WHO Director Chan Opens Annual Assembly With Optimism, Despite Economic Woes

World Health Organization Director General Margaret Chan today opened the annual assembly of the UN agency’s member states with a positive outlook on the future of public health. At a time of economic uncertainty, she called on countries to be efficient in their spending, to take ownership of the health of their people, and to look toward innovative health solutions.

At the 65th World Health Assembly (WHA), which is being held from 21-26 May, member states face a substantive agenda with pressing public health issues including the prevention and control of noncommunicable diseases, pandemic influenza preparedness, the draft global vaccine action plan, a mechanism to fight poor quality medicines, and the report of the consultative expert working group on research and development.

This WHA will also be called to move forward on organisational reform and confirm Chan’s nomination for a second term as director general (IPW, WHO, 2 May 2012).

All World Health Assembly documents are here.

In her opening remarks, Chan challenged “bitter observers” who claim that the “golden age for health development” has come to an end. She said although the first decade of the 21st century left “a legacy of innovations,” citing new vaccines and medicines, and new ways of financing health such as GAVI (Global Alliance for Vaccines and Immunization); the Global Fund to Fight AIDS, Tuberculosis and Malaria; and UNITAID, “the best days for health are ahead of us, not behind us.”

“It is true that money is tight and the future of the world economy looks uncertain. Health officials, development partners, and WHO are watching money closely. Money is important, but many other factors drive progress in public health,” Chan said.

Efficient Spending and Frugal Innovation

Chan emphasised the importance of country ownership in advancing public health, congratulating several countries on various national health initiatives, including India’s leadership in dramatically changing “the prospects for polio eradication.” She also hailed Australia for leading “resistance to the tobacco industry’s latest onslaught of aggressive tactics,” with its plain packaging of tobacco initiative.

Giving advice to health ministers, Chan said that it’s time to “get back to the basics” by concentrating on “primary health care, access to essential medicines and universal coverage.” She also said that countries must strive for efficiency and be intolerant of waste.

Additionally, with shrinking budgets and rising expectations, she said, “we must look to innovation as never before.” But she cautioned that the health innovation the world needs is not necessarily high-tech and expensive, rather it needs “frugal innovation.” She cited simple innovations like the WHO Safe Surgery Checklist, a paper-based checklist for surgeons, which has “significantly reduced surgical errors.”

Chan also commended progress made on pandemic influenza preparedness saying, “The result is a pioneering framework that extends traditional cooperation in the health-related public sectors to include annual contributions and firm commitments from private industry, in the name of health.”

A key agenda item, an overview of the work of the Pandemic Influenza Preparedness (PIP) Advisory Group and its recommendations to the director general is scheduled for discussion on Wednesday.

Caution Not to Demand “Quick” Health Results

Despite Chan’s optimism for the second decade of the 21st century in public health, she did raise some concerns. First, she said that with shrinking budgets, financial donors are under increasing pressure to demonstrate results.

“Taxpayers and parliamentarians want to see quick, tangible, and measurable results that demonstrate payback for the money,” Chan said. “This can be dangerous, especially for a disease like HIV/AIDS.”

As proof, she said that the chance of meeting the goal of universal access to antiretroviral (ARV) therapy is low. “We have good reason to believe that the UN target of having 15 million people on treatment by 2015 will not be met,” Chan said.

Her announcement comes as a sharp disappointment to public health leaders, as growing evidence shows that ARV therapy is an effective tool for prevention. She cautioned countries not to “measure how much health can be bought” and called on them to “seize the opportunity” to prevent the spread of the disease.

Secondly, she raised concerns over the “relentless rise of chronic noncommunicable diseases.” A key item for this Assembly, committee discussions on the prevention and control of NCDs started today and will continue tomorrow morning.

Finally, as the organisation continues to implement a sweeping reform, the director general highlighted the agency’s unique role as a “guardian, a protector and defender of health, including the right to health.” She also highlighted the organisation’s ability to react quickly to global health emergencies.

“WHO can mount an international response within 24 hours. This is because of WHO’s Global Outbreak Alert and Response Network, but also the capacity of our country offices to get visas, move supplies through customs, and coordinate every step with the ministry of health. No other agency can do this,” Chan said.

US Calls Attention to NCDs

United States Health and Human Services Secretary Kathleen Sibelius addressed the plenary session today, agreeing with Chan on the importance of access to healthcare and addressing the growing problem of NCDs.

She said that despite differences in country health needs, “one challenge we all face is how to keep our nations healthy,” Sibelius said, nodding to the two-year anniversary of the healthcare law in the US.

But she also said that beyond the importance of providing care to all, promoting policies to prevent NCDs is essential. She said that in the US, a new national strategy is putting the importance of prevention higher up in policymaking priorities.

Sibelius also mentioned research, saying, “From increasing prevention of diseases such as polio and heart disease, to conducting lifesaving research, to strengthening our humanitarian response and protection of vulnerable and marginalized populations, all of our efforts are enhanced through our partnership in this body.”

Sibelius’ full remarks are available here.

NGOs Urge Health Ministers to Act on R&D Recommendation

Earlier today, Médecins Sans Frontières (MSF, Doctors Without Borders) and the Drugs for Neglected Diseases initiative (DNDi) held a joint press conference in support of the recommendations made by the Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG). One of the key issues to be discussed this week, the CEWG has recommended member states to begin the process of establishing a binding convention on the coordination and financing of R&D for the health needs of developing countries.

Expected to be an area of contention during this Assembly, Kenya has submitted a resolution in support of starting the process that will lead to the negotiation of a binding agreement, while Switzerland is expected to call for more time to review and discuss the idea (IPW, WHO, 3 May 2012).

Speakers at the MSF-DNDi event urged member states not to wait. “Medical innovation is not delivering for the needs of people in developing countries. Governments have the power, the responsibility and, from today, the opportunity to change this,” said Michelle Childs, Director of Policy/Advocacy at MSFʼs Access Campaign, in a press release.

“A clear and compelling case has been made for an R&D convention. WHO member states must get on with starting the process, and not look for excuses to delay,” Childs said.

The international humanitarian medical organisation shared first-hand experience demonstrating failings of the current IPR-driven R&D system. From more effective treatments for drug-resistant tuberculosis to paediatric versions of HIV drugs, MSF’s list of unmet treatment needs in developing countries is long.

“Our field teams know where the medical needs are, but that knowledge isnʼt enough to address the gaps,” Tido von Schoen-Angerer, executive director of MSFʼs Access Campaign, said in the release. “We need to connect the research priorities with the money, to drive the money spent on medical research to where the needs are and to ensure that the fruits of innovation are affordable and accessible. This is where the R&D convention can bring about transformation.”

DNDi Executive Director Bernard Pécoul also spoke at the press event, sharing lessons learned through developing new medicines for neglected diseases. Beyond a sustainable financing mechanism, the non-profit drug R&D organisation supports other CEWG recommendations including open innovation and pro-access IP management and sustainable coordination of R&D with commitment from endemic countries (IPW, WHO, 11 May 2012).

In today’s agenda, discussions on the CEWG report, available here, were scheduled to begin on Friday. However, according to the Twitter feed of Thiru Balasubramaniam of Knowledge Ecology International, Brazil requested the Assembly to advance CEWG discussions. Thailand, Bolivia, Denmark and Australia supported Brazil’s request and it is likely that the report will be discussed on Wednesday.

Related Intellectual Property Watch articles here and here.