World Health Assembly concludes; makes key decisions affecting global public health
Assembly urged to finish polio eradication, in honour of late Director-General Dr LEE Jong-wook
27 May 2006 | Geneva - The World Health Assembly (WHA), the supreme decision-making body of the World Health Organization (WHO), wrapped-up its fifty-ninth session today. More than 2200 people from WHO's 192 Member States, nongovernmental organizations and other observers attended the meeting which took place from 22-27 May.
The Fifty-ninth WHA opened in a sombre mood following the sudden death on Monday morning of Dr LEE Jong-wook, WHO Director-General. Dr Lee, who was 61, had been in his post since July 2003.
Opening the formal proceedings of the Assembly, the Minister of Health of Spain, Elena Salgado, said Dr Lee "was an exceptional person and an exceptional Director-General." The Assembly observed a two-minute silence. Hundreds of WHA delegates signed books of condolence, adding to hundreds of tributes and messages which came in from people around the world.1
A special session of the Executive Board on 23 May appointed Dr Anders Nordström, previously Assistant Director-General for General Management, as Acting Director-General until a new Director-General is appointed and takes office.
The President of the 59th World Health Assembly was Professor Paulo Ivo Garrido, the Minister of Health of Mozambique.
Excerpts from a speech prepared by Dr Lee were read out to the Assembly by Dr Bill Kean, Executive Director of the Director-General's Office. In the speech, Dr Lee had set out his commitment to tackle difficult problems and change expectations. "What matters in reform is not words but action," he wrote. "I hope that the actions of this Organization speak for themselves." His report highlighted, among other issues, the need to urgently address the health worker shortage, to ensure universal access to HIV/AIDS treatment by 2010, to do much more to tackle malaria, and to put an end to polio.
The Assembly was also introduced to a young activist from Kenya, Johnson Mwakazi, who passionately urged an end to the stigmatization of people who are living with HIV/AIDS through his poem, “Underneath the Veil.”
The keynote speaker was His Royal Highness, The Prince of Wales, President of The Prince's Foundation for Integrated Health and Patron of a number of health charities. The Prince spoke of the importance of integrated health, which includes an integrated approach to nutrition, medicine, agriculture, the environment and social policies.
Delegates from 187 Member States, and more than 500 delegates representing 75 non-governmental organizations took part in discussions on several issues and resolutions over the six-day Assembly.
In his closing remarks to the WHA Plenary on 27 May, Dr Anders Nordström, WHO Acting Director-General, remembered Dr Lee, and his determination to see polio eradication completed. "In his memory, and in honour that all of that he stood for, let us commit with absolute dedication to see that goal quickly accomplished."
Summary of decisions and issues discussed at the 59th World Health Assembly
Highlights of the Assembly included the agreement to voluntarily implement parts of the International Health Regulations2 immediately, in particular those which relate to avian influenza and to a potential pandemic of human influenza. The provisions identified for early voluntary compliance include those relating to rapid and transparent notification, support to countries that request it in investigating and controlling outbreaks, and providing essential information including recommendations for control measures. The IHR (2005) were formally adopted at the Fifty-eighth World Health Assembly in 2005 and are to go into effect in 2007.
To support polio eradication, the Assembly adopted a resolution calling for increased focus on interrupting transmission in polio endemic areas, adherence to rapid response standards in case of importation of poliovirus and technical advice on planning for a post-eradication world. During the Assembly, WHO honoured a founding personality in the global effort to eradicate polio, William T. Sergeant, who for 12 years has led the programme overseeing polio eradication within Rotary International.3
With regard to HIV/AIDS, Member States congratulated WHO on the success of its contribution to the "3 by 5" initiative and expressed their strong support for the development of a five year plan to help to achieve universal access. Member States considered three specific issues. The first item addressed WHO's contribution to scaling up towards universal access to HIV/AIDS prevention, treatment and care. The WHA passed a resolution on HIV/AIDS and nutrition, which calls on Member States to ensure that special attention be given to integrating nutrition into all HIV/AIDS policies and programmes and to ensure that countries are able to develop evidence-based policies and programmes on HIV/AIDS and nutrition. The Assembly also passed a resolution calling upon WHO to work more closely with other UN agencies and donors to ensure a more coordinated support to countries in implementing their national HIV/AIDS responses.
A resolution on infant and young child nutrition urges Member States to renew their commitment to policies and programmes related to implementation of the International Code of Marketing of Breast-milk Substitutes and to revitalize the Baby-Friendly Hospital Initiative, and requests the Director-General to mobilize technical support in the implementation and independent monitoring of the Code.
The Assembly adopted a draft strategy for the prevention and control of sexually transmitted infections (STIs). The Global Strategy provides a framework for countries to improve and accelerate their STI programme and ensure that it is well integrated and linked with other services for family planning, maternal health, and HIV prevention and care. The WHA reinforced the importance of comprehensive interventions, particularly for young people, which provide full information, life-skills, education and care for the prevention and management of STIs.
In order to address the need for people in developing countries to access necessary medicines, vaccines and diagnostics, the Assembly also agreed to an intergovernmental working group open to all interested Member States to draw up a global strategy and plan of action in order to provide a medium-term framework based on the recommendations of the Commission on Intellectual Property Rights, Innovation and Public Health. The working group shall report to the Sixtieth World Health Assembly on the progress made, giving particular attention to needs-driven research and other potential areas for early implementation action. The working group shall submit the final global strategy and plan of action to the Sixty-first World Health Assembly.
The WHA adopted a resolution on International Trade and Health. The WHA urged Member States to work at national level to coordinate trade and health policies among the ministries of finance, health, and trade, and to engage other relevant public and private-sector stakeholders in dialogue on the challenges and opportunities that international trade and trade agreements present for public health. The Assembly called on the WHO Secretariat to support Member states' abilities to develop coherence in their trade and health policies, and to work with other competent international organizations on policy coherence and in generating and sharing of evidence on the relationship between trade and health.
The World Health Assembly expressed concern at the deterioration of the economic and health conditions as well as the humanitarian crises resulting in the occupied Palestinian territory including east Jerusalem and the occupied Syrian Golan. The Assembly adopted a resolution and requested the Director-General to organize a one-day emergency meeting to address this crisis, and to continue support to the Palestinian health services.
Given the world-wide shortage of health workers and their centrality to countries' health systems, the WHA adopted a resolution on the rapid scaling up of health workforce production. The resolution urges countries to promote training, including training partnerships, and financial support for health training institutions in developing countries. WHO will provide technical support to countries in these efforts. The WHA also confirmed its commitment to strengthen nursing and midwifery, including by establishing programmes which will support the recruitment and retention of nurses and midwives, and asked WHO to ensure that nurses and midwives are involved in planning for human resources for health.
In addition, a new alliance to address the worldwide shortage of nurses, doctors, midwives and other health workers was launched on 25 May. The Global Health Workforce Alliance4 will seek practical approaches to improve working conditions, address issues of migration, and start a programme to train more health workers in countries where there are shortages. The Alliance will also serve as an international information hub and monitoring body.
Countries expressed their concern that emergency preparedness in many countries is weak, and may not be able to cope with large-scale disasters. The WHA passed a resolution on emergency preparedness and response, requesting countries to further strengthen national emergency mitigation, preparedness, response, and recovery programmes, with a special focus on building health systems and community resilience. WHO will explore and implement measures to enhance the Organization's participation in the overall humanitarian response, and will compile a global database of authoritative technical health references in order to facilitate health sector response to emergencies and crises.
WHA Member States adopted the ten-year framework outlining the strategic direction for health partners across the globe, in light of the world's health challenges. The "Global Health Agenda" identifies seven priority areas including building global health security, promoting universal coverage, addressing the determinants of health and strengthening health systems, among others. This work is a result of broad consultation with Member States and partners over the past two years and analyzes the critical gaps in improving people's health, in particular that of the poor.
Recognizing sickle-cell anaemia as a common genetic disorder among people whose ancestors come from sub-Saharan Africa, India, Saudi Arabia and the Mediterranean and that about 300 000 infants are born with major hemoglobin disorders each year, the WHA adopted a resolution to develop and strengthen efforts to prevent and manage sickle-cell anaemia, particularly in affected low and middle income countries.
The WHA also resolved to intensify action in order to achieve the aim of preventing avoidable blindness. The goal is to eliminate avoidable blindness by the year 2020 and to halt and reverse the projected doubling of avoidable visual impairment in the world. WHO will continue to work towards this goal in partnership with the International Agency for the Prevention of Blindness, as part of "VISION 2020 - the Right to Sight".
The Assembly referred to The Global Strategy on Diet, Physical Activity and Health (DPAS) which was endorsed at the WHA in May 2004, the aim being to address unhealthy diet and physical inactivity, two of the major risk factors responsible for the growing burden of chronic diseases, including heart disease, stroke, diabetes and cancer. The biannual report to the WHA notes that while some progress has been made towards implementation of DPAS recommendations, the results are not universal. WHO will be developing additional recommendations to strengthen the implementation of the Strategy.
The Assembly reported on the outcome of the first session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control which was held from 6 to 7 February 2006, and confirmed the COP decision that the permanent secretariat, to be called the Convention Secretariat, will be established within WHO and located in Geneva.
Achievements of the World Alliance for Patient Safety since its launch in October 2004 were welcomed by Member states and non-governmental organizations. These include the active involvement of Member States in the Global Patient Safety Challenge "Clean Care is Safer Care" and other technical action areas such as reporting and learning, and active patient involvement.
The Assembly also considered several administrative issues.
The following issues have been deferred to the Executive Board in January 2007:
- destruction of variola virus stocks;
- health promotion in a globalized world;
- and WHO's role and responsibilities in health research.
The Sasakawa Health Prize was awarded to the International Leprosy Union (ILU), India and the Agape Rural Health Programme (Holistic Community Development Programme) of Puerto Princesa City, Palawan, Philippines. The Award should be shared between the two candidates. Each laureate will receive US$ 40 000.
The United Arab Emirates Health Foundation Prize was awarded to the Rafic Hariri Foundation, Lebanon and Ms. Aminath Jameel, Executive Director Manfaa Centre on Ageing, Maldives. The laureates will receive US$ 20 000 each.
The State of Kuwait Prize for Research in Health Promotion was awarded to the Association, Early Psychosis Intervention Programme, Singapore. The laureate will receive US$ 20 000.
New members of the Executive Board were elected, including two additional members. There will now be a total of 34 members instead of 32 representing the following countries: Afghanistan, Australia, Azerbaijan, Bahrain, Bhutan, Bolivia, Brazil, China, Denmark, Djibouti, El Salvador, Iraq, Jamaica, Japan, Kenya, Latvia, Lesotho, Liberia, Libyan Arab Jamahiriya, Luxembourg, Madagascar, Mali, Mexico, Namibia, Portugal, Romania, Rwanda, Singapore, Slovenia, Sri Lanka, Tonga, Thailand, Turkey, USA.
This Executive Board will meet from 29 May to 31 May. The process of election of a new Director-General will be on the agenda.
At the WHA, there were five Vice-Presidents: Mr A.A. Miguil (Djibouti) Dr M. Soledad Barria (Chile), Mr Pehin Suyoi Osman (Brunei Darussalam) Mr E. Nicolaescu (Romania) and Dr Siti Fadilah S.Supari (Indonesia).
The Chairmen of Committee A was Dr Anbumani Ramadoss, (India) and the Chairman of Committee B was Dr Ali Jaffer Mohammad (Oman) .
1 A tribute page in memory of Dr LEE Jong-wook
2 World Health Assembly agrees to immediate voluntary implementation of influenza-related provisions of International Health Regulations (2005)
3 WHO honours polio eradication visionary
4 New global alliance seeks to address worldwide shortage of doctors, nurses and other health workers
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