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Sixty-fifth World Health Assembly: daily notes on proceedings

Notes: Friday, 25 May 2012

WHO reform

Committee A approved the decision on WHO reform. Member States welcomed programmatic reforms and emphasized the need to include health determinants and equity in the next Programme of Work and Proposed Programme Budget.

On governance reforms, Member States agreed to maintain the present schedule of governing body meetings for now, with the proviso that the topic will be revisited at the Executive Board in January 2013, and asked the Secretariat to present a feasibility study on the possibility of shifting the financial year. They also endorsed proposals to enhance alignment between Regional Committees and the Executive Board, increase harmonization across the Regional Committees, and streamline decision-making in governing body meetings. They requested the Director-General to propose options on possible changes to the rules of procedure to limit the number of agenda items and resolutions coming before governing bodies. They also requested draft policy papers on WHO’s engagement with NGOs and the Organization’s relationships with private commercial entities, as well as a report on WHO’s hosting arrangements of health partnerships and proposals for harmonizing work with hosted partnerships.

On managerial reforms, Member States noted progress made in numerous areas, such as the establishment of an ethics office, and requested that the Director-General further develop proposals to increase the transparency, predictability and flexibility of WHO’s financing. They also requested a paper on the specific modalities of the second stage of independent evaluation as well as a monitoring and implementation framework on progress in the implementation of WHO reform.

Intensification of the global polio eradication initiative

Committee A today approved a draft resolution (EB130.R10) which declares the completion of poliomyelitis eradication a programmatic emergency for global public health. India was once again congratulated for stopping indigenous wild poliovirus circulation. However, three countries still face endemic transmission of wild polio virus; unless poliovirus transmission is stopped in these countries, there will be a global resurgence of the disease with a real risk of severe outbreaks in areas that have long been polio-free. The approved resolution requires the full implementation of current and new eradication strategies, the institution of strong national oversight and accountability mechanisms for all areas infected with poliovirus, and the application of appropriate vaccination recommendations for all travellers to and from areas infected with poliovirus.

Member States with poliovirus transmission are urged to declare such transmission to be a “national public health emergency”, requiring the development and full implementation of emergency action plans. Pakistan, Nigeria and Afghanistan have already established national emergency plans for polio eradication and shifted their national polio eradication initiatives to an emergency status, with an all-of-government and society approach to ensure all children are reached and vaccinated. During the discussion, partners reiterated their support to the polio eradication initiative and the importance of treating polio eradication as a programmatic emergency, and urged all partners to be fully committed in their action and their financing.

WHO Director-General Dr Margaret Chan and Assistant Director General Dr Bruce Aylward stated that polio eradication is at a tipping point between success and failure, and necessary funding is essential to ensure it tips in the right direction. The minimum additional funding needed for 2012 alone is USD 150 million.

Early marriages and young pregnancies

More than 30% of girls in developing countries are married before the age of 18, and 14% before the age of 15. Many delegates noted the importance of this agenda item and requested that the Organization continue raising awareness of the problem of early marriage and adolescent pregnancy and its consequences for young women and their infants.

Several noted the importance of implementing laws and policies and strengthening sexuality education. Guidelines recently issued by WHO on preventing adolescent pregnancy were welcomed. Some countries said that “one size does not fit all” and that family and community social norms must be considered. The Secretariat confirmed that it will work with regional offices to adapt the guidelines to public health realities country-by-country.

Staffing matters

The annual 2011 human resources report highlighted the need for HR issues to be at the heart of all aspects of the WHO reform agenda. The discussion touched upon the necessary efforts to attract and retain highly qualified staff and the remaining challenge to ensure gender and geographical diversity at all levels of the Organization. Gender imbalance at senior levels, inter-regional mobility and upcoming retirements are monitored and actions are taken in HQ and the regional offices. A focus on career development, internal rosters to accelerate recruitment and mobility between offices and across the regions is seen as central.

Implementers’ perspectives on the Global Fund

A side event chaired by the health ministers of Sudan and Ghana examined better ways for the Global Fund to engage local grantees in their processes, as the Fund transforms how it does business under new leadership. Participants discussed practical steps for strengthening their relationship.

Report of the internal auditor

Member States appreciated the work of the Internal Oversight Services (IOS), the efforts to achieve cost savings and the improved transparency of the matters raised in the report. Delegates also called for further strengthening of the IOS and would welcome greater focus on conducting performance audits of technical programmes.

Implementing the internal control framework across the Organization was seen as critical to improving compliance with rules and regulations and to address the audit recommendations. Delegates also expressed concern over the length of time to implement the recommendations and expressed the need for greater attention by the Secretariat to clear old items. There was a broad recognition that strengthening accountability, enforcement and compliance are a crucial element of the WHO reform process.

Elimination of schistosomiasis

Delegates requested amendments to the proposed resolution to support countries in evaluating interruption of schistosomiasis transmission and preventing its re-emergence. A few countries called for this resolution to be taken as a turning point for driving more efforts to address neglected tropical diseases. Delegates discussed the need for a health-systems approach, involving public-private partnerships, to ensure availability of drugs and their development. The draft resolution with amendments was approved.

Substandard/spurious/falsely-labelled/falsified/counterfeit medical products

Delegates approved a draft resolution on a new Member State mechanism proposing international cooperation on substandard, spurious, falsely-labelled, falsified or counterfeit (SSFFC) medical products. Many countries stressed the need for strengthening regulatory authorities and the critically important role that WHO plays in enhancing regional and international networking among the regulators. Emerging channels of distribution such as Internet sales pose a significant threat and require specific solutions. Representatives of NGOs and the pharmaceutical sector expressed their support for the mechanism.