseases, NCD disease rates are soaring worldwide, with heart disease having increased by 60% in the last 30 years, according to data published by the World Heart Summit, also convening this weekend in Geneva. Meanwhile, the WHO remains financially challenged. For the first time ever, this year’s WHA is supposed to approve stepped up rates of annual contributions by member states to the global health organization. It will also debate a January Executive Board recommendation to establish a “replenishment fund” for voluntary contributions by donors and member states that could be used in a more flexible way by the Organization than “earmarked” donations that make up the bulk of its budget today. Challenges moving far beyond the health sector Non-communicable diseases now account for 70% of deaths globally – WHO Director General Dr Tedros Adhanom Ghebreyesus at the opening of the 76th WHA. Overall, as it enters its 76th year of existence, the Organization is increasingly challenged by the need to respond coherently to an increasingly broad and complex portfolio of emerging disease threats – over which it often has little influence or control. Those include obesity, heart disease and hypertension stimulated by sedentary lifestyles and fast food diets; antimicrobial resistance from misuse and overuse of antibiotics in both the human and animal health sector; the climate crisis and air pollution; and as COVID-19 demonstrated to the world – vast disparities in access to health care including vital medicines and vaccines. “Non communicable diseases now account for some 70% of deaths globally,” noted Tedros in his opening WHA address. “Antimicrobial resistance threatens to unwind centuries of medical progress. Vast disparities in access to health resources exist between and within countries and communities. And the existential threat of climate change is jeopardizing the very habitability of our planet. “WHO has grown enormously but our resources have not,” Tedros added. “There is the challenge of being a technical scientific organization in a political, and increasingly politicized, environment.” “These are daunting and complex challenges. We will not solve them at the World Health Assembly and we will not solve them in our lifetimes, but we’re building a path that our children and grandchildren will walk down and that they will continue to build,” Tedros said. “The challenges of today are very different to those we faced in 1948. But the vision is the same.” 1969 International Health Regulations only covered four diseases In 1969 the International Health Regulations only covered four disease – former WHO official David Heymann (on left) speaking at WHO preview event at the Geneva Graduate Institute “When the [WHO] International Health Regulations were developed back in 1969, their goal was really to stop disease at borders,” pointed out David Heymann, a former high-ranking WHO official, at the Geneva Graduate Institute’s WHA preview event Sunday morning. “If a country reported one in four infections, cholera, yellow fever, plague or smallpox, then countries that were receiving passengers from those countries could request a vaccination certificate. There were pre-determined measures to stop disease transmission, and at that time, WHO was the exclusive owner of much of the information because countries reported to WHO, WHO did a risk assessment, and provided its recommendations.” While the IHR finally underwent a major update in 2005, greatly broadening the scope of what was to be reported – and empowering WHO to declare a “Public Health Emergency of International Concern (PHEIC),” the regulations have failed to keep up with the pace of change in the real world, he pointed out. The biggest failure, he contends, was in “the most important part of the IHR, which was the requirement of countries to establish core capacity in public health to be able to detect, respond and prevent national disease spread and death, and eventually prevent international spread by this rapid reaction.” In terms of risk assessments as well, as the digital transformation accelerated the spread of information, WHO was no longer the exclusive arbiter of risks from pathogens that appeared. “As we saw in the COVID pandemic, countries really preferred doing their own risk assessments. They had access to data which they had never had before – all respectable medical journals were publishing peer reviewed information in front of their paywall. So any government advisory group could get that and could make recommendations to their own government as to what to do. As a result, WHO lost its authoritative position in making recommendations, countries devised their own policies, and what ensued was “confusion, utter confusion” over global response, Heymann contended. “The [IHR] regulations to me, they’re really a vestige of the past.” Negotiations over pandemic accord will be on sidelines of formal WHA Gian Luca Burci, former WHO chief legal counsel describes the workings of the World Health Assembly – and what to expect at this session. This year’s WHA is set against the backdrop of ongoing negotiations over IHR revisions as well as the development of a new pandemic accord. Both are mired in controversial debates by member states over language on reporting outbreaks- including proposals for requiring countries to report emerging pathogen threats within hours. With respect to the pandemic accord, while all countries have paid lip service to the need to ensure more equitable distribution of drugs and vaccines in the next pandemic – they are at odds about draft language that would commit them, in advance, to set aside of fixed quantities of health tools for developing nations. Insofar as those negotiations are only due to conclude by May 2024, the most meaningful talks are likely to be in the corridors and on the sidelines of the WHA – rather than in the formal chambers of the meeting, being held at Geneva’s UN headquarters, said Gian Luca Burci, former chief WHO legal counsel at Sunday’s Graduate Institute session. “For [WHA] action, there is nothing specific on the IHR, Burci observed. With regards to the pandemic accord, the only main formal item explicitly on the agenda is the potential treaty’s cost.” “But there will be a Secretariat Briefing on the negotiations, and I’m sure there will be a lot of discussions, a lot of side conversations among delegates looking to break some of the deadlocks, and so forth.” Meanwhile, WHO continues to move ahead with voluntary initiatives aimed at improving outbreak detection and response. For example, just ahead of the WHA’s opening, WHO announced the launch of a new International Pathogen Surveillance Network, that aims to detect and report infectious disease threats in real time, making better use of digital and genomic tools that many countries still lack. WHO and partners are launching the International Pathogen Surveillance Network, a global network to help protect people from infectious disease threats through better use of pathogen genomics https://t.co/riuOjqB8Ju pic.twitter.com/vXqJZk6dzs — World Health Organization (WHO) (@WHO) May 20, 2023 The new network represents an ambitious effort to fill a critical gap in WHO’s existing system of disease outbreak alerts – which can right now be delayed by weeks or even months if countries resist disclosure. But without revisions to the IHR, such networks will remain purely voluntary. So the key question, as always remains: will all countries join, collaborate and cooperate – and who will support the improved capacity of low income countries for detecting and reporting new threats? WHO Calls on Countries to “Drastically Reduce” Climate Emissions to Improve Global Health 19/05/2023 Megha Kaveri Fossil fuel combustion is a leadng source of global warming as well as of health harmful air pollution emissions. The World Health Organization (WHO) has called for focused action to address global warming and climate change to promote health outcomes. Recommendations include concerted efforts to reduce carbon emissions, build climate-resilient and sustainable health systems and protect health from the impacts of climate change. There is also a decline in the treatment coverage for tuberculosis between 2019 and 2021, and a stall in the world’s progress to tackle non-communicable diseases (NCDs) like hypertension and adult obesity. “Climate and Health” is featured as a separate chapter in the latest edition of the World Health Statistics Report, published by the WHO on Friday. This underlines its importance as a major driver of health outcomes in coming years, WHO officials said. The 131-page annual compilation of health statistics, while providing a birds-eye view on the progress made on global health metrics, also highlights how the world is not on track to achieve the targets set out in the Sustainable Development Goals (SDGs) 2030. “The world is off track to reach the sustainable development goals,” said Dr Samira Asma, assistant director-general for data, analytics and delivery for impact at the WHO during a press briefing on Thursday. “Unless we pick up the pace, we risk losing countless lives that could have been saved, as well as failing to improve the quality of life for all”. Spotlight on climate change “For the first time, we have a dedicated section on climate change, recognizing its crucial role in shaping the global landscape,” Asma said, underlining the role climate plays in global health. The global average temperature during 2021 was around 1.20°C higher than levels observed during the pre-industrial years. The report added that it’s unlikely the world will be able to limit the rise in average temperature to the 1.5°C level agreed in the 2015-Paris Agreement, so as to avoid “irreversible and catastrophic changes to our natural and human systems”. “In order to stay within the 1.5˚C global warming limit set out in the 2015 Paris climate agreement, the world will need to drastically reduce emissions through large-scale transformation across social and economic systems,” the report emphasized. WHO’s spotlight on climate change and its connection to health comes at the heels of the Annual to Decadal Climate update released by the World Meteorological Organization (WMO) on Wednesday. The WMO report stated that the world is likely to breach the 1.5°C limit set by the Paris Agreement before 2027 – although if drastic mitigation measures were taken now they could still bring temperatures down again later. Apart urgent measures to reduce carbon emissions, countries should also concentrate on building climate-resilient and environmentally sustainable health systems to mitigate the effects of climate change on health. “At the global level, the health sector generates 4-5% of the global greenhouse gas emissions. Adopting sustainable practices brings benefits like improved accessibility, reliable services, and lower costs,” Dr Haidong Wang, the WHO unit head of monitoring, forecasting & inequalities, said. “Climate change has challenges to countries already dealing with non-communicable disease burdens. It may also lead to resurgence of infectious diseases”. Infectious diseases and NCDs The report revealed that in the past few years, the progress made by the world in combating infectious diseases like TB, HIV and malaria, and NCDs, have been reversed. Around 10.6 million people were diagnosed with TB in 2021, which is a 4.5% increase in numbers when compared with 2020. The global TB incidence rate increased by 3.6% between 2020 and 2021, reversing the progress made in the past two decades. “Tuberculosis treatment coverage dropped from 69% in 2019 to 61% in 2021,” Wang pointed out. The situation around NCDs are equally grim. Probability of dying from the four major NCDs (ages 30–69 years), projection versus SDGtarget, WHO regions and global, 2000–2048. If targeted efforts are not taken by countries, the objectives set out in the SDGs around tackling NCDs will remain unachieved. “The share of deaths caused annually by NCDs has grown to nearly three quarters of all deaths and, if the trend continues, is projected to reach about 86% globally by WHO’s 100th anniversary in 2048,” the report cautions. “The United Nations projects that total annual deaths will reach nearly 90 million globally in 2048; consequently, 77 million of these will be NCD deaths – a nearly 90% increase in absolute numbers over 2019”. COVID-19 pandemic: A medley of crises It is known that the COVID-19 pandemic caused unprecedented damage to health systems across the world. Not only did it kill millions of lives, it also caused considerable backsliding in decades-long efforts taken to address diseases like tuberculosis and HIV, and even changed the pattern of care-seeking across the world. “So the COVID-19 pandemic wasn’t just a health emergency, it was also a statistical crisis across the world,” Dr Dr Stephen MacFeely, WHOs director of data and analytics said. He added that several countries suspended longstanding surveys due to pandemic-related restrictions, making it impossible to acquire real data on issues like population and housing. “This shock interrupted the flow of data from already weak and fragile data systems.” Emphasizing on the need to have robust, disaggregated, good quality data for monitoring and surveillance purposes, MacFeely said that WHO will be launching a “Data Dot Portal”, as part of the agency’s World Health Data Hub project, to serve as a “one-stop shop for health data”. The portal will be launching at the end of next week, as curtains fall on the 76th World Health Assembly, after being in development for nearly four years. Image Credits: Chris LeBoutillier, World Health Organization. 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.
Egypt to Produce Insulin for Africa in New Collaboration with Eli Lilly 22/05/2023 Kerry Cullinan Dr Loyce Pace, with WHO’s Dr Bente Mikkelsen, Africa CDC’s Dr Jean Kaseya and EVA Pharma CEO Riad Armanious. GENEVA – Within months, insulin manufactured in Egypt will be available for distribution in sub-Saharan Africa, thanks to a collaboration between Eli Lilly and a local manufacturer that aims to produce one million doses of insulin by 2030. Eli Lilly is providing Egypt’s EVA Pharma with the active pharmaceutical ingredients (API) of insulin at a “significantly reduced price” to enable cheaper, faster production of the life-saving medication that is used to treat diabetes, one of the fastest-growing health problems on the continent. Eli Lilly will also provide a pro-bono technology transfer to enable EVA Pharma to formulate, fill and finish insulin vials and cartridges as part of its global commitment to enable 30 million insulin doses by 2030. Dr Bente Mikkelsen, WHO and Dr Jean Kaseya, Africa CDC Dr Bente Mikkelsen, Director of the Non-communicable Disease (NCD) Programme at the World Health Organization (WHO), welcomed the initiative, which was announced at a special event on the sidelines of the World Health Assembly (WHA) in Geneva. “If we can control diabetes, we can reach the SDG targets on NCDs,” said Mikkelsen. “We need to focus on early diagnosis and treatment and universal health coverage as 74% of global deaths are due to NCDs.” An estimated 3-4 million Africans are living with diabetes today – although less than 50% are aware of their status,” said Eli Lilly’s Leigh Ann Pusey, speaking at another event later on Monday. However, if current projections hold, some 54 million Africans are likely to suffer from diabetes by 2045, “That’s a 144% increase,” she said, representing the largest projected increase in diabetes rates globally, with Egypt particularly affected. EVA Pharma CEO Riad Armanious EVA Pharma CEO Riad Armanious said that his company had signed the agreement with Eli Lilly in December and his company had been building the manufacturing capacity to make insulin over the past five months. “We celebrating the completion of the biologics facility next week, then we will need regulatory approval but we expect to start manufacturing before the end of the year,” Armanious told Health Policy Watch. Voicing his support for the initiative, Dr Jean Kaseya, Director General of the Africa Centres for Disease Control and Prevention, revealed that his father had died of diabetes because he could not get insulin. “Only 30% of the therapeutics used in Africa are produced on the continent,” said Kaseya, adding that he was convening a meeting of local manufacturing with African leaders in July. Dr Loyce Pace, US Assistant Secretary for Global Affairs in the Department of Health and Human Services, said that people in the US also faced challenges getting access to insulin and that her country was committed to being a “real partner” in improving the global supply of insulin. Pace revealed that her own mother-in-law had died of diabetes in The Gambia because she was unable to get insulin. Image Credits: WHO. Ukraine Allies Call on World Health Assembly to Condemn Russian ‘Aggression’ 22/05/2023 Stefan Anderson World Health Assembly delegates minutes after votes on competing resolutions on the health crisis in Ukraine last year. Europe, the United States, Ukraine and its allies have submitted a draft resolution to the World Health Assembly (WHA) calling on the 194 member states of the World Health Organization (WHO) to condemn the health crisis caused by Russia’s “continued aggression against Ukraine.” The EU-led draft, published on Monday, is a near-identical replica of the resolution condemning Russian “aggression” passed by the WHA last year. They even share the same title. The resolution urges Russia to “immediately cease any attacks on hospitals and other health care facilities,” and to protect “civilians, health and humanitarian workers.” At least 8,500 civilians have been killed since Russia invaded Ukraine in February last year, and over 14,000 more have been injured, the UN Office of the High Commissioner for Human Rights said in its April status report. Russia responded by submitting a draft resolution of its own. The resolution, co-sponsored by Syria, makes no mention of Russia’s role in the health crisis in Ukraine. A similar effort to push through a counter-resolution failed last year. The Russian draft expresses “grave concern at the deteriorating humanitarian situation in and around Ukraine” and demands “all parties concerned to respect their obligations under international humanitarian and human rights law.” It also strongly condemns “attacks directed against civilians and health objects.” The WHO surveillance system for attacks on health care (SSA) lists 974 confirmed attacks on health facilities in Ukraine since the start of the war – an onslaught WHO Europe Director Dr Hans Kluge called “the largest attack on health care on European soil since the Second World War.” Over 100 health care workers have died in the attacks. Syrian President Bashar al-Assad, the Russian bill’s co-sponsor, has repeatedly used chemical weapons against his own people throughout the Syrian civil war. WHO tip-toes a fine line, but Ukraine health crisis in bounds The Russian delegation protested a US statement in support of Ukraine, calling on the chair to “ask people to speak about health.” The WHO has had a hard go of its attempts to remain politically neutral amid Russia’s invasion of Ukraine. Earlier this month, a year-long pressure campaign from EU states succeeded in forcing the closure of WHO’s non-communicable diseases office in Moscow. The announcement of its closure was accompanied by the news that the office will be relocated to Copenhagen next year. The use of the word “invasion” in a WHO status report on the organization’s emergency response in Ukraine caused a clash at this year’s Executive Board meeting, where Director-General Dr Tedros Adhanom Ghebreyesus vehemently defended his choice in response to Russian allegations that the report had been politicized. “I couldn’t find any other word that would represent it because it’s the truth,” Tedros said. “What could I say?” Interventions in plenary sessions calling out Russia’s role in the health crisis in Ukraine have so far been upheld by WHA President Dr Christopher Fearne despite repeated Russian protests. “We are not in New York, we are in the world health assembly,” the Russian delegation said in response to a statement by the United States that its invasion of Ukraine violated the charter of the United Nations. “We are ready to discuss the entire agenda, but not … any issues of aggression, or whatever these countries are saying.” Fearne called the health crisis in Ukraine “clearly a health matter relevant to this assembly”. “In fact,” he added, “we are to discuss it later on this week.” Image Credits: Health Policy Watch . Taiwan Excluded as World Health Assembly Opening Focuses on Pandemic Preparedness, and Funding 22/05/2023 Disha Shetty Dr Tedros Adhanom Ghebreyesus, director-general of the WHO. The 76th World Health Assembly turned political even before formal the proceedings began, with the decision to exclude Taiwan. The island was seeking an observer status, something that it had held previously between 2009 and 2016, with the support of the United States and others. But its inclusion was strongly opposed by China which maintains the island is its province and not an independent country. Pakistan backed China’s right to territorial integrity. The two countries said they did not object to the inclusion of experts from Taiwan in technical meetings and exchanges related to pandemic preparedness. As Taiwan’s bid failed, Dr Jui-Yuan Hsueh, Taiwan’s Minister of Health and Welfare, said the call was taken by WHA due to political considerations and pressure from China. In his keynote address, WHO Director-General Dr Tedros Adhanom Ghebreyesus listed the key priority for this year’s assembly, urging countries to work towards WHO’s triple billion targets and pick up the pace on achieving the health-related sustainable development goals (SGDs). Tedros also said the pandemic accord that the WHA will be negotiating this year will be an important step for future preparedness and requested countries to engage with the process. But Taiwan’s exclusion will have an impact on the pandemic accord, according to Health Minister Hsueh: “Without WHO membership, Taiwan is also unable to provide various surveillance data to the global influenza surveillance and the response system, which could alert the world to the next pandemic. Taiwan is willing and it should also be included in the pandemic accord that is under negotiation,”. Tedros also made it clear that finding ways to fund the various programmes of the WHO will be a priority. Despite South Asia currently being under another intense heatwave second year in a row, climate change was mentioned only briefly by Tedros. With COVID-19 no longer an official global health emergency, polio remains the only one global emergency. “After an all-time low of five wild poliovirus cases in 2021, we saw an increase last year, with 20 cases in Pakistan, two in Afghanistan and eight in Mozambique,” he said, adding that WHO is committed to polio eradication. “Last year, three million children previously inaccessible in Afghanistan received polio vaccines for the first time. And in October, donors pledged US$2.6 billion to support the push for eradication,” he said. Tedros also mentioned the work being done to roll out new vaccines for tuberculosis as quickly as possible. “It was done for COVID; it can be done for TB,” he said. He also acknowledged the need to bolster disaster response and funding, appealing to member countries to support funding efforts in 2024 so the health body was in the best possible shape to respond. In discussions, members drew attention to multiple emergencies in the Horn of Africa, Palestine, Syria, Ukraine and Yemen, among others. Additional reporting by Megha Kaveri What Can We Learn from the History of Health? New Podcast 22/05/2023 Editorial team It is often said that those who fail to learn from history are doomed to repeat it. So what, if anything, can we learn from the history of health? In this brand new season of the Global Health Matters podcast, host Garry Aslanyan takes a step back in time to look at why “history matters” and to discuss the value and merits of understanding global health history and the evolution of global health, particularly concerning the establishment of the World Health Organization (WHO), which this year celebrates its 75th anniversary. “All institutions have long histories,” guest Sanjoy Bhattacharya, head of the School of History and Professor of Medical and Global Health History at the University of Leeds in the UK, told Aslanyan.” And those long histories have determined negotiations between complex partnerships, complex organisations, and how we operate today is deeply determined by those long-term negotiations, which is historical. So history matters.” Speaking on the history of global health in terms of colonialism and colonial powers, Professor of Global Development Studies and Global Health at the University of Toronto in Canada, Anne-Emanuelle Birn, said, “In the 19th century, the arena that has evolved or erupted, transformed into global health history, began in a very particular context, that of imperialism, particularly European, but also North American imperialism and the growth of the colonial enterprise. “Health and medicine played a very important role, so one of the earliest precursors to global health history, or global health, was colonial medicine.” By the middle of the 20th century, after two world wars ravaged the world, there was renewed hope which saw the formation of several new international cooperation organization, such as the United Nations. In this arena, the World Health Organization was founded in April 1948, aiming to work worldwide to promote health and coordinate responses to health emergencies. “You have this transition, and it really takes off after the founding of the World Health Organization, this idea of international health, health between countries, through sometimes collective decision-making but also very much influenced by the world order, in that case, the Cold War,” Birn said. “For me, WHO is not just Geneva,” Bhattacharya said. “if you look at a bottom-up history of WHO, where you center the regional offices, I would submit that you actually get a much more decolonised and democratic history of international and global health than you would if you looked at Geneva and say that everything that is happening in global or international health is happening because of things that are happening in Geneva.” Taking a look at a very recent example of COVID-19, Birn points out that as much as coordinated international efforts can combat the quick spread of disease and introduce appropriate measures, at the same time, every country is in its own unique situation based on cultural and social factors. “With the COVID-19 pandemic, there was an expectation in certain quarters that history would help to address, resolve, shed light on the course of the pandemic,” Birn said. “There’s no way historical perspectives can resolve social, political, and other forms of tensions that the response to COVID-19 continues to engender, arguably. History can’t predict or liberate, and every pandemic has occurred in particular social, political, and cultural configurations. So there’s no recipe, right? The expectation was that history would provide a recipe.” “There are multiple historical narratives about any aspect of global pandemics,” Bhattacharya added. “So if you’re saying was COVID influenced by any historical narratives, then the problem then became that there wasn’t one historical narrative.” Looking into the past can sometimes provide the lessons or answers we seek, but as Bhattacharya pointed out, it is essential to know which or whose history one is learning. “History matters, but we must always ask which history matters because there are multiple histories.” This is part I of a two-part series. Image Credits: Global Health Matters Podcast via TDR. On 75th Anniversary World Health Assembly Must Confront New and Growing Threats 21/05/2023 Elaine Ruth Fletcher Member states attending the World Health Assembly’s high-level opening on Sunday, 21 May in Geneva. The World Health Assembly opened its annual meeting of member states Sunday on a celebratory note marking the 75th anniversary of the World Health Organization’s foundation in 1948. Eradicating smallpox, eliminating polio in most countries worldwide, and dramatic reductions in deaths from once-deadly childhood diseases preventable by clean water, basic medicines and vaccines are among a few of the historic accomplishments the Organization will be celebrating as this year’s 76th WHA session begins, said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in opening remarks at the WHA. “Smallpox is history and polio is on the brink. And epidemics of malaria, HIV and tuberculosis have all been pushed back,” said Dr Tedros. Thanks to the Framework Convention on Tobacco Control, smoking rates have declined in dozens of countries worldwide, with strict policies on tobacco advertising and taxes on tobacco products. He was speaking Sunday at a WHA preview event at the Geneva Graduate Institute’s Global Health Center, just before the official WHA curtain-raiser; the latter featured a lineup of high-level figures from around the world, including India’s Prime Minister Narendra Modi and former New Zealand Prime Minister Jacinda Ardern. Pandemic treaty negotiations set against regional conflicts The number of people living in zones of combined conflict and health emergencies has doubled since 2015 – Kate Dodson, UN Foundation But against those successes, this year’s WHA is taking place against the background of complex, ongoing negotiations over an ambitious new pandemic treaty and, in parallel, talks over revisions to the 2005 International Health Regulations that aim to supplement and replace archaic rules on international emergency response. The WHA also is taking place in a second year of war between Russia and the Ukraine – whose bitter dispute was the subject of competing WHA resolutions last year – and which will likely again surface in debates by the global health body this year. And the Ukraine-Russia war is only one of multiple conflicts destroying lives and global health. As this year’s WHA considers a new “Health for Peace Initiative”, some 39 million people are – or almost one in 20 of the world’s population – living in fragile and complex settings that combine conflict with health emergencies. “That’s an increase of 25% since just last year, and double since 2015,” noted Kate Dodson, vice president for global health at the United Nations Foundation, a co-sponsor of the Graduate School WHA opener. And while this week’s WHA session is set to approve update guidance to countries on “best buys” for reducing non-communicable diseases, NCD disease rates are soaring worldwide, with heart disease having increased by 60% in the last 30 years, according to data published by the World Heart Summit, also convening this weekend in Geneva. Meanwhile, the WHO remains financially challenged. For the first time ever, this year’s WHA is supposed to approve stepped up rates of annual contributions by member states to the global health organization. It will also debate a January Executive Board recommendation to establish a “replenishment fund” for voluntary contributions by donors and member states that could be used in a more flexible way by the Organization than “earmarked” donations that make up the bulk of its budget today. Challenges moving far beyond the health sector Non-communicable diseases now account for 70% of deaths globally – WHO Director General Dr Tedros Adhanom Ghebreyesus at the opening of the 76th WHA. Overall, as it enters its 76th year of existence, the Organization is increasingly challenged by the need to respond coherently to an increasingly broad and complex portfolio of emerging disease threats – over which it often has little influence or control. Those include obesity, heart disease and hypertension stimulated by sedentary lifestyles and fast food diets; antimicrobial resistance from misuse and overuse of antibiotics in both the human and animal health sector; the climate crisis and air pollution; and as COVID-19 demonstrated to the world – vast disparities in access to health care including vital medicines and vaccines. “Non communicable diseases now account for some 70% of deaths globally,” noted Tedros in his opening WHA address. “Antimicrobial resistance threatens to unwind centuries of medical progress. Vast disparities in access to health resources exist between and within countries and communities. And the existential threat of climate change is jeopardizing the very habitability of our planet. “WHO has grown enormously but our resources have not,” Tedros added. “There is the challenge of being a technical scientific organization in a political, and increasingly politicized, environment.” “These are daunting and complex challenges. We will not solve them at the World Health Assembly and we will not solve them in our lifetimes, but we’re building a path that our children and grandchildren will walk down and that they will continue to build,” Tedros said. “The challenges of today are very different to those we faced in 1948. But the vision is the same.” 1969 International Health Regulations only covered four diseases In 1969 the International Health Regulations only covered four disease – former WHO official David Heymann (on left) speaking at WHO preview event at the Geneva Graduate Institute “When the [WHO] International Health Regulations were developed back in 1969, their goal was really to stop disease at borders,” pointed out David Heymann, a former high-ranking WHO official, at the Geneva Graduate Institute’s WHA preview event Sunday morning. “If a country reported one in four infections, cholera, yellow fever, plague or smallpox, then countries that were receiving passengers from those countries could request a vaccination certificate. There were pre-determined measures to stop disease transmission, and at that time, WHO was the exclusive owner of much of the information because countries reported to WHO, WHO did a risk assessment, and provided its recommendations.” While the IHR finally underwent a major update in 2005, greatly broadening the scope of what was to be reported – and empowering WHO to declare a “Public Health Emergency of International Concern (PHEIC),” the regulations have failed to keep up with the pace of change in the real world, he pointed out. The biggest failure, he contends, was in “the most important part of the IHR, which was the requirement of countries to establish core capacity in public health to be able to detect, respond and prevent national disease spread and death, and eventually prevent international spread by this rapid reaction.” In terms of risk assessments as well, as the digital transformation accelerated the spread of information, WHO was no longer the exclusive arbiter of risks from pathogens that appeared. “As we saw in the COVID pandemic, countries really preferred doing their own risk assessments. They had access to data which they had never had before – all respectable medical journals were publishing peer reviewed information in front of their paywall. So any government advisory group could get that and could make recommendations to their own government as to what to do. As a result, WHO lost its authoritative position in making recommendations, countries devised their own policies, and what ensued was “confusion, utter confusion” over global response, Heymann contended. “The [IHR] regulations to me, they’re really a vestige of the past.” Negotiations over pandemic accord will be on sidelines of formal WHA Gian Luca Burci, former WHO chief legal counsel describes the workings of the World Health Assembly – and what to expect at this session. This year’s WHA is set against the backdrop of ongoing negotiations over IHR revisions as well as the development of a new pandemic accord. Both are mired in controversial debates by member states over language on reporting outbreaks- including proposals for requiring countries to report emerging pathogen threats within hours. With respect to the pandemic accord, while all countries have paid lip service to the need to ensure more equitable distribution of drugs and vaccines in the next pandemic – they are at odds about draft language that would commit them, in advance, to set aside of fixed quantities of health tools for developing nations. Insofar as those negotiations are only due to conclude by May 2024, the most meaningful talks are likely to be in the corridors and on the sidelines of the WHA – rather than in the formal chambers of the meeting, being held at Geneva’s UN headquarters, said Gian Luca Burci, former chief WHO legal counsel at Sunday’s Graduate Institute session. “For [WHA] action, there is nothing specific on the IHR, Burci observed. With regards to the pandemic accord, the only main formal item explicitly on the agenda is the potential treaty’s cost.” “But there will be a Secretariat Briefing on the negotiations, and I’m sure there will be a lot of discussions, a lot of side conversations among delegates looking to break some of the deadlocks, and so forth.” Meanwhile, WHO continues to move ahead with voluntary initiatives aimed at improving outbreak detection and response. For example, just ahead of the WHA’s opening, WHO announced the launch of a new International Pathogen Surveillance Network, that aims to detect and report infectious disease threats in real time, making better use of digital and genomic tools that many countries still lack. WHO and partners are launching the International Pathogen Surveillance Network, a global network to help protect people from infectious disease threats through better use of pathogen genomics https://t.co/riuOjqB8Ju pic.twitter.com/vXqJZk6dzs — World Health Organization (WHO) (@WHO) May 20, 2023 The new network represents an ambitious effort to fill a critical gap in WHO’s existing system of disease outbreak alerts – which can right now be delayed by weeks or even months if countries resist disclosure. But without revisions to the IHR, such networks will remain purely voluntary. So the key question, as always remains: will all countries join, collaborate and cooperate – and who will support the improved capacity of low income countries for detecting and reporting new threats? WHO Calls on Countries to “Drastically Reduce” Climate Emissions to Improve Global Health 19/05/2023 Megha Kaveri Fossil fuel combustion is a leadng source of global warming as well as of health harmful air pollution emissions. The World Health Organization (WHO) has called for focused action to address global warming and climate change to promote health outcomes. Recommendations include concerted efforts to reduce carbon emissions, build climate-resilient and sustainable health systems and protect health from the impacts of climate change. There is also a decline in the treatment coverage for tuberculosis between 2019 and 2021, and a stall in the world’s progress to tackle non-communicable diseases (NCDs) like hypertension and adult obesity. “Climate and Health” is featured as a separate chapter in the latest edition of the World Health Statistics Report, published by the WHO on Friday. This underlines its importance as a major driver of health outcomes in coming years, WHO officials said. The 131-page annual compilation of health statistics, while providing a birds-eye view on the progress made on global health metrics, also highlights how the world is not on track to achieve the targets set out in the Sustainable Development Goals (SDGs) 2030. “The world is off track to reach the sustainable development goals,” said Dr Samira Asma, assistant director-general for data, analytics and delivery for impact at the WHO during a press briefing on Thursday. “Unless we pick up the pace, we risk losing countless lives that could have been saved, as well as failing to improve the quality of life for all”. Spotlight on climate change “For the first time, we have a dedicated section on climate change, recognizing its crucial role in shaping the global landscape,” Asma said, underlining the role climate plays in global health. The global average temperature during 2021 was around 1.20°C higher than levels observed during the pre-industrial years. The report added that it’s unlikely the world will be able to limit the rise in average temperature to the 1.5°C level agreed in the 2015-Paris Agreement, so as to avoid “irreversible and catastrophic changes to our natural and human systems”. “In order to stay within the 1.5˚C global warming limit set out in the 2015 Paris climate agreement, the world will need to drastically reduce emissions through large-scale transformation across social and economic systems,” the report emphasized. WHO’s spotlight on climate change and its connection to health comes at the heels of the Annual to Decadal Climate update released by the World Meteorological Organization (WMO) on Wednesday. The WMO report stated that the world is likely to breach the 1.5°C limit set by the Paris Agreement before 2027 – although if drastic mitigation measures were taken now they could still bring temperatures down again later. Apart urgent measures to reduce carbon emissions, countries should also concentrate on building climate-resilient and environmentally sustainable health systems to mitigate the effects of climate change on health. “At the global level, the health sector generates 4-5% of the global greenhouse gas emissions. Adopting sustainable practices brings benefits like improved accessibility, reliable services, and lower costs,” Dr Haidong Wang, the WHO unit head of monitoring, forecasting & inequalities, said. “Climate change has challenges to countries already dealing with non-communicable disease burdens. It may also lead to resurgence of infectious diseases”. Infectious diseases and NCDs The report revealed that in the past few years, the progress made by the world in combating infectious diseases like TB, HIV and malaria, and NCDs, have been reversed. Around 10.6 million people were diagnosed with TB in 2021, which is a 4.5% increase in numbers when compared with 2020. The global TB incidence rate increased by 3.6% between 2020 and 2021, reversing the progress made in the past two decades. “Tuberculosis treatment coverage dropped from 69% in 2019 to 61% in 2021,” Wang pointed out. The situation around NCDs are equally grim. Probability of dying from the four major NCDs (ages 30–69 years), projection versus SDGtarget, WHO regions and global, 2000–2048. If targeted efforts are not taken by countries, the objectives set out in the SDGs around tackling NCDs will remain unachieved. “The share of deaths caused annually by NCDs has grown to nearly three quarters of all deaths and, if the trend continues, is projected to reach about 86% globally by WHO’s 100th anniversary in 2048,” the report cautions. “The United Nations projects that total annual deaths will reach nearly 90 million globally in 2048; consequently, 77 million of these will be NCD deaths – a nearly 90% increase in absolute numbers over 2019”. COVID-19 pandemic: A medley of crises It is known that the COVID-19 pandemic caused unprecedented damage to health systems across the world. Not only did it kill millions of lives, it also caused considerable backsliding in decades-long efforts taken to address diseases like tuberculosis and HIV, and even changed the pattern of care-seeking across the world. “So the COVID-19 pandemic wasn’t just a health emergency, it was also a statistical crisis across the world,” Dr Dr Stephen MacFeely, WHOs director of data and analytics said. He added that several countries suspended longstanding surveys due to pandemic-related restrictions, making it impossible to acquire real data on issues like population and housing. “This shock interrupted the flow of data from already weak and fragile data systems.” Emphasizing on the need to have robust, disaggregated, good quality data for monitoring and surveillance purposes, MacFeely said that WHO will be launching a “Data Dot Portal”, as part of the agency’s World Health Data Hub project, to serve as a “one-stop shop for health data”. The portal will be launching at the end of next week, as curtains fall on the 76th World Health Assembly, after being in development for nearly four years. Image Credits: Chris LeBoutillier, World Health Organization. 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.
Ukraine Allies Call on World Health Assembly to Condemn Russian ‘Aggression’ 22/05/2023 Stefan Anderson World Health Assembly delegates minutes after votes on competing resolutions on the health crisis in Ukraine last year. Europe, the United States, Ukraine and its allies have submitted a draft resolution to the World Health Assembly (WHA) calling on the 194 member states of the World Health Organization (WHO) to condemn the health crisis caused by Russia’s “continued aggression against Ukraine.” The EU-led draft, published on Monday, is a near-identical replica of the resolution condemning Russian “aggression” passed by the WHA last year. They even share the same title. The resolution urges Russia to “immediately cease any attacks on hospitals and other health care facilities,” and to protect “civilians, health and humanitarian workers.” At least 8,500 civilians have been killed since Russia invaded Ukraine in February last year, and over 14,000 more have been injured, the UN Office of the High Commissioner for Human Rights said in its April status report. Russia responded by submitting a draft resolution of its own. The resolution, co-sponsored by Syria, makes no mention of Russia’s role in the health crisis in Ukraine. A similar effort to push through a counter-resolution failed last year. The Russian draft expresses “grave concern at the deteriorating humanitarian situation in and around Ukraine” and demands “all parties concerned to respect their obligations under international humanitarian and human rights law.” It also strongly condemns “attacks directed against civilians and health objects.” The WHO surveillance system for attacks on health care (SSA) lists 974 confirmed attacks on health facilities in Ukraine since the start of the war – an onslaught WHO Europe Director Dr Hans Kluge called “the largest attack on health care on European soil since the Second World War.” Over 100 health care workers have died in the attacks. Syrian President Bashar al-Assad, the Russian bill’s co-sponsor, has repeatedly used chemical weapons against his own people throughout the Syrian civil war. WHO tip-toes a fine line, but Ukraine health crisis in bounds The Russian delegation protested a US statement in support of Ukraine, calling on the chair to “ask people to speak about health.” The WHO has had a hard go of its attempts to remain politically neutral amid Russia’s invasion of Ukraine. Earlier this month, a year-long pressure campaign from EU states succeeded in forcing the closure of WHO’s non-communicable diseases office in Moscow. The announcement of its closure was accompanied by the news that the office will be relocated to Copenhagen next year. The use of the word “invasion” in a WHO status report on the organization’s emergency response in Ukraine caused a clash at this year’s Executive Board meeting, where Director-General Dr Tedros Adhanom Ghebreyesus vehemently defended his choice in response to Russian allegations that the report had been politicized. “I couldn’t find any other word that would represent it because it’s the truth,” Tedros said. “What could I say?” Interventions in plenary sessions calling out Russia’s role in the health crisis in Ukraine have so far been upheld by WHA President Dr Christopher Fearne despite repeated Russian protests. “We are not in New York, we are in the world health assembly,” the Russian delegation said in response to a statement by the United States that its invasion of Ukraine violated the charter of the United Nations. “We are ready to discuss the entire agenda, but not … any issues of aggression, or whatever these countries are saying.” Fearne called the health crisis in Ukraine “clearly a health matter relevant to this assembly”. “In fact,” he added, “we are to discuss it later on this week.” Image Credits: Health Policy Watch . Taiwan Excluded as World Health Assembly Opening Focuses on Pandemic Preparedness, and Funding 22/05/2023 Disha Shetty Dr Tedros Adhanom Ghebreyesus, director-general of the WHO. The 76th World Health Assembly turned political even before formal the proceedings began, with the decision to exclude Taiwan. The island was seeking an observer status, something that it had held previously between 2009 and 2016, with the support of the United States and others. But its inclusion was strongly opposed by China which maintains the island is its province and not an independent country. Pakistan backed China’s right to territorial integrity. The two countries said they did not object to the inclusion of experts from Taiwan in technical meetings and exchanges related to pandemic preparedness. As Taiwan’s bid failed, Dr Jui-Yuan Hsueh, Taiwan’s Minister of Health and Welfare, said the call was taken by WHA due to political considerations and pressure from China. In his keynote address, WHO Director-General Dr Tedros Adhanom Ghebreyesus listed the key priority for this year’s assembly, urging countries to work towards WHO’s triple billion targets and pick up the pace on achieving the health-related sustainable development goals (SGDs). Tedros also said the pandemic accord that the WHA will be negotiating this year will be an important step for future preparedness and requested countries to engage with the process. But Taiwan’s exclusion will have an impact on the pandemic accord, according to Health Minister Hsueh: “Without WHO membership, Taiwan is also unable to provide various surveillance data to the global influenza surveillance and the response system, which could alert the world to the next pandemic. Taiwan is willing and it should also be included in the pandemic accord that is under negotiation,”. Tedros also made it clear that finding ways to fund the various programmes of the WHO will be a priority. Despite South Asia currently being under another intense heatwave second year in a row, climate change was mentioned only briefly by Tedros. With COVID-19 no longer an official global health emergency, polio remains the only one global emergency. “After an all-time low of five wild poliovirus cases in 2021, we saw an increase last year, with 20 cases in Pakistan, two in Afghanistan and eight in Mozambique,” he said, adding that WHO is committed to polio eradication. “Last year, three million children previously inaccessible in Afghanistan received polio vaccines for the first time. And in October, donors pledged US$2.6 billion to support the push for eradication,” he said. Tedros also mentioned the work being done to roll out new vaccines for tuberculosis as quickly as possible. “It was done for COVID; it can be done for TB,” he said. He also acknowledged the need to bolster disaster response and funding, appealing to member countries to support funding efforts in 2024 so the health body was in the best possible shape to respond. In discussions, members drew attention to multiple emergencies in the Horn of Africa, Palestine, Syria, Ukraine and Yemen, among others. Additional reporting by Megha Kaveri What Can We Learn from the History of Health? New Podcast 22/05/2023 Editorial team It is often said that those who fail to learn from history are doomed to repeat it. So what, if anything, can we learn from the history of health? In this brand new season of the Global Health Matters podcast, host Garry Aslanyan takes a step back in time to look at why “history matters” and to discuss the value and merits of understanding global health history and the evolution of global health, particularly concerning the establishment of the World Health Organization (WHO), which this year celebrates its 75th anniversary. “All institutions have long histories,” guest Sanjoy Bhattacharya, head of the School of History and Professor of Medical and Global Health History at the University of Leeds in the UK, told Aslanyan.” And those long histories have determined negotiations between complex partnerships, complex organisations, and how we operate today is deeply determined by those long-term negotiations, which is historical. So history matters.” Speaking on the history of global health in terms of colonialism and colonial powers, Professor of Global Development Studies and Global Health at the University of Toronto in Canada, Anne-Emanuelle Birn, said, “In the 19th century, the arena that has evolved or erupted, transformed into global health history, began in a very particular context, that of imperialism, particularly European, but also North American imperialism and the growth of the colonial enterprise. “Health and medicine played a very important role, so one of the earliest precursors to global health history, or global health, was colonial medicine.” By the middle of the 20th century, after two world wars ravaged the world, there was renewed hope which saw the formation of several new international cooperation organization, such as the United Nations. In this arena, the World Health Organization was founded in April 1948, aiming to work worldwide to promote health and coordinate responses to health emergencies. “You have this transition, and it really takes off after the founding of the World Health Organization, this idea of international health, health between countries, through sometimes collective decision-making but also very much influenced by the world order, in that case, the Cold War,” Birn said. “For me, WHO is not just Geneva,” Bhattacharya said. “if you look at a bottom-up history of WHO, where you center the regional offices, I would submit that you actually get a much more decolonised and democratic history of international and global health than you would if you looked at Geneva and say that everything that is happening in global or international health is happening because of things that are happening in Geneva.” Taking a look at a very recent example of COVID-19, Birn points out that as much as coordinated international efforts can combat the quick spread of disease and introduce appropriate measures, at the same time, every country is in its own unique situation based on cultural and social factors. “With the COVID-19 pandemic, there was an expectation in certain quarters that history would help to address, resolve, shed light on the course of the pandemic,” Birn said. “There’s no way historical perspectives can resolve social, political, and other forms of tensions that the response to COVID-19 continues to engender, arguably. History can’t predict or liberate, and every pandemic has occurred in particular social, political, and cultural configurations. So there’s no recipe, right? The expectation was that history would provide a recipe.” “There are multiple historical narratives about any aspect of global pandemics,” Bhattacharya added. “So if you’re saying was COVID influenced by any historical narratives, then the problem then became that there wasn’t one historical narrative.” Looking into the past can sometimes provide the lessons or answers we seek, but as Bhattacharya pointed out, it is essential to know which or whose history one is learning. “History matters, but we must always ask which history matters because there are multiple histories.” This is part I of a two-part series. Image Credits: Global Health Matters Podcast via TDR. On 75th Anniversary World Health Assembly Must Confront New and Growing Threats 21/05/2023 Elaine Ruth Fletcher Member states attending the World Health Assembly’s high-level opening on Sunday, 21 May in Geneva. The World Health Assembly opened its annual meeting of member states Sunday on a celebratory note marking the 75th anniversary of the World Health Organization’s foundation in 1948. Eradicating smallpox, eliminating polio in most countries worldwide, and dramatic reductions in deaths from once-deadly childhood diseases preventable by clean water, basic medicines and vaccines are among a few of the historic accomplishments the Organization will be celebrating as this year’s 76th WHA session begins, said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in opening remarks at the WHA. “Smallpox is history and polio is on the brink. And epidemics of malaria, HIV and tuberculosis have all been pushed back,” said Dr Tedros. Thanks to the Framework Convention on Tobacco Control, smoking rates have declined in dozens of countries worldwide, with strict policies on tobacco advertising and taxes on tobacco products. He was speaking Sunday at a WHA preview event at the Geneva Graduate Institute’s Global Health Center, just before the official WHA curtain-raiser; the latter featured a lineup of high-level figures from around the world, including India’s Prime Minister Narendra Modi and former New Zealand Prime Minister Jacinda Ardern. Pandemic treaty negotiations set against regional conflicts The number of people living in zones of combined conflict and health emergencies has doubled since 2015 – Kate Dodson, UN Foundation But against those successes, this year’s WHA is taking place against the background of complex, ongoing negotiations over an ambitious new pandemic treaty and, in parallel, talks over revisions to the 2005 International Health Regulations that aim to supplement and replace archaic rules on international emergency response. The WHA also is taking place in a second year of war between Russia and the Ukraine – whose bitter dispute was the subject of competing WHA resolutions last year – and which will likely again surface in debates by the global health body this year. And the Ukraine-Russia war is only one of multiple conflicts destroying lives and global health. As this year’s WHA considers a new “Health for Peace Initiative”, some 39 million people are – or almost one in 20 of the world’s population – living in fragile and complex settings that combine conflict with health emergencies. “That’s an increase of 25% since just last year, and double since 2015,” noted Kate Dodson, vice president for global health at the United Nations Foundation, a co-sponsor of the Graduate School WHA opener. And while this week’s WHA session is set to approve update guidance to countries on “best buys” for reducing non-communicable diseases, NCD disease rates are soaring worldwide, with heart disease having increased by 60% in the last 30 years, according to data published by the World Heart Summit, also convening this weekend in Geneva. Meanwhile, the WHO remains financially challenged. For the first time ever, this year’s WHA is supposed to approve stepped up rates of annual contributions by member states to the global health organization. It will also debate a January Executive Board recommendation to establish a “replenishment fund” for voluntary contributions by donors and member states that could be used in a more flexible way by the Organization than “earmarked” donations that make up the bulk of its budget today. Challenges moving far beyond the health sector Non-communicable diseases now account for 70% of deaths globally – WHO Director General Dr Tedros Adhanom Ghebreyesus at the opening of the 76th WHA. Overall, as it enters its 76th year of existence, the Organization is increasingly challenged by the need to respond coherently to an increasingly broad and complex portfolio of emerging disease threats – over which it often has little influence or control. Those include obesity, heart disease and hypertension stimulated by sedentary lifestyles and fast food diets; antimicrobial resistance from misuse and overuse of antibiotics in both the human and animal health sector; the climate crisis and air pollution; and as COVID-19 demonstrated to the world – vast disparities in access to health care including vital medicines and vaccines. “Non communicable diseases now account for some 70% of deaths globally,” noted Tedros in his opening WHA address. “Antimicrobial resistance threatens to unwind centuries of medical progress. Vast disparities in access to health resources exist between and within countries and communities. And the existential threat of climate change is jeopardizing the very habitability of our planet. “WHO has grown enormously but our resources have not,” Tedros added. “There is the challenge of being a technical scientific organization in a political, and increasingly politicized, environment.” “These are daunting and complex challenges. We will not solve them at the World Health Assembly and we will not solve them in our lifetimes, but we’re building a path that our children and grandchildren will walk down and that they will continue to build,” Tedros said. “The challenges of today are very different to those we faced in 1948. But the vision is the same.” 1969 International Health Regulations only covered four diseases In 1969 the International Health Regulations only covered four disease – former WHO official David Heymann (on left) speaking at WHO preview event at the Geneva Graduate Institute “When the [WHO] International Health Regulations were developed back in 1969, their goal was really to stop disease at borders,” pointed out David Heymann, a former high-ranking WHO official, at the Geneva Graduate Institute’s WHA preview event Sunday morning. “If a country reported one in four infections, cholera, yellow fever, plague or smallpox, then countries that were receiving passengers from those countries could request a vaccination certificate. There were pre-determined measures to stop disease transmission, and at that time, WHO was the exclusive owner of much of the information because countries reported to WHO, WHO did a risk assessment, and provided its recommendations.” While the IHR finally underwent a major update in 2005, greatly broadening the scope of what was to be reported – and empowering WHO to declare a “Public Health Emergency of International Concern (PHEIC),” the regulations have failed to keep up with the pace of change in the real world, he pointed out. The biggest failure, he contends, was in “the most important part of the IHR, which was the requirement of countries to establish core capacity in public health to be able to detect, respond and prevent national disease spread and death, and eventually prevent international spread by this rapid reaction.” In terms of risk assessments as well, as the digital transformation accelerated the spread of information, WHO was no longer the exclusive arbiter of risks from pathogens that appeared. “As we saw in the COVID pandemic, countries really preferred doing their own risk assessments. They had access to data which they had never had before – all respectable medical journals were publishing peer reviewed information in front of their paywall. So any government advisory group could get that and could make recommendations to their own government as to what to do. As a result, WHO lost its authoritative position in making recommendations, countries devised their own policies, and what ensued was “confusion, utter confusion” over global response, Heymann contended. “The [IHR] regulations to me, they’re really a vestige of the past.” Negotiations over pandemic accord will be on sidelines of formal WHA Gian Luca Burci, former WHO chief legal counsel describes the workings of the World Health Assembly – and what to expect at this session. This year’s WHA is set against the backdrop of ongoing negotiations over IHR revisions as well as the development of a new pandemic accord. Both are mired in controversial debates by member states over language on reporting outbreaks- including proposals for requiring countries to report emerging pathogen threats within hours. With respect to the pandemic accord, while all countries have paid lip service to the need to ensure more equitable distribution of drugs and vaccines in the next pandemic – they are at odds about draft language that would commit them, in advance, to set aside of fixed quantities of health tools for developing nations. Insofar as those negotiations are only due to conclude by May 2024, the most meaningful talks are likely to be in the corridors and on the sidelines of the WHA – rather than in the formal chambers of the meeting, being held at Geneva’s UN headquarters, said Gian Luca Burci, former chief WHO legal counsel at Sunday’s Graduate Institute session. “For [WHA] action, there is nothing specific on the IHR, Burci observed. With regards to the pandemic accord, the only main formal item explicitly on the agenda is the potential treaty’s cost.” “But there will be a Secretariat Briefing on the negotiations, and I’m sure there will be a lot of discussions, a lot of side conversations among delegates looking to break some of the deadlocks, and so forth.” Meanwhile, WHO continues to move ahead with voluntary initiatives aimed at improving outbreak detection and response. For example, just ahead of the WHA’s opening, WHO announced the launch of a new International Pathogen Surveillance Network, that aims to detect and report infectious disease threats in real time, making better use of digital and genomic tools that many countries still lack. WHO and partners are launching the International Pathogen Surveillance Network, a global network to help protect people from infectious disease threats through better use of pathogen genomics https://t.co/riuOjqB8Ju pic.twitter.com/vXqJZk6dzs — World Health Organization (WHO) (@WHO) May 20, 2023 The new network represents an ambitious effort to fill a critical gap in WHO’s existing system of disease outbreak alerts – which can right now be delayed by weeks or even months if countries resist disclosure. But without revisions to the IHR, such networks will remain purely voluntary. So the key question, as always remains: will all countries join, collaborate and cooperate – and who will support the improved capacity of low income countries for detecting and reporting new threats? WHO Calls on Countries to “Drastically Reduce” Climate Emissions to Improve Global Health 19/05/2023 Megha Kaveri Fossil fuel combustion is a leadng source of global warming as well as of health harmful air pollution emissions. The World Health Organization (WHO) has called for focused action to address global warming and climate change to promote health outcomes. Recommendations include concerted efforts to reduce carbon emissions, build climate-resilient and sustainable health systems and protect health from the impacts of climate change. There is also a decline in the treatment coverage for tuberculosis between 2019 and 2021, and a stall in the world’s progress to tackle non-communicable diseases (NCDs) like hypertension and adult obesity. “Climate and Health” is featured as a separate chapter in the latest edition of the World Health Statistics Report, published by the WHO on Friday. This underlines its importance as a major driver of health outcomes in coming years, WHO officials said. The 131-page annual compilation of health statistics, while providing a birds-eye view on the progress made on global health metrics, also highlights how the world is not on track to achieve the targets set out in the Sustainable Development Goals (SDGs) 2030. “The world is off track to reach the sustainable development goals,” said Dr Samira Asma, assistant director-general for data, analytics and delivery for impact at the WHO during a press briefing on Thursday. “Unless we pick up the pace, we risk losing countless lives that could have been saved, as well as failing to improve the quality of life for all”. Spotlight on climate change “For the first time, we have a dedicated section on climate change, recognizing its crucial role in shaping the global landscape,” Asma said, underlining the role climate plays in global health. The global average temperature during 2021 was around 1.20°C higher than levels observed during the pre-industrial years. The report added that it’s unlikely the world will be able to limit the rise in average temperature to the 1.5°C level agreed in the 2015-Paris Agreement, so as to avoid “irreversible and catastrophic changes to our natural and human systems”. “In order to stay within the 1.5˚C global warming limit set out in the 2015 Paris climate agreement, the world will need to drastically reduce emissions through large-scale transformation across social and economic systems,” the report emphasized. WHO’s spotlight on climate change and its connection to health comes at the heels of the Annual to Decadal Climate update released by the World Meteorological Organization (WMO) on Wednesday. The WMO report stated that the world is likely to breach the 1.5°C limit set by the Paris Agreement before 2027 – although if drastic mitigation measures were taken now they could still bring temperatures down again later. Apart urgent measures to reduce carbon emissions, countries should also concentrate on building climate-resilient and environmentally sustainable health systems to mitigate the effects of climate change on health. “At the global level, the health sector generates 4-5% of the global greenhouse gas emissions. Adopting sustainable practices brings benefits like improved accessibility, reliable services, and lower costs,” Dr Haidong Wang, the WHO unit head of monitoring, forecasting & inequalities, said. “Climate change has challenges to countries already dealing with non-communicable disease burdens. It may also lead to resurgence of infectious diseases”. Infectious diseases and NCDs The report revealed that in the past few years, the progress made by the world in combating infectious diseases like TB, HIV and malaria, and NCDs, have been reversed. Around 10.6 million people were diagnosed with TB in 2021, which is a 4.5% increase in numbers when compared with 2020. The global TB incidence rate increased by 3.6% between 2020 and 2021, reversing the progress made in the past two decades. “Tuberculosis treatment coverage dropped from 69% in 2019 to 61% in 2021,” Wang pointed out. The situation around NCDs are equally grim. Probability of dying from the four major NCDs (ages 30–69 years), projection versus SDGtarget, WHO regions and global, 2000–2048. If targeted efforts are not taken by countries, the objectives set out in the SDGs around tackling NCDs will remain unachieved. “The share of deaths caused annually by NCDs has grown to nearly three quarters of all deaths and, if the trend continues, is projected to reach about 86% globally by WHO’s 100th anniversary in 2048,” the report cautions. “The United Nations projects that total annual deaths will reach nearly 90 million globally in 2048; consequently, 77 million of these will be NCD deaths – a nearly 90% increase in absolute numbers over 2019”. COVID-19 pandemic: A medley of crises It is known that the COVID-19 pandemic caused unprecedented damage to health systems across the world. Not only did it kill millions of lives, it also caused considerable backsliding in decades-long efforts taken to address diseases like tuberculosis and HIV, and even changed the pattern of care-seeking across the world. “So the COVID-19 pandemic wasn’t just a health emergency, it was also a statistical crisis across the world,” Dr Dr Stephen MacFeely, WHOs director of data and analytics said. He added that several countries suspended longstanding surveys due to pandemic-related restrictions, making it impossible to acquire real data on issues like population and housing. “This shock interrupted the flow of data from already weak and fragile data systems.” Emphasizing on the need to have robust, disaggregated, good quality data for monitoring and surveillance purposes, MacFeely said that WHO will be launching a “Data Dot Portal”, as part of the agency’s World Health Data Hub project, to serve as a “one-stop shop for health data”. The portal will be launching at the end of next week, as curtains fall on the 76th World Health Assembly, after being in development for nearly four years. Image Credits: Chris LeBoutillier, World Health Organization. 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.
Taiwan Excluded as World Health Assembly Opening Focuses on Pandemic Preparedness, and Funding 22/05/2023 Disha Shetty Dr Tedros Adhanom Ghebreyesus, director-general of the WHO. The 76th World Health Assembly turned political even before formal the proceedings began, with the decision to exclude Taiwan. The island was seeking an observer status, something that it had held previously between 2009 and 2016, with the support of the United States and others. But its inclusion was strongly opposed by China which maintains the island is its province and not an independent country. Pakistan backed China’s right to territorial integrity. The two countries said they did not object to the inclusion of experts from Taiwan in technical meetings and exchanges related to pandemic preparedness. As Taiwan’s bid failed, Dr Jui-Yuan Hsueh, Taiwan’s Minister of Health and Welfare, said the call was taken by WHA due to political considerations and pressure from China. In his keynote address, WHO Director-General Dr Tedros Adhanom Ghebreyesus listed the key priority for this year’s assembly, urging countries to work towards WHO’s triple billion targets and pick up the pace on achieving the health-related sustainable development goals (SGDs). Tedros also said the pandemic accord that the WHA will be negotiating this year will be an important step for future preparedness and requested countries to engage with the process. But Taiwan’s exclusion will have an impact on the pandemic accord, according to Health Minister Hsueh: “Without WHO membership, Taiwan is also unable to provide various surveillance data to the global influenza surveillance and the response system, which could alert the world to the next pandemic. Taiwan is willing and it should also be included in the pandemic accord that is under negotiation,”. Tedros also made it clear that finding ways to fund the various programmes of the WHO will be a priority. Despite South Asia currently being under another intense heatwave second year in a row, climate change was mentioned only briefly by Tedros. With COVID-19 no longer an official global health emergency, polio remains the only one global emergency. “After an all-time low of five wild poliovirus cases in 2021, we saw an increase last year, with 20 cases in Pakistan, two in Afghanistan and eight in Mozambique,” he said, adding that WHO is committed to polio eradication. “Last year, three million children previously inaccessible in Afghanistan received polio vaccines for the first time. And in October, donors pledged US$2.6 billion to support the push for eradication,” he said. Tedros also mentioned the work being done to roll out new vaccines for tuberculosis as quickly as possible. “It was done for COVID; it can be done for TB,” he said. He also acknowledged the need to bolster disaster response and funding, appealing to member countries to support funding efforts in 2024 so the health body was in the best possible shape to respond. In discussions, members drew attention to multiple emergencies in the Horn of Africa, Palestine, Syria, Ukraine and Yemen, among others. Additional reporting by Megha Kaveri What Can We Learn from the History of Health? New Podcast 22/05/2023 Editorial team It is often said that those who fail to learn from history are doomed to repeat it. So what, if anything, can we learn from the history of health? In this brand new season of the Global Health Matters podcast, host Garry Aslanyan takes a step back in time to look at why “history matters” and to discuss the value and merits of understanding global health history and the evolution of global health, particularly concerning the establishment of the World Health Organization (WHO), which this year celebrates its 75th anniversary. “All institutions have long histories,” guest Sanjoy Bhattacharya, head of the School of History and Professor of Medical and Global Health History at the University of Leeds in the UK, told Aslanyan.” And those long histories have determined negotiations between complex partnerships, complex organisations, and how we operate today is deeply determined by those long-term negotiations, which is historical. So history matters.” Speaking on the history of global health in terms of colonialism and colonial powers, Professor of Global Development Studies and Global Health at the University of Toronto in Canada, Anne-Emanuelle Birn, said, “In the 19th century, the arena that has evolved or erupted, transformed into global health history, began in a very particular context, that of imperialism, particularly European, but also North American imperialism and the growth of the colonial enterprise. “Health and medicine played a very important role, so one of the earliest precursors to global health history, or global health, was colonial medicine.” By the middle of the 20th century, after two world wars ravaged the world, there was renewed hope which saw the formation of several new international cooperation organization, such as the United Nations. In this arena, the World Health Organization was founded in April 1948, aiming to work worldwide to promote health and coordinate responses to health emergencies. “You have this transition, and it really takes off after the founding of the World Health Organization, this idea of international health, health between countries, through sometimes collective decision-making but also very much influenced by the world order, in that case, the Cold War,” Birn said. “For me, WHO is not just Geneva,” Bhattacharya said. “if you look at a bottom-up history of WHO, where you center the regional offices, I would submit that you actually get a much more decolonised and democratic history of international and global health than you would if you looked at Geneva and say that everything that is happening in global or international health is happening because of things that are happening in Geneva.” Taking a look at a very recent example of COVID-19, Birn points out that as much as coordinated international efforts can combat the quick spread of disease and introduce appropriate measures, at the same time, every country is in its own unique situation based on cultural and social factors. “With the COVID-19 pandemic, there was an expectation in certain quarters that history would help to address, resolve, shed light on the course of the pandemic,” Birn said. “There’s no way historical perspectives can resolve social, political, and other forms of tensions that the response to COVID-19 continues to engender, arguably. History can’t predict or liberate, and every pandemic has occurred in particular social, political, and cultural configurations. So there’s no recipe, right? The expectation was that history would provide a recipe.” “There are multiple historical narratives about any aspect of global pandemics,” Bhattacharya added. “So if you’re saying was COVID influenced by any historical narratives, then the problem then became that there wasn’t one historical narrative.” Looking into the past can sometimes provide the lessons or answers we seek, but as Bhattacharya pointed out, it is essential to know which or whose history one is learning. “History matters, but we must always ask which history matters because there are multiple histories.” This is part I of a two-part series. Image Credits: Global Health Matters Podcast via TDR. On 75th Anniversary World Health Assembly Must Confront New and Growing Threats 21/05/2023 Elaine Ruth Fletcher Member states attending the World Health Assembly’s high-level opening on Sunday, 21 May in Geneva. The World Health Assembly opened its annual meeting of member states Sunday on a celebratory note marking the 75th anniversary of the World Health Organization’s foundation in 1948. Eradicating smallpox, eliminating polio in most countries worldwide, and dramatic reductions in deaths from once-deadly childhood diseases preventable by clean water, basic medicines and vaccines are among a few of the historic accomplishments the Organization will be celebrating as this year’s 76th WHA session begins, said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in opening remarks at the WHA. “Smallpox is history and polio is on the brink. And epidemics of malaria, HIV and tuberculosis have all been pushed back,” said Dr Tedros. Thanks to the Framework Convention on Tobacco Control, smoking rates have declined in dozens of countries worldwide, with strict policies on tobacco advertising and taxes on tobacco products. He was speaking Sunday at a WHA preview event at the Geneva Graduate Institute’s Global Health Center, just before the official WHA curtain-raiser; the latter featured a lineup of high-level figures from around the world, including India’s Prime Minister Narendra Modi and former New Zealand Prime Minister Jacinda Ardern. Pandemic treaty negotiations set against regional conflicts The number of people living in zones of combined conflict and health emergencies has doubled since 2015 – Kate Dodson, UN Foundation But against those successes, this year’s WHA is taking place against the background of complex, ongoing negotiations over an ambitious new pandemic treaty and, in parallel, talks over revisions to the 2005 International Health Regulations that aim to supplement and replace archaic rules on international emergency response. The WHA also is taking place in a second year of war between Russia and the Ukraine – whose bitter dispute was the subject of competing WHA resolutions last year – and which will likely again surface in debates by the global health body this year. And the Ukraine-Russia war is only one of multiple conflicts destroying lives and global health. As this year’s WHA considers a new “Health for Peace Initiative”, some 39 million people are – or almost one in 20 of the world’s population – living in fragile and complex settings that combine conflict with health emergencies. “That’s an increase of 25% since just last year, and double since 2015,” noted Kate Dodson, vice president for global health at the United Nations Foundation, a co-sponsor of the Graduate School WHA opener. And while this week’s WHA session is set to approve update guidance to countries on “best buys” for reducing non-communicable diseases, NCD disease rates are soaring worldwide, with heart disease having increased by 60% in the last 30 years, according to data published by the World Heart Summit, also convening this weekend in Geneva. Meanwhile, the WHO remains financially challenged. For the first time ever, this year’s WHA is supposed to approve stepped up rates of annual contributions by member states to the global health organization. It will also debate a January Executive Board recommendation to establish a “replenishment fund” for voluntary contributions by donors and member states that could be used in a more flexible way by the Organization than “earmarked” donations that make up the bulk of its budget today. Challenges moving far beyond the health sector Non-communicable diseases now account for 70% of deaths globally – WHO Director General Dr Tedros Adhanom Ghebreyesus at the opening of the 76th WHA. Overall, as it enters its 76th year of existence, the Organization is increasingly challenged by the need to respond coherently to an increasingly broad and complex portfolio of emerging disease threats – over which it often has little influence or control. Those include obesity, heart disease and hypertension stimulated by sedentary lifestyles and fast food diets; antimicrobial resistance from misuse and overuse of antibiotics in both the human and animal health sector; the climate crisis and air pollution; and as COVID-19 demonstrated to the world – vast disparities in access to health care including vital medicines and vaccines. “Non communicable diseases now account for some 70% of deaths globally,” noted Tedros in his opening WHA address. “Antimicrobial resistance threatens to unwind centuries of medical progress. Vast disparities in access to health resources exist between and within countries and communities. And the existential threat of climate change is jeopardizing the very habitability of our planet. “WHO has grown enormously but our resources have not,” Tedros added. “There is the challenge of being a technical scientific organization in a political, and increasingly politicized, environment.” “These are daunting and complex challenges. We will not solve them at the World Health Assembly and we will not solve them in our lifetimes, but we’re building a path that our children and grandchildren will walk down and that they will continue to build,” Tedros said. “The challenges of today are very different to those we faced in 1948. But the vision is the same.” 1969 International Health Regulations only covered four diseases In 1969 the International Health Regulations only covered four disease – former WHO official David Heymann (on left) speaking at WHO preview event at the Geneva Graduate Institute “When the [WHO] International Health Regulations were developed back in 1969, their goal was really to stop disease at borders,” pointed out David Heymann, a former high-ranking WHO official, at the Geneva Graduate Institute’s WHA preview event Sunday morning. “If a country reported one in four infections, cholera, yellow fever, plague or smallpox, then countries that were receiving passengers from those countries could request a vaccination certificate. There were pre-determined measures to stop disease transmission, and at that time, WHO was the exclusive owner of much of the information because countries reported to WHO, WHO did a risk assessment, and provided its recommendations.” While the IHR finally underwent a major update in 2005, greatly broadening the scope of what was to be reported – and empowering WHO to declare a “Public Health Emergency of International Concern (PHEIC),” the regulations have failed to keep up with the pace of change in the real world, he pointed out. The biggest failure, he contends, was in “the most important part of the IHR, which was the requirement of countries to establish core capacity in public health to be able to detect, respond and prevent national disease spread and death, and eventually prevent international spread by this rapid reaction.” In terms of risk assessments as well, as the digital transformation accelerated the spread of information, WHO was no longer the exclusive arbiter of risks from pathogens that appeared. “As we saw in the COVID pandemic, countries really preferred doing their own risk assessments. They had access to data which they had never had before – all respectable medical journals were publishing peer reviewed information in front of their paywall. So any government advisory group could get that and could make recommendations to their own government as to what to do. As a result, WHO lost its authoritative position in making recommendations, countries devised their own policies, and what ensued was “confusion, utter confusion” over global response, Heymann contended. “The [IHR] regulations to me, they’re really a vestige of the past.” Negotiations over pandemic accord will be on sidelines of formal WHA Gian Luca Burci, former WHO chief legal counsel describes the workings of the World Health Assembly – and what to expect at this session. This year’s WHA is set against the backdrop of ongoing negotiations over IHR revisions as well as the development of a new pandemic accord. Both are mired in controversial debates by member states over language on reporting outbreaks- including proposals for requiring countries to report emerging pathogen threats within hours. With respect to the pandemic accord, while all countries have paid lip service to the need to ensure more equitable distribution of drugs and vaccines in the next pandemic – they are at odds about draft language that would commit them, in advance, to set aside of fixed quantities of health tools for developing nations. Insofar as those negotiations are only due to conclude by May 2024, the most meaningful talks are likely to be in the corridors and on the sidelines of the WHA – rather than in the formal chambers of the meeting, being held at Geneva’s UN headquarters, said Gian Luca Burci, former chief WHO legal counsel at Sunday’s Graduate Institute session. “For [WHA] action, there is nothing specific on the IHR, Burci observed. With regards to the pandemic accord, the only main formal item explicitly on the agenda is the potential treaty’s cost.” “But there will be a Secretariat Briefing on the negotiations, and I’m sure there will be a lot of discussions, a lot of side conversations among delegates looking to break some of the deadlocks, and so forth.” Meanwhile, WHO continues to move ahead with voluntary initiatives aimed at improving outbreak detection and response. For example, just ahead of the WHA’s opening, WHO announced the launch of a new International Pathogen Surveillance Network, that aims to detect and report infectious disease threats in real time, making better use of digital and genomic tools that many countries still lack. WHO and partners are launching the International Pathogen Surveillance Network, a global network to help protect people from infectious disease threats through better use of pathogen genomics https://t.co/riuOjqB8Ju pic.twitter.com/vXqJZk6dzs — World Health Organization (WHO) (@WHO) May 20, 2023 The new network represents an ambitious effort to fill a critical gap in WHO’s existing system of disease outbreak alerts – which can right now be delayed by weeks or even months if countries resist disclosure. But without revisions to the IHR, such networks will remain purely voluntary. So the key question, as always remains: will all countries join, collaborate and cooperate – and who will support the improved capacity of low income countries for detecting and reporting new threats? WHO Calls on Countries to “Drastically Reduce” Climate Emissions to Improve Global Health 19/05/2023 Megha Kaveri Fossil fuel combustion is a leadng source of global warming as well as of health harmful air pollution emissions. The World Health Organization (WHO) has called for focused action to address global warming and climate change to promote health outcomes. Recommendations include concerted efforts to reduce carbon emissions, build climate-resilient and sustainable health systems and protect health from the impacts of climate change. There is also a decline in the treatment coverage for tuberculosis between 2019 and 2021, and a stall in the world’s progress to tackle non-communicable diseases (NCDs) like hypertension and adult obesity. “Climate and Health” is featured as a separate chapter in the latest edition of the World Health Statistics Report, published by the WHO on Friday. This underlines its importance as a major driver of health outcomes in coming years, WHO officials said. The 131-page annual compilation of health statistics, while providing a birds-eye view on the progress made on global health metrics, also highlights how the world is not on track to achieve the targets set out in the Sustainable Development Goals (SDGs) 2030. “The world is off track to reach the sustainable development goals,” said Dr Samira Asma, assistant director-general for data, analytics and delivery for impact at the WHO during a press briefing on Thursday. “Unless we pick up the pace, we risk losing countless lives that could have been saved, as well as failing to improve the quality of life for all”. Spotlight on climate change “For the first time, we have a dedicated section on climate change, recognizing its crucial role in shaping the global landscape,” Asma said, underlining the role climate plays in global health. The global average temperature during 2021 was around 1.20°C higher than levels observed during the pre-industrial years. The report added that it’s unlikely the world will be able to limit the rise in average temperature to the 1.5°C level agreed in the 2015-Paris Agreement, so as to avoid “irreversible and catastrophic changes to our natural and human systems”. “In order to stay within the 1.5˚C global warming limit set out in the 2015 Paris climate agreement, the world will need to drastically reduce emissions through large-scale transformation across social and economic systems,” the report emphasized. WHO’s spotlight on climate change and its connection to health comes at the heels of the Annual to Decadal Climate update released by the World Meteorological Organization (WMO) on Wednesday. The WMO report stated that the world is likely to breach the 1.5°C limit set by the Paris Agreement before 2027 – although if drastic mitigation measures were taken now they could still bring temperatures down again later. Apart urgent measures to reduce carbon emissions, countries should also concentrate on building climate-resilient and environmentally sustainable health systems to mitigate the effects of climate change on health. “At the global level, the health sector generates 4-5% of the global greenhouse gas emissions. Adopting sustainable practices brings benefits like improved accessibility, reliable services, and lower costs,” Dr Haidong Wang, the WHO unit head of monitoring, forecasting & inequalities, said. “Climate change has challenges to countries already dealing with non-communicable disease burdens. It may also lead to resurgence of infectious diseases”. Infectious diseases and NCDs The report revealed that in the past few years, the progress made by the world in combating infectious diseases like TB, HIV and malaria, and NCDs, have been reversed. Around 10.6 million people were diagnosed with TB in 2021, which is a 4.5% increase in numbers when compared with 2020. The global TB incidence rate increased by 3.6% between 2020 and 2021, reversing the progress made in the past two decades. “Tuberculosis treatment coverage dropped from 69% in 2019 to 61% in 2021,” Wang pointed out. The situation around NCDs are equally grim. Probability of dying from the four major NCDs (ages 30–69 years), projection versus SDGtarget, WHO regions and global, 2000–2048. If targeted efforts are not taken by countries, the objectives set out in the SDGs around tackling NCDs will remain unachieved. “The share of deaths caused annually by NCDs has grown to nearly three quarters of all deaths and, if the trend continues, is projected to reach about 86% globally by WHO’s 100th anniversary in 2048,” the report cautions. “The United Nations projects that total annual deaths will reach nearly 90 million globally in 2048; consequently, 77 million of these will be NCD deaths – a nearly 90% increase in absolute numbers over 2019”. COVID-19 pandemic: A medley of crises It is known that the COVID-19 pandemic caused unprecedented damage to health systems across the world. Not only did it kill millions of lives, it also caused considerable backsliding in decades-long efforts taken to address diseases like tuberculosis and HIV, and even changed the pattern of care-seeking across the world. “So the COVID-19 pandemic wasn’t just a health emergency, it was also a statistical crisis across the world,” Dr Dr Stephen MacFeely, WHOs director of data and analytics said. He added that several countries suspended longstanding surveys due to pandemic-related restrictions, making it impossible to acquire real data on issues like population and housing. “This shock interrupted the flow of data from already weak and fragile data systems.” Emphasizing on the need to have robust, disaggregated, good quality data for monitoring and surveillance purposes, MacFeely said that WHO will be launching a “Data Dot Portal”, as part of the agency’s World Health Data Hub project, to serve as a “one-stop shop for health data”. The portal will be launching at the end of next week, as curtains fall on the 76th World Health Assembly, after being in development for nearly four years. Image Credits: Chris LeBoutillier, World Health Organization. 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.
What Can We Learn from the History of Health? New Podcast 22/05/2023 Editorial team It is often said that those who fail to learn from history are doomed to repeat it. So what, if anything, can we learn from the history of health? In this brand new season of the Global Health Matters podcast, host Garry Aslanyan takes a step back in time to look at why “history matters” and to discuss the value and merits of understanding global health history and the evolution of global health, particularly concerning the establishment of the World Health Organization (WHO), which this year celebrates its 75th anniversary. “All institutions have long histories,” guest Sanjoy Bhattacharya, head of the School of History and Professor of Medical and Global Health History at the University of Leeds in the UK, told Aslanyan.” And those long histories have determined negotiations between complex partnerships, complex organisations, and how we operate today is deeply determined by those long-term negotiations, which is historical. So history matters.” Speaking on the history of global health in terms of colonialism and colonial powers, Professor of Global Development Studies and Global Health at the University of Toronto in Canada, Anne-Emanuelle Birn, said, “In the 19th century, the arena that has evolved or erupted, transformed into global health history, began in a very particular context, that of imperialism, particularly European, but also North American imperialism and the growth of the colonial enterprise. “Health and medicine played a very important role, so one of the earliest precursors to global health history, or global health, was colonial medicine.” By the middle of the 20th century, after two world wars ravaged the world, there was renewed hope which saw the formation of several new international cooperation organization, such as the United Nations. In this arena, the World Health Organization was founded in April 1948, aiming to work worldwide to promote health and coordinate responses to health emergencies. “You have this transition, and it really takes off after the founding of the World Health Organization, this idea of international health, health between countries, through sometimes collective decision-making but also very much influenced by the world order, in that case, the Cold War,” Birn said. “For me, WHO is not just Geneva,” Bhattacharya said. “if you look at a bottom-up history of WHO, where you center the regional offices, I would submit that you actually get a much more decolonised and democratic history of international and global health than you would if you looked at Geneva and say that everything that is happening in global or international health is happening because of things that are happening in Geneva.” Taking a look at a very recent example of COVID-19, Birn points out that as much as coordinated international efforts can combat the quick spread of disease and introduce appropriate measures, at the same time, every country is in its own unique situation based on cultural and social factors. “With the COVID-19 pandemic, there was an expectation in certain quarters that history would help to address, resolve, shed light on the course of the pandemic,” Birn said. “There’s no way historical perspectives can resolve social, political, and other forms of tensions that the response to COVID-19 continues to engender, arguably. History can’t predict or liberate, and every pandemic has occurred in particular social, political, and cultural configurations. So there’s no recipe, right? The expectation was that history would provide a recipe.” “There are multiple historical narratives about any aspect of global pandemics,” Bhattacharya added. “So if you’re saying was COVID influenced by any historical narratives, then the problem then became that there wasn’t one historical narrative.” Looking into the past can sometimes provide the lessons or answers we seek, but as Bhattacharya pointed out, it is essential to know which or whose history one is learning. “History matters, but we must always ask which history matters because there are multiple histories.” This is part I of a two-part series. Image Credits: Global Health Matters Podcast via TDR. On 75th Anniversary World Health Assembly Must Confront New and Growing Threats 21/05/2023 Elaine Ruth Fletcher Member states attending the World Health Assembly’s high-level opening on Sunday, 21 May in Geneva. The World Health Assembly opened its annual meeting of member states Sunday on a celebratory note marking the 75th anniversary of the World Health Organization’s foundation in 1948. Eradicating smallpox, eliminating polio in most countries worldwide, and dramatic reductions in deaths from once-deadly childhood diseases preventable by clean water, basic medicines and vaccines are among a few of the historic accomplishments the Organization will be celebrating as this year’s 76th WHA session begins, said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in opening remarks at the WHA. “Smallpox is history and polio is on the brink. And epidemics of malaria, HIV and tuberculosis have all been pushed back,” said Dr Tedros. Thanks to the Framework Convention on Tobacco Control, smoking rates have declined in dozens of countries worldwide, with strict policies on tobacco advertising and taxes on tobacco products. He was speaking Sunday at a WHA preview event at the Geneva Graduate Institute’s Global Health Center, just before the official WHA curtain-raiser; the latter featured a lineup of high-level figures from around the world, including India’s Prime Minister Narendra Modi and former New Zealand Prime Minister Jacinda Ardern. Pandemic treaty negotiations set against regional conflicts The number of people living in zones of combined conflict and health emergencies has doubled since 2015 – Kate Dodson, UN Foundation But against those successes, this year’s WHA is taking place against the background of complex, ongoing negotiations over an ambitious new pandemic treaty and, in parallel, talks over revisions to the 2005 International Health Regulations that aim to supplement and replace archaic rules on international emergency response. The WHA also is taking place in a second year of war between Russia and the Ukraine – whose bitter dispute was the subject of competing WHA resolutions last year – and which will likely again surface in debates by the global health body this year. And the Ukraine-Russia war is only one of multiple conflicts destroying lives and global health. As this year’s WHA considers a new “Health for Peace Initiative”, some 39 million people are – or almost one in 20 of the world’s population – living in fragile and complex settings that combine conflict with health emergencies. “That’s an increase of 25% since just last year, and double since 2015,” noted Kate Dodson, vice president for global health at the United Nations Foundation, a co-sponsor of the Graduate School WHA opener. And while this week’s WHA session is set to approve update guidance to countries on “best buys” for reducing non-communicable diseases, NCD disease rates are soaring worldwide, with heart disease having increased by 60% in the last 30 years, according to data published by the World Heart Summit, also convening this weekend in Geneva. Meanwhile, the WHO remains financially challenged. For the first time ever, this year’s WHA is supposed to approve stepped up rates of annual contributions by member states to the global health organization. It will also debate a January Executive Board recommendation to establish a “replenishment fund” for voluntary contributions by donors and member states that could be used in a more flexible way by the Organization than “earmarked” donations that make up the bulk of its budget today. Challenges moving far beyond the health sector Non-communicable diseases now account for 70% of deaths globally – WHO Director General Dr Tedros Adhanom Ghebreyesus at the opening of the 76th WHA. Overall, as it enters its 76th year of existence, the Organization is increasingly challenged by the need to respond coherently to an increasingly broad and complex portfolio of emerging disease threats – over which it often has little influence or control. Those include obesity, heart disease and hypertension stimulated by sedentary lifestyles and fast food diets; antimicrobial resistance from misuse and overuse of antibiotics in both the human and animal health sector; the climate crisis and air pollution; and as COVID-19 demonstrated to the world – vast disparities in access to health care including vital medicines and vaccines. “Non communicable diseases now account for some 70% of deaths globally,” noted Tedros in his opening WHA address. “Antimicrobial resistance threatens to unwind centuries of medical progress. Vast disparities in access to health resources exist between and within countries and communities. And the existential threat of climate change is jeopardizing the very habitability of our planet. “WHO has grown enormously but our resources have not,” Tedros added. “There is the challenge of being a technical scientific organization in a political, and increasingly politicized, environment.” “These are daunting and complex challenges. We will not solve them at the World Health Assembly and we will not solve them in our lifetimes, but we’re building a path that our children and grandchildren will walk down and that they will continue to build,” Tedros said. “The challenges of today are very different to those we faced in 1948. But the vision is the same.” 1969 International Health Regulations only covered four diseases In 1969 the International Health Regulations only covered four disease – former WHO official David Heymann (on left) speaking at WHO preview event at the Geneva Graduate Institute “When the [WHO] International Health Regulations were developed back in 1969, their goal was really to stop disease at borders,” pointed out David Heymann, a former high-ranking WHO official, at the Geneva Graduate Institute’s WHA preview event Sunday morning. “If a country reported one in four infections, cholera, yellow fever, plague or smallpox, then countries that were receiving passengers from those countries could request a vaccination certificate. There were pre-determined measures to stop disease transmission, and at that time, WHO was the exclusive owner of much of the information because countries reported to WHO, WHO did a risk assessment, and provided its recommendations.” While the IHR finally underwent a major update in 2005, greatly broadening the scope of what was to be reported – and empowering WHO to declare a “Public Health Emergency of International Concern (PHEIC),” the regulations have failed to keep up with the pace of change in the real world, he pointed out. The biggest failure, he contends, was in “the most important part of the IHR, which was the requirement of countries to establish core capacity in public health to be able to detect, respond and prevent national disease spread and death, and eventually prevent international spread by this rapid reaction.” In terms of risk assessments as well, as the digital transformation accelerated the spread of information, WHO was no longer the exclusive arbiter of risks from pathogens that appeared. “As we saw in the COVID pandemic, countries really preferred doing their own risk assessments. They had access to data which they had never had before – all respectable medical journals were publishing peer reviewed information in front of their paywall. So any government advisory group could get that and could make recommendations to their own government as to what to do. As a result, WHO lost its authoritative position in making recommendations, countries devised their own policies, and what ensued was “confusion, utter confusion” over global response, Heymann contended. “The [IHR] regulations to me, they’re really a vestige of the past.” Negotiations over pandemic accord will be on sidelines of formal WHA Gian Luca Burci, former WHO chief legal counsel describes the workings of the World Health Assembly – and what to expect at this session. This year’s WHA is set against the backdrop of ongoing negotiations over IHR revisions as well as the development of a new pandemic accord. Both are mired in controversial debates by member states over language on reporting outbreaks- including proposals for requiring countries to report emerging pathogen threats within hours. With respect to the pandemic accord, while all countries have paid lip service to the need to ensure more equitable distribution of drugs and vaccines in the next pandemic – they are at odds about draft language that would commit them, in advance, to set aside of fixed quantities of health tools for developing nations. Insofar as those negotiations are only due to conclude by May 2024, the most meaningful talks are likely to be in the corridors and on the sidelines of the WHA – rather than in the formal chambers of the meeting, being held at Geneva’s UN headquarters, said Gian Luca Burci, former chief WHO legal counsel at Sunday’s Graduate Institute session. “For [WHA] action, there is nothing specific on the IHR, Burci observed. With regards to the pandemic accord, the only main formal item explicitly on the agenda is the potential treaty’s cost.” “But there will be a Secretariat Briefing on the negotiations, and I’m sure there will be a lot of discussions, a lot of side conversations among delegates looking to break some of the deadlocks, and so forth.” Meanwhile, WHO continues to move ahead with voluntary initiatives aimed at improving outbreak detection and response. For example, just ahead of the WHA’s opening, WHO announced the launch of a new International Pathogen Surveillance Network, that aims to detect and report infectious disease threats in real time, making better use of digital and genomic tools that many countries still lack. WHO and partners are launching the International Pathogen Surveillance Network, a global network to help protect people from infectious disease threats through better use of pathogen genomics https://t.co/riuOjqB8Ju pic.twitter.com/vXqJZk6dzs — World Health Organization (WHO) (@WHO) May 20, 2023 The new network represents an ambitious effort to fill a critical gap in WHO’s existing system of disease outbreak alerts – which can right now be delayed by weeks or even months if countries resist disclosure. But without revisions to the IHR, such networks will remain purely voluntary. So the key question, as always remains: will all countries join, collaborate and cooperate – and who will support the improved capacity of low income countries for detecting and reporting new threats? WHO Calls on Countries to “Drastically Reduce” Climate Emissions to Improve Global Health 19/05/2023 Megha Kaveri Fossil fuel combustion is a leadng source of global warming as well as of health harmful air pollution emissions. The World Health Organization (WHO) has called for focused action to address global warming and climate change to promote health outcomes. Recommendations include concerted efforts to reduce carbon emissions, build climate-resilient and sustainable health systems and protect health from the impacts of climate change. There is also a decline in the treatment coverage for tuberculosis between 2019 and 2021, and a stall in the world’s progress to tackle non-communicable diseases (NCDs) like hypertension and adult obesity. “Climate and Health” is featured as a separate chapter in the latest edition of the World Health Statistics Report, published by the WHO on Friday. This underlines its importance as a major driver of health outcomes in coming years, WHO officials said. The 131-page annual compilation of health statistics, while providing a birds-eye view on the progress made on global health metrics, also highlights how the world is not on track to achieve the targets set out in the Sustainable Development Goals (SDGs) 2030. “The world is off track to reach the sustainable development goals,” said Dr Samira Asma, assistant director-general for data, analytics and delivery for impact at the WHO during a press briefing on Thursday. “Unless we pick up the pace, we risk losing countless lives that could have been saved, as well as failing to improve the quality of life for all”. Spotlight on climate change “For the first time, we have a dedicated section on climate change, recognizing its crucial role in shaping the global landscape,” Asma said, underlining the role climate plays in global health. The global average temperature during 2021 was around 1.20°C higher than levels observed during the pre-industrial years. The report added that it’s unlikely the world will be able to limit the rise in average temperature to the 1.5°C level agreed in the 2015-Paris Agreement, so as to avoid “irreversible and catastrophic changes to our natural and human systems”. “In order to stay within the 1.5˚C global warming limit set out in the 2015 Paris climate agreement, the world will need to drastically reduce emissions through large-scale transformation across social and economic systems,” the report emphasized. WHO’s spotlight on climate change and its connection to health comes at the heels of the Annual to Decadal Climate update released by the World Meteorological Organization (WMO) on Wednesday. The WMO report stated that the world is likely to breach the 1.5°C limit set by the Paris Agreement before 2027 – although if drastic mitigation measures were taken now they could still bring temperatures down again later. Apart urgent measures to reduce carbon emissions, countries should also concentrate on building climate-resilient and environmentally sustainable health systems to mitigate the effects of climate change on health. “At the global level, the health sector generates 4-5% of the global greenhouse gas emissions. Adopting sustainable practices brings benefits like improved accessibility, reliable services, and lower costs,” Dr Haidong Wang, the WHO unit head of monitoring, forecasting & inequalities, said. “Climate change has challenges to countries already dealing with non-communicable disease burdens. It may also lead to resurgence of infectious diseases”. Infectious diseases and NCDs The report revealed that in the past few years, the progress made by the world in combating infectious diseases like TB, HIV and malaria, and NCDs, have been reversed. Around 10.6 million people were diagnosed with TB in 2021, which is a 4.5% increase in numbers when compared with 2020. The global TB incidence rate increased by 3.6% between 2020 and 2021, reversing the progress made in the past two decades. “Tuberculosis treatment coverage dropped from 69% in 2019 to 61% in 2021,” Wang pointed out. The situation around NCDs are equally grim. Probability of dying from the four major NCDs (ages 30–69 years), projection versus SDGtarget, WHO regions and global, 2000–2048. If targeted efforts are not taken by countries, the objectives set out in the SDGs around tackling NCDs will remain unachieved. “The share of deaths caused annually by NCDs has grown to nearly three quarters of all deaths and, if the trend continues, is projected to reach about 86% globally by WHO’s 100th anniversary in 2048,” the report cautions. “The United Nations projects that total annual deaths will reach nearly 90 million globally in 2048; consequently, 77 million of these will be NCD deaths – a nearly 90% increase in absolute numbers over 2019”. COVID-19 pandemic: A medley of crises It is known that the COVID-19 pandemic caused unprecedented damage to health systems across the world. Not only did it kill millions of lives, it also caused considerable backsliding in decades-long efforts taken to address diseases like tuberculosis and HIV, and even changed the pattern of care-seeking across the world. “So the COVID-19 pandemic wasn’t just a health emergency, it was also a statistical crisis across the world,” Dr Dr Stephen MacFeely, WHOs director of data and analytics said. He added that several countries suspended longstanding surveys due to pandemic-related restrictions, making it impossible to acquire real data on issues like population and housing. “This shock interrupted the flow of data from already weak and fragile data systems.” Emphasizing on the need to have robust, disaggregated, good quality data for monitoring and surveillance purposes, MacFeely said that WHO will be launching a “Data Dot Portal”, as part of the agency’s World Health Data Hub project, to serve as a “one-stop shop for health data”. The portal will be launching at the end of next week, as curtains fall on the 76th World Health Assembly, after being in development for nearly four years. Image Credits: Chris LeBoutillier, World Health Organization. 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.
On 75th Anniversary World Health Assembly Must Confront New and Growing Threats 21/05/2023 Elaine Ruth Fletcher Member states attending the World Health Assembly’s high-level opening on Sunday, 21 May in Geneva. The World Health Assembly opened its annual meeting of member states Sunday on a celebratory note marking the 75th anniversary of the World Health Organization’s foundation in 1948. Eradicating smallpox, eliminating polio in most countries worldwide, and dramatic reductions in deaths from once-deadly childhood diseases preventable by clean water, basic medicines and vaccines are among a few of the historic accomplishments the Organization will be celebrating as this year’s 76th WHA session begins, said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in opening remarks at the WHA. “Smallpox is history and polio is on the brink. And epidemics of malaria, HIV and tuberculosis have all been pushed back,” said Dr Tedros. Thanks to the Framework Convention on Tobacco Control, smoking rates have declined in dozens of countries worldwide, with strict policies on tobacco advertising and taxes on tobacco products. He was speaking Sunday at a WHA preview event at the Geneva Graduate Institute’s Global Health Center, just before the official WHA curtain-raiser; the latter featured a lineup of high-level figures from around the world, including India’s Prime Minister Narendra Modi and former New Zealand Prime Minister Jacinda Ardern. Pandemic treaty negotiations set against regional conflicts The number of people living in zones of combined conflict and health emergencies has doubled since 2015 – Kate Dodson, UN Foundation But against those successes, this year’s WHA is taking place against the background of complex, ongoing negotiations over an ambitious new pandemic treaty and, in parallel, talks over revisions to the 2005 International Health Regulations that aim to supplement and replace archaic rules on international emergency response. The WHA also is taking place in a second year of war between Russia and the Ukraine – whose bitter dispute was the subject of competing WHA resolutions last year – and which will likely again surface in debates by the global health body this year. And the Ukraine-Russia war is only one of multiple conflicts destroying lives and global health. As this year’s WHA considers a new “Health for Peace Initiative”, some 39 million people are – or almost one in 20 of the world’s population – living in fragile and complex settings that combine conflict with health emergencies. “That’s an increase of 25% since just last year, and double since 2015,” noted Kate Dodson, vice president for global health at the United Nations Foundation, a co-sponsor of the Graduate School WHA opener. And while this week’s WHA session is set to approve update guidance to countries on “best buys” for reducing non-communicable diseases, NCD disease rates are soaring worldwide, with heart disease having increased by 60% in the last 30 years, according to data published by the World Heart Summit, also convening this weekend in Geneva. Meanwhile, the WHO remains financially challenged. For the first time ever, this year’s WHA is supposed to approve stepped up rates of annual contributions by member states to the global health organization. It will also debate a January Executive Board recommendation to establish a “replenishment fund” for voluntary contributions by donors and member states that could be used in a more flexible way by the Organization than “earmarked” donations that make up the bulk of its budget today. Challenges moving far beyond the health sector Non-communicable diseases now account for 70% of deaths globally – WHO Director General Dr Tedros Adhanom Ghebreyesus at the opening of the 76th WHA. Overall, as it enters its 76th year of existence, the Organization is increasingly challenged by the need to respond coherently to an increasingly broad and complex portfolio of emerging disease threats – over which it often has little influence or control. Those include obesity, heart disease and hypertension stimulated by sedentary lifestyles and fast food diets; antimicrobial resistance from misuse and overuse of antibiotics in both the human and animal health sector; the climate crisis and air pollution; and as COVID-19 demonstrated to the world – vast disparities in access to health care including vital medicines and vaccines. “Non communicable diseases now account for some 70% of deaths globally,” noted Tedros in his opening WHA address. “Antimicrobial resistance threatens to unwind centuries of medical progress. Vast disparities in access to health resources exist between and within countries and communities. And the existential threat of climate change is jeopardizing the very habitability of our planet. “WHO has grown enormously but our resources have not,” Tedros added. “There is the challenge of being a technical scientific organization in a political, and increasingly politicized, environment.” “These are daunting and complex challenges. We will not solve them at the World Health Assembly and we will not solve them in our lifetimes, but we’re building a path that our children and grandchildren will walk down and that they will continue to build,” Tedros said. “The challenges of today are very different to those we faced in 1948. But the vision is the same.” 1969 International Health Regulations only covered four diseases In 1969 the International Health Regulations only covered four disease – former WHO official David Heymann (on left) speaking at WHO preview event at the Geneva Graduate Institute “When the [WHO] International Health Regulations were developed back in 1969, their goal was really to stop disease at borders,” pointed out David Heymann, a former high-ranking WHO official, at the Geneva Graduate Institute’s WHA preview event Sunday morning. “If a country reported one in four infections, cholera, yellow fever, plague or smallpox, then countries that were receiving passengers from those countries could request a vaccination certificate. There were pre-determined measures to stop disease transmission, and at that time, WHO was the exclusive owner of much of the information because countries reported to WHO, WHO did a risk assessment, and provided its recommendations.” While the IHR finally underwent a major update in 2005, greatly broadening the scope of what was to be reported – and empowering WHO to declare a “Public Health Emergency of International Concern (PHEIC),” the regulations have failed to keep up with the pace of change in the real world, he pointed out. The biggest failure, he contends, was in “the most important part of the IHR, which was the requirement of countries to establish core capacity in public health to be able to detect, respond and prevent national disease spread and death, and eventually prevent international spread by this rapid reaction.” In terms of risk assessments as well, as the digital transformation accelerated the spread of information, WHO was no longer the exclusive arbiter of risks from pathogens that appeared. “As we saw in the COVID pandemic, countries really preferred doing their own risk assessments. They had access to data which they had never had before – all respectable medical journals were publishing peer reviewed information in front of their paywall. So any government advisory group could get that and could make recommendations to their own government as to what to do. As a result, WHO lost its authoritative position in making recommendations, countries devised their own policies, and what ensued was “confusion, utter confusion” over global response, Heymann contended. “The [IHR] regulations to me, they’re really a vestige of the past.” Negotiations over pandemic accord will be on sidelines of formal WHA Gian Luca Burci, former WHO chief legal counsel describes the workings of the World Health Assembly – and what to expect at this session. This year’s WHA is set against the backdrop of ongoing negotiations over IHR revisions as well as the development of a new pandemic accord. Both are mired in controversial debates by member states over language on reporting outbreaks- including proposals for requiring countries to report emerging pathogen threats within hours. With respect to the pandemic accord, while all countries have paid lip service to the need to ensure more equitable distribution of drugs and vaccines in the next pandemic – they are at odds about draft language that would commit them, in advance, to set aside of fixed quantities of health tools for developing nations. Insofar as those negotiations are only due to conclude by May 2024, the most meaningful talks are likely to be in the corridors and on the sidelines of the WHA – rather than in the formal chambers of the meeting, being held at Geneva’s UN headquarters, said Gian Luca Burci, former chief WHO legal counsel at Sunday’s Graduate Institute session. “For [WHA] action, there is nothing specific on the IHR, Burci observed. With regards to the pandemic accord, the only main formal item explicitly on the agenda is the potential treaty’s cost.” “But there will be a Secretariat Briefing on the negotiations, and I’m sure there will be a lot of discussions, a lot of side conversations among delegates looking to break some of the deadlocks, and so forth.” Meanwhile, WHO continues to move ahead with voluntary initiatives aimed at improving outbreak detection and response. For example, just ahead of the WHA’s opening, WHO announced the launch of a new International Pathogen Surveillance Network, that aims to detect and report infectious disease threats in real time, making better use of digital and genomic tools that many countries still lack. WHO and partners are launching the International Pathogen Surveillance Network, a global network to help protect people from infectious disease threats through better use of pathogen genomics https://t.co/riuOjqB8Ju pic.twitter.com/vXqJZk6dzs — World Health Organization (WHO) (@WHO) May 20, 2023 The new network represents an ambitious effort to fill a critical gap in WHO’s existing system of disease outbreak alerts – which can right now be delayed by weeks or even months if countries resist disclosure. But without revisions to the IHR, such networks will remain purely voluntary. So the key question, as always remains: will all countries join, collaborate and cooperate – and who will support the improved capacity of low income countries for detecting and reporting new threats? WHO Calls on Countries to “Drastically Reduce” Climate Emissions to Improve Global Health 19/05/2023 Megha Kaveri Fossil fuel combustion is a leadng source of global warming as well as of health harmful air pollution emissions. The World Health Organization (WHO) has called for focused action to address global warming and climate change to promote health outcomes. Recommendations include concerted efforts to reduce carbon emissions, build climate-resilient and sustainable health systems and protect health from the impacts of climate change. There is also a decline in the treatment coverage for tuberculosis between 2019 and 2021, and a stall in the world’s progress to tackle non-communicable diseases (NCDs) like hypertension and adult obesity. “Climate and Health” is featured as a separate chapter in the latest edition of the World Health Statistics Report, published by the WHO on Friday. This underlines its importance as a major driver of health outcomes in coming years, WHO officials said. The 131-page annual compilation of health statistics, while providing a birds-eye view on the progress made on global health metrics, also highlights how the world is not on track to achieve the targets set out in the Sustainable Development Goals (SDGs) 2030. “The world is off track to reach the sustainable development goals,” said Dr Samira Asma, assistant director-general for data, analytics and delivery for impact at the WHO during a press briefing on Thursday. “Unless we pick up the pace, we risk losing countless lives that could have been saved, as well as failing to improve the quality of life for all”. Spotlight on climate change “For the first time, we have a dedicated section on climate change, recognizing its crucial role in shaping the global landscape,” Asma said, underlining the role climate plays in global health. The global average temperature during 2021 was around 1.20°C higher than levels observed during the pre-industrial years. The report added that it’s unlikely the world will be able to limit the rise in average temperature to the 1.5°C level agreed in the 2015-Paris Agreement, so as to avoid “irreversible and catastrophic changes to our natural and human systems”. “In order to stay within the 1.5˚C global warming limit set out in the 2015 Paris climate agreement, the world will need to drastically reduce emissions through large-scale transformation across social and economic systems,” the report emphasized. WHO’s spotlight on climate change and its connection to health comes at the heels of the Annual to Decadal Climate update released by the World Meteorological Organization (WMO) on Wednesday. The WMO report stated that the world is likely to breach the 1.5°C limit set by the Paris Agreement before 2027 – although if drastic mitigation measures were taken now they could still bring temperatures down again later. Apart urgent measures to reduce carbon emissions, countries should also concentrate on building climate-resilient and environmentally sustainable health systems to mitigate the effects of climate change on health. “At the global level, the health sector generates 4-5% of the global greenhouse gas emissions. Adopting sustainable practices brings benefits like improved accessibility, reliable services, and lower costs,” Dr Haidong Wang, the WHO unit head of monitoring, forecasting & inequalities, said. “Climate change has challenges to countries already dealing with non-communicable disease burdens. It may also lead to resurgence of infectious diseases”. Infectious diseases and NCDs The report revealed that in the past few years, the progress made by the world in combating infectious diseases like TB, HIV and malaria, and NCDs, have been reversed. Around 10.6 million people were diagnosed with TB in 2021, which is a 4.5% increase in numbers when compared with 2020. The global TB incidence rate increased by 3.6% between 2020 and 2021, reversing the progress made in the past two decades. “Tuberculosis treatment coverage dropped from 69% in 2019 to 61% in 2021,” Wang pointed out. The situation around NCDs are equally grim. Probability of dying from the four major NCDs (ages 30–69 years), projection versus SDGtarget, WHO regions and global, 2000–2048. If targeted efforts are not taken by countries, the objectives set out in the SDGs around tackling NCDs will remain unachieved. “The share of deaths caused annually by NCDs has grown to nearly three quarters of all deaths and, if the trend continues, is projected to reach about 86% globally by WHO’s 100th anniversary in 2048,” the report cautions. “The United Nations projects that total annual deaths will reach nearly 90 million globally in 2048; consequently, 77 million of these will be NCD deaths – a nearly 90% increase in absolute numbers over 2019”. COVID-19 pandemic: A medley of crises It is known that the COVID-19 pandemic caused unprecedented damage to health systems across the world. Not only did it kill millions of lives, it also caused considerable backsliding in decades-long efforts taken to address diseases like tuberculosis and HIV, and even changed the pattern of care-seeking across the world. “So the COVID-19 pandemic wasn’t just a health emergency, it was also a statistical crisis across the world,” Dr Dr Stephen MacFeely, WHOs director of data and analytics said. He added that several countries suspended longstanding surveys due to pandemic-related restrictions, making it impossible to acquire real data on issues like population and housing. “This shock interrupted the flow of data from already weak and fragile data systems.” Emphasizing on the need to have robust, disaggregated, good quality data for monitoring and surveillance purposes, MacFeely said that WHO will be launching a “Data Dot Portal”, as part of the agency’s World Health Data Hub project, to serve as a “one-stop shop for health data”. The portal will be launching at the end of next week, as curtains fall on the 76th World Health Assembly, after being in development for nearly four years. Image Credits: Chris LeBoutillier, World Health Organization. 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
WHO Calls on Countries to “Drastically Reduce” Climate Emissions to Improve Global Health 19/05/2023 Megha Kaveri Fossil fuel combustion is a leadng source of global warming as well as of health harmful air pollution emissions. The World Health Organization (WHO) has called for focused action to address global warming and climate change to promote health outcomes. Recommendations include concerted efforts to reduce carbon emissions, build climate-resilient and sustainable health systems and protect health from the impacts of climate change. There is also a decline in the treatment coverage for tuberculosis between 2019 and 2021, and a stall in the world’s progress to tackle non-communicable diseases (NCDs) like hypertension and adult obesity. “Climate and Health” is featured as a separate chapter in the latest edition of the World Health Statistics Report, published by the WHO on Friday. This underlines its importance as a major driver of health outcomes in coming years, WHO officials said. The 131-page annual compilation of health statistics, while providing a birds-eye view on the progress made on global health metrics, also highlights how the world is not on track to achieve the targets set out in the Sustainable Development Goals (SDGs) 2030. “The world is off track to reach the sustainable development goals,” said Dr Samira Asma, assistant director-general for data, analytics and delivery for impact at the WHO during a press briefing on Thursday. “Unless we pick up the pace, we risk losing countless lives that could have been saved, as well as failing to improve the quality of life for all”. Spotlight on climate change “For the first time, we have a dedicated section on climate change, recognizing its crucial role in shaping the global landscape,” Asma said, underlining the role climate plays in global health. The global average temperature during 2021 was around 1.20°C higher than levels observed during the pre-industrial years. The report added that it’s unlikely the world will be able to limit the rise in average temperature to the 1.5°C level agreed in the 2015-Paris Agreement, so as to avoid “irreversible and catastrophic changes to our natural and human systems”. “In order to stay within the 1.5˚C global warming limit set out in the 2015 Paris climate agreement, the world will need to drastically reduce emissions through large-scale transformation across social and economic systems,” the report emphasized. WHO’s spotlight on climate change and its connection to health comes at the heels of the Annual to Decadal Climate update released by the World Meteorological Organization (WMO) on Wednesday. The WMO report stated that the world is likely to breach the 1.5°C limit set by the Paris Agreement before 2027 – although if drastic mitigation measures were taken now they could still bring temperatures down again later. Apart urgent measures to reduce carbon emissions, countries should also concentrate on building climate-resilient and environmentally sustainable health systems to mitigate the effects of climate change on health. “At the global level, the health sector generates 4-5% of the global greenhouse gas emissions. Adopting sustainable practices brings benefits like improved accessibility, reliable services, and lower costs,” Dr Haidong Wang, the WHO unit head of monitoring, forecasting & inequalities, said. “Climate change has challenges to countries already dealing with non-communicable disease burdens. It may also lead to resurgence of infectious diseases”. Infectious diseases and NCDs The report revealed that in the past few years, the progress made by the world in combating infectious diseases like TB, HIV and malaria, and NCDs, have been reversed. Around 10.6 million people were diagnosed with TB in 2021, which is a 4.5% increase in numbers when compared with 2020. The global TB incidence rate increased by 3.6% between 2020 and 2021, reversing the progress made in the past two decades. “Tuberculosis treatment coverage dropped from 69% in 2019 to 61% in 2021,” Wang pointed out. The situation around NCDs are equally grim. Probability of dying from the four major NCDs (ages 30–69 years), projection versus SDGtarget, WHO regions and global, 2000–2048. If targeted efforts are not taken by countries, the objectives set out in the SDGs around tackling NCDs will remain unachieved. “The share of deaths caused annually by NCDs has grown to nearly three quarters of all deaths and, if the trend continues, is projected to reach about 86% globally by WHO’s 100th anniversary in 2048,” the report cautions. “The United Nations projects that total annual deaths will reach nearly 90 million globally in 2048; consequently, 77 million of these will be NCD deaths – a nearly 90% increase in absolute numbers over 2019”. COVID-19 pandemic: A medley of crises It is known that the COVID-19 pandemic caused unprecedented damage to health systems across the world. Not only did it kill millions of lives, it also caused considerable backsliding in decades-long efforts taken to address diseases like tuberculosis and HIV, and even changed the pattern of care-seeking across the world. “So the COVID-19 pandemic wasn’t just a health emergency, it was also a statistical crisis across the world,” Dr Dr Stephen MacFeely, WHOs director of data and analytics said. He added that several countries suspended longstanding surveys due to pandemic-related restrictions, making it impossible to acquire real data on issues like population and housing. “This shock interrupted the flow of data from already weak and fragile data systems.” Emphasizing on the need to have robust, disaggregated, good quality data for monitoring and surveillance purposes, MacFeely said that WHO will be launching a “Data Dot Portal”, as part of the agency’s World Health Data Hub project, to serve as a “one-stop shop for health data”. The portal will be launching at the end of next week, as curtains fall on the 76th World Health Assembly, after being in development for nearly four years. Image Credits: Chris LeBoutillier, World Health Organization. Posts navigation Older postsNewer posts