Sixty-eighth World Health Assembly [to 23 May 2015]

Editor’s Note:
The World Health Assembly continues through 26 May. Initial high-level actions are being reported on through press releases, including the three below on WHO’s emergency and response programme stemming from the Ebola crisis, polio, malaria, yellow fever, and the IHRs (International Health Regulations). Further below is a link to a draft resolution which we understand is still in discussion at WHA addressing issues around the GVAP (Global Vaccine Action Plan).

Sixty-eighth World Health Assembly [full documentation]

WHO Director-General’s speech at the Sixty-eighth World Health Assembly
Dr Margaret Chan, Director-General of the World Health Organization
18 May 2015
[Closing text]
…Ladies and gentlemen,
The threats to health have multiplied, but so has our capacity to respond. For some reason, health brings out the very best in human creativity and determination.

We enter the post-2015 era blessed with a host of new initiatives, instruments, interventions, including new vaccines, and precise strategies with time-bound goals. The momentum behind the MDGs will continue. WHO has mature programmes, with strong track records of success, to guide this work.

Above all, our work is driven by a fierce commitment to equity, social justice, and the right to health. As the number of countries aiming for universal health coverage grows, we are in a position to change the mindset that poor people living in poor places will inevitably have poor health care. This is no longer true.

The Ebola outbreak shook this Organization to its core. As noted in the interim assessment report, this was a defining moment for the work of WHO and an historic political moment for world leaders to give WHO new relevance and empower it to lead in global health.

I urge you to make this happen. I will do my part.

World Health Assembly gives WHO green light to reform emergency and response progamme
News release
23 May 2015 ¦ GENEVA – Delegates at the World Health Assembly made a series of decisions stemming from the 2014 Ebola virus disease outbreak. These give the WHO Secretariat the go-ahead to carry out structural reforms so it can prepare for and respond rapidly, flexibly and effectively to emergencies and disease outbreaks.

Preparing for and responding to emergencies
Delegates at the 68th World Health Assembly welcomed WHO’s commitment to deep reforms of its emergency work, in particular by setting out clear and effective command and control mechanisms across all 3 levels of the Organization – headquarters, regional and country offices.
At the same time, WHO will establish an emergency programme, which will be guided by an all-hazards health emergency approach, that emphasizes adaptability, flexibility and accountability, humanitarian principles, predictability, timeliness and country ownership.

WHO will set up a US$ 100-million contingency fund to provide financing for in-field operations for up to 3 months. The contingency fund will run initially as a two-year pilot and will then be evaluated.

Delegates appreciated the key coordination role played by WHO in its ongoing work to develop vaccines, diagnostics and drugs for Ebola virus disease. They noted the importance of being able to accelerate research and development activities to tackle health threats for which solutions do not currently exist. They also requested the Secretariat to continue and enhance WHO’s work in helping countries better prepare for emergencies by strengthening national health systems.

International Health Regulations (2005)
The Director-General was asked to set up a review committee under the International Health Regulations (2005) to:
:: assess the effectiveness of the International Health Regulations with regard to the prevention, preparedness and response to the Ebola outbreak
:: assess the status of implementation of recommendations from the previous Review Committee in 2011 and its impact on the Ebola outbreak
:: recommend steps to improve functioning, transparency, effectiveness and efficiency of the International Health Regulations and improve preparedness and response for future health emergencies.

WHA reaches agreement on polio, International Health Regulations and strengthening surgical care
News release
22 May 2015 ¦ GENEVA – The World Health Assembly continued progress Friday, reaching agreements on polio eradication; further implementation of the International Health Regulations (2005); surgical care and medical products.

Delegates at the World Health Assembly today agreed on a resolution in which Member States recommit to stopping polio and to preparing for the phased withdrawal of oral polio vaccines.
The meeting noted that Polio eradication can only be achieved through global solidarity. Reviewing the latest global epidemiology and the impact of on-going efforts, delegates highlighted progress across Africa (which has not seen a case due to wild poliovirus since August 2014), and success in halting three large multi-country outbreaks in the Middle East, Horn of Africa and Central Africa. They also noted continuing efforts in Pakistan, and the strong progress being made, in close coordination with Gavi, the Vaccine Alliance, towards introduction of inactivated polio vaccine (IPV) and preparations for the phased withdrawal of oral polio vaccines.

International Health Regulations
Delegates endorsed the International Health Regulations Review Committee recommendation to extend the deadline to 2016 to all countries that need more time to implement the Regulations. The recommendation also emphasizes a dynamic, ongoing process of evaluation and improvement, and the value of independent assessment.

The recent Ebola outbreak has highlighted the importance of all countries having strong capacities to rapidly detect, respond to and prevent global public health threats such as disease outbreaks. The International Health Regulations (2005), oblige all Member States to have these capacities in place. Only one-third of all countries (64), however, reported that they had met the minimum requirements in 2014.

Speakers at today’s meeting recognized the important role WHO plays in providing expertise and guidance to help countries enhance surveillance systems and laboratory services, build early warning and alert systems, and train health workers so that they can deal with major public health threats. They expressed strong support for pairing well-resourced countries with other countries to help them to meet the IHR requirements.

Yellow fever
In 2013, WHO’s expert advisory group on immunization (SAGE) recommended that a single dose of yellow fever vaccine provides life-long immunity to the disease, making boosters unnecessary. Under the International Health Regulations (2005), vaccination may be required of any traveller leaving an area at risk of yellow fever transmission. The Regulations currently specify that travellers should renew immunization every ten years. Changes to the Regulations recognizing the adequacy of a single dose of the vaccine will come into force in June 2016.
Some countries may, however, wish to institute the changes immediately. Delegates agreed to inform WHO if their governments decide to apply these changes immediately, and accept the validity of yellow fever vaccination certificates as life-long. WHO will publish an updated list of these countries online to inform international travellers. The Secretariat has also agreed to establish a scientific advisory group to work with affected countries to maintain up-to-date analysis of areas at risk.

Surgical care
Delegates of the World Health Assembly agreed a resolution on strengthening emergency and essential surgical care and anaesthesia.

A wide range of conditions – from cancer and diabetes to obstructed labour and road traffic injuries – can be successfully treated by surgery. In many parts of the world, access to emergency and essential services is extremely limited, with low and middle income countries concentrating available surgical care in urban centres. As a result, maternal mortality rates remain high, minor surgical issues become lethal and treatable injuries can lead to death or disability.

This resolution will help countries adopt and implement policies which will integrate safe, quality and cost effective surgical care into the health system as a whole. It highlights the importance of both expanding access and improving the quality and safety of services; strengthening the surgical workforce; improving data collection, monitoring and evaluation; ensuring access to safe anaesthetics such as Ketamine; and fostering global collaboration and partnerships. The resolution also underscores the need to raise awareness of the issue and build political commitment

Substandard, spurious, falsely labelled, falsified and counterfeit medical products
Substandard, spurious, falsely labelled, falsified and counterfeit medical products continue to threaten health, not only because they do not provide the benefits they advertise, but because they also pose a serious health risk, and undermine the credibility of health systems. The World Health Assembly had set up a mechanism to raise awareness, gather evidence, implement policies and evaluate effectiveness of efforts to address this issue, and had planned to review the impact of that mechanism in 2016. Delegates today agreed to postpone this to 2017 – both to allow more time for the review itself and for implementation of new policies to tackle the problem.
World Health Assembly agrees Global Malaria Strategy and Programme Budget 2016-17

GENEVA – WHO Member States today agreed a new global malaria strategy for 2016-2030 and approved the Organization’s proposed programme budget for 2016-2017.
News release
20 May 2015 ¦

Global Malaria Strategy
The strategy aims to reduce the global disease burden by 40% by 2020, and by at least 90% by 2030. It also aims to eliminate malaria in at least 35 new countries by 2030.
Between 2000 and 2013, the global malaria mortality rate dropped by 47%. A major expansion of the WHO-recommended core package of measures – vector control, chemoprevention, diagnostic testing and treatment – has proved both cost effective and efficient. Nevertheless, millions of people are still unable to access malaria prevention and treatment, and most cases and deaths continue to go unregistered and unreported. In 2013, malaria killed an estimated 584 000 people.
The new strategy aims to build on recent successes to radically reduce this figure. Developed in close consultation with endemic countries and partners, the strategy provides a comprehensive framework so countries can develop tailored programmes that will sustain and accelerate progress towards malaria elimination.
It comprises three key elements: ensuring universal access to malaria prevention, diagnosis and treatment; accelerating efforts towards elimination and attainment of malaria-free status; and strengthening malaria surveillance. It emphasises the importance of innovation and research, and the critical need for political commitment, sustainable financing, strong health systems, and collaboration across different sectors.

Programme Budget 2016-17
Member States also approved WHO’s proposed Programme Budget for 2016-17. The budget of US$ 4384.9 million includes a US$ 236 million increase over the 2014-15 programme budget requirement to meet the needs of countries; leverage the experience gained during the Ebola outbreak; address emerging priorities such as antimicrobial resistance, health and the environment, malaria and viral hepatitis; and implement resolutions passed by the Assembly and WHO’s Regional Committees. Additional funds will also be used to further strengthen transparency, improve risk management and enhance accountability.

Draft Resolutions
A68/A/CONF./4 Rev.1
Global vaccine action plan
Draft resolution proposed by the delegations of Algeria, Egypt, Libya, Morocco, Nigeria, Pakistan, Qatar, Saudi Arabia, Thailand, Tunisia