The World Health Assembly (WHA) on Monday greenlit a slew of decisions and resolutions that aim to bring another one billion people under the coverage of universal health coverage (UHC), as the 76th WHA session drew closer to its end. 

The plan is the bedrock of WHO’s vision to deliver on so-called “triple billion targets” WHO Director General Dr Tedros Adhanom Ghebreyesus set as a goal in 2018. The targets, that aim to ensure stronger emergency response, access to UHC and beter health and well-being for 1 billion people each, form the backbone around which this year’s discussions have taken place. 

A core focus of the UHC target is the expansion and strengthening of primary healthcare access – viewed as a key means of bringing  more people closer to vital health services. 

“Strong primary health care is especially vital for delivering life saving services, maternal and child health, including routine immunization,” stressed Tedros in his opening remarks at the WHA last Sunday.  Countries definitely agreed, stressing over and over in comments Saturday and Monday the relevance of primary health care services. 

Landmark resolution on harmful chemicals, including plastics 

In terms of WHO’s pillar of work on better health and well-being, WHA also approved a landmark resolution calling for countries to scale-up work addressing harmful chemicals. The resolution refers to the need for countries to explore emerging linkages between plastic pollution and human health.

The resolution, spearheaded by Peru, is the first time ever that WHA has addressed the plastics issue – already widely acknowledged to be a growing environmental blight

Racing to catch up after last week was dominated by protracted debates over divisive topics like Ukraine and Palestine, WHA delegates settled into a routine of long statements and rapid approval of the wide range of technical items remaining on their agenda for this year’s session, which ends Tuesday.   See related story:

Landmark Resolution on Chemical Pollution Passes World Health Assembly

New thrust on fake medicines and rehabilitation services 

Among other key action-points addressed on Monday was a decision aiming to strengthen countries’ control over substandard and falsified medical products, as well as a resolution committing countries to boost rehabilitation services, to meet growing demands as non-communicable diseases rise. 

As part of the substandard medicines initiative, the Assembly’s Committee A, which reviews programmatic work items, OK’d the establishment of an independent evaluation to monitor the member states performance. 

In their comments, countries stressed that substandard diagnostics and medical devices are a problem along with fake and substandard medicines, per se; all are targeted in this week’s decision. 

“The lack of access to affordable, appropriate, good quality and safe medical devices is a major public health issue,” said Botswana, speaking on behalf of 47 countries in the Africa region. “African member states calls for resources to ensure availability of skilled human personnel, and to meet maintenance needs for the medical devices.”

With regards to rehabilitation, the resolution, led by Israel, aims to bolster services to the billions of people who suffer from disabilities or chronic disease that impairs their physical, mental or social functionality.

In 2019 around 2.4 billion individuals had conditions that would have benefited from rehabilitation, WHO estimates – a 63% increase over the past three decades.  And since then, COVID-19, conflicts and other humanitarian crises are also adding significantly to the demand for such services.

Many individuals simply do not receive the rehabilitation they require, despite the high cost. “A majority of those with unmet needs live in low- and middle-income countries, where as much as 50% of people do not receive the rehabilitation they need,” the background text for the resolution states.  WHO is already providing assistance to 35 countries to gather data, develop national plans and strengthen the rehabilitation workforce.

The resolution urges member states to build national rehabilitation programmes – particularly at primary health care level, and to “ensure the integrated and coordinated provision of high-quality, affordable,
accessible, gender sensitive, appropriate and evidence-based interventions for rehabilitation along the continuum of care.”

It also calls upon WHO to develop a global rehabilitation baseline report by 2026, as well as global health system rehabilitation targets and indicators “for effective coverage” for 2030.

“Best Buys’’ to combat NCDs

Last week, WHA delegates approved WHO recommendations for an expanded set of “Best Buys” that countries should use to prevent and control NCDs. These include stronger taxes and warning labels on unhealthy foods, so as to combat non-communicable diseases that now constitute 70% of deaths.  

Non-communicable diseases have been a major focus during this year’s WHA discussions.  

“As the global population is growing. People are living longer, and the emergence of non-communicable diseases, the need for rehabilitation services is on the increase. A recent WHO report suggests that 2.4 billion people are in need of rehabilitation services, and to meet this huge demand the importance for promoting, and investing in community-based rehabilitation (CBR) has never been more urgent,” said Malawi. 

Support for disability inclusion

The WHA also endorsed a new WHO strategy to strengthen disability inclusion within countries and health ministries. While the strategy found widespread support, WHA member states raised questions about steps WHO, as an agency, is also taking to include people with disabilities and stakeholder groups into the work of the organization.

“We would like to know what the plans are to ensure that organizations of people with disabilities are systematically included in the technical work of the organization as is stated in the strategy,” Mexico asked. 

“This would help us to ensure that disability is really incorporated in the work of the WHO for issues on recruitment, and to adapt a physical and digital infrastructure through the universal design and reasonable adjustments for different tools.”   

Societal stigmatization and discrimination related to disability and limited access to SRHR services perpetuates health inequities. These deprivations must be dismantled. @UNFPA @WHO @Atayeshe @DrTedros @UNFPA_Geneva #WHA76 @WeDecideGlobal pic.twitter.com/89OtVkBl4Y

— Monica Ferro (@monicapferro) May 29, 2023

Other countries highlighted the lack of data on people with disabilities as well as intersectional issues, such as the challenges pregnant women living with disability face in accessing healthcare.  

Visa restrictions limit participation by global south in professional events

After the experience of the pandemic in which public behaviour was a key determinant in the uptake of vaccines, WHA members also expressed support for a new strategy to  mainstream behavioural sciences in the work of the global health agency.

“We saw how trust is a core aspect of a successful pandemic response, vertically as trust between citizen and state, and horizontally as trust in your fellow citizen,” said the WHA delegate from Denmark. 

“Low public trust is a worldwide public health concern. It needs a stronger global collaboration, and it needs global initiatives.” 

“However, building sustainable trust in authorities and among communities does not happen overnight. It requires some deep insight, structural approaches, and it can be a slow process,” he added. 

But as WHA drew to a close, countries also brought up a range of other concerns around the WHA’s policies and recommendations.

For instance, developing countries face visa restrictions in trying to share knowledge around topics like health and behavioural sciences, the delegate from Jamaica suggested – referring to a “gap” faced by participants from the global south in getting to professional meetings and conferences.  

“We appreciate and support the priority placed in the report on fostering dialogue with academic institutions and practitioners to help reduce the gap,” the delegate said.

Image Credits: WHO, WHO .