WHO: Sixty-seventh World Health Assembly [WHA]
[Editor’s Note: The Sixty-seventh World Health Assembly concluded on Saturday, 31 May. Key interviews, video, the WHA Journal and all documentation available here: http://www.who.int/mediacentre/events/2014/wha67/en/.
News release: World Health Assembly closes
24 May 2014 | GENEVA – The Sixty-seventh World Health Assembly closed today, after adopting more than 20 resolutions on public health issues of global importance.
“This has been an intense Health Assembly, with a record-breaking number of agenda items, documents and resolutions, and nearly 3,500 registered delegates,” said Dr Margaret Chan, WHO’s Director-General. “This is a reflection of the growing number of complexity of health issues, and your deep interest in addressing them.”
A number of the Health Assembly resolutions were approved today on the following issues.
:: Antimicrobial drug resistance
The delegates recognized their growing concern of antimicrobial resistance and urged governments to strengthen national action and international collaboration. This requires sharing information on the extent of resistance and the use of antibiotics in humans and animals. It also involves improving awareness among health providers and the public of the threat posed by resistance, the need for responsible use of antibiotics, and the importance of good hand hygiene and other measures to prevent infections.
The resolution urges Member States to strengthen drug management systems, to support research to extend the lifespan of existing drugs, and to encourage the development of new diagnostics and treatment options.
As requested in the resolution, WHO will develop a draft global action plan to combat antimicrobial resistance, including antibiotic resistance for presentation to the World Health Assembly for approval next year.
:: Implementation of the International Health Regulations (2005)
Yellow fever is a disease specified in the International Health Regulations (2005) for which countries may require proof of vaccination from travellers as a condition of entry under certain circumstances, and may take certain measures if an arriving traveller does not have this certificate in his possession.
The Health Assembly adopted revised provisions on yellow fever vaccination or revaccination under the International Health Regulations (2005). These include extending the validity of a certificate of vaccination against yellow fever from 10 years to the extent of the life of the vaccinated person. The revised provisions are based on the recommendations of the Strategic Advisory Group of Experts (SAGE) on immunization following its scientific review and analysis of evidence.
Member States reaffirmed their strong and continuous commitment to the implementation of International Health Regulations (2005).
:: Public health impacts of exposure to mercury and mercury compounds: the role of WHO and ministries of public health in the implementation of the Minamata Convention
The World Health Assembly requested the WHO Secretariat provide expert advice to help health ministries implement the Minamata Convention on Mercury. Most mercury is released as a result of human activity, such as burning coal and waste and mining for mercury, gold and other metals. WHO considers mercury one of the top ten chemicals or groups of chemicals of major public health concern.
The 2013 Minamata Convention aims to “protect human health and the environment from anthropogenic emissions and releases of mercury and mercury compounds”. The legally binding convention will enter into force when 50 countries have ratified it. It encourages countries to identify and better protect people who are at particular risk from mercury and highlights the need to provide effective health services for everyone who has been affected by exposed to mercury.
:: Addressing the global challenge of violence, in particular against women and girls
Across the world, each year, nearly 1.4 million people lose their lives to violence. Women and girls experience specific forms of violence that are often hidden. Globally, 1 in 3 women experience physical and/or sexual violence at least once in her life. For every person who dies as a result of violence, many more are injured and suffer from a range of adverse physical and mental health outcomes.
Member States will work to strengthen the role of the health system in addressing violence. WHO will develop a global plan of action to strengthen the role of national health systems within a multi-sectoral response to address interpersonal violence, in particular against women and girls, and against children.
:: Follow up of the Recife Political Declaration on Human Resources for Health: renewed commitments towards universal health coverage
The Recife Political Declaration was formulated and adopted by participants of the Third Global Forum on Human Resources for Health, in November 2013. Rooted in the right to health approach, the Recife Declaration recognizes the centrality of human resources for health in the drive towards universal health coverage. It commits governments to creating the conditions for the inclusive development of a shared vision with other stakeholders and reaffirms the role of the WHO Global Code of Practice on the International Recruitment of Health Personnel as a guide for action to strengthen the health workforce and health systems.
:: Follow-up of the report of the Consultative Expert Working Group on Research and Development: Financing and Coordination
The Heath Assembly approved a resolution that significantly advances the quest for innovative, sustainable solutions for financing and coordinating health research and development (R&D) for diseases that disproportionately affect developing countries. The decision provides a firm go-ahead on the implementation of innovative health R&D demonstration projects.
By virtue of this decision, WHO will take the first steps to establish at the Special Programme for Research and Training in Tropical Diseases (TDR) a pooled fund for voluntary contributions towards R&D for diseases of the poor. WHO Member States have emphasised the importance of inclusive coordination of these new developments.
:: Access to essential medicines
WHO’s strategy to help countries improve access to essential medicines was approved. Key principles include selecting a limited range of medicines on the basis of the best evidence available, efficient procurement, affordable prices, effective distribution systems, and rational use. The WHO Essential medicines list was recognized as a valuable tool that enables countries to identify a core set of medicines which need to be available to provide quality medical care.
:: Regulatory system strengthening
Effective medicines regulation ensures that medicines and medical products are of the required quality, safety and efficacy; medicines are appropriately manufactured, stored, distributed and dispensed; illegal manufacturing and trade is controlled and prevented; health professionals and patients have the necessary information to enable them to use medicines rationally; promotion and advertising is regulated and fair; and access to medicines is not hindered by unjustified regulatory work.
In order to improve the regulation of medical products globally and ensure that medical products are of assured quality, more emphasis needs to be placed on regulatory strengthening, and promoting collaboration in regulatory systems.
The WHA mandated WHO, in cooperation with national regulators, to continue its important role globally in medicines regulation through establishing necessary norms and standards, supporting regulatory capacity-building and strengthening safety monitoring programmes. Through its Prequalification programme, WHO is requested to continue to ensures the quality, safety and efficacy of selected priority essential medicines, diagnostics and vaccines. A new development endorsed by Member States is the future progressive transition of prequalification to networks of strengthened regulatory authorities.
:: Health intervention and technology assessment in support of universal health coverage
Many countries currently lack the capacity to assess the merits of health technology. Health technology assessment (HTA) involves systematically evaluating the properties, effects, and/or impacts of different health technologies. Its main purpose is to inform technology-related policy-making in health care, and thus improve the uptake of cost-effective new technologies and prevent the uptake of technologies that are of doubtful value for the health system. Wasteful spending on medicines and other technologies has been identified as a major cause of inefficiencies in health service delivery.
Following the adoption of a resolution on HTA at the Health Assembly, WHO will support capacity-building for health technology assessment in countries. It will provide tools and guidance to prioritize health technologies and intensify networking and information exchange among countries to support priority setting.
:: Health in the post-2015 development agenda
Member States approved a resolution on health in the post-2015 development agenda, stressing the need for ongoing engagement in the process of setting the agenda. This includes a need to complete the unfinished work of the health Millennium Development Goals, newborn health, as well as an increased focus on noncommunicable diseases, mental health and neglected tropical diseases. The resolution also stresses the importance of universal health coverage and the need to strengthen health systems.
Accountability through regular assessment of progress by strengthening civil registration, vital statistics and health information systems are crucial. Member States emphasized the importance of having health at the core of the post-2015 development agenda.
:: Newborn health: draft action plan
The first-ever global plan to end preventable newborn deaths and stillbirths by 2035 calls for all countries to aim for fewer than 10 newborn deaths per 1000 live births and less than 10 stillbirths per 1000 total births by 2035.
Every year almost 3 million babies die in the first month of life and 2.6 million babies are stillborn (die in the last 3 months of pregnancy or during childbirth). Most of these deaths could be prevented by cost-effective interventions.
The Plan’s goals will require every country to invest in high-quality care before, during and after childbirth for every pregnant woman and newborn and highlights the urgent need to record all births and deaths.
SUMMARY OF THE SESSION: GLOBAL VACCINE ACTION PLAN, ITEM 12.2
WHO 67th WORLD HEALTH ASSEMBLY
Geneva, 21st May 2014
Fifty-four speakers including 50 representatives from Member States, one observer, civil society organizations and the GAVI Alliance took the floor during the discussion on the Global Vaccine Action Plan (GVAP).
Delegates commended the Strategic Advisory Group of Experts (SAGE) on immunization for an excellent assessment report and took note of the recommendations, particularly on the need to improve data quality.
While Member States acknowledged WHO’s fundamental role in facilitating the rollout of the GVAP, they also highlighted the need for all stakeholders, particularly national governments to play a leading role in making the needed investments in immunization and in monitoring programme performance.
Delegates highlighted several issues that must be addressed if the global immunization goals are to be achieved including:
:: Sustainable access to vaccines — especially the newer vaccines — at affordable prices for all countries, especially the middle-income countries who are not eligible for funding support from the GAVI Alliance;
:: Technology transfer to facilitate local manufacture of vaccines as a means of ensuring vaccine security;
:: Guidance to improve data quality including the use of new technologies like electronic registries;
:: Assistance on risk communication and management to address misinformation in some countries and communities on the need for immunization and its impact on vaccination coverage; and
:: Support countries to review the evidence and conduct economic analysis leading to informed decisions based on local priorities and needs.
In its response, the WHO secretariat, while taking note of all the issues raised by the delegates also reminded the Assembly that the GVAP progress report indicated that the world was not on track to achieve some of the key immunization goals for the decade and urged for more concerted action by all immunization stakeholders.
 Brazil; Cote d’Ivoire; Jamaica; Malaysia; Bahrain; Colombia; Thailand; Lebanon; Republic of Korea; China; Ecuador; Burundi; Indonesia; Japan; Vietnam; Russia; Iraq; Kenya; Surinam; Congo; Oman; Spain; Togo; Mexico; Namibia; Maldives; Morocco; South Africa; Germany; Mongolia; Algeria; Iran; India; Egypt; Barbados; Burkina-Faso; Jordan; Costa Rica; UAE; Uruguay; Tunisia; USA; Ethiopia; Trinidad-Tobago; Grenada; Azerbaijan; Malawi; Libya; Argentina; Tanzania.
 International Pharmacists Federation and MSF
 WHA 67, Document A67/12, http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_12-en.pdf
WHA 67 – Selected Documentation
A67/6 – Framework of engagement with non-State actors
A67/11 – Draft global strategy and targets for tuberculosis prevention, care and control after 201
A67/12 – Global vaccine action plan
A67/15 A67/15 Add.1 – Maternal, infant and young child nutrition
A67/16 – Disability: Draft WHO global disability action plan 2014–2021: Better health for all people with disability
A67/19 – Monitoring the achievement of the health-related Millennium Development Goals
A67/20 – Monitoring the achievement of the health-related Millennium Development Goals
A67/21 A67/21 Corr.1 – Newborn health: draft action plan/ Every newborn: an action plan to end preventable deaths
A67/22 – Addressing the global challenge of violence in particular against women and girls
A67/23 – Multisectoral action for a life course approach to healthy ageing
A67/30 – Access to essential medicines
A67/33 – Health intervention and technology assessment in support of universal health coverage
A67/33 – Health intervention and technology assessment in support of universal health coverage
A67/34 – Follow-up of the Recife Political Declaration on Human Resources for Health: renewed commitments towards universal health coverage
A67/35 A67/35 Add.1 – Implementation of the International Health Regulations (2005)
A67/36 A67/36 Add.1 – Pandemic Influenza Preparedness: sharing of influenza viruses and access to vaccines and other benefits
A67/37 – Smallpox eradication: destruction of variola virus stocks
A67/38 – Poliomyelitis: intensification of the global eradication initiative
A67/39 – Antimicrobial drug resistance
A67/39 Add.1 – Draft global action plan on antimicrobial resistance
Global strategy and targets for tuberculosis prevention, care and control after 2015