140th Session of WHO Executive Board
The annual address of the WHO Director-General to the executive board is always a good measure of the current state of affairs in global public health. Middle East Health publishes an edited version of Dr Margaret Chan’s speech on January 23 in Geneva.
The World Economic Forum (in January) identified rising income and wealth inequality as the most significant trend that will shape global development over the next 10 years.
In a world facing considerable uncertainty, international health development remains a unifying force and a solid reference point for delivering fair social outcomes under the 2030 Agenda for Sustainable Development.
Key WHO achievements over just the past few months illustrate the range of our work and its impact on the lives of people, especially vulnerable groups.
At the start of this year, WHO and the US National Cancer Institute published a landmark report on the economics of tobacco and tobacco control. At nearly 700 pages, this is a definitive assessment, prepared by more than 60 authors and peer-reviewed by an additional 70 experts.
The report shows how tobacco control, including significant tax increases on tobacco products, can save lives while also generating revenues for health and development.
As documented, the economic losses caused by smoking far outweighs global revenue from tobacco taxes, estimated at nearly $270 billion in 2013-2014.
If all countries raised cigarette taxes by about 80 cents per pack, annual tax revenues could increase by 47%, amounting to an additional $140 billion per year.
The overarching conclusion is stark: tobacco control makes good economic sense and does not harm economies. The evidence is abundant and compelling. It ought to put an end to one of the tobacco industry’s most frequent and effective arguments.
Ministers of health are convinced by the evidence. I ask you to be vocal in persuading ministers of finance, trade, foreign affairs, and others not to be swayed by industry’s false claims.
It takes courage to issue reports that antagonize powerful economic operators. Economic power readily translates into political power.
It falls to WHO to do this. If we fail toaccept this responsibility, we will never make sufficient progress against lifestylerelated noncommunicable diseases.
In September 2016, WHO and industry groups announced new financing arrangements, in line with industry practices, that will sustainably finance the WHO Prequalification Programme from now into the future.
The programme is one of our most successful initiatives. It has transformed the market for public health vaccines and other medical products, making supplies more abundant and predictable, and prices affordable.
In addition, the new financing model is designed to ensure equity among manufacturers, with provisions included to enable small manufacturers that meet quality safety and efficacies standards to enter the market on an equal footing with large companies.
More good news for affordable medicines came the next month, when WHO released a report documenting dramatic price reductions for a revolutionary cure for hepatitis C infections. Strategies used include price negotiations, local production, and licensing agreements that promote competition among generic manufacturers.
As noted in the report, price reductions have made treatment possible for more than 1 million people living with chronic hepatitis C infection in the developing world.
Last September, WHO released country air quality estimates showing that 92% of the world’s population lives in places where air pollution levels exceed WHO limits.
That same month, WHO announced an end to the largest emergency vaccination campaign against yellow fever ever undertaken in Africa. A crisis was averted.
More good news came in November, when WHO statistics showed that measles immunization over the past 15 years has spared more than 20 million young lives. That good news contrasts sharply with the hundreds of measles deaths that are still occurring every day.
And, of course, our annual reports on the HIV, tuberculosis, and malaria situations made headlines, with the best news coming from the shrinking malaria map.
The achievement that brought the most joyful headlines came at the end of last year, when WHO published final trial results demonstrating that the new Ebola vaccine confers nearly 100% protection. Several media outlets covered the vaccine results as the year’s most uplifting news.
We have by no means defeated this re-emerging disease, but when the next outbreak inevitably occurs, responders will not be empty-handed. I thank our many partners, countries who supported that clinical trial, including thegovernment and people of Guinea, for making this happen.
Outbreaks and emergencies response
WHO has given the research community a shortlist of especially worrisome pathogens with epidemic potential.
The R&D blueprint, developed in response to lessons learned during the Ebola outbreak, has been immediately applied to expedite the development of new medical products for Zika virus disease. It aims to cut the time needed to develop and manufacture candidate products from years to months.
As a contribution to the global health emergency workforce which is very important to many countries, the initiative for building up a strike force of emergency medical teams has moved forward quickly. Through this initiative, international preparedness to provide clinical care during emergencies has been structured and standardized.
The requirements for WHO verification 140th Session of WHO Executive Board and registration are high. Having the competence of an emergency team peerreviewed and verified is a source of great national pride. Many countries have already done that and many countries have registered. This is life-saving capacity building at its best. It is rapidly making order out of a situation historically prone to chaos.
To date, legally binding agreements have secured access to around 350 million doses of vaccine to be delivered, as they roll off the production line, during the next influenza pandemic.
Partnership financial contributions from industry for which I am grateful have been invested to build surveillance, laboratory, regulatory, and other capacities in developing countries.
This is a ground-breaking model for partnership with the private and nongovernmental sectors to ensure greater fairness in global public health. It is also a model for global solidarity that addresses critical policy, operational, and capacity barriers ahead of an emergency.
The world is better prepared for the next influenza pandemic, but not at all well enough.
I am asking all countries to keep a close watch over outbreaks of avian influenza in birds and related human cases. Just since November of last year, nearly 40 countries have reported fresh outbreaks of highly pathogenic avian influenza in poultry or wild birds.
The rapidly expanding geographical distribution of these outbreaks and the number of virus strains currently cocirculating have put WHO on high alert. For example, the H5N6 virus causing severe outbreaks in Asia is a new strain created by gene-swapping among four different viruses.
Since 2013, China has reported seasonal epidemics of H7N9 infections in humans, now amounting to more than 1,000 cases, of which 38.5% were fatal.
The latest epidemic, which began in late September 2016 and since December has shown a sudden and steep increase in cases. In two clusters, WHO could not rule out limited human-to-human transmission, though no sustained transmission has been detected to date.
As required by the International Health Regulations, all countries must detect and report human cases promptly. We cannot afford to miss the early signals.
Tobacco control can
save billions of dollars, millions of lives
Policies to control tobacco use, including tobacco tax and price increases, can generate significant government revenues for health and development work, according to a new landmark global report from WHO and the National Cancer Institute of the United States of America. Such measures can also greatly reduce tobacco use and protect people’s health from the world’s leading killers, such as cancers and heart disease.
But left unchecked, the tobacco industry and the deadly impact of its products cost the world’s economies more than US$ 1 trillion annually in healthcare expenditures and lost productivity, according to findings published in The economics of tobacco and tobacco control. Currently, around 6 million people die annually as a result of tobacco use, with most living in developing countries.
The almost 700-page monograph examines existing evidence on two broad areas:
“The economic impact of tobacco on countries, and the general public, is huge, as this new report shows,” says Dr Oleg Chestnov, WHO’s Assistant Director-General for Noncommunicable Diseases (NCDs) and mental health. “The tobacco industry produces and markets products that kill millions of people prematurely, rob households of finances that could have been used for food and education, and impose immense healthcare costs on families, communities and countries.”
Globally, there are 1.1 billion tobacco smokers aged 15 or older, with around 80% living in low- and middleincome countries. Approximately 226 million smokers live in poverty.
The monograph, citing a 2016 study, states that annual excise revenues from cigarettesglobally could increase by 47%, or US$ 140 billion, if all countries raised excise taxes by about US$ 0.80 per pack. Additionally, this tax increase would raise cigarette retail prices on average by 42%, leading to a 9% decline in smoking rates and up to 66 million fewer adult smokers.
“The research summarized in this monograph confirms that evidence-based tobacco control interventions make sense from an economic as well as a public health standpoint,” says the monograph’s co-editor, Distinguished Professor Frank Chaloupka, of the Department of Economics at the University of Illinois at Chicago.
The monograph’s major conclusions include:
|Date of upload: 18th Mar 2017|
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