World Health Assembly

Public health challenges
‘growing in complexity’


World Health Assembly The 67th World Health Assembly wrapped up its 5-day session in Geneva on 24 May, after adopting more than 20 resolutions on public health issues of global importance. Middle East Health reports.

“This has been an intense Health Assembly, with a record-breaking number of agenda items, documents and resolutions, and nearly 3500 registered delegates,” said Dr Margaret Chan, WHO’s Director-General. “This is a reflection of the growing number and complexity of health issues, and your deep interest in addressing them.”

In her opening address to the Health Assembly, Dr Chan voiced her deep concern about the increase worldwide of childhood obesity, with numbers climbing fastest in developing countries. “As the 2014 World Health Statistics report bluntly states, ‘Our children are getting fatter,’” she said.

To gather the best possible advice on dealing with this crisis, Dr Chan announced that she has established a highlevel Commission on Ending Childhood Obesity. The Commission - co-chaired by Sir Peter Gluckman, Chief Science Advisor to New Zealand’s Prime Minister, and Dr Sania Nishtar, founder of Pakistan’s health policy think tank, Heartfile – will produce a consensus report specifying which approaches are likely to be most effective in different contexts around the world. The recommendations of the report will be announced at next year’s Health Assembly.


Dr Chan challenged the Health Assembly to consider the potential impact on health worldwide of the changing poverty map – with 70% of the world’s poor living in middle-income countries with emerging economies. “Will economic growth be accompanied by a proportionate increase in domestic budgets for health? Will countries put polices in place to ensure that benefits are fairly shared?” she asked. “If not, the world will see a growing number of rich countries full of poor people.”

Climate Change

She also alerted delegates to the importance of addressing climate change: “In March, the Intergovernmental Panel on Climate Change issued its most disturbing report to date, with a strong focus on the consequences for health.” Many delegates focused on the links between climate and health in the Health Assembly’s opening plenary debate, particularly the impact of climate on important social and environmental determinants of health – clean air, safe drinking water, sufficient food and secure shelter.


Dr Chan warned about the resurgence of polio. “Two years ago, the international spread of polio virus had nearly ceased. Not anymore. At end-2013, 60% of polio cases resulted from international spread, with strong evidence that adult travellers were playing a role. The trend has continued this year, during the low transmission season for polio, a situation described by the emergency committee as “extraordinary”.

“What accounts for this change? Armed conflict that flies in the face of international humanitarian law. Civil unrest. Migrant populations. Weak border controls. Poor routine immunization coverage. Bans on vaccination by militant groups. And the targeted killing of polio workers.

“Two years ago, polio was on its knees, thanks to committed political leadership, better strategies and tools, and the dedication of millions of polio workers.

“The factors responsible for this setback are largely beyond the control of the health sector. They are only some of several dangers for health in a world shaped by some universal and ominous trends,” she cautioned.

“Given the challenges that lie ahead, and the high expectations for health, WHO’s dedicated and committed staff will need to perform better than ever. We are well-motivated to do so.

“Better health is a good way to track the world’s true progress in poverty elimination, inclusive growth, and equity.”


Key resolutions adopted at the World Health Assembly

New global strategy and targets for tuberculosis

Member States approved a resolution endorsing a new global strategy and targets for tuberculosis (TB) prevention, care and control after 2015. The strategy aims to end the global TB epidemic, with targets to reduce TB deaths by 95% and to cut new cases by 90% by 2035. It sets interim milestones for 2020, 2025, and 2030. The resolution calls on governments to adapt and implement the strategy with high-level commitment and financing. It reinforces a focus within the strategy on serving populations highly vulnerable to infection and poor health care access, such as migrants. The strategy and resolution highlight the need to engage partners within the health sector and beyond, such as in the fields of social protection, labour, immigration and justice. The resolution requests the WHO Secretariat to help Member States adapt and operationalize the strategy, noting the importance of tackling the problem of multidrug-resistant TB and promoting collaboration across international borders. WHO is also asked to monitor implementation and evaluate progress towards the milestones and the 2035 targets.

The estimated number of people falling ill with tuberculosis each year is slowly declining and the world is on track to achieve the Millennium Development Goal to reverse the spread of TB by 2015. However, TB remains one of the world’s deadliest communicable diseases, present in all regions of the world. In 2012, 8.6 million people fell ill with TB and 1.3 million died from TB. Some 450,000 people developed multidrug-resistant TB in 2012. 

Antimicrobial drug resistance

The delegates recognized their growing concern of antimicrobial resistance and urged governments to strengthen national action and international collaboration. This requires sharing information on the extent of resistance and the use of antibiotics in humans and animals. It also involves improving awareness among health providers and the public of the threat posed by resistance, the need for responsible use of antibiotics, and the importance of good hand hygiene and other measures to prevent infections. The resolution urges Member States to strengthen drug management systems, to support research to extend the lifespan of existing drugs, and to encourage the development of new diagnostics and treatment options.

As requested in the resolution, WHO will develop a draft global action plan to combat antimicrobial resistance, including antibiotic resistance for presentation to the World Health Assembly for approval next year.

Addressing the global challenge of violence, in particular against women and girls

Across the world, each year, nearly 1.4 million people lose their lives to violence. Women and girls experience specific forms of violence that are often hidden. Globally, one in three women experience physical and/or sexual violence at least once in her life. For every person who dies as a result of violence, many more are injured and suffer from a range of adverse physical and mental health conditions.

Member States will work to strengthen the role of the health system in addressing violence. WHO will develop a global plan of action to strengthen the role of national health systems within a multisectoral response to address interpersonal violence, in particular against women and girls, and against children.

Access to essential medicines

WHO’s strategy to help countries improve access to essential medicines was approved. Key principles include selecting a limited range of medicines on the basis of the best evidence available, efficient procurement, affordable prices, effective distribution systems, and rational use. The WHO Essential medicines list was recognized as a valuable tool that enables countries to identify a core set of medicines which need to be available to provide quality medical care.

Health intervention and technology assessment in support of universal health coverage

Many countries currently lack the capacity to assess the merits of health technology. Health Technology Assessment (HTA) involves systematically evaluating the properties, effects, and/or impacts of different health technologies. Its main purpose is to inform technology-related policy-making in health care, and thus improve the uptake of cost-effective new technologies and prevent the uptake of technologies that are of doubtful value for the health system. Wasteful spending on medicines and other technologies has been identified as a major cause of inefficiencies in health service delivery.

Following the adoption of a resolution on HTA at the Health Assembly, WHO will support capacity-building for health technology assessment in countries. It will provide tools and guidance to prioritize health technologies and intensify networking and information exchange among countries to support priority setting.

Health in the post-2015 development agenda

Member States approved a resolution on health in the post-2015 development agenda, stressing the need for ongoing engagement in the process of setting the agenda. This includes a need to complete the unfinished work of the health Millennium Development Goals, newborn health, as well as an increased focus on non-communicable diseases, mental health, and neglected tropical diseases. The resolution also stresses the importance of universal health coverage and the need to strengthen health systems. Accountability through regular assessment of progress by strengthening civil registration, vital statistics and health information systems are crucial. Member States emphasized the importance of having health at the core of the post-2015 development agenda.

Newborn health: draft action plan

The first-ever global plan to end preventable newborn deaths and stillbirths by 2035, calls for all countries to aim for fewer than 10 newborn deaths per 1000 live births and less than 10 stillbirths per 1000 total births by 2035.

Every year almost 3 million babies die in the first month of life and 2.6 million babies are stillborn (die in the last 3 months of pregnancy or during childbirth). Most of these deaths could be prevented by cost-effective interventions.

The Plan’s goals will require every country to invest in high-quality care before, during and after childbirth for every pregnant woman and newborn and highlights the urgent need to record all births and deaths.


At the World Health Assembly, WHO Director-General Dr Margaret Chan and the President of the 67th World Health Assembly, Dr Roberto Tomas Morales Ojeda, awarded four prizes to leaders in public health.

The Ihsan Dogramaci Family Health Foundation Prize is awarded to Professor Zulfiqar Bhutta (Pakistan) for his global work on child and newborn survival and health.

The Sasakawa Health Prize is awarded to the Leprosy Control Foundation /Dominican Institution of Dermatology and Skin Surgery “Dr Hubert Bogaert Diaz” to expand services for children affected by skin diseases other than leprosy.

The United Arab Emirates Health Foundation Prize was awarded to the Institution for Research in Health (INISA) (Costa Rica) for its work on gastric cancer and occupational exposure to pesticides.

The Dr Lee Jong-wook Memorial Prize for Public Health was awarded jointly to Professor Sinata Koulla-Shiro (Cameroon) and the Czech Society of Cardiology (Czech Republic).

 Date of upload: 14th July 2014


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