Back to the WHA!
From May 23 to 26 I had the chance to attend the 69th World Health
Assembly (WHA). Like two years ago for my first WHA, this week was packed
with interesting debates and relevant discussions related to our advocacy on
Global Health, Sustainable Development Goals and the 2030 Agenda (SDGs),
Research and Innovation for poverty-related and neglected tropical diseases
(PRNDs), Women’s, Children’s and adolescents’ health but also nutrition and
Anti-microbial resistance (AMR). Although the focus of this year was on
different topics, some things remain unchanged at the Palais des Nations.
Here are my highlights of the 69th WHA:
Some things don’t change
Like two years ago, committee meetings have days of delay, making it
impossible to plan your agenda and almost inevitable that you miss some key
debates. As I left Geneva on Thursday, discussions on CEWG had just started
with the creation of a new drafting group.
Campaign was again running to fight against Guinea worm and polio, which
still have not been eradicated yet, demonstrating the difficulty of the last
mile effort to eradicate PRNDs – see below pictures from two years ago and
this year.
And peacocks are still making their weird noise around the Palais.
However this year was also rich of new developments.
R&I higher on the agenda
This year there was a lot at stake for GH R&D as pointed out by the Global
Health Technology Coalition and Geneva Center for Security Policy (GCSP)
panel discussion between the follow-up to the CEWG report, AMR, and the blue
print on R&D in epidemics.
To pick some highlights this year, I would mention access and the issue of
delinkage of the costs of the R&D and price of new health solutions. Access
has always been discussed at the WHA but this year, a number of side events
brought a broader perspective on what accessibility and affordability of
medicines mean in practice.
If everyone agrees that we desperately need new and improved vaccines, drugs
and diagnostics that are of high quality, accessible and affordable, it is
more complicated to discuss the practical ways to implement this, especially
for PRNDs. As mentioned by David Kaslow, PATH, during the PATH and Medicines
for Malaria Venture side event “Access to innovation for all: Is it
possible?”, a one-size-fits-all approach will not be able tackle the issue of
access. Accessibility is also intrinsically linked with other aspects such as
local manufacturing capacities, regulatory framework and health system
capacities. Even when there is innovation, often the costs of registering the
new device is extremely high and in the absence of regulatory framework,
delays can reach up to 4 years. The lack of skills and supporting environment
to the development of local manufacturing capabilities in low and middle
income countries are also major obstacles.
There are definitely improvements to be made. For Suerie Moon, Harvard
Kennedy School of Public Health, the model is broken but can be fixed and
should be, if we were to achieve Sustainable Development Goals, as well as
the Global Convergence. While recognising that improvements are needed, David
Reddy, Medicines for Malaria Venture, and Christopher Elias, Bill and Melinda
Gates Foundation, also highlighted the key role of current initiatives such
as PDPs supporting about 75% of the candidates in the current GH R&D pipeline
and stressed the need to maintain these approaches.
One thing new is the urgency and political momentum on this, notably with the
creation of the UN High level panel on access to medicines, maybe not for the
right reason. As pointed out by Herbert Barnard, Ministry of Health of The
Netherlands during the side event “Achieving Affordable Access to Health
Technologies”: it is a challenge for everyone, no longer only in low and
middle income countries also with the rise of AMR.
Adolescents, accountability and rights at the heart of a life course approach
to health
Before 2014 we used to talk about Reproductive, Maternal, New born and Child
Health – RMNCH. With the Every Newborn Action plan, the international
community’s approach to health took a turn, which was then confirmed in the
2030 Agenda: adolescents’ health needs to be a priority and health should be
tackled in a continuum of care. So now we talk about RMNCAH, and a lifecourse approach. Adolescents are now at the centre of the discussion on the
SDGs, as they will be the generation live under the 2030 Agenda and leading
its implementation and its follow-up. They are at the core of the new Global
Strategy for Women’s, Children’s and Adolescents’ Health 2030 as explained
during the side event ‘Survive, Thrive, transform: implementing the Global
Strategy for Women’s, Children’s and Adolescents’ Health’.
Another revolution is also the key focus on Human Rights and equity. Also
announced during the side event, a high level working group has been created
by the UN Commissioner on Human rights to look at Human rights in Health with
a focus on universal norms and standards, and data on discrimination.
Of course, these commitments need to be followed up and this is when the
critical role of CSOs in accountability comes into play. Several groups and
platforms form the civil society and with independent bodies have been
created such as the Global Dialogue for Citizen-led Accountability for
Women’s, Children’s and Adolescents’ Health and a broader advocacy coalition
for Universal Health Coverage in partnership with among others, Action for
Global Health, World Vision, Global Health Advocates, Global Health Council,
CBM and London School for Hygiene and Tropical Medicine, Stop Aids Alliance,
Save the Children UK, and Results UK.
Within all these debates, CSOs partners, such as IPPF, raise the questions of
inclusion of FP/SRHR on different items of the WHA agenda including Health in
the 2030 Agenda for Sustainable Development through oral statements.