World Health Assembly on 75th anniversary must confront new and growing threats

world health assembly held its annual general meeting on Sunday A congratulatory message commemorating the 75th anniversary of the founding of the World Health Organization in 1948.

The eradication of smallpox, the eradication of polio in most countries around the world, and the dramatic decline in deaths from once-fatal childhood diseases preventable by clean water, basic medicines and vaccines, will be the first of this year. Some of the historic achievements WHA celebrates as the 76th WHA Congress begins. WHO Director-General Dr Tedros Adhanom Ghebreyesus said in his opening remarks at the WHA.

“Smallpox is history, polio is on the brink, and epidemics of malaria, HIV and tuberculosis have all been brought under control,” Dr Tedros said.

Thanks to the Framework Convention on Tobacco Control, strict policies on tobacco advertising and taxes on tobacco products have reduced smoking rates in dozens of countries around the world.

he was talking At the WHA preview event on Sunday Just before the official closing of the WHA at the Center for Global Health at the Graduate School of Geneva. The latter included high-ranking officials from around the world, including Indian Prime Minister Narendra Modi and former New Zealand Prime Minister Jacinda Ardern.

Pandemic Treaty Negotiations to Combat Regional Conflicts

But despite these successes, this year’s WHA aimed to complement and replace now-outdated international rules, alongside complex and ongoing negotiations over an ambitious new pandemic treaty. It is being held against the backdrop of negotiations over the 2005 revision of the International Health Regulations. Emergency response.

WHA is also happening in the second year of the war between Russia and Ukraine. The fierce conflict Subjects of last year’s competing WHA resolutions – and it will likely happen again surface in debate This year was also announced by the International Health Organization.

And the war between Ukraine and Russia is just one of multiple conflicts destroying lives and global health. As this year’s WHA considers a new Health for Peace initiative, some 39 million people – almost one in 20 of the world’s population – are vulnerable to a combination of conflict and health emergencies. We live in a complex environment.

“That’s just a 25 percent increase from last year and double from 2015,” said Kate Dodson, vice president for global health at the United Nations Foundation, which co-sponsored the graduate WHA opening ceremony.

And while the WHA meeting this week is set to approve updated guidance to countries on the ‘best buy’ to reduce non-communicable diseases, data show NCD disease rates are soaring worldwide and heart disease is on the rise. It has increased by 60% in the last 30 years.Published by world heart summitwhich will be held in Geneva this weekend.

Meanwhile, the WHO is still in financial trouble. This year, for the first time in its history, the WHA will approve an increase in annual contributions by member states to the World Health Organization.

It will also establish a “replenishment fund” for voluntary donations from donors and member states that can be used by the organization in a more flexible way than the “directed” contributions that make up the majority of the current budget1. We will also discuss the Board’s recommendations for the month. .

Challenges far beyond the medical field

All in all, the 76-year-old organization is increasingly challenged by the need to consistently respond to the increasingly broad and complex threat of emerging diseases, but with the leverage and You often have very little control.

These include obesity, heart disease, and high blood pressure caused by a sedentary lifestyle and fast food diet. Antimicrobial resistance due to misuse and overuse of antibiotics in both human and animal health fields. Climate crisis and air pollution. And as COVID-19 has shown the world, there are wide disparities in access to healthcare, including critical medicines and vaccines.

“Currently, about 70% of deaths worldwide are due to non-communicable diseases,” Tedros said in his opening address to the WHA.

“Antimicrobial resistance threatens to undo centuries of medical progress. There are wide disparities in access to health care resources, both between countries and communities, and within countries and regions. threat to the survival of the planet is jeopardizing the very habitability of the planet.

“WHO has grown a lot, but our resources have not yet grown,” Tedros added. “Being a technical and scientific organization in a political and increasingly politicized environment presents challenges.

“These are daunting and complex issues. They are building a path that their grandchildren will walk and they will continue to build,” said Tedros.

“Today’s challenges are very different from those we faced in 1948. But the vision is the same.”

The 1969 International Health Regulations covered only four diseases

“then, [WHO] The International Health Regulations were enacted in 1969, but their goal was really to stop the disease at our borders,” former WHO senior official David Heyman noted at a WHA preview event at the Geneva Graduate School on Sunday morning. bottom.

“If a country reports one in four infections of cholera, yellow fever, plague or smallpox, countries accepting passengers from those countries can require vaccination certificates. At that time, WHO was the exclusive owner of much of the information, as there were pre-determined measures to stop the transmission of .”

The IHR finally underwent a major revision in 2005, greatly expanding the scope of what it reported and empowering the WHO to declare a Public Health Emergency of International Concern (PHEIC). , regulation has not kept up with its pace. He pointed out changes in the real world.

The biggest failure, he argues, is in “the most important part of the IHR.” It was a call for countries to establish public health core competencies that could detect, respond to, and prevent domestic disease epidemics and deaths, and ultimately prevent the international spread of infectious diseases. . This quick response made it go viral. ”

In terms of risk assessment, WHO is no longer the sole arbiter of risk from emerging pathogens as digital transformation accelerates the dissemination of information.

“As we saw with the COVID-19 pandemic, countries really preferred to do their own risk assessments. They now have access to data that they have never had before. All the high-end medical journals posted peer-reviewed information before the paywall, so government advisory groups could get it and make recommendations to their governments on what to do. .

As a result, the WHO lost its authoritative position to make recommendations, countries devised their own policies, and what followed was “chaos, total chaos” over the global response, Heyman argued. . ” [IHR] For me, regulation is really a relic of the past. ”

Negotiations over pandemic agreement separate from formal WHA

This year’s WHA is set against the backdrop of ongoing negotiations to revise the IHR and develop a new pandemic agreement.

Both countries have been embroiled in controversial debates by member states over the language of outbreak reporting, including a proposal to require states to report emerging pathogen threats within hours. As for the Pandemic Agreement, while all countries have verbally responded to the need to ensure more equitable distribution of medicines and vaccines in the next pandemic, the draft wording promises to suspend fixed deadlines in advance. have conflicting opinions. Provide a large amount of health equipment to developing countries.

As long as these negotiations are due to be completed by May 2024, the most meaningful negotiations will likely take place in the corridors and beside the WHA, rather than in the formal chambers of the conference at UN Headquarters in Geneva. “It’s expensive,” he said. Former WHO Chief Legal Advisor Gian Luca Bursi will take the stage at the postgraduate session on Sunday.

“for [WHA] Mr Burci said there was action but nothing specific about the IHR. The only major formal issue clearly on the agenda for the Pandemic Agreement is the potential cost of the treaty.

“However, a Secretariat briefing on the negotiations will be held, and there will be many discussions and side conversations between delegates in an attempt to break some of the stalemate.”

Meanwhile, WHO continues to pursue voluntary efforts aimed at improving outbreak detection and response. For example, prior to the opening of WHA, WHO announced the launch of a new Global Pathogen Surveillance Network. The network aims to detect and report infectious disease threats in real time, leveraging digital and genomic tools that many countries still lack.

WHO and partners are launching the Global Pathogen Surveillance Network, a global network to protect people from infectious disease threats through more effective use of pathogen genomics. https://t.co/riuOjqB8Ju pic.twitter.com/vXqJZk6dzs

— World Health Organization (WHO) (@WHO) May 20, 2023

The new network represents an ambitious effort to fill an important gap in the world. WHO‘s existing disease outbreak alert system can now be delayed by weeks or even months if countries resist disclosure. But without modification, IHR, such networks remain purely voluntary.So the key question remains, as always: Will all countries participate, cooperate, cooperate, and who will help? Improving the capabilities of low-income people Which countries detect and report new threats?