The 64th World Health Assembly, with more than 2,700 delegates, including health ministers and senior health officials from 192 World Health Organization (WHO) member states, nongovernment organizations, civil society groups and other observers concluded business on Tuesday afternoon.
The World Health Assembly spent eight days working through a broad agenda developed by the previous executive board. In the end, 28 resolutions and three decisions were adopted to guide the upcoming work of the organization and to address priority global health issues.
"I believe this has been an especially productive and profoundly effective Assembly," says Dr. Margaret Chan, director-general of the WHO. "These World Health Assemblies are having a tremendous impact on the health of this world."
After opening speeches from Chan, Sheikh Hasina (prime minister of Bangladesh ) and Bill Gates, co-chair of the Bill & Melinda Gates Foundation, the policy work of the Health Assembly began with a presentation of outcomes from the independent Review Committee which reviewed WHO's response to the influenza pandemic and the International Health Regulations. After a year of investigation, the committee agreed that the International Health Regulations helped better prepare the world to cope with public health emergencies but that the world is currently ill prepared to respond to a severe pandemic or to any other public health emergency on a similarly global and threatening scale. In addition, the Committee declared that the pandemic (H1N1) 2009 was indeed a real pandemic and found no evidence WHO was influenced by industry in its decision making.
Improving global preparedness for future pandemics
In another agenda item aimed to improve global preparedness for future pandemics, delegates approved a framework for pandemic influenza preparedness, the culmination of four years of negotiation between WHO's Member States. The framework will improve influenza virus sharing and access to vaccines and other benefits. Member States agreed the framework lays the groundwork for better preparedness and better access to tools and knowledge. The next phase is to ensure the implementation of the agreement.
Five resolutions to strengthen health systems
Progress on prevention and control of NCD and the achievement of the Millennium Development Goals (MDGs) will require strong health systems and the Assembly recognized the importance of this area of work. The delegates approved five resolutions to strengthen health systems including strategies to strengthen nursing and midwifery, actions to improve the health workforce through effective implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel, and efforts to improve national policy dialogue to build more robust health policies, strategies and plans. In addition two other resolutions encourage sustainable health financing structures and universal coverage of health care and services, and focus on strengthening national health emergency and disaster management capacities and resilience of health systems.
Resolutions and reports support health-related MDGs
Health-related MDGs received support with resolutions and reports on immunization strategy, infant and young child nutrition, child injury prevention, safe management of drinking water, malaria, and the presentation of the final report of the Commission on Information and Accountability for Women's and Children's Health.
The progress report on the global immunization vision and strategy was widely supported. Delegates highlighted their country's achievements in increasing immunization coverage, reducing vaccine-preventable deaths and implementing advocacy events such as the regional immunization weeks. But they also recognized that several challenges remain, including mobilizing more resources to strengthen national immunization programmes; ensuring a balanced approach in strengthening immunization systems; introducing new vaccines; preventing a resurgence of measles through high vaccination coverage; and facilitating vaccine technology transfer to developing countries. The work outlined in the strategy will contribute to overcoming these challenges.
Member states commend WHO's leadership and collaboration with UNICEF, the Bill & Melinda Gates Foundation, and other partners on the Decade of Vaccines -- a vision for using the next 10 years to achieve immunization goals and reach important milestones in vaccine research, development, financing and public support.
A new, comprehensive strategy to combat HIV
The Health Assembly adopted a new, comprehensive strategy to combat HIV, The Global Health Sector Strategy on HIV/AIDS, 2011-2015, which will guide actions by WHO and countries around the world during this critical time for the future of the HIV response. At least 4.2 million new HIV infections would be averted and 2 million lives could be saved, if WHO's existing HIV treatment recommendations were fully implemented in 2011-2015. Under the new Strategy, WHO aims to promote greater innovation in HIV prevention, diagnosis, treatment, and care services so that countries can achieve the goal of universal access to HIV services.
Reaffirmed that the remaining stock of smallpox virus should be destroyed
The Health Assembly strongly reaffirmed the decision of previous Assemblies that the remaining stock of smallpox (variola) virus should be destroyed when crucial research based on the virus has been completed. The state of variola virus research will be reviewed at the 67th World Health Assembly in 2014 and in light of that, determining a date for destruction of the remaining virus stocks will be discussed.
Annual report on the eradication guinea-worm disease
The delegates adopted a resolution paving the way for an annual report on the eradication of dracunculiasis (more commonly known as guinea-worm disease) to be presented every year beginning with the next Health Assembly. Dracunculiasis is the second disease which is approaching eradication (the first being smallpox) and it occurs only after people drink contaminated water. Previously it was responsible for millions of infections across Africa and Asia. The disease mainly occurs in remote poverty-stricken areas, with limited or no access to safe drinking water.
Strong commitment to polio eradication
The global health community sent a sign of strong commitment to polio eradication with discussion focusing on the 'significant advances' since the launch of a new strategic plan and new, bivalent oral poliovirus vaccine in 2010. In India and Nigeria -- the source of all importations of wild poliovirus into previously polio-free countries in recent years -- polio cases declined by 95 percent between 2009 and 2010; during the same period polio cases due to the type 3 virus declined by 92 percent globally. Delegates called for strong national and subnational leadership by political authorities for the implementation of polio eradication strategies and highlighted the need for countries to significantly strengthen routine immunization. Delegates expressed particular concern over the funding gap of US$ 665 million to fully carry out polio eradication activities in 2011 and 2012. Delegates requested WHO to provide additional technical support to countries with ongoing, re-established polio transmission (Angola, Chad, Democratic Republic of the Congo), to continue to pursue research for post-eradication risk management and to help countries maintain high-quality surveillance and population immunity until eradication is complete globally.
Revitalizing the Global Task Force on Cholera Control
Delegates agreed that cholera remains public health threat for many countries and the incidence is on the rise. They expressed the urgent need for effective public health interventions, such as solid surveillance systems, improved environmental management, access to clean water and proper sanitation, and the adequate use of cholera vaccines as a complementary measure. Cholera was recognized as an indicator of how well the environment is managed. Member States underscored the need to revitalize the Global Task Force on Cholera Control and emphasized the need to scale up advocacy measures.
Improving access to safe water and sanitation
The WHA adopted a resolution to reinvigorate efforts in clean drinking water, sanitation and health. Waterborne diseases continue to kill more than two million people per year. Member states called for WHO to strengthen its major normative functions on water and health, and expand its monitoring role of progress toward access to safe water and sanitation. The resolution also underscores the need for continued capacity development by strengthening health policy at all levels.
Protect public health from chemicals and waste
Delegations acknowledged the need to better handle chemicals and waste management to protect public health. They agreed that special attention should be given to the management of pesticides and other chemicals to prevent stockpiles of unwanted chemicals accumulating and to prevent human exposure through contaminated air and water. As a follow-up to the phasing out of mercury from healthcare facilities, Member States requested WHO through the Libreville Declaration on Health and Environment and other global initiatives to maintain healthcare waste management as a priority issue on its public health agenda, to protect the environment and ensure safety of staff, waste workers and communities.