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. 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. Sexual Health Derailed the Last World Health Assembly; What Are This Year’s Flashpoints? 18/05/2023 Kerry Cullinan Last year’s WHA late on the Saturday night, as Committee A struggled to reach agreement. Much of this year’s WHA agenda, being held in Geneva between 21 and 30 May, should be preoccupied with pandemic preparedness and the WHO’s budget. But there are some obscure items for anti-rights conservatives to latch onto if they want to derail discussion – and there is growing appetite for such disruptions throughout all UN agencies. While officially, this year’s WHA is supposed to focus on a wide range of policy issues around the three pillars of WHO’s “Three Billion” strategy, which include emergencies and pandemics, non-communicable diseases and healthier populations, a few hidden minefields scattered in the agenda threaten to create unexpected flashpoints which could divert attention from the substance of the meeting. They include, once again, language around sexual health, but also as well as concerns about the place of states’ sovereign rights in the pandemic treaty, an initiative on a new WHO replenishment fund, as well as the perennial debates around the demand by Taiwan to be reinstated as a WHA observer, and the status of health in the Occupied Palestinian territories. What are the potential red-herring flashpoints lurking in the shadows of a dry and detailed agenda? Here´s a brief review of the landscape: Anti-rights red flags? At last year´s World Health Assembly (WHA), an unexpected and protracted standoff over references to “sexuality”, “sexual orientation” and “men who have sex with men” in a technical guideline on HIV and hepatitis – pushed member states into an overnight session, delaying the close of the entire event. Last year, the Eastern Mediterranean Region (EMRO), supported by key North African countries, led the charge, with Saudi Arabia, Egypt and Nigeria vociferous in their condemnation of behaviours they deemed antithetical to their cultures. This forced talks late into the night and, finally, an unprecedented vote on the vexatious guide after numerous compromise clauses failed. The Saudi delegate in a heated WHA debate over sexual rights and terminology. If the conservatives are scanning assembly documents for men having sex with men, they’re unlikely to find any references. But if they are intent on looking for polarising needles in the agenda haystack, some might take issue with the report on the Global Strategy for Women’s, Children’s and Adolescents’ Health. This refers to the WHO’s updated handbook on family planning, which contains references to post-abortion care and gender identity. These are red flags for the right-wing UN coalition of member states, Group of Friends of the Family, founded by Egypt, Belarus and Qatar to advocate for the “natural family” that is becoming more vocal and more closely aligned with US rightwing Christian groups through annual World Congress of Families gatherings. Multilateralism under fire This year’s WHA takes place in an even tougher environment. Russia’s ongoing war in Ukraine has polarised the international community, compounding the economic struggles wrought by three pandemic years. “The multilateral system is under greater strain than at any time since the creation of the United Nations,” UN Secretary-General Antonio Guterres warned in an address to the Security Council last month. “We are witnessing a deepening climate crisis, soaring inequalities, a rising threat from terrorism, a global pushback against human rights and gender equality, and the unregulated development of dangerous technologies,” he added. “All these global challenges can only be solved through respect for international law, adherence to global commitments, and the adoption of appropriate frameworks of multilateral governance.” Heightened US-China tensions may well be inflamed by the large presence of Taiwan at this year’s WHA. The US appeal for it to be reinstated as an observer has been followed by a formal request from Belize for this to be included on the agenda. The health of Palestinians, with an unprecedented rise of Israeli settler violence accounting for 25% of casualties, is also a geopolitical flashpoint. National sovereignty and pandemic response Much of this year’s WHA, themed “Health For All: 75 years of improving public health”, will be around measures to counter the next pandemic – particularly universal health care and health and how to increase WHO’s finances. The assembly will hear and comment on progress made on two pandemic-related processes: one to amend the International Health Regulations (IHR) to make them fit for the next pandemic and the other, to draw up a pandemic accord. But both negotiations are ongoing with a deadline of next year’s WHA, so it is unlikely that conflicts will climax at this session. However, concerns about member states’ sovereignty are likely to be expressed, something that Russia and China have stressed in previous discussions. Meanwhile, misinformation continues to churn outside of the WHA from those who opposed COVID-19 vaccines and lockdowns who claim that the pandemic accord will give WHO superpowers, and could lead to international “vaccine passports”. Anti-vaxxer and US presidential hopeful Robert F Kennedy and his organisation, Children’s Health Defense, are key sources of this misinformation and have organised global protests aimed at urging countries to exit the WHO on Saturday 20 May, the day before the WHA opens. WHO finances in the spotlight Members of the WHO Working Group on Sustainable Finance hammer out an agreement on increasing member state contributions this week, with Germany’s Björn Kümmel on far left. As with last year, moves to increase the WHO’s budget ceiling are also likely to be a focus of animated discussion. Member states are supposed to be increasing their assessed contributions in line with a resolution passed last year. The 2024/ 25 proposed budget is therefore based on the portion of members’ contributions being raised from a dismal 12% of the budget to 20%, which the WHA budget document on the budget describes as “marking a historic move towards a more empowered and independent WHO”. During the Executive Board discussion in January on increasing WHO contributions, the Africa region expressed the expectation that WHO would channel far more resources to country and regional offices – something that the WHO has tried to do and reports that country allocation had increased from 39% in the 2018/19 to 50% in the proposed 2024/ 25 budget. The Agile Member States Task Group on Strengthening WHO’s Budgetary, Programmatic and Financing Governance has worked hard to find a way to stabilise WHO income, making it less dependent on donors and also more efficient. Replenishment Fund The assembly also will discuss a proposal from the WHO’s Executive Committee for the establishment of a replenishment fund. Most member states accept that the WHO is underfunded and over-reliant on donors’ conditional grants, slanting the work of the body. While a replenishment fund, effectively, also involves recruiting more in voluntary donations, the process is public and therefore potentially more transparent – similar to the periodic replenishment drives conducted by organisations such as The Global Fund and Gavi, the Vaccine Alliance. Also, typically such funds are not designated for specific donor projects – but able to be used flexibly by the organisation involved. Ahead of the January Executive Board meeting, the WHO’s Programme, Budget and Administration Committee (PBAC) “acknowledged WHO’s need for more flexible, predictable and sustainable financing and considered that a replenishment mechanism provided a possible solution, especially for chronically underfunded areas of the organization’s programme budget”. Meanwhile, a fascinating recent analysis of all WHA resolutions between 1948 and 2021 was recently published in the BMJ. It notes: “While the WHO has been criticised for its siloed approach to address global health issues, the analysis suggests that this approach is not the collective will of the WHA but may relate to the way the WHO has been increasingly funded through earmarked voluntary contributions to specific programmes.” Whatever decisions are taken, the attention of the international global health sector will be in Geneva over the next 10 days. Image Credits: Germany's UN Mission in Geneva . Focus on Influencing Substance of Pandemic Accord as Process Unlikely to Change, EU Official Advises Civil Society 18/05/2023 Kerry Cullinan WHO member states discuss new pandemic convention or treaty in July 2022. Civil society is unlikely to be included in the World Health Organization (WHO)’s pandemic accord negotiations and should focus on making an impact on its content, according to a European Union official. “I don’t see these rules.. changing very easily at this stage. So I would concentrate efforts in working on the substance more than on the process,” Americo Zampetti, a senior leader of the delegation of the EU at the UN, told a webinar convened by the Geneva Global Health Hub (G2H2) on Wednesday. While the EU would be “quite content” with civil society being more active in the discussion, “some other partners are not similarly keen in being open and transparent and making the best use of civil society contribution”, he added. “Civil society is particularly apt at advocating so I would concentrate on advocating on substance more than on process because I see the process as basically gone,” he advised. Americo Zampetti However, the EU would “make a very strong case” for civil society participation in the institutional machinery leading to the adoption of the agreement, and “we trust that civil society will be a very active partner in implementing any future agreement”, he added. Margot Nauleau from Save the Children warned that governments would need to work with the people to implement new pandemic obligations. “This must start by building trust and legitimacy in the policy process because the absence of transparency and engagement will lead to misinformation and confusion,” said Nauleau. “The negotiations on the pandemic code and the International Health Regulations are becoming more and more exclusive of civil society,” she added. “We no longer have access to the drafting group and there is no transparency on the textual proposals that are made by member states.” This runs counter to the WHO Constitution and the Sustainable Development Goals, she added. To rectify this, Save the Children has three recommendations to the WHO. The first involves more civil society involvement in the negotiation and drafting by, for example, enabling them access to “all relevant documentation, including the draft, and intervene in a timely and unrestricted way during the plenary and the working group sessions of the negotiations”. The second recommendation is to include civil society in treaty decision-making bodies, as the Framework Convention on Climate Change does. The third involves civil society inclusion in the “monitoring and compliance mechanisms of these instruments”, as is the case for the Nagoya Protocol. Environment and tobacco control Yves Ladar, Permanent Representative of Earth Justice to the UN in Geneva, said that civil society had been integrally involved in a number of key environmental agreements and brought a lot of expertise to these. One of these was Aarhus Convention, signed in 1998, which “provides access to access to information, effective public participation and access to justice in environmental matters”, said Ladar. Patricia Lambert Patricia Lambert from the Campaign for Tobacco-Free Kids, was part of negotiations for the Framework Convention on Tobacco Control as legal adviser to South Africa. Civil society fought hard to be included in the FCTC negotiations, and one of the clauses of the Convention notes that “participation of civil society is essential” in achieving its objectives, said Lambert, advising groups to “organise, organise, organise”. “I’m very discomforted to hear that, as far as the process goes, civil society has largely been left out,” said Lambert. “What is working against you that was not present at the time of the FCTC negotiations [adopted 23 years go], is the hardening of attitudes in certain governments to civil society and to civil society participation.” It’s Time to End AIDS: Why EU Should Fund Search for HIV Vaccine 18/05/2023 Frances Fitzgerald, Sirpa Pietikäinen, Sara Cerdas, Cyrus Engerer, Antoni Comín i Oliveres, Catharina Rinzema & Marc Angel The HIV pandemic has affected over 2.3 million people in the World Health Organization’s (WHO) European Region, with nearly 300 new diagnoses made daily in 2021. The COVID-19 pandemic and geopolitical turbulences in the region impacted the course of the HIV pandemic and the response, displacing populations, and disrupting access to care and HIV testing. Today, living with HIV is no longer a reason for despair and the management of HIV is well codified. As there is no cure, people living with HIV undertake life-long treatment that allows them to have healthy and long lives. The effectiveness of treatment is indisputable but the estimated treatment cost per person per year remains high. In Spain, it is estimated to be €11,638, while in Germany it soars to around €32,100. In France, the cost reaches €14,821, and in Italy, it amounts to €6,300. While the introduction of pre-exposure prophylaxis (PrEP) in 2012 was a breakthrough in HIV prevention in Europe and globally, the burden of HIV continues to fall disproportionately in certain regions, like eastern Europe, as well as on vulnerable populations that include migrants, sex workers, people who use drugs and men who have sex with men. These disparities are felt in various aspects of HIV prevention and treatment, including limited access to testing and inadequate availability and affordability of prevention tools like PrEP. Significant economic and human rights impact WHO Europe: HIV in Europe 2021 Although the incidence of HIV in the region may not be as alarming as in other parts of the world, its impact is significant, not only on European economies but also on the human rights of its marginalised populations. Within this context, immunisation is a crucial means of safeguarding public health, reducing morbidity and mortality. Additionally, it delivers advantages for the social and economic fabric of nations and helps alleviate the burden on healthcare systems. Despite the disruption caused by COVID-19 in recent years, European scientists have rallied together in the pursuit of an effective HIV vaccine, conducting several early-phase trials with the backing of funding from Horizon 2020. These trials use original technologies often not developed elsewhere. However, plans and funds to ensure their continuity are urgently required, especially given the need for larger trials to achieve conclusive results. So, why should Europe invest in the search for an HIV vaccine? First, an HIV vaccine would naturally help control the pandemic on the continent, not only from a prevention point of view but also because HIV vaccines are key to cure and remission of the virus. Simultaneously, the vaccine would have a tremendous impact on improving public health, not only on HIV-related issues but also on other infectious diseases. For example, the long-term research conducted for an HIV vaccine played a crucial role towards the rapid development of a COVID-19 vaccine. Moreover, it has proven to be critical in paving the way for the development of vaccines for other diseases not only strengthening the networks of European research institutions but improving the necessary infrastructure. Thus, investing in an HIV vaccine undoubtedly means investing in pandemic preparedness, and in global health security. Lastly, the development and distribution of an effective HIV vaccine have the potential to improve global health equity. It would ensure that everyone, regardless of their socioeconomic status or geographic location, has access to life-saving technologies, leaving no one behind. Additionally, an HIV vaccine would further protect vulnerable populations and reduce health disparities, contributing to the fight against HIV-related stigma and discrimination. By improving prevention and providing opportunities for greater control of HIV, an HIV vaccine would have a worldwide impact beyond Europe. Vulnerable populations Through its Global Health Strategy, the European Union is committed to deepening its leadership in global health matters, assuring that everyone everywhere has access to the highest attainable standards of health, based on solidarity and human rights. This will be achieved by, amongst other priorities, tackling the root causes of ill health, focusing on vulnerable populations, and working towards a mechanism that fosters the development of, and equitable access to, vaccines. As the COVID-19 pandemic made clear, the EU has an unprecedented opportunity to become a global health leader. Investing in the development of an HIV vaccine that can save the lives of people all over the world must be a fundamental part of this strategy, with positive benefits for individual health and human rights, as well as for economies and health security. It is time to invest in R&D for an HIV vaccine. It is time to ensure that the HIV pandemic no longer poses a threat to public health and individual well-being, and by doing so, protect human rights and advance equity. It is time to end AIDS. Frances Fitzgerald is a Member of the European Parliament, Ireland Sirpa Pietikäinen is a Member of the European Parliament, Finland Sara Cerdas is a Member of the European Parliament, Portugal Cyrus Engerer is a Member of the European Parliament, Malta Antoni Comín i Oliveres is a Member of the European Parliament, Spain Catharina Rinzema is a Member of the European Parliament, The Netherlands Marc Angel is a member of the European Parliament, Luxembourg Image Credits: Ehimetalor Akhere Unuabona/ Unsplash. 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... 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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. 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. Sexual Health Derailed the Last World Health Assembly; What Are This Year’s Flashpoints? 18/05/2023 Kerry Cullinan Last year’s WHA late on the Saturday night, as Committee A struggled to reach agreement. Much of this year’s WHA agenda, being held in Geneva between 21 and 30 May, should be preoccupied with pandemic preparedness and the WHO’s budget. But there are some obscure items for anti-rights conservatives to latch onto if they want to derail discussion – and there is growing appetite for such disruptions throughout all UN agencies. While officially, this year’s WHA is supposed to focus on a wide range of policy issues around the three pillars of WHO’s “Three Billion” strategy, which include emergencies and pandemics, non-communicable diseases and healthier populations, a few hidden minefields scattered in the agenda threaten to create unexpected flashpoints which could divert attention from the substance of the meeting. They include, once again, language around sexual health, but also as well as concerns about the place of states’ sovereign rights in the pandemic treaty, an initiative on a new WHO replenishment fund, as well as the perennial debates around the demand by Taiwan to be reinstated as a WHA observer, and the status of health in the Occupied Palestinian territories. What are the potential red-herring flashpoints lurking in the shadows of a dry and detailed agenda? Here´s a brief review of the landscape: Anti-rights red flags? At last year´s World Health Assembly (WHA), an unexpected and protracted standoff over references to “sexuality”, “sexual orientation” and “men who have sex with men” in a technical guideline on HIV and hepatitis – pushed member states into an overnight session, delaying the close of the entire event. Last year, the Eastern Mediterranean Region (EMRO), supported by key North African countries, led the charge, with Saudi Arabia, Egypt and Nigeria vociferous in their condemnation of behaviours they deemed antithetical to their cultures. This forced talks late into the night and, finally, an unprecedented vote on the vexatious guide after numerous compromise clauses failed. The Saudi delegate in a heated WHA debate over sexual rights and terminology. If the conservatives are scanning assembly documents for men having sex with men, they’re unlikely to find any references. But if they are intent on looking for polarising needles in the agenda haystack, some might take issue with the report on the Global Strategy for Women’s, Children’s and Adolescents’ Health. This refers to the WHO’s updated handbook on family planning, which contains references to post-abortion care and gender identity. These are red flags for the right-wing UN coalition of member states, Group of Friends of the Family, founded by Egypt, Belarus and Qatar to advocate for the “natural family” that is becoming more vocal and more closely aligned with US rightwing Christian groups through annual World Congress of Families gatherings. Multilateralism under fire This year’s WHA takes place in an even tougher environment. Russia’s ongoing war in Ukraine has polarised the international community, compounding the economic struggles wrought by three pandemic years. “The multilateral system is under greater strain than at any time since the creation of the United Nations,” UN Secretary-General Antonio Guterres warned in an address to the Security Council last month. “We are witnessing a deepening climate crisis, soaring inequalities, a rising threat from terrorism, a global pushback against human rights and gender equality, and the unregulated development of dangerous technologies,” he added. “All these global challenges can only be solved through respect for international law, adherence to global commitments, and the adoption of appropriate frameworks of multilateral governance.” Heightened US-China tensions may well be inflamed by the large presence of Taiwan at this year’s WHA. The US appeal for it to be reinstated as an observer has been followed by a formal request from Belize for this to be included on the agenda. The health of Palestinians, with an unprecedented rise of Israeli settler violence accounting for 25% of casualties, is also a geopolitical flashpoint. National sovereignty and pandemic response Much of this year’s WHA, themed “Health For All: 75 years of improving public health”, will be around measures to counter the next pandemic – particularly universal health care and health and how to increase WHO’s finances. The assembly will hear and comment on progress made on two pandemic-related processes: one to amend the International Health Regulations (IHR) to make them fit for the next pandemic and the other, to draw up a pandemic accord. But both negotiations are ongoing with a deadline of next year’s WHA, so it is unlikely that conflicts will climax at this session. However, concerns about member states’ sovereignty are likely to be expressed, something that Russia and China have stressed in previous discussions. Meanwhile, misinformation continues to churn outside of the WHA from those who opposed COVID-19 vaccines and lockdowns who claim that the pandemic accord will give WHO superpowers, and could lead to international “vaccine passports”. Anti-vaxxer and US presidential hopeful Robert F Kennedy and his organisation, Children’s Health Defense, are key sources of this misinformation and have organised global protests aimed at urging countries to exit the WHO on Saturday 20 May, the day before the WHA opens. WHO finances in the spotlight Members of the WHO Working Group on Sustainable Finance hammer out an agreement on increasing member state contributions this week, with Germany’s Björn Kümmel on far left. As with last year, moves to increase the WHO’s budget ceiling are also likely to be a focus of animated discussion. Member states are supposed to be increasing their assessed contributions in line with a resolution passed last year. The 2024/ 25 proposed budget is therefore based on the portion of members’ contributions being raised from a dismal 12% of the budget to 20%, which the WHA budget document on the budget describes as “marking a historic move towards a more empowered and independent WHO”. During the Executive Board discussion in January on increasing WHO contributions, the Africa region expressed the expectation that WHO would channel far more resources to country and regional offices – something that the WHO has tried to do and reports that country allocation had increased from 39% in the 2018/19 to 50% in the proposed 2024/ 25 budget. The Agile Member States Task Group on Strengthening WHO’s Budgetary, Programmatic and Financing Governance has worked hard to find a way to stabilise WHO income, making it less dependent on donors and also more efficient. Replenishment Fund The assembly also will discuss a proposal from the WHO’s Executive Committee for the establishment of a replenishment fund. Most member states accept that the WHO is underfunded and over-reliant on donors’ conditional grants, slanting the work of the body. While a replenishment fund, effectively, also involves recruiting more in voluntary donations, the process is public and therefore potentially more transparent – similar to the periodic replenishment drives conducted by organisations such as The Global Fund and Gavi, the Vaccine Alliance. Also, typically such funds are not designated for specific donor projects – but able to be used flexibly by the organisation involved. Ahead of the January Executive Board meeting, the WHO’s Programme, Budget and Administration Committee (PBAC) “acknowledged WHO’s need for more flexible, predictable and sustainable financing and considered that a replenishment mechanism provided a possible solution, especially for chronically underfunded areas of the organization’s programme budget”. Meanwhile, a fascinating recent analysis of all WHA resolutions between 1948 and 2021 was recently published in the BMJ. It notes: “While the WHO has been criticised for its siloed approach to address global health issues, the analysis suggests that this approach is not the collective will of the WHA but may relate to the way the WHO has been increasingly funded through earmarked voluntary contributions to specific programmes.” Whatever decisions are taken, the attention of the international global health sector will be in Geneva over the next 10 days. Image Credits: Germany's UN Mission in Geneva . Focus on Influencing Substance of Pandemic Accord as Process Unlikely to Change, EU Official Advises Civil Society 18/05/2023 Kerry Cullinan WHO member states discuss new pandemic convention or treaty in July 2022. Civil society is unlikely to be included in the World Health Organization (WHO)’s pandemic accord negotiations and should focus on making an impact on its content, according to a European Union official. “I don’t see these rules.. changing very easily at this stage. So I would concentrate efforts in working on the substance more than on the process,” Americo Zampetti, a senior leader of the delegation of the EU at the UN, told a webinar convened by the Geneva Global Health Hub (G2H2) on Wednesday. While the EU would be “quite content” with civil society being more active in the discussion, “some other partners are not similarly keen in being open and transparent and making the best use of civil society contribution”, he added. “Civil society is particularly apt at advocating so I would concentrate on advocating on substance more than on process because I see the process as basically gone,” he advised. Americo Zampetti However, the EU would “make a very strong case” for civil society participation in the institutional machinery leading to the adoption of the agreement, and “we trust that civil society will be a very active partner in implementing any future agreement”, he added. Margot Nauleau from Save the Children warned that governments would need to work with the people to implement new pandemic obligations. “This must start by building trust and legitimacy in the policy process because the absence of transparency and engagement will lead to misinformation and confusion,” said Nauleau. “The negotiations on the pandemic code and the International Health Regulations are becoming more and more exclusive of civil society,” she added. “We no longer have access to the drafting group and there is no transparency on the textual proposals that are made by member states.” This runs counter to the WHO Constitution and the Sustainable Development Goals, she added. To rectify this, Save the Children has three recommendations to the WHO. The first involves more civil society involvement in the negotiation and drafting by, for example, enabling them access to “all relevant documentation, including the draft, and intervene in a timely and unrestricted way during the plenary and the working group sessions of the negotiations”. The second recommendation is to include civil society in treaty decision-making bodies, as the Framework Convention on Climate Change does. The third involves civil society inclusion in the “monitoring and compliance mechanisms of these instruments”, as is the case for the Nagoya Protocol. Environment and tobacco control Yves Ladar, Permanent Representative of Earth Justice to the UN in Geneva, said that civil society had been integrally involved in a number of key environmental agreements and brought a lot of expertise to these. One of these was Aarhus Convention, signed in 1998, which “provides access to access to information, effective public participation and access to justice in environmental matters”, said Ladar. Patricia Lambert Patricia Lambert from the Campaign for Tobacco-Free Kids, was part of negotiations for the Framework Convention on Tobacco Control as legal adviser to South Africa. Civil society fought hard to be included in the FCTC negotiations, and one of the clauses of the Convention notes that “participation of civil society is essential” in achieving its objectives, said Lambert, advising groups to “organise, organise, organise”. “I’m very discomforted to hear that, as far as the process goes, civil society has largely been left out,” said Lambert. “What is working against you that was not present at the time of the FCTC negotiations [adopted 23 years go], is the hardening of attitudes in certain governments to civil society and to civil society participation.” It’s Time to End AIDS: Why EU Should Fund Search for HIV Vaccine 18/05/2023 Frances Fitzgerald, Sirpa Pietikäinen, Sara Cerdas, Cyrus Engerer, Antoni Comín i Oliveres, Catharina Rinzema & Marc Angel The HIV pandemic has affected over 2.3 million people in the World Health Organization’s (WHO) European Region, with nearly 300 new diagnoses made daily in 2021. The COVID-19 pandemic and geopolitical turbulences in the region impacted the course of the HIV pandemic and the response, displacing populations, and disrupting access to care and HIV testing. Today, living with HIV is no longer a reason for despair and the management of HIV is well codified. As there is no cure, people living with HIV undertake life-long treatment that allows them to have healthy and long lives. The effectiveness of treatment is indisputable but the estimated treatment cost per person per year remains high. In Spain, it is estimated to be €11,638, while in Germany it soars to around €32,100. In France, the cost reaches €14,821, and in Italy, it amounts to €6,300. While the introduction of pre-exposure prophylaxis (PrEP) in 2012 was a breakthrough in HIV prevention in Europe and globally, the burden of HIV continues to fall disproportionately in certain regions, like eastern Europe, as well as on vulnerable populations that include migrants, sex workers, people who use drugs and men who have sex with men. These disparities are felt in various aspects of HIV prevention and treatment, including limited access to testing and inadequate availability and affordability of prevention tools like PrEP. Significant economic and human rights impact WHO Europe: HIV in Europe 2021 Although the incidence of HIV in the region may not be as alarming as in other parts of the world, its impact is significant, not only on European economies but also on the human rights of its marginalised populations. Within this context, immunisation is a crucial means of safeguarding public health, reducing morbidity and mortality. Additionally, it delivers advantages for the social and economic fabric of nations and helps alleviate the burden on healthcare systems. Despite the disruption caused by COVID-19 in recent years, European scientists have rallied together in the pursuit of an effective HIV vaccine, conducting several early-phase trials with the backing of funding from Horizon 2020. These trials use original technologies often not developed elsewhere. However, plans and funds to ensure their continuity are urgently required, especially given the need for larger trials to achieve conclusive results. So, why should Europe invest in the search for an HIV vaccine? First, an HIV vaccine would naturally help control the pandemic on the continent, not only from a prevention point of view but also because HIV vaccines are key to cure and remission of the virus. Simultaneously, the vaccine would have a tremendous impact on improving public health, not only on HIV-related issues but also on other infectious diseases. For example, the long-term research conducted for an HIV vaccine played a crucial role towards the rapid development of a COVID-19 vaccine. Moreover, it has proven to be critical in paving the way for the development of vaccines for other diseases not only strengthening the networks of European research institutions but improving the necessary infrastructure. Thus, investing in an HIV vaccine undoubtedly means investing in pandemic preparedness, and in global health security. Lastly, the development and distribution of an effective HIV vaccine have the potential to improve global health equity. It would ensure that everyone, regardless of their socioeconomic status or geographic location, has access to life-saving technologies, leaving no one behind. Additionally, an HIV vaccine would further protect vulnerable populations and reduce health disparities, contributing to the fight against HIV-related stigma and discrimination. By improving prevention and providing opportunities for greater control of HIV, an HIV vaccine would have a worldwide impact beyond Europe. Vulnerable populations Through its Global Health Strategy, the European Union is committed to deepening its leadership in global health matters, assuring that everyone everywhere has access to the highest attainable standards of health, based on solidarity and human rights. This will be achieved by, amongst other priorities, tackling the root causes of ill health, focusing on vulnerable populations, and working towards a mechanism that fosters the development of, and equitable access to, vaccines. As the COVID-19 pandemic made clear, the EU has an unprecedented opportunity to become a global health leader. Investing in the development of an HIV vaccine that can save the lives of people all over the world must be a fundamental part of this strategy, with positive benefits for individual health and human rights, as well as for economies and health security. It is time to invest in R&D for an HIV vaccine. It is time to ensure that the HIV pandemic no longer poses a threat to public health and individual well-being, and by doing so, protect human rights and advance equity. It is time to end AIDS. Frances Fitzgerald is a Member of the European Parliament, Ireland Sirpa Pietikäinen is a Member of the European Parliament, Finland Sara Cerdas is a Member of the European Parliament, Portugal Cyrus Engerer is a Member of the European Parliament, Malta Antoni Comín i Oliveres is a Member of the European Parliament, Spain Catharina Rinzema is a Member of the European Parliament, The Netherlands Marc Angel is a member of the European Parliament, Luxembourg Image Credits: Ehimetalor Akhere Unuabona/ Unsplash. 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... 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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. 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. Sexual Health Derailed the Last World Health Assembly; What Are This Year’s Flashpoints? 18/05/2023 Kerry Cullinan Last year’s WHA late on the Saturday night, as Committee A struggled to reach agreement. Much of this year’s WHA agenda, being held in Geneva between 21 and 30 May, should be preoccupied with pandemic preparedness and the WHO’s budget. But there are some obscure items for anti-rights conservatives to latch onto if they want to derail discussion – and there is growing appetite for such disruptions throughout all UN agencies. While officially, this year’s WHA is supposed to focus on a wide range of policy issues around the three pillars of WHO’s “Three Billion” strategy, which include emergencies and pandemics, non-communicable diseases and healthier populations, a few hidden minefields scattered in the agenda threaten to create unexpected flashpoints which could divert attention from the substance of the meeting. They include, once again, language around sexual health, but also as well as concerns about the place of states’ sovereign rights in the pandemic treaty, an initiative on a new WHO replenishment fund, as well as the perennial debates around the demand by Taiwan to be reinstated as a WHA observer, and the status of health in the Occupied Palestinian territories. What are the potential red-herring flashpoints lurking in the shadows of a dry and detailed agenda? Here´s a brief review of the landscape: Anti-rights red flags? At last year´s World Health Assembly (WHA), an unexpected and protracted standoff over references to “sexuality”, “sexual orientation” and “men who have sex with men” in a technical guideline on HIV and hepatitis – pushed member states into an overnight session, delaying the close of the entire event. Last year, the Eastern Mediterranean Region (EMRO), supported by key North African countries, led the charge, with Saudi Arabia, Egypt and Nigeria vociferous in their condemnation of behaviours they deemed antithetical to their cultures. This forced talks late into the night and, finally, an unprecedented vote on the vexatious guide after numerous compromise clauses failed. The Saudi delegate in a heated WHA debate over sexual rights and terminology. If the conservatives are scanning assembly documents for men having sex with men, they’re unlikely to find any references. But if they are intent on looking for polarising needles in the agenda haystack, some might take issue with the report on the Global Strategy for Women’s, Children’s and Adolescents’ Health. This refers to the WHO’s updated handbook on family planning, which contains references to post-abortion care and gender identity. These are red flags for the right-wing UN coalition of member states, Group of Friends of the Family, founded by Egypt, Belarus and Qatar to advocate for the “natural family” that is becoming more vocal and more closely aligned with US rightwing Christian groups through annual World Congress of Families gatherings. Multilateralism under fire This year’s WHA takes place in an even tougher environment. Russia’s ongoing war in Ukraine has polarised the international community, compounding the economic struggles wrought by three pandemic years. “The multilateral system is under greater strain than at any time since the creation of the United Nations,” UN Secretary-General Antonio Guterres warned in an address to the Security Council last month. “We are witnessing a deepening climate crisis, soaring inequalities, a rising threat from terrorism, a global pushback against human rights and gender equality, and the unregulated development of dangerous technologies,” he added. “All these global challenges can only be solved through respect for international law, adherence to global commitments, and the adoption of appropriate frameworks of multilateral governance.” Heightened US-China tensions may well be inflamed by the large presence of Taiwan at this year’s WHA. The US appeal for it to be reinstated as an observer has been followed by a formal request from Belize for this to be included on the agenda. The health of Palestinians, with an unprecedented rise of Israeli settler violence accounting for 25% of casualties, is also a geopolitical flashpoint. National sovereignty and pandemic response Much of this year’s WHA, themed “Health For All: 75 years of improving public health”, will be around measures to counter the next pandemic – particularly universal health care and health and how to increase WHO’s finances. The assembly will hear and comment on progress made on two pandemic-related processes: one to amend the International Health Regulations (IHR) to make them fit for the next pandemic and the other, to draw up a pandemic accord. But both negotiations are ongoing with a deadline of next year’s WHA, so it is unlikely that conflicts will climax at this session. However, concerns about member states’ sovereignty are likely to be expressed, something that Russia and China have stressed in previous discussions. Meanwhile, misinformation continues to churn outside of the WHA from those who opposed COVID-19 vaccines and lockdowns who claim that the pandemic accord will give WHO superpowers, and could lead to international “vaccine passports”. Anti-vaxxer and US presidential hopeful Robert F Kennedy and his organisation, Children’s Health Defense, are key sources of this misinformation and have organised global protests aimed at urging countries to exit the WHO on Saturday 20 May, the day before the WHA opens. WHO finances in the spotlight Members of the WHO Working Group on Sustainable Finance hammer out an agreement on increasing member state contributions this week, with Germany’s Björn Kümmel on far left. As with last year, moves to increase the WHO’s budget ceiling are also likely to be a focus of animated discussion. Member states are supposed to be increasing their assessed contributions in line with a resolution passed last year. The 2024/ 25 proposed budget is therefore based on the portion of members’ contributions being raised from a dismal 12% of the budget to 20%, which the WHA budget document on the budget describes as “marking a historic move towards a more empowered and independent WHO”. During the Executive Board discussion in January on increasing WHO contributions, the Africa region expressed the expectation that WHO would channel far more resources to country and regional offices – something that the WHO has tried to do and reports that country allocation had increased from 39% in the 2018/19 to 50% in the proposed 2024/ 25 budget. The Agile Member States Task Group on Strengthening WHO’s Budgetary, Programmatic and Financing Governance has worked hard to find a way to stabilise WHO income, making it less dependent on donors and also more efficient. Replenishment Fund The assembly also will discuss a proposal from the WHO’s Executive Committee for the establishment of a replenishment fund. Most member states accept that the WHO is underfunded and over-reliant on donors’ conditional grants, slanting the work of the body. While a replenishment fund, effectively, also involves recruiting more in voluntary donations, the process is public and therefore potentially more transparent – similar to the periodic replenishment drives conducted by organisations such as The Global Fund and Gavi, the Vaccine Alliance. Also, typically such funds are not designated for specific donor projects – but able to be used flexibly by the organisation involved. Ahead of the January Executive Board meeting, the WHO’s Programme, Budget and Administration Committee (PBAC) “acknowledged WHO’s need for more flexible, predictable and sustainable financing and considered that a replenishment mechanism provided a possible solution, especially for chronically underfunded areas of the organization’s programme budget”. Meanwhile, a fascinating recent analysis of all WHA resolutions between 1948 and 2021 was recently published in the BMJ. It notes: “While the WHO has been criticised for its siloed approach to address global health issues, the analysis suggests that this approach is not the collective will of the WHA but may relate to the way the WHO has been increasingly funded through earmarked voluntary contributions to specific programmes.” Whatever decisions are taken, the attention of the international global health sector will be in Geneva over the next 10 days. Image Credits: Germany's UN Mission in Geneva . Focus on Influencing Substance of Pandemic Accord as Process Unlikely to Change, EU Official Advises Civil Society 18/05/2023 Kerry Cullinan WHO member states discuss new pandemic convention or treaty in July 2022. Civil society is unlikely to be included in the World Health Organization (WHO)’s pandemic accord negotiations and should focus on making an impact on its content, according to a European Union official. “I don’t see these rules.. changing very easily at this stage. So I would concentrate efforts in working on the substance more than on the process,” Americo Zampetti, a senior leader of the delegation of the EU at the UN, told a webinar convened by the Geneva Global Health Hub (G2H2) on Wednesday. While the EU would be “quite content” with civil society being more active in the discussion, “some other partners are not similarly keen in being open and transparent and making the best use of civil society contribution”, he added. “Civil society is particularly apt at advocating so I would concentrate on advocating on substance more than on process because I see the process as basically gone,” he advised. Americo Zampetti However, the EU would “make a very strong case” for civil society participation in the institutional machinery leading to the adoption of the agreement, and “we trust that civil society will be a very active partner in implementing any future agreement”, he added. Margot Nauleau from Save the Children warned that governments would need to work with the people to implement new pandemic obligations. “This must start by building trust and legitimacy in the policy process because the absence of transparency and engagement will lead to misinformation and confusion,” said Nauleau. “The negotiations on the pandemic code and the International Health Regulations are becoming more and more exclusive of civil society,” she added. “We no longer have access to the drafting group and there is no transparency on the textual proposals that are made by member states.” This runs counter to the WHO Constitution and the Sustainable Development Goals, she added. To rectify this, Save the Children has three recommendations to the WHO. The first involves more civil society involvement in the negotiation and drafting by, for example, enabling them access to “all relevant documentation, including the draft, and intervene in a timely and unrestricted way during the plenary and the working group sessions of the negotiations”. The second recommendation is to include civil society in treaty decision-making bodies, as the Framework Convention on Climate Change does. The third involves civil society inclusion in the “monitoring and compliance mechanisms of these instruments”, as is the case for the Nagoya Protocol. Environment and tobacco control Yves Ladar, Permanent Representative of Earth Justice to the UN in Geneva, said that civil society had been integrally involved in a number of key environmental agreements and brought a lot of expertise to these. One of these was Aarhus Convention, signed in 1998, which “provides access to access to information, effective public participation and access to justice in environmental matters”, said Ladar. Patricia Lambert Patricia Lambert from the Campaign for Tobacco-Free Kids, was part of negotiations for the Framework Convention on Tobacco Control as legal adviser to South Africa. Civil society fought hard to be included in the FCTC negotiations, and one of the clauses of the Convention notes that “participation of civil society is essential” in achieving its objectives, said Lambert, advising groups to “organise, organise, organise”. “I’m very discomforted to hear that, as far as the process goes, civil society has largely been left out,” said Lambert. “What is working against you that was not present at the time of the FCTC negotiations [adopted 23 years go], is the hardening of attitudes in certain governments to civil society and to civil society participation.” It’s Time to End AIDS: Why EU Should Fund Search for HIV Vaccine 18/05/2023 Frances Fitzgerald, Sirpa Pietikäinen, Sara Cerdas, Cyrus Engerer, Antoni Comín i Oliveres, Catharina Rinzema & Marc Angel The HIV pandemic has affected over 2.3 million people in the World Health Organization’s (WHO) European Region, with nearly 300 new diagnoses made daily in 2021. The COVID-19 pandemic and geopolitical turbulences in the region impacted the course of the HIV pandemic and the response, displacing populations, and disrupting access to care and HIV testing. Today, living with HIV is no longer a reason for despair and the management of HIV is well codified. As there is no cure, people living with HIV undertake life-long treatment that allows them to have healthy and long lives. The effectiveness of treatment is indisputable but the estimated treatment cost per person per year remains high. In Spain, it is estimated to be €11,638, while in Germany it soars to around €32,100. In France, the cost reaches €14,821, and in Italy, it amounts to €6,300. While the introduction of pre-exposure prophylaxis (PrEP) in 2012 was a breakthrough in HIV prevention in Europe and globally, the burden of HIV continues to fall disproportionately in certain regions, like eastern Europe, as well as on vulnerable populations that include migrants, sex workers, people who use drugs and men who have sex with men. These disparities are felt in various aspects of HIV prevention and treatment, including limited access to testing and inadequate availability and affordability of prevention tools like PrEP. Significant economic and human rights impact WHO Europe: HIV in Europe 2021 Although the incidence of HIV in the region may not be as alarming as in other parts of the world, its impact is significant, not only on European economies but also on the human rights of its marginalised populations. Within this context, immunisation is a crucial means of safeguarding public health, reducing morbidity and mortality. Additionally, it delivers advantages for the social and economic fabric of nations and helps alleviate the burden on healthcare systems. Despite the disruption caused by COVID-19 in recent years, European scientists have rallied together in the pursuit of an effective HIV vaccine, conducting several early-phase trials with the backing of funding from Horizon 2020. These trials use original technologies often not developed elsewhere. However, plans and funds to ensure their continuity are urgently required, especially given the need for larger trials to achieve conclusive results. So, why should Europe invest in the search for an HIV vaccine? First, an HIV vaccine would naturally help control the pandemic on the continent, not only from a prevention point of view but also because HIV vaccines are key to cure and remission of the virus. Simultaneously, the vaccine would have a tremendous impact on improving public health, not only on HIV-related issues but also on other infectious diseases. For example, the long-term research conducted for an HIV vaccine played a crucial role towards the rapid development of a COVID-19 vaccine. Moreover, it has proven to be critical in paving the way for the development of vaccines for other diseases not only strengthening the networks of European research institutions but improving the necessary infrastructure. Thus, investing in an HIV vaccine undoubtedly means investing in pandemic preparedness, and in global health security. Lastly, the development and distribution of an effective HIV vaccine have the potential to improve global health equity. It would ensure that everyone, regardless of their socioeconomic status or geographic location, has access to life-saving technologies, leaving no one behind. Additionally, an HIV vaccine would further protect vulnerable populations and reduce health disparities, contributing to the fight against HIV-related stigma and discrimination. By improving prevention and providing opportunities for greater control of HIV, an HIV vaccine would have a worldwide impact beyond Europe. Vulnerable populations Through its Global Health Strategy, the European Union is committed to deepening its leadership in global health matters, assuring that everyone everywhere has access to the highest attainable standards of health, based on solidarity and human rights. This will be achieved by, amongst other priorities, tackling the root causes of ill health, focusing on vulnerable populations, and working towards a mechanism that fosters the development of, and equitable access to, vaccines. As the COVID-19 pandemic made clear, the EU has an unprecedented opportunity to become a global health leader. Investing in the development of an HIV vaccine that can save the lives of people all over the world must be a fundamental part of this strategy, with positive benefits for individual health and human rights, as well as for economies and health security. It is time to invest in R&D for an HIV vaccine. It is time to ensure that the HIV pandemic no longer poses a threat to public health and individual well-being, and by doing so, protect human rights and advance equity. It is time to end AIDS. Frances Fitzgerald is a Member of the European Parliament, Ireland Sirpa Pietikäinen is a Member of the European Parliament, Finland Sara Cerdas is a Member of the European Parliament, Portugal Cyrus Engerer is a Member of the European Parliament, Malta Antoni Comín i Oliveres is a Member of the European Parliament, Spain Catharina Rinzema is a Member of the European Parliament, The Netherlands Marc Angel is a member of the European Parliament, Luxembourg Image Credits: Ehimetalor Akhere Unuabona/ Unsplash. 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... 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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. Sexual Health Derailed the Last World Health Assembly; What Are This Year’s Flashpoints? 18/05/2023 Kerry Cullinan Last year’s WHA late on the Saturday night, as Committee A struggled to reach agreement. Much of this year’s WHA agenda, being held in Geneva between 21 and 30 May, should be preoccupied with pandemic preparedness and the WHO’s budget. But there are some obscure items for anti-rights conservatives to latch onto if they want to derail discussion – and there is growing appetite for such disruptions throughout all UN agencies. While officially, this year’s WHA is supposed to focus on a wide range of policy issues around the three pillars of WHO’s “Three Billion” strategy, which include emergencies and pandemics, non-communicable diseases and healthier populations, a few hidden minefields scattered in the agenda threaten to create unexpected flashpoints which could divert attention from the substance of the meeting. They include, once again, language around sexual health, but also as well as concerns about the place of states’ sovereign rights in the pandemic treaty, an initiative on a new WHO replenishment fund, as well as the perennial debates around the demand by Taiwan to be reinstated as a WHA observer, and the status of health in the Occupied Palestinian territories. What are the potential red-herring flashpoints lurking in the shadows of a dry and detailed agenda? Here´s a brief review of the landscape: Anti-rights red flags? At last year´s World Health Assembly (WHA), an unexpected and protracted standoff over references to “sexuality”, “sexual orientation” and “men who have sex with men” in a technical guideline on HIV and hepatitis – pushed member states into an overnight session, delaying the close of the entire event. Last year, the Eastern Mediterranean Region (EMRO), supported by key North African countries, led the charge, with Saudi Arabia, Egypt and Nigeria vociferous in their condemnation of behaviours they deemed antithetical to their cultures. This forced talks late into the night and, finally, an unprecedented vote on the vexatious guide after numerous compromise clauses failed. The Saudi delegate in a heated WHA debate over sexual rights and terminology. If the conservatives are scanning assembly documents for men having sex with men, they’re unlikely to find any references. But if they are intent on looking for polarising needles in the agenda haystack, some might take issue with the report on the Global Strategy for Women’s, Children’s and Adolescents’ Health. This refers to the WHO’s updated handbook on family planning, which contains references to post-abortion care and gender identity. These are red flags for the right-wing UN coalition of member states, Group of Friends of the Family, founded by Egypt, Belarus and Qatar to advocate for the “natural family” that is becoming more vocal and more closely aligned with US rightwing Christian groups through annual World Congress of Families gatherings. Multilateralism under fire This year’s WHA takes place in an even tougher environment. Russia’s ongoing war in Ukraine has polarised the international community, compounding the economic struggles wrought by three pandemic years. “The multilateral system is under greater strain than at any time since the creation of the United Nations,” UN Secretary-General Antonio Guterres warned in an address to the Security Council last month. “We are witnessing a deepening climate crisis, soaring inequalities, a rising threat from terrorism, a global pushback against human rights and gender equality, and the unregulated development of dangerous technologies,” he added. “All these global challenges can only be solved through respect for international law, adherence to global commitments, and the adoption of appropriate frameworks of multilateral governance.” Heightened US-China tensions may well be inflamed by the large presence of Taiwan at this year’s WHA. The US appeal for it to be reinstated as an observer has been followed by a formal request from Belize for this to be included on the agenda. The health of Palestinians, with an unprecedented rise of Israeli settler violence accounting for 25% of casualties, is also a geopolitical flashpoint. National sovereignty and pandemic response Much of this year’s WHA, themed “Health For All: 75 years of improving public health”, will be around measures to counter the next pandemic – particularly universal health care and health and how to increase WHO’s finances. The assembly will hear and comment on progress made on two pandemic-related processes: one to amend the International Health Regulations (IHR) to make them fit for the next pandemic and the other, to draw up a pandemic accord. But both negotiations are ongoing with a deadline of next year’s WHA, so it is unlikely that conflicts will climax at this session. However, concerns about member states’ sovereignty are likely to be expressed, something that Russia and China have stressed in previous discussions. Meanwhile, misinformation continues to churn outside of the WHA from those who opposed COVID-19 vaccines and lockdowns who claim that the pandemic accord will give WHO superpowers, and could lead to international “vaccine passports”. Anti-vaxxer and US presidential hopeful Robert F Kennedy and his organisation, Children’s Health Defense, are key sources of this misinformation and have organised global protests aimed at urging countries to exit the WHO on Saturday 20 May, the day before the WHA opens. WHO finances in the spotlight Members of the WHO Working Group on Sustainable Finance hammer out an agreement on increasing member state contributions this week, with Germany’s Björn Kümmel on far left. As with last year, moves to increase the WHO’s budget ceiling are also likely to be a focus of animated discussion. Member states are supposed to be increasing their assessed contributions in line with a resolution passed last year. The 2024/ 25 proposed budget is therefore based on the portion of members’ contributions being raised from a dismal 12% of the budget to 20%, which the WHA budget document on the budget describes as “marking a historic move towards a more empowered and independent WHO”. During the Executive Board discussion in January on increasing WHO contributions, the Africa region expressed the expectation that WHO would channel far more resources to country and regional offices – something that the WHO has tried to do and reports that country allocation had increased from 39% in the 2018/19 to 50% in the proposed 2024/ 25 budget. The Agile Member States Task Group on Strengthening WHO’s Budgetary, Programmatic and Financing Governance has worked hard to find a way to stabilise WHO income, making it less dependent on donors and also more efficient. Replenishment Fund The assembly also will discuss a proposal from the WHO’s Executive Committee for the establishment of a replenishment fund. Most member states accept that the WHO is underfunded and over-reliant on donors’ conditional grants, slanting the work of the body. While a replenishment fund, effectively, also involves recruiting more in voluntary donations, the process is public and therefore potentially more transparent – similar to the periodic replenishment drives conducted by organisations such as The Global Fund and Gavi, the Vaccine Alliance. Also, typically such funds are not designated for specific donor projects – but able to be used flexibly by the organisation involved. Ahead of the January Executive Board meeting, the WHO’s Programme, Budget and Administration Committee (PBAC) “acknowledged WHO’s need for more flexible, predictable and sustainable financing and considered that a replenishment mechanism provided a possible solution, especially for chronically underfunded areas of the organization’s programme budget”. Meanwhile, a fascinating recent analysis of all WHA resolutions between 1948 and 2021 was recently published in the BMJ. It notes: “While the WHO has been criticised for its siloed approach to address global health issues, the analysis suggests that this approach is not the collective will of the WHA but may relate to the way the WHO has been increasingly funded through earmarked voluntary contributions to specific programmes.” Whatever decisions are taken, the attention of the international global health sector will be in Geneva over the next 10 days. Image Credits: Germany's UN Mission in Geneva . Focus on Influencing Substance of Pandemic Accord as Process Unlikely to Change, EU Official Advises Civil Society 18/05/2023 Kerry Cullinan WHO member states discuss new pandemic convention or treaty in July 2022. Civil society is unlikely to be included in the World Health Organization (WHO)’s pandemic accord negotiations and should focus on making an impact on its content, according to a European Union official. “I don’t see these rules.. changing very easily at this stage. So I would concentrate efforts in working on the substance more than on the process,” Americo Zampetti, a senior leader of the delegation of the EU at the UN, told a webinar convened by the Geneva Global Health Hub (G2H2) on Wednesday. While the EU would be “quite content” with civil society being more active in the discussion, “some other partners are not similarly keen in being open and transparent and making the best use of civil society contribution”, he added. “Civil society is particularly apt at advocating so I would concentrate on advocating on substance more than on process because I see the process as basically gone,” he advised. Americo Zampetti However, the EU would “make a very strong case” for civil society participation in the institutional machinery leading to the adoption of the agreement, and “we trust that civil society will be a very active partner in implementing any future agreement”, he added. Margot Nauleau from Save the Children warned that governments would need to work with the people to implement new pandemic obligations. “This must start by building trust and legitimacy in the policy process because the absence of transparency and engagement will lead to misinformation and confusion,” said Nauleau. “The negotiations on the pandemic code and the International Health Regulations are becoming more and more exclusive of civil society,” she added. “We no longer have access to the drafting group and there is no transparency on the textual proposals that are made by member states.” This runs counter to the WHO Constitution and the Sustainable Development Goals, she added. To rectify this, Save the Children has three recommendations to the WHO. The first involves more civil society involvement in the negotiation and drafting by, for example, enabling them access to “all relevant documentation, including the draft, and intervene in a timely and unrestricted way during the plenary and the working group sessions of the negotiations”. The second recommendation is to include civil society in treaty decision-making bodies, as the Framework Convention on Climate Change does. The third involves civil society inclusion in the “monitoring and compliance mechanisms of these instruments”, as is the case for the Nagoya Protocol. Environment and tobacco control Yves Ladar, Permanent Representative of Earth Justice to the UN in Geneva, said that civil society had been integrally involved in a number of key environmental agreements and brought a lot of expertise to these. One of these was Aarhus Convention, signed in 1998, which “provides access to access to information, effective public participation and access to justice in environmental matters”, said Ladar. Patricia Lambert Patricia Lambert from the Campaign for Tobacco-Free Kids, was part of negotiations for the Framework Convention on Tobacco Control as legal adviser to South Africa. Civil society fought hard to be included in the FCTC negotiations, and one of the clauses of the Convention notes that “participation of civil society is essential” in achieving its objectives, said Lambert, advising groups to “organise, organise, organise”. “I’m very discomforted to hear that, as far as the process goes, civil society has largely been left out,” said Lambert. “What is working against you that was not present at the time of the FCTC negotiations [adopted 23 years go], is the hardening of attitudes in certain governments to civil society and to civil society participation.” It’s Time to End AIDS: Why EU Should Fund Search for HIV Vaccine 18/05/2023 Frances Fitzgerald, Sirpa Pietikäinen, Sara Cerdas, Cyrus Engerer, Antoni Comín i Oliveres, Catharina Rinzema & Marc Angel The HIV pandemic has affected over 2.3 million people in the World Health Organization’s (WHO) European Region, with nearly 300 new diagnoses made daily in 2021. The COVID-19 pandemic and geopolitical turbulences in the region impacted the course of the HIV pandemic and the response, displacing populations, and disrupting access to care and HIV testing. Today, living with HIV is no longer a reason for despair and the management of HIV is well codified. As there is no cure, people living with HIV undertake life-long treatment that allows them to have healthy and long lives. The effectiveness of treatment is indisputable but the estimated treatment cost per person per year remains high. In Spain, it is estimated to be €11,638, while in Germany it soars to around €32,100. In France, the cost reaches €14,821, and in Italy, it amounts to €6,300. While the introduction of pre-exposure prophylaxis (PrEP) in 2012 was a breakthrough in HIV prevention in Europe and globally, the burden of HIV continues to fall disproportionately in certain regions, like eastern Europe, as well as on vulnerable populations that include migrants, sex workers, people who use drugs and men who have sex with men. These disparities are felt in various aspects of HIV prevention and treatment, including limited access to testing and inadequate availability and affordability of prevention tools like PrEP. Significant economic and human rights impact WHO Europe: HIV in Europe 2021 Although the incidence of HIV in the region may not be as alarming as in other parts of the world, its impact is significant, not only on European economies but also on the human rights of its marginalised populations. Within this context, immunisation is a crucial means of safeguarding public health, reducing morbidity and mortality. Additionally, it delivers advantages for the social and economic fabric of nations and helps alleviate the burden on healthcare systems. Despite the disruption caused by COVID-19 in recent years, European scientists have rallied together in the pursuit of an effective HIV vaccine, conducting several early-phase trials with the backing of funding from Horizon 2020. These trials use original technologies often not developed elsewhere. However, plans and funds to ensure their continuity are urgently required, especially given the need for larger trials to achieve conclusive results. So, why should Europe invest in the search for an HIV vaccine? First, an HIV vaccine would naturally help control the pandemic on the continent, not only from a prevention point of view but also because HIV vaccines are key to cure and remission of the virus. Simultaneously, the vaccine would have a tremendous impact on improving public health, not only on HIV-related issues but also on other infectious diseases. For example, the long-term research conducted for an HIV vaccine played a crucial role towards the rapid development of a COVID-19 vaccine. Moreover, it has proven to be critical in paving the way for the development of vaccines for other diseases not only strengthening the networks of European research institutions but improving the necessary infrastructure. Thus, investing in an HIV vaccine undoubtedly means investing in pandemic preparedness, and in global health security. Lastly, the development and distribution of an effective HIV vaccine have the potential to improve global health equity. It would ensure that everyone, regardless of their socioeconomic status or geographic location, has access to life-saving technologies, leaving no one behind. Additionally, an HIV vaccine would further protect vulnerable populations and reduce health disparities, contributing to the fight against HIV-related stigma and discrimination. By improving prevention and providing opportunities for greater control of HIV, an HIV vaccine would have a worldwide impact beyond Europe. Vulnerable populations Through its Global Health Strategy, the European Union is committed to deepening its leadership in global health matters, assuring that everyone everywhere has access to the highest attainable standards of health, based on solidarity and human rights. This will be achieved by, amongst other priorities, tackling the root causes of ill health, focusing on vulnerable populations, and working towards a mechanism that fosters the development of, and equitable access to, vaccines. As the COVID-19 pandemic made clear, the EU has an unprecedented opportunity to become a global health leader. Investing in the development of an HIV vaccine that can save the lives of people all over the world must be a fundamental part of this strategy, with positive benefits for individual health and human rights, as well as for economies and health security. It is time to invest in R&D for an HIV vaccine. It is time to ensure that the HIV pandemic no longer poses a threat to public health and individual well-being, and by doing so, protect human rights and advance equity. It is time to end AIDS. Frances Fitzgerald is a Member of the European Parliament, Ireland Sirpa Pietikäinen is a Member of the European Parliament, Finland Sara Cerdas is a Member of the European Parliament, Portugal Cyrus Engerer is a Member of the European Parliament, Malta Antoni Comín i Oliveres is a Member of the European Parliament, Spain Catharina Rinzema is a Member of the European Parliament, The Netherlands Marc Angel is a member of the European Parliament, Luxembourg Image Credits: Ehimetalor Akhere Unuabona/ Unsplash. 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... 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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. Sexual Health Derailed the Last World Health Assembly; What Are This Year’s Flashpoints? 18/05/2023 Kerry Cullinan Last year’s WHA late on the Saturday night, as Committee A struggled to reach agreement. Much of this year’s WHA agenda, being held in Geneva between 21 and 30 May, should be preoccupied with pandemic preparedness and the WHO’s budget. But there are some obscure items for anti-rights conservatives to latch onto if they want to derail discussion – and there is growing appetite for such disruptions throughout all UN agencies. While officially, this year’s WHA is supposed to focus on a wide range of policy issues around the three pillars of WHO’s “Three Billion” strategy, which include emergencies and pandemics, non-communicable diseases and healthier populations, a few hidden minefields scattered in the agenda threaten to create unexpected flashpoints which could divert attention from the substance of the meeting. They include, once again, language around sexual health, but also as well as concerns about the place of states’ sovereign rights in the pandemic treaty, an initiative on a new WHO replenishment fund, as well as the perennial debates around the demand by Taiwan to be reinstated as a WHA observer, and the status of health in the Occupied Palestinian territories. What are the potential red-herring flashpoints lurking in the shadows of a dry and detailed agenda? Here´s a brief review of the landscape: Anti-rights red flags? At last year´s World Health Assembly (WHA), an unexpected and protracted standoff over references to “sexuality”, “sexual orientation” and “men who have sex with men” in a technical guideline on HIV and hepatitis – pushed member states into an overnight session, delaying the close of the entire event. Last year, the Eastern Mediterranean Region (EMRO), supported by key North African countries, led the charge, with Saudi Arabia, Egypt and Nigeria vociferous in their condemnation of behaviours they deemed antithetical to their cultures. This forced talks late into the night and, finally, an unprecedented vote on the vexatious guide after numerous compromise clauses failed. The Saudi delegate in a heated WHA debate over sexual rights and terminology. If the conservatives are scanning assembly documents for men having sex with men, they’re unlikely to find any references. But if they are intent on looking for polarising needles in the agenda haystack, some might take issue with the report on the Global Strategy for Women’s, Children’s and Adolescents’ Health. This refers to the WHO’s updated handbook on family planning, which contains references to post-abortion care and gender identity. These are red flags for the right-wing UN coalition of member states, Group of Friends of the Family, founded by Egypt, Belarus and Qatar to advocate for the “natural family” that is becoming more vocal and more closely aligned with US rightwing Christian groups through annual World Congress of Families gatherings. Multilateralism under fire This year’s WHA takes place in an even tougher environment. Russia’s ongoing war in Ukraine has polarised the international community, compounding the economic struggles wrought by three pandemic years. “The multilateral system is under greater strain than at any time since the creation of the United Nations,” UN Secretary-General Antonio Guterres warned in an address to the Security Council last month. “We are witnessing a deepening climate crisis, soaring inequalities, a rising threat from terrorism, a global pushback against human rights and gender equality, and the unregulated development of dangerous technologies,” he added. “All these global challenges can only be solved through respect for international law, adherence to global commitments, and the adoption of appropriate frameworks of multilateral governance.” Heightened US-China tensions may well be inflamed by the large presence of Taiwan at this year’s WHA. The US appeal for it to be reinstated as an observer has been followed by a formal request from Belize for this to be included on the agenda. The health of Palestinians, with an unprecedented rise of Israeli settler violence accounting for 25% of casualties, is also a geopolitical flashpoint. National sovereignty and pandemic response Much of this year’s WHA, themed “Health For All: 75 years of improving public health”, will be around measures to counter the next pandemic – particularly universal health care and health and how to increase WHO’s finances. The assembly will hear and comment on progress made on two pandemic-related processes: one to amend the International Health Regulations (IHR) to make them fit for the next pandemic and the other, to draw up a pandemic accord. But both negotiations are ongoing with a deadline of next year’s WHA, so it is unlikely that conflicts will climax at this session. However, concerns about member states’ sovereignty are likely to be expressed, something that Russia and China have stressed in previous discussions. Meanwhile, misinformation continues to churn outside of the WHA from those who opposed COVID-19 vaccines and lockdowns who claim that the pandemic accord will give WHO superpowers, and could lead to international “vaccine passports”. Anti-vaxxer and US presidential hopeful Robert F Kennedy and his organisation, Children’s Health Defense, are key sources of this misinformation and have organised global protests aimed at urging countries to exit the WHO on Saturday 20 May, the day before the WHA opens. WHO finances in the spotlight Members of the WHO Working Group on Sustainable Finance hammer out an agreement on increasing member state contributions this week, with Germany’s Björn Kümmel on far left. As with last year, moves to increase the WHO’s budget ceiling are also likely to be a focus of animated discussion. Member states are supposed to be increasing their assessed contributions in line with a resolution passed last year. The 2024/ 25 proposed budget is therefore based on the portion of members’ contributions being raised from a dismal 12% of the budget to 20%, which the WHA budget document on the budget describes as “marking a historic move towards a more empowered and independent WHO”. During the Executive Board discussion in January on increasing WHO contributions, the Africa region expressed the expectation that WHO would channel far more resources to country and regional offices – something that the WHO has tried to do and reports that country allocation had increased from 39% in the 2018/19 to 50% in the proposed 2024/ 25 budget. The Agile Member States Task Group on Strengthening WHO’s Budgetary, Programmatic and Financing Governance has worked hard to find a way to stabilise WHO income, making it less dependent on donors and also more efficient. Replenishment Fund The assembly also will discuss a proposal from the WHO’s Executive Committee for the establishment of a replenishment fund. Most member states accept that the WHO is underfunded and over-reliant on donors’ conditional grants, slanting the work of the body. While a replenishment fund, effectively, also involves recruiting more in voluntary donations, the process is public and therefore potentially more transparent – similar to the periodic replenishment drives conducted by organisations such as The Global Fund and Gavi, the Vaccine Alliance. Also, typically such funds are not designated for specific donor projects – but able to be used flexibly by the organisation involved. Ahead of the January Executive Board meeting, the WHO’s Programme, Budget and Administration Committee (PBAC) “acknowledged WHO’s need for more flexible, predictable and sustainable financing and considered that a replenishment mechanism provided a possible solution, especially for chronically underfunded areas of the organization’s programme budget”. Meanwhile, a fascinating recent analysis of all WHA resolutions between 1948 and 2021 was recently published in the BMJ. It notes: “While the WHO has been criticised for its siloed approach to address global health issues, the analysis suggests that this approach is not the collective will of the WHA but may relate to the way the WHO has been increasingly funded through earmarked voluntary contributions to specific programmes.” Whatever decisions are taken, the attention of the international global health sector will be in Geneva over the next 10 days. Image Credits: Germany's UN Mission in Geneva . Focus on Influencing Substance of Pandemic Accord as Process Unlikely to Change, EU Official Advises Civil Society 18/05/2023 Kerry Cullinan WHO member states discuss new pandemic convention or treaty in July 2022. Civil society is unlikely to be included in the World Health Organization (WHO)’s pandemic accord negotiations and should focus on making an impact on its content, according to a European Union official. “I don’t see these rules.. changing very easily at this stage. So I would concentrate efforts in working on the substance more than on the process,” Americo Zampetti, a senior leader of the delegation of the EU at the UN, told a webinar convened by the Geneva Global Health Hub (G2H2) on Wednesday. While the EU would be “quite content” with civil society being more active in the discussion, “some other partners are not similarly keen in being open and transparent and making the best use of civil society contribution”, he added. “Civil society is particularly apt at advocating so I would concentrate on advocating on substance more than on process because I see the process as basically gone,” he advised. Americo Zampetti However, the EU would “make a very strong case” for civil society participation in the institutional machinery leading to the adoption of the agreement, and “we trust that civil society will be a very active partner in implementing any future agreement”, he added. Margot Nauleau from Save the Children warned that governments would need to work with the people to implement new pandemic obligations. “This must start by building trust and legitimacy in the policy process because the absence of transparency and engagement will lead to misinformation and confusion,” said Nauleau. “The negotiations on the pandemic code and the International Health Regulations are becoming more and more exclusive of civil society,” she added. “We no longer have access to the drafting group and there is no transparency on the textual proposals that are made by member states.” This runs counter to the WHO Constitution and the Sustainable Development Goals, she added. To rectify this, Save the Children has three recommendations to the WHO. The first involves more civil society involvement in the negotiation and drafting by, for example, enabling them access to “all relevant documentation, including the draft, and intervene in a timely and unrestricted way during the plenary and the working group sessions of the negotiations”. The second recommendation is to include civil society in treaty decision-making bodies, as the Framework Convention on Climate Change does. The third involves civil society inclusion in the “monitoring and compliance mechanisms of these instruments”, as is the case for the Nagoya Protocol. Environment and tobacco control Yves Ladar, Permanent Representative of Earth Justice to the UN in Geneva, said that civil society had been integrally involved in a number of key environmental agreements and brought a lot of expertise to these. One of these was Aarhus Convention, signed in 1998, which “provides access to access to information, effective public participation and access to justice in environmental matters”, said Ladar. Patricia Lambert Patricia Lambert from the Campaign for Tobacco-Free Kids, was part of negotiations for the Framework Convention on Tobacco Control as legal adviser to South Africa. Civil society fought hard to be included in the FCTC negotiations, and one of the clauses of the Convention notes that “participation of civil society is essential” in achieving its objectives, said Lambert, advising groups to “organise, organise, organise”. “I’m very discomforted to hear that, as far as the process goes, civil society has largely been left out,” said Lambert. “What is working against you that was not present at the time of the FCTC negotiations [adopted 23 years go], is the hardening of attitudes in certain governments to civil society and to civil society participation.” It’s Time to End AIDS: Why EU Should Fund Search for HIV Vaccine 18/05/2023 Frances Fitzgerald, Sirpa Pietikäinen, Sara Cerdas, Cyrus Engerer, Antoni Comín i Oliveres, Catharina Rinzema & Marc Angel The HIV pandemic has affected over 2.3 million people in the World Health Organization’s (WHO) European Region, with nearly 300 new diagnoses made daily in 2021. The COVID-19 pandemic and geopolitical turbulences in the region impacted the course of the HIV pandemic and the response, displacing populations, and disrupting access to care and HIV testing. Today, living with HIV is no longer a reason for despair and the management of HIV is well codified. As there is no cure, people living with HIV undertake life-long treatment that allows them to have healthy and long lives. The effectiveness of treatment is indisputable but the estimated treatment cost per person per year remains high. In Spain, it is estimated to be €11,638, while in Germany it soars to around €32,100. In France, the cost reaches €14,821, and in Italy, it amounts to €6,300. While the introduction of pre-exposure prophylaxis (PrEP) in 2012 was a breakthrough in HIV prevention in Europe and globally, the burden of HIV continues to fall disproportionately in certain regions, like eastern Europe, as well as on vulnerable populations that include migrants, sex workers, people who use drugs and men who have sex with men. These disparities are felt in various aspects of HIV prevention and treatment, including limited access to testing and inadequate availability and affordability of prevention tools like PrEP. Significant economic and human rights impact WHO Europe: HIV in Europe 2021 Although the incidence of HIV in the region may not be as alarming as in other parts of the world, its impact is significant, not only on European economies but also on the human rights of its marginalised populations. Within this context, immunisation is a crucial means of safeguarding public health, reducing morbidity and mortality. Additionally, it delivers advantages for the social and economic fabric of nations and helps alleviate the burden on healthcare systems. Despite the disruption caused by COVID-19 in recent years, European scientists have rallied together in the pursuit of an effective HIV vaccine, conducting several early-phase trials with the backing of funding from Horizon 2020. These trials use original technologies often not developed elsewhere. However, plans and funds to ensure their continuity are urgently required, especially given the need for larger trials to achieve conclusive results. So, why should Europe invest in the search for an HIV vaccine? First, an HIV vaccine would naturally help control the pandemic on the continent, not only from a prevention point of view but also because HIV vaccines are key to cure and remission of the virus. Simultaneously, the vaccine would have a tremendous impact on improving public health, not only on HIV-related issues but also on other infectious diseases. For example, the long-term research conducted for an HIV vaccine played a crucial role towards the rapid development of a COVID-19 vaccine. Moreover, it has proven to be critical in paving the way for the development of vaccines for other diseases not only strengthening the networks of European research institutions but improving the necessary infrastructure. Thus, investing in an HIV vaccine undoubtedly means investing in pandemic preparedness, and in global health security. Lastly, the development and distribution of an effective HIV vaccine have the potential to improve global health equity. It would ensure that everyone, regardless of their socioeconomic status or geographic location, has access to life-saving technologies, leaving no one behind. Additionally, an HIV vaccine would further protect vulnerable populations and reduce health disparities, contributing to the fight against HIV-related stigma and discrimination. By improving prevention and providing opportunities for greater control of HIV, an HIV vaccine would have a worldwide impact beyond Europe. Vulnerable populations Through its Global Health Strategy, the European Union is committed to deepening its leadership in global health matters, assuring that everyone everywhere has access to the highest attainable standards of health, based on solidarity and human rights. This will be achieved by, amongst other priorities, tackling the root causes of ill health, focusing on vulnerable populations, and working towards a mechanism that fosters the development of, and equitable access to, vaccines. As the COVID-19 pandemic made clear, the EU has an unprecedented opportunity to become a global health leader. Investing in the development of an HIV vaccine that can save the lives of people all over the world must be a fundamental part of this strategy, with positive benefits for individual health and human rights, as well as for economies and health security. It is time to invest in R&D for an HIV vaccine. It is time to ensure that the HIV pandemic no longer poses a threat to public health and individual well-being, and by doing so, protect human rights and advance equity. It is time to end AIDS. Frances Fitzgerald is a Member of the European Parliament, Ireland Sirpa Pietikäinen is a Member of the European Parliament, Finland Sara Cerdas is a Member of the European Parliament, Portugal Cyrus Engerer is a Member of the European Parliament, Malta Antoni Comín i Oliveres is a Member of the European Parliament, Spain Catharina Rinzema is a Member of the European Parliament, The Netherlands Marc Angel is a member of the European Parliament, Luxembourg Image Credits: Ehimetalor Akhere Unuabona/ Unsplash. 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... 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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. Sexual Health Derailed the Last World Health Assembly; What Are This Year’s Flashpoints? 18/05/2023 Kerry Cullinan Last year’s WHA late on the Saturday night, as Committee A struggled to reach agreement. Much of this year’s WHA agenda, being held in Geneva between 21 and 30 May, should be preoccupied with pandemic preparedness and the WHO’s budget. But there are some obscure items for anti-rights conservatives to latch onto if they want to derail discussion – and there is growing appetite for such disruptions throughout all UN agencies. While officially, this year’s WHA is supposed to focus on a wide range of policy issues around the three pillars of WHO’s “Three Billion” strategy, which include emergencies and pandemics, non-communicable diseases and healthier populations, a few hidden minefields scattered in the agenda threaten to create unexpected flashpoints which could divert attention from the substance of the meeting. They include, once again, language around sexual health, but also as well as concerns about the place of states’ sovereign rights in the pandemic treaty, an initiative on a new WHO replenishment fund, as well as the perennial debates around the demand by Taiwan to be reinstated as a WHA observer, and the status of health in the Occupied Palestinian territories. What are the potential red-herring flashpoints lurking in the shadows of a dry and detailed agenda? Here´s a brief review of the landscape: Anti-rights red flags? At last year´s World Health Assembly (WHA), an unexpected and protracted standoff over references to “sexuality”, “sexual orientation” and “men who have sex with men” in a technical guideline on HIV and hepatitis – pushed member states into an overnight session, delaying the close of the entire event. Last year, the Eastern Mediterranean Region (EMRO), supported by key North African countries, led the charge, with Saudi Arabia, Egypt and Nigeria vociferous in their condemnation of behaviours they deemed antithetical to their cultures. This forced talks late into the night and, finally, an unprecedented vote on the vexatious guide after numerous compromise clauses failed. The Saudi delegate in a heated WHA debate over sexual rights and terminology. If the conservatives are scanning assembly documents for men having sex with men, they’re unlikely to find any references. But if they are intent on looking for polarising needles in the agenda haystack, some might take issue with the report on the Global Strategy for Women’s, Children’s and Adolescents’ Health. This refers to the WHO’s updated handbook on family planning, which contains references to post-abortion care and gender identity. These are red flags for the right-wing UN coalition of member states, Group of Friends of the Family, founded by Egypt, Belarus and Qatar to advocate for the “natural family” that is becoming more vocal and more closely aligned with US rightwing Christian groups through annual World Congress of Families gatherings. Multilateralism under fire This year’s WHA takes place in an even tougher environment. Russia’s ongoing war in Ukraine has polarised the international community, compounding the economic struggles wrought by three pandemic years. “The multilateral system is under greater strain than at any time since the creation of the United Nations,” UN Secretary-General Antonio Guterres warned in an address to the Security Council last month. “We are witnessing a deepening climate crisis, soaring inequalities, a rising threat from terrorism, a global pushback against human rights and gender equality, and the unregulated development of dangerous technologies,” he added. “All these global challenges can only be solved through respect for international law, adherence to global commitments, and the adoption of appropriate frameworks of multilateral governance.” Heightened US-China tensions may well be inflamed by the large presence of Taiwan at this year’s WHA. The US appeal for it to be reinstated as an observer has been followed by a formal request from Belize for this to be included on the agenda. The health of Palestinians, with an unprecedented rise of Israeli settler violence accounting for 25% of casualties, is also a geopolitical flashpoint. National sovereignty and pandemic response Much of this year’s WHA, themed “Health For All: 75 years of improving public health”, will be around measures to counter the next pandemic – particularly universal health care and health and how to increase WHO’s finances. The assembly will hear and comment on progress made on two pandemic-related processes: one to amend the International Health Regulations (IHR) to make them fit for the next pandemic and the other, to draw up a pandemic accord. But both negotiations are ongoing with a deadline of next year’s WHA, so it is unlikely that conflicts will climax at this session. However, concerns about member states’ sovereignty are likely to be expressed, something that Russia and China have stressed in previous discussions. Meanwhile, misinformation continues to churn outside of the WHA from those who opposed COVID-19 vaccines and lockdowns who claim that the pandemic accord will give WHO superpowers, and could lead to international “vaccine passports”. Anti-vaxxer and US presidential hopeful Robert F Kennedy and his organisation, Children’s Health Defense, are key sources of this misinformation and have organised global protests aimed at urging countries to exit the WHO on Saturday 20 May, the day before the WHA opens. WHO finances in the spotlight Members of the WHO Working Group on Sustainable Finance hammer out an agreement on increasing member state contributions this week, with Germany’s Björn Kümmel on far left. As with last year, moves to increase the WHO’s budget ceiling are also likely to be a focus of animated discussion. Member states are supposed to be increasing their assessed contributions in line with a resolution passed last year. The 2024/ 25 proposed budget is therefore based on the portion of members’ contributions being raised from a dismal 12% of the budget to 20%, which the WHA budget document on the budget describes as “marking a historic move towards a more empowered and independent WHO”. During the Executive Board discussion in January on increasing WHO contributions, the Africa region expressed the expectation that WHO would channel far more resources to country and regional offices – something that the WHO has tried to do and reports that country allocation had increased from 39% in the 2018/19 to 50% in the proposed 2024/ 25 budget. The Agile Member States Task Group on Strengthening WHO’s Budgetary, Programmatic and Financing Governance has worked hard to find a way to stabilise WHO income, making it less dependent on donors and also more efficient. Replenishment Fund The assembly also will discuss a proposal from the WHO’s Executive Committee for the establishment of a replenishment fund. Most member states accept that the WHO is underfunded and over-reliant on donors’ conditional grants, slanting the work of the body. While a replenishment fund, effectively, also involves recruiting more in voluntary donations, the process is public and therefore potentially more transparent – similar to the periodic replenishment drives conducted by organisations such as The Global Fund and Gavi, the Vaccine Alliance. Also, typically such funds are not designated for specific donor projects – but able to be used flexibly by the organisation involved. Ahead of the January Executive Board meeting, the WHO’s Programme, Budget and Administration Committee (PBAC) “acknowledged WHO’s need for more flexible, predictable and sustainable financing and considered that a replenishment mechanism provided a possible solution, especially for chronically underfunded areas of the organization’s programme budget”. Meanwhile, a fascinating recent analysis of all WHA resolutions between 1948 and 2021 was recently published in the BMJ. It notes: “While the WHO has been criticised for its siloed approach to address global health issues, the analysis suggests that this approach is not the collective will of the WHA but may relate to the way the WHO has been increasingly funded through earmarked voluntary contributions to specific programmes.” Whatever decisions are taken, the attention of the international global health sector will be in Geneva over the next 10 days. Image Credits: Germany's UN Mission in Geneva . Focus on Influencing Substance of Pandemic Accord as Process Unlikely to Change, EU Official Advises Civil Society 18/05/2023 Kerry Cullinan WHO member states discuss new pandemic convention or treaty in July 2022. Civil society is unlikely to be included in the World Health Organization (WHO)’s pandemic accord negotiations and should focus on making an impact on its content, according to a European Union official. “I don’t see these rules.. changing very easily at this stage. So I would concentrate efforts in working on the substance more than on the process,” Americo Zampetti, a senior leader of the delegation of the EU at the UN, told a webinar convened by the Geneva Global Health Hub (G2H2) on Wednesday. While the EU would be “quite content” with civil society being more active in the discussion, “some other partners are not similarly keen in being open and transparent and making the best use of civil society contribution”, he added. “Civil society is particularly apt at advocating so I would concentrate on advocating on substance more than on process because I see the process as basically gone,” he advised. Americo Zampetti However, the EU would “make a very strong case” for civil society participation in the institutional machinery leading to the adoption of the agreement, and “we trust that civil society will be a very active partner in implementing any future agreement”, he added. Margot Nauleau from Save the Children warned that governments would need to work with the people to implement new pandemic obligations. “This must start by building trust and legitimacy in the policy process because the absence of transparency and engagement will lead to misinformation and confusion,” said Nauleau. “The negotiations on the pandemic code and the International Health Regulations are becoming more and more exclusive of civil society,” she added. “We no longer have access to the drafting group and there is no transparency on the textual proposals that are made by member states.” This runs counter to the WHO Constitution and the Sustainable Development Goals, she added. To rectify this, Save the Children has three recommendations to the WHO. The first involves more civil society involvement in the negotiation and drafting by, for example, enabling them access to “all relevant documentation, including the draft, and intervene in a timely and unrestricted way during the plenary and the working group sessions of the negotiations”. The second recommendation is to include civil society in treaty decision-making bodies, as the Framework Convention on Climate Change does. The third involves civil society inclusion in the “monitoring and compliance mechanisms of these instruments”, as is the case for the Nagoya Protocol. Environment and tobacco control Yves Ladar, Permanent Representative of Earth Justice to the UN in Geneva, said that civil society had been integrally involved in a number of key environmental agreements and brought a lot of expertise to these. One of these was Aarhus Convention, signed in 1998, which “provides access to access to information, effective public participation and access to justice in environmental matters”, said Ladar. Patricia Lambert Patricia Lambert from the Campaign for Tobacco-Free Kids, was part of negotiations for the Framework Convention on Tobacco Control as legal adviser to South Africa. Civil society fought hard to be included in the FCTC negotiations, and one of the clauses of the Convention notes that “participation of civil society is essential” in achieving its objectives, said Lambert, advising groups to “organise, organise, organise”. “I’m very discomforted to hear that, as far as the process goes, civil society has largely been left out,” said Lambert. “What is working against you that was not present at the time of the FCTC negotiations [adopted 23 years go], is the hardening of attitudes in certain governments to civil society and to civil society participation.” It’s Time to End AIDS: Why EU Should Fund Search for HIV Vaccine 18/05/2023 Frances Fitzgerald, Sirpa Pietikäinen, Sara Cerdas, Cyrus Engerer, Antoni Comín i Oliveres, Catharina Rinzema & Marc Angel The HIV pandemic has affected over 2.3 million people in the World Health Organization’s (WHO) European Region, with nearly 300 new diagnoses made daily in 2021. The COVID-19 pandemic and geopolitical turbulences in the region impacted the course of the HIV pandemic and the response, displacing populations, and disrupting access to care and HIV testing. Today, living with HIV is no longer a reason for despair and the management of HIV is well codified. As there is no cure, people living with HIV undertake life-long treatment that allows them to have healthy and long lives. The effectiveness of treatment is indisputable but the estimated treatment cost per person per year remains high. In Spain, it is estimated to be €11,638, while in Germany it soars to around €32,100. In France, the cost reaches €14,821, and in Italy, it amounts to €6,300. While the introduction of pre-exposure prophylaxis (PrEP) in 2012 was a breakthrough in HIV prevention in Europe and globally, the burden of HIV continues to fall disproportionately in certain regions, like eastern Europe, as well as on vulnerable populations that include migrants, sex workers, people who use drugs and men who have sex with men. These disparities are felt in various aspects of HIV prevention and treatment, including limited access to testing and inadequate availability and affordability of prevention tools like PrEP. Significant economic and human rights impact WHO Europe: HIV in Europe 2021 Although the incidence of HIV in the region may not be as alarming as in other parts of the world, its impact is significant, not only on European economies but also on the human rights of its marginalised populations. Within this context, immunisation is a crucial means of safeguarding public health, reducing morbidity and mortality. Additionally, it delivers advantages for the social and economic fabric of nations and helps alleviate the burden on healthcare systems. Despite the disruption caused by COVID-19 in recent years, European scientists have rallied together in the pursuit of an effective HIV vaccine, conducting several early-phase trials with the backing of funding from Horizon 2020. These trials use original technologies often not developed elsewhere. However, plans and funds to ensure their continuity are urgently required, especially given the need for larger trials to achieve conclusive results. So, why should Europe invest in the search for an HIV vaccine? First, an HIV vaccine would naturally help control the pandemic on the continent, not only from a prevention point of view but also because HIV vaccines are key to cure and remission of the virus. Simultaneously, the vaccine would have a tremendous impact on improving public health, not only on HIV-related issues but also on other infectious diseases. For example, the long-term research conducted for an HIV vaccine played a crucial role towards the rapid development of a COVID-19 vaccine. Moreover, it has proven to be critical in paving the way for the development of vaccines for other diseases not only strengthening the networks of European research institutions but improving the necessary infrastructure. Thus, investing in an HIV vaccine undoubtedly means investing in pandemic preparedness, and in global health security. Lastly, the development and distribution of an effective HIV vaccine have the potential to improve global health equity. It would ensure that everyone, regardless of their socioeconomic status or geographic location, has access to life-saving technologies, leaving no one behind. Additionally, an HIV vaccine would further protect vulnerable populations and reduce health disparities, contributing to the fight against HIV-related stigma and discrimination. By improving prevention and providing opportunities for greater control of HIV, an HIV vaccine would have a worldwide impact beyond Europe. Vulnerable populations Through its Global Health Strategy, the European Union is committed to deepening its leadership in global health matters, assuring that everyone everywhere has access to the highest attainable standards of health, based on solidarity and human rights. This will be achieved by, amongst other priorities, tackling the root causes of ill health, focusing on vulnerable populations, and working towards a mechanism that fosters the development of, and equitable access to, vaccines. As the COVID-19 pandemic made clear, the EU has an unprecedented opportunity to become a global health leader. Investing in the development of an HIV vaccine that can save the lives of people all over the world must be a fundamental part of this strategy, with positive benefits for individual health and human rights, as well as for economies and health security. It is time to invest in R&D for an HIV vaccine. It is time to ensure that the HIV pandemic no longer poses a threat to public health and individual well-being, and by doing so, protect human rights and advance equity. It is time to end AIDS. Frances Fitzgerald is a Member of the European Parliament, Ireland Sirpa Pietikäinen is a Member of the European Parliament, Finland Sara Cerdas is a Member of the European Parliament, Portugal Cyrus Engerer is a Member of the European Parliament, Malta Antoni Comín i Oliveres is a Member of the European Parliament, Spain Catharina Rinzema is a Member of the European Parliament, The Netherlands Marc Angel is a member of the European Parliament, Luxembourg Image Credits: Ehimetalor Akhere Unuabona/ Unsplash. 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... 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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. Sexual Health Derailed the Last World Health Assembly; What Are This Year’s Flashpoints? 18/05/2023 Kerry Cullinan Last year’s WHA late on the Saturday night, as Committee A struggled to reach agreement. Much of this year’s WHA agenda, being held in Geneva between 21 and 30 May, should be preoccupied with pandemic preparedness and the WHO’s budget. But there are some obscure items for anti-rights conservatives to latch onto if they want to derail discussion – and there is growing appetite for such disruptions throughout all UN agencies. While officially, this year’s WHA is supposed to focus on a wide range of policy issues around the three pillars of WHO’s “Three Billion” strategy, which include emergencies and pandemics, non-communicable diseases and healthier populations, a few hidden minefields scattered in the agenda threaten to create unexpected flashpoints which could divert attention from the substance of the meeting. They include, once again, language around sexual health, but also as well as concerns about the place of states’ sovereign rights in the pandemic treaty, an initiative on a new WHO replenishment fund, as well as the perennial debates around the demand by Taiwan to be reinstated as a WHA observer, and the status of health in the Occupied Palestinian territories. What are the potential red-herring flashpoints lurking in the shadows of a dry and detailed agenda? Here´s a brief review of the landscape: Anti-rights red flags? At last year´s World Health Assembly (WHA), an unexpected and protracted standoff over references to “sexuality”, “sexual orientation” and “men who have sex with men” in a technical guideline on HIV and hepatitis – pushed member states into an overnight session, delaying the close of the entire event. Last year, the Eastern Mediterranean Region (EMRO), supported by key North African countries, led the charge, with Saudi Arabia, Egypt and Nigeria vociferous in their condemnation of behaviours they deemed antithetical to their cultures. This forced talks late into the night and, finally, an unprecedented vote on the vexatious guide after numerous compromise clauses failed. The Saudi delegate in a heated WHA debate over sexual rights and terminology. If the conservatives are scanning assembly documents for men having sex with men, they’re unlikely to find any references. But if they are intent on looking for polarising needles in the agenda haystack, some might take issue with the report on the Global Strategy for Women’s, Children’s and Adolescents’ Health. This refers to the WHO’s updated handbook on family planning, which contains references to post-abortion care and gender identity. These are red flags for the right-wing UN coalition of member states, Group of Friends of the Family, founded by Egypt, Belarus and Qatar to advocate for the “natural family” that is becoming more vocal and more closely aligned with US rightwing Christian groups through annual World Congress of Families gatherings. Multilateralism under fire This year’s WHA takes place in an even tougher environment. Russia’s ongoing war in Ukraine has polarised the international community, compounding the economic struggles wrought by three pandemic years. “The multilateral system is under greater strain than at any time since the creation of the United Nations,” UN Secretary-General Antonio Guterres warned in an address to the Security Council last month. “We are witnessing a deepening climate crisis, soaring inequalities, a rising threat from terrorism, a global pushback against human rights and gender equality, and the unregulated development of dangerous technologies,” he added. “All these global challenges can only be solved through respect for international law, adherence to global commitments, and the adoption of appropriate frameworks of multilateral governance.” Heightened US-China tensions may well be inflamed by the large presence of Taiwan at this year’s WHA. The US appeal for it to be reinstated as an observer has been followed by a formal request from Belize for this to be included on the agenda. The health of Palestinians, with an unprecedented rise of Israeli settler violence accounting for 25% of casualties, is also a geopolitical flashpoint. National sovereignty and pandemic response Much of this year’s WHA, themed “Health For All: 75 years of improving public health”, will be around measures to counter the next pandemic – particularly universal health care and health and how to increase WHO’s finances. The assembly will hear and comment on progress made on two pandemic-related processes: one to amend the International Health Regulations (IHR) to make them fit for the next pandemic and the other, to draw up a pandemic accord. But both negotiations are ongoing with a deadline of next year’s WHA, so it is unlikely that conflicts will climax at this session. However, concerns about member states’ sovereignty are likely to be expressed, something that Russia and China have stressed in previous discussions. Meanwhile, misinformation continues to churn outside of the WHA from those who opposed COVID-19 vaccines and lockdowns who claim that the pandemic accord will give WHO superpowers, and could lead to international “vaccine passports”. Anti-vaxxer and US presidential hopeful Robert F Kennedy and his organisation, Children’s Health Defense, are key sources of this misinformation and have organised global protests aimed at urging countries to exit the WHO on Saturday 20 May, the day before the WHA opens. WHO finances in the spotlight Members of the WHO Working Group on Sustainable Finance hammer out an agreement on increasing member state contributions this week, with Germany’s Björn Kümmel on far left. As with last year, moves to increase the WHO’s budget ceiling are also likely to be a focus of animated discussion. Member states are supposed to be increasing their assessed contributions in line with a resolution passed last year. The 2024/ 25 proposed budget is therefore based on the portion of members’ contributions being raised from a dismal 12% of the budget to 20%, which the WHA budget document on the budget describes as “marking a historic move towards a more empowered and independent WHO”. During the Executive Board discussion in January on increasing WHO contributions, the Africa region expressed the expectation that WHO would channel far more resources to country and regional offices – something that the WHO has tried to do and reports that country allocation had increased from 39% in the 2018/19 to 50% in the proposed 2024/ 25 budget. The Agile Member States Task Group on Strengthening WHO’s Budgetary, Programmatic and Financing Governance has worked hard to find a way to stabilise WHO income, making it less dependent on donors and also more efficient. Replenishment Fund The assembly also will discuss a proposal from the WHO’s Executive Committee for the establishment of a replenishment fund. Most member states accept that the WHO is underfunded and over-reliant on donors’ conditional grants, slanting the work of the body. While a replenishment fund, effectively, also involves recruiting more in voluntary donations, the process is public and therefore potentially more transparent – similar to the periodic replenishment drives conducted by organisations such as The Global Fund and Gavi, the Vaccine Alliance. Also, typically such funds are not designated for specific donor projects – but able to be used flexibly by the organisation involved. Ahead of the January Executive Board meeting, the WHO’s Programme, Budget and Administration Committee (PBAC) “acknowledged WHO’s need for more flexible, predictable and sustainable financing and considered that a replenishment mechanism provided a possible solution, especially for chronically underfunded areas of the organization’s programme budget”. Meanwhile, a fascinating recent analysis of all WHA resolutions between 1948 and 2021 was recently published in the BMJ. It notes: “While the WHO has been criticised for its siloed approach to address global health issues, the analysis suggests that this approach is not the collective will of the WHA but may relate to the way the WHO has been increasingly funded through earmarked voluntary contributions to specific programmes.” Whatever decisions are taken, the attention of the international global health sector will be in Geneva over the next 10 days. Image Credits: Germany's UN Mission in Geneva . Focus on Influencing Substance of Pandemic Accord as Process Unlikely to Change, EU Official Advises Civil Society 18/05/2023 Kerry Cullinan WHO member states discuss new pandemic convention or treaty in July 2022. Civil society is unlikely to be included in the World Health Organization (WHO)’s pandemic accord negotiations and should focus on making an impact on its content, according to a European Union official. “I don’t see these rules.. changing very easily at this stage. So I would concentrate efforts in working on the substance more than on the process,” Americo Zampetti, a senior leader of the delegation of the EU at the UN, told a webinar convened by the Geneva Global Health Hub (G2H2) on Wednesday. While the EU would be “quite content” with civil society being more active in the discussion, “some other partners are not similarly keen in being open and transparent and making the best use of civil society contribution”, he added. “Civil society is particularly apt at advocating so I would concentrate on advocating on substance more than on process because I see the process as basically gone,” he advised. Americo Zampetti However, the EU would “make a very strong case” for civil society participation in the institutional machinery leading to the adoption of the agreement, and “we trust that civil society will be a very active partner in implementing any future agreement”, he added. Margot Nauleau from Save the Children warned that governments would need to work with the people to implement new pandemic obligations. “This must start by building trust and legitimacy in the policy process because the absence of transparency and engagement will lead to misinformation and confusion,” said Nauleau. “The negotiations on the pandemic code and the International Health Regulations are becoming more and more exclusive of civil society,” she added. “We no longer have access to the drafting group and there is no transparency on the textual proposals that are made by member states.” This runs counter to the WHO Constitution and the Sustainable Development Goals, she added. To rectify this, Save the Children has three recommendations to the WHO. The first involves more civil society involvement in the negotiation and drafting by, for example, enabling them access to “all relevant documentation, including the draft, and intervene in a timely and unrestricted way during the plenary and the working group sessions of the negotiations”. The second recommendation is to include civil society in treaty decision-making bodies, as the Framework Convention on Climate Change does. The third involves civil society inclusion in the “monitoring and compliance mechanisms of these instruments”, as is the case for the Nagoya Protocol. Environment and tobacco control Yves Ladar, Permanent Representative of Earth Justice to the UN in Geneva, said that civil society had been integrally involved in a number of key environmental agreements and brought a lot of expertise to these. One of these was Aarhus Convention, signed in 1998, which “provides access to access to information, effective public participation and access to justice in environmental matters”, said Ladar. Patricia Lambert Patricia Lambert from the Campaign for Tobacco-Free Kids, was part of negotiations for the Framework Convention on Tobacco Control as legal adviser to South Africa. Civil society fought hard to be included in the FCTC negotiations, and one of the clauses of the Convention notes that “participation of civil society is essential” in achieving its objectives, said Lambert, advising groups to “organise, organise, organise”. “I’m very discomforted to hear that, as far as the process goes, civil society has largely been left out,” said Lambert. “What is working against you that was not present at the time of the FCTC negotiations [adopted 23 years go], is the hardening of attitudes in certain governments to civil society and to civil society participation.” It’s Time to End AIDS: Why EU Should Fund Search for HIV Vaccine 18/05/2023 Frances Fitzgerald, Sirpa Pietikäinen, Sara Cerdas, Cyrus Engerer, Antoni Comín i Oliveres, Catharina Rinzema & Marc Angel The HIV pandemic has affected over 2.3 million people in the World Health Organization’s (WHO) European Region, with nearly 300 new diagnoses made daily in 2021. The COVID-19 pandemic and geopolitical turbulences in the region impacted the course of the HIV pandemic and the response, displacing populations, and disrupting access to care and HIV testing. Today, living with HIV is no longer a reason for despair and the management of HIV is well codified. As there is no cure, people living with HIV undertake life-long treatment that allows them to have healthy and long lives. The effectiveness of treatment is indisputable but the estimated treatment cost per person per year remains high. In Spain, it is estimated to be €11,638, while in Germany it soars to around €32,100. In France, the cost reaches €14,821, and in Italy, it amounts to €6,300. While the introduction of pre-exposure prophylaxis (PrEP) in 2012 was a breakthrough in HIV prevention in Europe and globally, the burden of HIV continues to fall disproportionately in certain regions, like eastern Europe, as well as on vulnerable populations that include migrants, sex workers, people who use drugs and men who have sex with men. These disparities are felt in various aspects of HIV prevention and treatment, including limited access to testing and inadequate availability and affordability of prevention tools like PrEP. Significant economic and human rights impact WHO Europe: HIV in Europe 2021 Although the incidence of HIV in the region may not be as alarming as in other parts of the world, its impact is significant, not only on European economies but also on the human rights of its marginalised populations. Within this context, immunisation is a crucial means of safeguarding public health, reducing morbidity and mortality. Additionally, it delivers advantages for the social and economic fabric of nations and helps alleviate the burden on healthcare systems. Despite the disruption caused by COVID-19 in recent years, European scientists have rallied together in the pursuit of an effective HIV vaccine, conducting several early-phase trials with the backing of funding from Horizon 2020. These trials use original technologies often not developed elsewhere. However, plans and funds to ensure their continuity are urgently required, especially given the need for larger trials to achieve conclusive results. So, why should Europe invest in the search for an HIV vaccine? First, an HIV vaccine would naturally help control the pandemic on the continent, not only from a prevention point of view but also because HIV vaccines are key to cure and remission of the virus. Simultaneously, the vaccine would have a tremendous impact on improving public health, not only on HIV-related issues but also on other infectious diseases. For example, the long-term research conducted for an HIV vaccine played a crucial role towards the rapid development of a COVID-19 vaccine. Moreover, it has proven to be critical in paving the way for the development of vaccines for other diseases not only strengthening the networks of European research institutions but improving the necessary infrastructure. Thus, investing in an HIV vaccine undoubtedly means investing in pandemic preparedness, and in global health security. Lastly, the development and distribution of an effective HIV vaccine have the potential to improve global health equity. It would ensure that everyone, regardless of their socioeconomic status or geographic location, has access to life-saving technologies, leaving no one behind. Additionally, an HIV vaccine would further protect vulnerable populations and reduce health disparities, contributing to the fight against HIV-related stigma and discrimination. By improving prevention and providing opportunities for greater control of HIV, an HIV vaccine would have a worldwide impact beyond Europe. Vulnerable populations Through its Global Health Strategy, the European Union is committed to deepening its leadership in global health matters, assuring that everyone everywhere has access to the highest attainable standards of health, based on solidarity and human rights. This will be achieved by, amongst other priorities, tackling the root causes of ill health, focusing on vulnerable populations, and working towards a mechanism that fosters the development of, and equitable access to, vaccines. As the COVID-19 pandemic made clear, the EU has an unprecedented opportunity to become a global health leader. Investing in the development of an HIV vaccine that can save the lives of people all over the world must be a fundamental part of this strategy, with positive benefits for individual health and human rights, as well as for economies and health security. It is time to invest in R&D for an HIV vaccine. It is time to ensure that the HIV pandemic no longer poses a threat to public health and individual well-being, and by doing so, protect human rights and advance equity. It is time to end AIDS. Frances Fitzgerald is a Member of the European Parliament, Ireland Sirpa Pietikäinen is a Member of the European Parliament, Finland Sara Cerdas is a Member of the European Parliament, Portugal Cyrus Engerer is a Member of the European Parliament, Malta Antoni Comín i Oliveres is a Member of the European Parliament, Spain Catharina Rinzema is a Member of the European Parliament, The Netherlands Marc Angel is a member of the European Parliament, Luxembourg Image Credits: Ehimetalor Akhere Unuabona/ Unsplash. 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... 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Sexual Health Derailed the Last World Health Assembly; What Are This Year’s Flashpoints? 18/05/2023 Kerry Cullinan Last year’s WHA late on the Saturday night, as Committee A struggled to reach agreement. Much of this year’s WHA agenda, being held in Geneva between 21 and 30 May, should be preoccupied with pandemic preparedness and the WHO’s budget. But there are some obscure items for anti-rights conservatives to latch onto if they want to derail discussion – and there is growing appetite for such disruptions throughout all UN agencies. While officially, this year’s WHA is supposed to focus on a wide range of policy issues around the three pillars of WHO’s “Three Billion” strategy, which include emergencies and pandemics, non-communicable diseases and healthier populations, a few hidden minefields scattered in the agenda threaten to create unexpected flashpoints which could divert attention from the substance of the meeting. They include, once again, language around sexual health, but also as well as concerns about the place of states’ sovereign rights in the pandemic treaty, an initiative on a new WHO replenishment fund, as well as the perennial debates around the demand by Taiwan to be reinstated as a WHA observer, and the status of health in the Occupied Palestinian territories. What are the potential red-herring flashpoints lurking in the shadows of a dry and detailed agenda? Here´s a brief review of the landscape: Anti-rights red flags? At last year´s World Health Assembly (WHA), an unexpected and protracted standoff over references to “sexuality”, “sexual orientation” and “men who have sex with men” in a technical guideline on HIV and hepatitis – pushed member states into an overnight session, delaying the close of the entire event. Last year, the Eastern Mediterranean Region (EMRO), supported by key North African countries, led the charge, with Saudi Arabia, Egypt and Nigeria vociferous in their condemnation of behaviours they deemed antithetical to their cultures. This forced talks late into the night and, finally, an unprecedented vote on the vexatious guide after numerous compromise clauses failed. The Saudi delegate in a heated WHA debate over sexual rights and terminology. If the conservatives are scanning assembly documents for men having sex with men, they’re unlikely to find any references. But if they are intent on looking for polarising needles in the agenda haystack, some might take issue with the report on the Global Strategy for Women’s, Children’s and Adolescents’ Health. This refers to the WHO’s updated handbook on family planning, which contains references to post-abortion care and gender identity. These are red flags for the right-wing UN coalition of member states, Group of Friends of the Family, founded by Egypt, Belarus and Qatar to advocate for the “natural family” that is becoming more vocal and more closely aligned with US rightwing Christian groups through annual World Congress of Families gatherings. Multilateralism under fire This year’s WHA takes place in an even tougher environment. Russia’s ongoing war in Ukraine has polarised the international community, compounding the economic struggles wrought by three pandemic years. “The multilateral system is under greater strain than at any time since the creation of the United Nations,” UN Secretary-General Antonio Guterres warned in an address to the Security Council last month. “We are witnessing a deepening climate crisis, soaring inequalities, a rising threat from terrorism, a global pushback against human rights and gender equality, and the unregulated development of dangerous technologies,” he added. “All these global challenges can only be solved through respect for international law, adherence to global commitments, and the adoption of appropriate frameworks of multilateral governance.” Heightened US-China tensions may well be inflamed by the large presence of Taiwan at this year’s WHA. The US appeal for it to be reinstated as an observer has been followed by a formal request from Belize for this to be included on the agenda. The health of Palestinians, with an unprecedented rise of Israeli settler violence accounting for 25% of casualties, is also a geopolitical flashpoint. National sovereignty and pandemic response Much of this year’s WHA, themed “Health For All: 75 years of improving public health”, will be around measures to counter the next pandemic – particularly universal health care and health and how to increase WHO’s finances. The assembly will hear and comment on progress made on two pandemic-related processes: one to amend the International Health Regulations (IHR) to make them fit for the next pandemic and the other, to draw up a pandemic accord. But both negotiations are ongoing with a deadline of next year’s WHA, so it is unlikely that conflicts will climax at this session. However, concerns about member states’ sovereignty are likely to be expressed, something that Russia and China have stressed in previous discussions. Meanwhile, misinformation continues to churn outside of the WHA from those who opposed COVID-19 vaccines and lockdowns who claim that the pandemic accord will give WHO superpowers, and could lead to international “vaccine passports”. Anti-vaxxer and US presidential hopeful Robert F Kennedy and his organisation, Children’s Health Defense, are key sources of this misinformation and have organised global protests aimed at urging countries to exit the WHO on Saturday 20 May, the day before the WHA opens. WHO finances in the spotlight Members of the WHO Working Group on Sustainable Finance hammer out an agreement on increasing member state contributions this week, with Germany’s Björn Kümmel on far left. As with last year, moves to increase the WHO’s budget ceiling are also likely to be a focus of animated discussion. Member states are supposed to be increasing their assessed contributions in line with a resolution passed last year. The 2024/ 25 proposed budget is therefore based on the portion of members’ contributions being raised from a dismal 12% of the budget to 20%, which the WHA budget document on the budget describes as “marking a historic move towards a more empowered and independent WHO”. During the Executive Board discussion in January on increasing WHO contributions, the Africa region expressed the expectation that WHO would channel far more resources to country and regional offices – something that the WHO has tried to do and reports that country allocation had increased from 39% in the 2018/19 to 50% in the proposed 2024/ 25 budget. The Agile Member States Task Group on Strengthening WHO’s Budgetary, Programmatic and Financing Governance has worked hard to find a way to stabilise WHO income, making it less dependent on donors and also more efficient. Replenishment Fund The assembly also will discuss a proposal from the WHO’s Executive Committee for the establishment of a replenishment fund. Most member states accept that the WHO is underfunded and over-reliant on donors’ conditional grants, slanting the work of the body. While a replenishment fund, effectively, also involves recruiting more in voluntary donations, the process is public and therefore potentially more transparent – similar to the periodic replenishment drives conducted by organisations such as The Global Fund and Gavi, the Vaccine Alliance. Also, typically such funds are not designated for specific donor projects – but able to be used flexibly by the organisation involved. Ahead of the January Executive Board meeting, the WHO’s Programme, Budget and Administration Committee (PBAC) “acknowledged WHO’s need for more flexible, predictable and sustainable financing and considered that a replenishment mechanism provided a possible solution, especially for chronically underfunded areas of the organization’s programme budget”. Meanwhile, a fascinating recent analysis of all WHA resolutions between 1948 and 2021 was recently published in the BMJ. It notes: “While the WHO has been criticised for its siloed approach to address global health issues, the analysis suggests that this approach is not the collective will of the WHA but may relate to the way the WHO has been increasingly funded through earmarked voluntary contributions to specific programmes.” Whatever decisions are taken, the attention of the international global health sector will be in Geneva over the next 10 days. Image Credits: Germany's UN Mission in Geneva . Focus on Influencing Substance of Pandemic Accord as Process Unlikely to Change, EU Official Advises Civil Society 18/05/2023 Kerry Cullinan WHO member states discuss new pandemic convention or treaty in July 2022. Civil society is unlikely to be included in the World Health Organization (WHO)’s pandemic accord negotiations and should focus on making an impact on its content, according to a European Union official. “I don’t see these rules.. changing very easily at this stage. So I would concentrate efforts in working on the substance more than on the process,” Americo Zampetti, a senior leader of the delegation of the EU at the UN, told a webinar convened by the Geneva Global Health Hub (G2H2) on Wednesday. While the EU would be “quite content” with civil society being more active in the discussion, “some other partners are not similarly keen in being open and transparent and making the best use of civil society contribution”, he added. “Civil society is particularly apt at advocating so I would concentrate on advocating on substance more than on process because I see the process as basically gone,” he advised. Americo Zampetti However, the EU would “make a very strong case” for civil society participation in the institutional machinery leading to the adoption of the agreement, and “we trust that civil society will be a very active partner in implementing any future agreement”, he added. Margot Nauleau from Save the Children warned that governments would need to work with the people to implement new pandemic obligations. “This must start by building trust and legitimacy in the policy process because the absence of transparency and engagement will lead to misinformation and confusion,” said Nauleau. “The negotiations on the pandemic code and the International Health Regulations are becoming more and more exclusive of civil society,” she added. “We no longer have access to the drafting group and there is no transparency on the textual proposals that are made by member states.” This runs counter to the WHO Constitution and the Sustainable Development Goals, she added. To rectify this, Save the Children has three recommendations to the WHO. The first involves more civil society involvement in the negotiation and drafting by, for example, enabling them access to “all relevant documentation, including the draft, and intervene in a timely and unrestricted way during the plenary and the working group sessions of the negotiations”. The second recommendation is to include civil society in treaty decision-making bodies, as the Framework Convention on Climate Change does. The third involves civil society inclusion in the “monitoring and compliance mechanisms of these instruments”, as is the case for the Nagoya Protocol. Environment and tobacco control Yves Ladar, Permanent Representative of Earth Justice to the UN in Geneva, said that civil society had been integrally involved in a number of key environmental agreements and brought a lot of expertise to these. One of these was Aarhus Convention, signed in 1998, which “provides access to access to information, effective public participation and access to justice in environmental matters”, said Ladar. Patricia Lambert Patricia Lambert from the Campaign for Tobacco-Free Kids, was part of negotiations for the Framework Convention on Tobacco Control as legal adviser to South Africa. Civil society fought hard to be included in the FCTC negotiations, and one of the clauses of the Convention notes that “participation of civil society is essential” in achieving its objectives, said Lambert, advising groups to “organise, organise, organise”. “I’m very discomforted to hear that, as far as the process goes, civil society has largely been left out,” said Lambert. “What is working against you that was not present at the time of the FCTC negotiations [adopted 23 years go], is the hardening of attitudes in certain governments to civil society and to civil society participation.” It’s Time to End AIDS: Why EU Should Fund Search for HIV Vaccine 18/05/2023 Frances Fitzgerald, Sirpa Pietikäinen, Sara Cerdas, Cyrus Engerer, Antoni Comín i Oliveres, Catharina Rinzema & Marc Angel The HIV pandemic has affected over 2.3 million people in the World Health Organization’s (WHO) European Region, with nearly 300 new diagnoses made daily in 2021. The COVID-19 pandemic and geopolitical turbulences in the region impacted the course of the HIV pandemic and the response, displacing populations, and disrupting access to care and HIV testing. Today, living with HIV is no longer a reason for despair and the management of HIV is well codified. As there is no cure, people living with HIV undertake life-long treatment that allows them to have healthy and long lives. The effectiveness of treatment is indisputable but the estimated treatment cost per person per year remains high. In Spain, it is estimated to be €11,638, while in Germany it soars to around €32,100. In France, the cost reaches €14,821, and in Italy, it amounts to €6,300. While the introduction of pre-exposure prophylaxis (PrEP) in 2012 was a breakthrough in HIV prevention in Europe and globally, the burden of HIV continues to fall disproportionately in certain regions, like eastern Europe, as well as on vulnerable populations that include migrants, sex workers, people who use drugs and men who have sex with men. These disparities are felt in various aspects of HIV prevention and treatment, including limited access to testing and inadequate availability and affordability of prevention tools like PrEP. Significant economic and human rights impact WHO Europe: HIV in Europe 2021 Although the incidence of HIV in the region may not be as alarming as in other parts of the world, its impact is significant, not only on European economies but also on the human rights of its marginalised populations. Within this context, immunisation is a crucial means of safeguarding public health, reducing morbidity and mortality. Additionally, it delivers advantages for the social and economic fabric of nations and helps alleviate the burden on healthcare systems. Despite the disruption caused by COVID-19 in recent years, European scientists have rallied together in the pursuit of an effective HIV vaccine, conducting several early-phase trials with the backing of funding from Horizon 2020. These trials use original technologies often not developed elsewhere. However, plans and funds to ensure their continuity are urgently required, especially given the need for larger trials to achieve conclusive results. So, why should Europe invest in the search for an HIV vaccine? First, an HIV vaccine would naturally help control the pandemic on the continent, not only from a prevention point of view but also because HIV vaccines are key to cure and remission of the virus. Simultaneously, the vaccine would have a tremendous impact on improving public health, not only on HIV-related issues but also on other infectious diseases. For example, the long-term research conducted for an HIV vaccine played a crucial role towards the rapid development of a COVID-19 vaccine. Moreover, it has proven to be critical in paving the way for the development of vaccines for other diseases not only strengthening the networks of European research institutions but improving the necessary infrastructure. Thus, investing in an HIV vaccine undoubtedly means investing in pandemic preparedness, and in global health security. Lastly, the development and distribution of an effective HIV vaccine have the potential to improve global health equity. It would ensure that everyone, regardless of their socioeconomic status or geographic location, has access to life-saving technologies, leaving no one behind. Additionally, an HIV vaccine would further protect vulnerable populations and reduce health disparities, contributing to the fight against HIV-related stigma and discrimination. By improving prevention and providing opportunities for greater control of HIV, an HIV vaccine would have a worldwide impact beyond Europe. Vulnerable populations Through its Global Health Strategy, the European Union is committed to deepening its leadership in global health matters, assuring that everyone everywhere has access to the highest attainable standards of health, based on solidarity and human rights. This will be achieved by, amongst other priorities, tackling the root causes of ill health, focusing on vulnerable populations, and working towards a mechanism that fosters the development of, and equitable access to, vaccines. As the COVID-19 pandemic made clear, the EU has an unprecedented opportunity to become a global health leader. Investing in the development of an HIV vaccine that can save the lives of people all over the world must be a fundamental part of this strategy, with positive benefits for individual health and human rights, as well as for economies and health security. It is time to invest in R&D for an HIV vaccine. It is time to ensure that the HIV pandemic no longer poses a threat to public health and individual well-being, and by doing so, protect human rights and advance equity. It is time to end AIDS. Frances Fitzgerald is a Member of the European Parliament, Ireland Sirpa Pietikäinen is a Member of the European Parliament, Finland Sara Cerdas is a Member of the European Parliament, Portugal Cyrus Engerer is a Member of the European Parliament, Malta Antoni Comín i Oliveres is a Member of the European Parliament, Spain Catharina Rinzema is a Member of the European Parliament, The Netherlands Marc Angel is a member of the European Parliament, Luxembourg Image Credits: Ehimetalor Akhere Unuabona/ Unsplash. 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... 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Focus on Influencing Substance of Pandemic Accord as Process Unlikely to Change, EU Official Advises Civil Society 18/05/2023 Kerry Cullinan WHO member states discuss new pandemic convention or treaty in July 2022. Civil society is unlikely to be included in the World Health Organization (WHO)’s pandemic accord negotiations and should focus on making an impact on its content, according to a European Union official. “I don’t see these rules.. changing very easily at this stage. So I would concentrate efforts in working on the substance more than on the process,” Americo Zampetti, a senior leader of the delegation of the EU at the UN, told a webinar convened by the Geneva Global Health Hub (G2H2) on Wednesday. While the EU would be “quite content” with civil society being more active in the discussion, “some other partners are not similarly keen in being open and transparent and making the best use of civil society contribution”, he added. “Civil society is particularly apt at advocating so I would concentrate on advocating on substance more than on process because I see the process as basically gone,” he advised. Americo Zampetti However, the EU would “make a very strong case” for civil society participation in the institutional machinery leading to the adoption of the agreement, and “we trust that civil society will be a very active partner in implementing any future agreement”, he added. Margot Nauleau from Save the Children warned that governments would need to work with the people to implement new pandemic obligations. “This must start by building trust and legitimacy in the policy process because the absence of transparency and engagement will lead to misinformation and confusion,” said Nauleau. “The negotiations on the pandemic code and the International Health Regulations are becoming more and more exclusive of civil society,” she added. “We no longer have access to the drafting group and there is no transparency on the textual proposals that are made by member states.” This runs counter to the WHO Constitution and the Sustainable Development Goals, she added. To rectify this, Save the Children has three recommendations to the WHO. The first involves more civil society involvement in the negotiation and drafting by, for example, enabling them access to “all relevant documentation, including the draft, and intervene in a timely and unrestricted way during the plenary and the working group sessions of the negotiations”. The second recommendation is to include civil society in treaty decision-making bodies, as the Framework Convention on Climate Change does. The third involves civil society inclusion in the “monitoring and compliance mechanisms of these instruments”, as is the case for the Nagoya Protocol. Environment and tobacco control Yves Ladar, Permanent Representative of Earth Justice to the UN in Geneva, said that civil society had been integrally involved in a number of key environmental agreements and brought a lot of expertise to these. One of these was Aarhus Convention, signed in 1998, which “provides access to access to information, effective public participation and access to justice in environmental matters”, said Ladar. Patricia Lambert Patricia Lambert from the Campaign for Tobacco-Free Kids, was part of negotiations for the Framework Convention on Tobacco Control as legal adviser to South Africa. Civil society fought hard to be included in the FCTC negotiations, and one of the clauses of the Convention notes that “participation of civil society is essential” in achieving its objectives, said Lambert, advising groups to “organise, organise, organise”. “I’m very discomforted to hear that, as far as the process goes, civil society has largely been left out,” said Lambert. “What is working against you that was not present at the time of the FCTC negotiations [adopted 23 years go], is the hardening of attitudes in certain governments to civil society and to civil society participation.” It’s Time to End AIDS: Why EU Should Fund Search for HIV Vaccine 18/05/2023 Frances Fitzgerald, Sirpa Pietikäinen, Sara Cerdas, Cyrus Engerer, Antoni Comín i Oliveres, Catharina Rinzema & Marc Angel The HIV pandemic has affected over 2.3 million people in the World Health Organization’s (WHO) European Region, with nearly 300 new diagnoses made daily in 2021. The COVID-19 pandemic and geopolitical turbulences in the region impacted the course of the HIV pandemic and the response, displacing populations, and disrupting access to care and HIV testing. Today, living with HIV is no longer a reason for despair and the management of HIV is well codified. As there is no cure, people living with HIV undertake life-long treatment that allows them to have healthy and long lives. The effectiveness of treatment is indisputable but the estimated treatment cost per person per year remains high. In Spain, it is estimated to be €11,638, while in Germany it soars to around €32,100. In France, the cost reaches €14,821, and in Italy, it amounts to €6,300. While the introduction of pre-exposure prophylaxis (PrEP) in 2012 was a breakthrough in HIV prevention in Europe and globally, the burden of HIV continues to fall disproportionately in certain regions, like eastern Europe, as well as on vulnerable populations that include migrants, sex workers, people who use drugs and men who have sex with men. These disparities are felt in various aspects of HIV prevention and treatment, including limited access to testing and inadequate availability and affordability of prevention tools like PrEP. Significant economic and human rights impact WHO Europe: HIV in Europe 2021 Although the incidence of HIV in the region may not be as alarming as in other parts of the world, its impact is significant, not only on European economies but also on the human rights of its marginalised populations. Within this context, immunisation is a crucial means of safeguarding public health, reducing morbidity and mortality. Additionally, it delivers advantages for the social and economic fabric of nations and helps alleviate the burden on healthcare systems. Despite the disruption caused by COVID-19 in recent years, European scientists have rallied together in the pursuit of an effective HIV vaccine, conducting several early-phase trials with the backing of funding from Horizon 2020. These trials use original technologies often not developed elsewhere. However, plans and funds to ensure their continuity are urgently required, especially given the need for larger trials to achieve conclusive results. So, why should Europe invest in the search for an HIV vaccine? First, an HIV vaccine would naturally help control the pandemic on the continent, not only from a prevention point of view but also because HIV vaccines are key to cure and remission of the virus. Simultaneously, the vaccine would have a tremendous impact on improving public health, not only on HIV-related issues but also on other infectious diseases. For example, the long-term research conducted for an HIV vaccine played a crucial role towards the rapid development of a COVID-19 vaccine. Moreover, it has proven to be critical in paving the way for the development of vaccines for other diseases not only strengthening the networks of European research institutions but improving the necessary infrastructure. Thus, investing in an HIV vaccine undoubtedly means investing in pandemic preparedness, and in global health security. Lastly, the development and distribution of an effective HIV vaccine have the potential to improve global health equity. It would ensure that everyone, regardless of their socioeconomic status or geographic location, has access to life-saving technologies, leaving no one behind. Additionally, an HIV vaccine would further protect vulnerable populations and reduce health disparities, contributing to the fight against HIV-related stigma and discrimination. By improving prevention and providing opportunities for greater control of HIV, an HIV vaccine would have a worldwide impact beyond Europe. Vulnerable populations Through its Global Health Strategy, the European Union is committed to deepening its leadership in global health matters, assuring that everyone everywhere has access to the highest attainable standards of health, based on solidarity and human rights. This will be achieved by, amongst other priorities, tackling the root causes of ill health, focusing on vulnerable populations, and working towards a mechanism that fosters the development of, and equitable access to, vaccines. As the COVID-19 pandemic made clear, the EU has an unprecedented opportunity to become a global health leader. Investing in the development of an HIV vaccine that can save the lives of people all over the world must be a fundamental part of this strategy, with positive benefits for individual health and human rights, as well as for economies and health security. It is time to invest in R&D for an HIV vaccine. It is time to ensure that the HIV pandemic no longer poses a threat to public health and individual well-being, and by doing so, protect human rights and advance equity. It is time to end AIDS. Frances Fitzgerald is a Member of the European Parliament, Ireland Sirpa Pietikäinen is a Member of the European Parliament, Finland Sara Cerdas is a Member of the European Parliament, Portugal Cyrus Engerer is a Member of the European Parliament, Malta Antoni Comín i Oliveres is a Member of the European Parliament, Spain Catharina Rinzema is a Member of the European Parliament, The Netherlands Marc Angel is a member of the European Parliament, Luxembourg Image Credits: Ehimetalor Akhere Unuabona/ Unsplash. 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
It’s Time to End AIDS: Why EU Should Fund Search for HIV Vaccine 18/05/2023 Frances Fitzgerald, Sirpa Pietikäinen, Sara Cerdas, Cyrus Engerer, Antoni Comín i Oliveres, Catharina Rinzema & Marc Angel The HIV pandemic has affected over 2.3 million people in the World Health Organization’s (WHO) European Region, with nearly 300 new diagnoses made daily in 2021. The COVID-19 pandemic and geopolitical turbulences in the region impacted the course of the HIV pandemic and the response, displacing populations, and disrupting access to care and HIV testing. Today, living with HIV is no longer a reason for despair and the management of HIV is well codified. As there is no cure, people living with HIV undertake life-long treatment that allows them to have healthy and long lives. The effectiveness of treatment is indisputable but the estimated treatment cost per person per year remains high. In Spain, it is estimated to be €11,638, while in Germany it soars to around €32,100. In France, the cost reaches €14,821, and in Italy, it amounts to €6,300. While the introduction of pre-exposure prophylaxis (PrEP) in 2012 was a breakthrough in HIV prevention in Europe and globally, the burden of HIV continues to fall disproportionately in certain regions, like eastern Europe, as well as on vulnerable populations that include migrants, sex workers, people who use drugs and men who have sex with men. These disparities are felt in various aspects of HIV prevention and treatment, including limited access to testing and inadequate availability and affordability of prevention tools like PrEP. Significant economic and human rights impact WHO Europe: HIV in Europe 2021 Although the incidence of HIV in the region may not be as alarming as in other parts of the world, its impact is significant, not only on European economies but also on the human rights of its marginalised populations. Within this context, immunisation is a crucial means of safeguarding public health, reducing morbidity and mortality. Additionally, it delivers advantages for the social and economic fabric of nations and helps alleviate the burden on healthcare systems. Despite the disruption caused by COVID-19 in recent years, European scientists have rallied together in the pursuit of an effective HIV vaccine, conducting several early-phase trials with the backing of funding from Horizon 2020. These trials use original technologies often not developed elsewhere. However, plans and funds to ensure their continuity are urgently required, especially given the need for larger trials to achieve conclusive results. So, why should Europe invest in the search for an HIV vaccine? First, an HIV vaccine would naturally help control the pandemic on the continent, not only from a prevention point of view but also because HIV vaccines are key to cure and remission of the virus. Simultaneously, the vaccine would have a tremendous impact on improving public health, not only on HIV-related issues but also on other infectious diseases. For example, the long-term research conducted for an HIV vaccine played a crucial role towards the rapid development of a COVID-19 vaccine. Moreover, it has proven to be critical in paving the way for the development of vaccines for other diseases not only strengthening the networks of European research institutions but improving the necessary infrastructure. Thus, investing in an HIV vaccine undoubtedly means investing in pandemic preparedness, and in global health security. Lastly, the development and distribution of an effective HIV vaccine have the potential to improve global health equity. It would ensure that everyone, regardless of their socioeconomic status or geographic location, has access to life-saving technologies, leaving no one behind. Additionally, an HIV vaccine would further protect vulnerable populations and reduce health disparities, contributing to the fight against HIV-related stigma and discrimination. By improving prevention and providing opportunities for greater control of HIV, an HIV vaccine would have a worldwide impact beyond Europe. Vulnerable populations Through its Global Health Strategy, the European Union is committed to deepening its leadership in global health matters, assuring that everyone everywhere has access to the highest attainable standards of health, based on solidarity and human rights. This will be achieved by, amongst other priorities, tackling the root causes of ill health, focusing on vulnerable populations, and working towards a mechanism that fosters the development of, and equitable access to, vaccines. As the COVID-19 pandemic made clear, the EU has an unprecedented opportunity to become a global health leader. Investing in the development of an HIV vaccine that can save the lives of people all over the world must be a fundamental part of this strategy, with positive benefits for individual health and human rights, as well as for economies and health security. It is time to invest in R&D for an HIV vaccine. It is time to ensure that the HIV pandemic no longer poses a threat to public health and individual well-being, and by doing so, protect human rights and advance equity. It is time to end AIDS. Frances Fitzgerald is a Member of the European Parliament, Ireland Sirpa Pietikäinen is a Member of the European Parliament, Finland Sara Cerdas is a Member of the European Parliament, Portugal Cyrus Engerer is a Member of the European Parliament, Malta Antoni Comín i Oliveres is a Member of the European Parliament, Spain Catharina Rinzema is a Member of the European Parliament, The Netherlands Marc Angel is a member of the European Parliament, Luxembourg Image Credits: Ehimetalor Akhere Unuabona/ Unsplash. Posts navigation Older postsNewer posts