23 January 2001
GLOBAL HEALTH ISSUES
107TH SESSION OF WHO’S EXECUTIVE BOARD
The 107th session of the World Health Organization’s (WHO) Executive Board ended in Geneva last night. The 32 Board Members, under the chairmanship of Dr Jorge Jiménez de la Jara of Chile, covered a wide range of topics during their seven days of deliberations. Among the highlights: infant and child feeding, assessment of health systems performance, new international health regulations, nursing and midwifery, and schistosomiasis.
Malnutrition of infants and young children remains one of the most severe global public health problems – malnutrition still contributes to nearly half of the 10.5 million deaths each year among pre-school children worldwide. The Board adopted a resolution which calls for protection, promotion and support of breastfeeding and complementary feeding practices, together with improving the nutrition of women of reproductive age, especially during and after pregnancy. It also calls for support of the Baby-friendly Hospital Initiative.
The year 2001 marks the 20th anniversary of the adoption of the International Code of Marketing of Breast-milk Substitutes. The Board in its resolution calls for strengthening of "national mechanisms to ensure global compliance with the Code."
Last year’s The world health report 2000: Health systems - improving performance caused comment and debate in all 191 WHO Member States. It was the first time ever that the performance of all national health systems has been evaluated. The Board adopted a resolution on the processes for helping Member States contribute to WHO’s assessments. The next draft report is to completed by May 2002 for publication, after consultation, in October 2002.
A resolution on strengthening nursing and midwifery was adopted by the Board. There is a global concern for the widespread and increasing shortage of nurses and midwives. The situation is particularly acute in developing countries, where unstable and dwindling funding of the health sector coupled with low salaries and poor working conditions have already led to members of the profession either emigrating in vast numbers to countries offering better prospects, or leaving the profession altogether. For example, these experts heard, the number of nurses arriving in the UK from overseas has risen by 48% in the last 12 months, while a hospital in Zambia, which needs 1,500 nurses to function effectively, currently only has 500 nurses on staff.
The Board resolution calls on WHO Member States to "support the recruitment and retention of a skilled and motivated nursing and midwifery workforce within health services." It also requests the Director-General to set up "mechanisms for enquiry into the global shortage of nursing and midwifery personnel, including the impact of migration."
The globalization of infectious diseases is such that an outbreak in one country is potentially a concern for the whole world. The need for international cooperation on epidemic alert and response is greater today than ever before due to increased population movements, growth in international trade and biological products, changes in methods of food processing, social and environmental changes. WHO aims to contain the global public health threat of emerging infectious diseases, epidemics and drug-resistant infectious agents.
A global outbreak alert and response network was established by WHO in April 2000. Reports of current epidemic outbreaks received by WHO and deemed to have potential international importance are included in a weekly e-mail service (Outbreak verification list) distributed to public health officials and global surveillance partners worldwide.
The Board examined WHO’s proposed revision of the International Health Regulations. Among the new elements of the Regulations are: expansion of reported diseases, especially epidemics, and the use of information from all reliable sources, as a basis for a country to verify the status of an outbreak.
Apart from formulating a global strategy for containment of antimicrobial drug resistance, and continuing work on revision of the International Health Regulations, the Board’s resolution requests WHO "to provide support for building up national capacity for epidemic alert and response." A special emphasis is placed on "development of laboratory diagnostic competence and training in intervention epidemiology in the most exposed countries." The new International Health Regulations should be presented to the World Health Assembly in 2004.
The Board discussed a WHO report on control of schistosomiasis and soil-transmitted helminth infections, which remain the most prevalent parasitic infections in the world. The burden of disease is enormous. About 2 billion people are affected worldwide, of whom 300 million suffer severe morbidity. The burden of the disease (currently over 40% of the total disease burden due to all tropical diseases excluding malaria) can be greatly reduced through regular treatment with single doses of inexpensive drugs ranging from US$0.03 to US$0.30. A number of countries, such as Brazil, China, Egypt and the Philippines, managed to control these infections well.
WHO has defined a simple and comprehensive package to reduce the impact of schistosomiasis and soil-transmitted helminths which includes chemotherapy for all high-risk groups. WHO believes that these control measures can reduce morbidity by 80%. However, in order to reduce transmission more permanently, this strategy needs to be complemented by improved access to sanitation and clean water.
Other topics discussed by the Board included the 2002-2003 Programme Budget, progress on the Framework Convention on Tobacco Control, Roll Back Malaria, and Mental Health – which will be the subject of both this year’s World Health Report and World Health Day.
The Board decided to include the issue of depleted uranium as a separate technical item at this year’s World Health Assembly to be held in Geneva from 14 to 22 May.
For further information please contact Mr Valery Abramov, WHO Spokesperson's Office. Tel. (+41 22) 791 2543; Fax (+41 22) 791 4858; e-mail:email@example.com or Mr Gregory Hartl, WHO Spokesperson, WHO, Geneva, Switzerland. Tel. (+41 22) 791 4458; Fax (+41 22) 791 4858; e-mail: firstname.lastname@example.org All WHO Press Releases, Fact Sheets and Features as well as other information on this subject can be obtained on Internet on the WHO home page http://www.who.int/