New resolutions
to improve global public health

The 63rd World Health Assembly, which brought together Health Ministers and senior health officials from the World Health Organisation’s Member States, discussed a wide range of global public health issues and issued a number of resolutions. Middle East Health provides a summary of the key points.

Medicine is one sphere of human endeavour where there is often a strong show of global unity. This was much in evidence at the 63rd World Health Assembly in Geneva. The annual fiveday meeting concluded on 22 May with a range of international agreements that are designed to improve global public health in an increasingly interconnected world.

“You reached agreement on some items that are a real gift to public health, everywhere. We now have a code of practice on the international recruitment of health personnel,” Dr Margaret Chan, WHO Director-General, told delegates in her closing remarks. “In addition, you have given public health a policy instrument and guidance for tackling one of the world’s fastest growing and most alarming health problems. This is the rise of chronic noncommunicable diseases, like cardiovascular disease, cancer, diabetes, and chronic respiratory disease.”

More than 2,800 delegates attended the World Health Assembly this year.


The delegates adopted resolutions on a variety of global health issues including:

Public health, innovation and intellectual property

The issue of intellectual property is critical for 4.8 billion people who live in developing countries, more than 40% of them living on less than US$2 a day. Poverty affects their access to health products to fight disease. The debate this year focused on financing issues, including the rational use of funds, and conducting research through regional networks. The global strategy proposes that WHO should play a strategic and central role in the relationship between public health and innovation and intellectual property within its mandate. The strategy was designed to promote new thinking in innovation and access to medicines, which would encourage needs-driven research rather than purely market-driven research. A new consultative working group will examine the way to take this work forward and is expected to report back to the 65th Health Assembly in 2012.

Counterfeit medical products

A working group on counterfeit medical products proposed, and the Health Assembly accepted, that WHO convene an intergovernmental working group, participation in which is to be open to all Member States. This group will examine WHO’s:

● role in ensuring availability of goodquality, safe, efficacious and affordable medicines

● relationship with the International Medical Products Anti-Counterfeiting Taskforce (IMPACT)

● role in prevention and control of substandard/spurious/falsely-labelled/ falsified/counterfeit medical products.

The working group will make specific recommendations to the 64th World Health Assembly, in 2011.

Viral hepatitis

Member States accepted the report to the World Health Assembly and adopted a resolution including a World Hepatitis Day on 28 July. Viral hepatitis (i.e. hepatitis A, B, C, D and E) – a combination of diseases that are estimated to kill over 1 million people each year and an estimated 1 in 12 persons are currently infected and have to face a life with liver disease if unrecognised. This endorsement by Member States calls for WHO to develop a comprehensive approach to the prevention and control of these diseases.

Health-related Millennium Development Goals

The resolution expresses concern at the relatively slow progress in attaining the Millennium Development Goals (MDGs), particularly in sub-Saharan Africa and at the fact that maternal, newborn and child health as well as universal access to reproductive health services remain constrained by health inequities. Member States noted that MDGs 4 and 5 were lagging behind and agreed to strengthen national health systems as well as take into account health equity in all national policies. They also reaffirmed the value of primary health care and renewed their commitment to prevent and eliminate maternal, newborn and child mortality and morbidity.

International recruitment of health personnel

The code of practice on the international recruitment of health personnel aims to establish and promote voluntary principles and practices for the ethical international recruitment of health personnel. It provides Member States with ethical principles for international health worker recruitment that strengthen the health systems of developing countries. It discourages states from actively recruiting health personnel from developing countries that face critical shortages of health workers, and encourages them to facilitate the “circular migration of health personnel” to maximise skills and knowledge sharing. It also enshrines equal rights of both migrant and non-migrant health workers.

● International recruitment of health personnel: draft global code of practice – 3 December 2009

Food Safety

A large number of countries noted many diseases can be caused by unsafe food, that national food production systems are susceptible for food safety problems and that more food is traded across borders than ever before. The resolution supports improving the evidence base to estimate the burden of food borne diseases and the strengthening of global networks including INFOSAN (International Food Safety Authorities Network) and to improve the assessment, management and communications of foodborne and zoonotic risks in a timely manner.

WHO is encouraged to continue working directly with FAO and OIE to strengthen public health, support economic development, and continue joint risk assessments through WHO/FAO expert bodies, and establishment of standards through the FAO/WHO Codex Alimentarius Commission.

Noncommunicable diseases: global strategy

Noncommunicable diseases – mainly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes – kill nearly 35 million people per year. Almost 90% of fatalities before the age of 60 occur in developing countries and are largely preventable.

Member States reviewed progress achieved during the first two years in implementing the Action Plan for the Global Strategy on the Prevention and Control of Noncommunicable Diseases. Member States highlighted successful approaches in:

● implementing interventions aimed at monitoring noncommunicable diseases and their contributing factors;

● addressing risk factors and determinants supported by effective mechanisms of intersectoral action; and

● improving health care for people with noncommunicable diseases through health system strengthening.

Developing countries also underlined that official development assistance in building sustainable institutional capacity to tackle noncommunicable diseases remains insignificant.

Strategies to reduce the harmful use of alcohol

Each year, 2.5 million people worldwide die of alcohol-related causes. Harmful drinking is a risk factor for noncommunicable diseases and is also associated with various infectious diseases, as well as road traffic accidents, violence and suicides. For the first time, delegations from all Member States reached consensus on a resolution to confront the harmful use of alcohol. In addition to the resolution, Member States discussed a global strategy to reduce the harmful use of alcohol which sets priority areas for action and recommends a portfolio of policy options and measures.

Global eradication of measles

Member States endorsed a series of interim targets set for 2015 as milestones towards the eventual global eradication of measles. Countries were encouraged by the efforts and progress made in controlling measles but also highlighted the challenges that need to be addressed to achieve the 2015 targets. These include competing public health priorities, weak immunisation systems, sustaining high routine vaccination coverage, addressing the funding gap, vaccinating the hard-to-reach population and addressing an increasing number of measles outbreaks particularly in cross border areas. Success in achieving the measles 2015 targets is a key issue if the Millennium Development Goal 4 to reduce child mortality is to be reached.

Blood products

The resolution paves the way to increase access to safe blood transfusion and to safe and affordable blood products in developing countries by encouraging them to establish national regulatory systems, using expertise and regulatory experience that already exists in other parts of the world.

Human organ and tissue transplantation

New guidelines on human organ and tissue transplantation, add two new guiding principles to existing guidance. The first improves safety, quality and efficacy of both donation and transplantation procedures, as well as the human materials used. The second increases transparency, while ensuring the protection of the anonymity and privacy of donors and recipients.

Treatment and prevention of pneumonia

WHO Member States adopted a resolution on the treatment and prevention of pneumonia – the number one killer of children under five years globally. The resolution makes it clear that intensified efforts to address pneumonia are imperative if the achievement of Millennium Development Goal 4 is to be achieved.

Infant and young child nutrition

About 112 million children worldwide are underweight and 186 million children under five are stunted (i.e. low height-forage), 90% living in 36 countries. Malnutrition in children is related to inappropriate infant and young child feeding practices. Globally, only 35% of infants less than six months of age are exclusively breastfed and complementary feeding practices are far from optimal. Improvement of breastfeeding practices could save annually the lives of about one million children. Complementary feeding along with continual breastfeeding for up to two years or beyond could save the lives of another half a million children. The resolution includes a call for increased political commitment, the implementation of the global strategy for infant and young child feeding, and strengthening of nutritional surveillance systems and improved use of millennium development goal indicators to monitor progress.

Birth defects

A resolution was adopted to help redress the limited focus to date on preventing and managing birth defects, especially in low- and middle-income countries. The resolution calls on Member States to prevent birth defects wherever possible, to implement screening programmes, and to provide ongoing support and care to children with birth defects and their families.

Pandemic influenza

Members States expressed strong support for the continuing efforts of the Open- Ended Working Group to further global pandemic influenza preparedness by strengthening the sharing of influenza viruses and of benefits such as vaccines. Member States spoke on the progress made at the recent intergovernmental meeting (held 10-12 May 2010) and characterised the interaction as transparent, substantive, collaborative and an important foundation for future negotiation in this area. The role of industry as a stakeholder in the process to increase global capacity for vaccine production, increased technology transfer to developing countries, and access to supplies of vaccine and medicines at affordable prices for resource-limited countries were among issues raised. A number of countries urged the collaboration to move forward to increase pandemic preparedness and protect global public health. Having considered the report of the Open-Ended Working Group (15 April 2010), a resolution was passed:

● to request the Director-General to continue to support the effort and undertake any technical consultations and studies as necessary

● to decide that the group will report through the Executive Board to the Sixtyfourth World Health Assembly (May 2011)

International Health Regulations (2005

The first report of the of the review committee assessing the functioning of the International Health Regulations (IHR) during pandemic influenza was discussed. Delegates stressed that the IHR is broader than pandemic and plays a vital role in global public health, and their countries fully support IHR implementation. Delegates detailed activities that their countries are carrying out to implement the regulations at national and regional levels. Member States underscored the need for individual, country-based capacity strengthening, learning from past lessons, the importance of flexibility and of reaching out beyond the health sector. They further expressed their appreciation of the IHR training and awareness raising activities supported by WHO and stressed the importance of monitoring IHR implementation. They also emphasised the need for strong communication and partnerships.

Occupied Palestinian territory

Looking at the deteriorating health conditions in the occupied Palestinian territory, the WHA adopted a resolution calling on Israel to end the siege of the Gaza Strip, among other directives. (See report over page).

ate of upload: 15th Aug 2010

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