World Badly ‘Unprepared’ for Pandemics
Pandemic
WHO DG Tedros Adhanom Ghebreyesus at 75th WHA

GENEVA – The world is still not ready to handle pandemics despite all of the international efforts to improve health care in recent years, Dr Tedros Adhanom Ghebreyesus warned in a wide-ranging opening address to the World Health Assembly’s 194 member nations.

The World Health Organization must respond to dozens of global emergencies — cyclones, volcanoes, earthquakes, outbreaks, wars – while handling the COVID-19 pandemic, and it created a new hub for pandemic and epidemic intelligence in Berlin earlier this year.

And yet it is not enough because “it’s clear that the world was – and remains — unprepared for a pandemic,” Tedros said. “The pandemic is far from over. And even as we continue to fight it, we face the task of restoring essential health services, with 90% of member states reporting disruption to one or more essential health services.”

More optimistically, Tedros said the world’s needs “remain daunting and complex. But none of these challenges are insurmountable. For every challenge, there are solutions. If there is a will, there is a way.”

His opening speech on the second day of the Assembly began with a look back at the UN health agency’s past five years, during which Tedros’ first term as director-general has been marked by “many calls for WHO to change,” he noted, in its work methods and culture.

“And there is no question that more change is needed,” said Tedros, who is widely expected to be appointed to a second five-year term. “Allow me now to look forward to where I believe we need to go in the next five years. … We are calling on every government to put the health of its people at the center of its plans for development and growth.”

Tedros said the pandemic shows not only why the world needs WHO but also why it needs to be “stronger, empowered and sustainably financed.” To that end, he welcomed a working group’s recommendation to raise assessed contributions to 50% of the core budget over the next decade. These fixed contributions only comprise 17% of WHO’s budget, leaving it to a few rich countries and philanthropies to voluntarily cover most of WHO’s costs.

“You elected me five short years ago, with an ambitious agenda for universal health coverage; health emergencies; women’s, children’s and adolescents’ health; the health impacts of climate and environmental change; and a transformed WHO,” he noted, adding those priorities evolved into the five-year plan for achieving its “triple billion” targets that the Assembly adopted in 2018.

They aim by 2023 to help 1 billion more people benefit from universal health coverage; 1 billion more people be better protected from health emergencies; and 1 billion more people enjoy better health and well-being.

Pandemics progress still slow

“Progress isn’t always fast or easy to measure. But in ways small and large, seen and unseen, I am proud to say that this organization is making a difference. Let me start with our efforts to see 1 billion people enjoying better health and well-being,” he said. “Our projection is that we will almost reach this target by 2023, but progress is only about one quarter of what is required to reach the relevant SDG [Sustainable Development Goals] targets.”

For examples of other global health progress, Tedros also pointed to declining tobacco use, less industrially-produced trans fat in the global food supply and more excise taxes on at least one health-harming product, such as tobacco, alcohol or sugary drinks.

He also cited new WHO limits for air quality “based on mounting evidence of the harms to health of air pollution at even lower concentrations than previously thought” and new WHO health guidelines or tools that 71 countries are using to respond to violence against women.

But on the universal health coverage goal, he said, the world is “far behind, and progress is less than one quarter of what is required” to reach the target.

“Even before the pandemic, we estimated that only 270 million more people would be covered by 2023, a shortfall of 730 million people against the target of 1 billion,” said Tedros. “Disruptions to health services during the pandemic have sent us backwards, and we estimate the shortfall could reach 840 million.”

But there has been a 29% global increase in the number of health workers between 2013 and 2020, he noted, in contrast to previous projections for a global shortage of 18 million health workers by 2030. “That projected shortage has now shrunk to 15 million but it is still a massive shortage,” he added.

Tedros said that in the past five years there has been “significant progress in expanding access to medicines and other essential health products” – such as 53 prequalified vaccines, 50 in-vitro diagnostics and 288 medicines, including new therapies for HIV, hepatitis, TB, malaria, NTDs and COVID-19 – and two prequalified biosimilar cancer medicines along with a pilot program to prequalify human insulin.

Since the start of the pandemic in March 2020, WHO approved emergency use listings for 12 COVID-19 vaccines and 28 in-vitro diagnostics. And within 15 days of those vaccine listings, he said, 101 countries were “illustrating the weight that these countries place on WHO’s stamp of approval” through their own regulatory authorizations of those vaccines.

He said the UN target on hepatitis B — part of the U.N.’s 17 SDGs that contain 169 targets – has been met, and since 2015 the number of people who got treatment for hepatitis C increased ninefold to 9.4 million, reversing the trend of increasing mortality for the first time. And for the first time, the world has a malaria vaccine, enabling more than 1 million children in Ghana, Kenya and Malawi to receive at least one of 4 doses recommended for them from 5 months of age. Each year more than 260,000 African children under five die of malaria.

And on non-communicable diseases, he said, WHO helped 36 countries over the past five years to integrate services to prevent, detect and treat NCDs – one or more chronic conditions, like obesity, heart or kidney disease, or cardiovascular diseases – into primary health care programs, and supported 25 countries with rehabilitation services. WHO also helped 31 more countries to integrate mental health services into primary health care. “Child survival has improved dramatically over the past 20 years,” he said, “although 54 countries are off track to meet the SDG child survival targets.”

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