The 60th WHA was held in Geneva from 14th to 23rd May 2007. The Assembly has been efficent thanks to the good will of delegations and the work of both Committe A and B. The 1st Assembly under the new DG Margaret Chan approved the largest-ever budget for the Organization and adopted a record number of resolutions on public health issues and on the technical and administrative work of WHO.
In the closing Item, Dr. Robinson, chairman of Committe A took the floor to thank the delegations fir the good work accomplished during this 60th WHA. He particularly noted the constructive atmosphere in the debate. His committee adopted 15 resolutions. 2 on the strategic medium plan and 13 on technical and healt issues. Only 2 working group were needed to discuss the draft reports. Dr. Robinson congratulates the Presidency and the DG Margaret Chan for her first WHA as director general.
Thomas Zeltner, the president of Committee B and Swiss secretary of state for Public health, addresses the audience to acknowledge the work of the Assembly. He precised, that despite the comments, there is not yet a complete ban for smoking in public places in Switzerland, but a proposal is submitted to the Parliament and shall be submitted to approval. M. Zeltner said that his committee has been very efficient and that its rapid work allowed to transfer some items from committee A. He thanked all delegations and the work of the Secretariat, the presidency, WHO staff and DG Dr. Chan.
Decisions and issues discussed at the 60th World Health Assembly
Member States agreed a resolution which will help all countries better prepare for the global public health threat which an influenza pandemic presents. The resolution, "Sharing of Influenza viruses and access to vaccines and other benefits," restates the general principles of the necessity of sharing both in the preparations for an influenza pandemic and the benefits that will flow from improved international cooperation and preparation, such as greater quantities of and equitable access to H5N1 and pandemic vaccines.
The resolution requests WHO to establish an international stockpile of vaccines for H5N1 or other influenza viruses of pandemic potential, and to formulate mechanisms and guidelines aimed at ensuring fair and equitable distribution of pandemic-influenza vaccines at affordable prices in the event of a pandemic.
It also tasks an interdisciplinary working group with drawing up new Terms of Reference (TORs) for the WHO Influenza Collaborating Centre Network, and its H5 reference laboratories, for the sharing of influenza viruses. The new TORs will take into account the origin of influenza viruses going into the WHO Global Influenza Surveillance Network, and will make their use more transparent. Once finalized, these TORs will be submitted to a special Intergovernmental Meeting of WHO Member States and regional economic organizations.
The Assembly reached a last-minute agreement on public health, innovation and intellectual property. The resolution expressed appreciation to the Director-General for her commitment to the process of the Intergovernmental Working Group on the issue and encouraged her to guide the process to draw up a global strategy and plan of action. The resolution also requested the Director-General to provide technical and policy support to countries.
The Assembly approved a budget for 2008-2009 of $4.2 billion, an increase of nearly $1 billion from the $3.3 billion approved for 2006-2007. The new budget highlights the continued trend of increased investment in global public health. For WHO it means being able to provide more support to countries, in close collaboration with UN and other partners. For the first time, this budget is part of a six-year strategic plan for the Organization, which Member States also adopted at the Assembly.
Member States expressed their concern that malaria continues to cause more than one million preventable deaths every year. The Assembly passed a resolution to intensify access to affordable, safe and effective antimalarial combination treatments, to intermittent preventive treatment in pregnancies, to insecticide treated mosquito nets, and indoor residual spraying for malaria control with suitable and safe insecticide. Member States requested that donors adjust their policies so as to progressively cease to fund the provision and distribution of oral artemisinin monotherapies, and to join in campaigns to prohibit the marketing, distribution and use of counterfeit antimalarial medicines.
All Member States were urged to develop and implement long-term plans for tuberculosis (TB) prevention and control, in line with the WHO Stop TB Strategy. The actions the resolution are aimed at accelerating progress towards halving TB deaths and prevalence by 2015, through the full implementation of the Global Plan to Stop TB, 2006-2015. WHO is requested to strengthen its support to countries affected by TB, in particular those heavily affected by Multidrug-resistant and Extensively Drug-Resistant TB (MD/XDR-TB) as well as TB/HIV.
Indigenous polio survives in parts of only four countries. Member States resolved to step up their efforts to eradicate the virus swiftly, while taking steps to minimize the risk of its international spread. Stressing the financial and humanitarian gains to be made from completing eradication and the ongoing dividends of the highly-developed polio infrastructure, the Director-General presented the 'Case for Completing Polio Eradication', outlining a clear justification for the international donor community to rapidly fill a global funding gap of US$540 million for 2007-2008. Insufficient funding is currently imperilling the 20-year, US$5.3 billion international effort.
The Assembly adopted a resolution on integrating gender analysis and actions into the work of WHO, demonstrating the importance Member States place on including gender perspectives such as disaggregation of data based on sex in all publications and reports.
The WHA adopted a resolution expressing concern over the continuous deterioration of the health and economic conditions of the populations in the occupied Palestinian territory. The need for universal coverage of health services was reaffirmed while recognizing that the acute shortage of financial and medical resources is jeopardizing access of the population to curative and preventive services. The Assembly requested the WHO Director-General to report on the health and economic situation in the occupied Palestinian territory and to continue to provide the necessary technical assistance to meet the health needs of the Palestinians.
The Assembly passed a resolution on better medicines for children, requesting the Director-General to undertake a program of work to improve access to essential medicines for children. This year, WHO will develop a Model List of Essential Medicines for Children, as well as evidence-based medicines information for prescribers and carers, and identify key research and development requirements for producing better medicines for children.
In a resolution on health technologies, in particular medical devices, the Assembly urged Member States to draw up national guidelines and plans for the assessment, procurement and management of technologies used in healthcare.
A resolution on rational use of medicines promotes an integrated, health systems approach to promoting more appropriate use of medicines - specifically, national multidisciplinary bodies to monitor medicines use and promote rational use. The Assembly agreed that a comprehensive review of all research undertaken on the variola virus, which causes smallpox, be undertaken beginning in 2010. The WHA asked that the results of that research - and conclusions concerning the need for any further research - be presented to the 64th World Health Assembly in 2011. The economic burden of oral disease is predicted to grow rapidly worldwide, particularly in disadvantaged and poor populations, unless oral preventive programmes are implemented. The WHA resolution urges WHO to provide advice and technical support for strengthening oral health programmes at country, regional and global levels, in collaboration with other UN organizations, WHO collaborating centres and NGOs.
The WHA passed a resolution urging Member States and the Secretariat to increase investment in, and strengthen efforts towards health promotion as the cornerstone of primary health care and a core function of public health.
The Assembly adopted a resolution on emergency trauma care systems, which draws the attention of governments to the need to strengthen pre-hospital and emergency trauma care systems (including mass casualty management efforts) and describes a number of steps governments could take. It also invites WHO to scale up its efforts to support countries.
Member States approved the resolution on strengthening of health information systems and enhancing WHO's work on health statistics in general. They also called on the DG to strengthen the information and evidence culture of WHO itself, and ensure the use of accurate and timely health statistics in order to generate evidence for major policy decisions and recommendations within WHO.
Member States approved a resolution and reiterated the importance of a coherent research strategy for WHO which will help to disseminate the outcomes of research and its utilization in decision- and policy-making for more effective health policies.
Member States approved a resolution on the control of leishmaniasis, which is recognized as one of the most neglected tropical diseases. Member States were urged to encourage research on leishmaniasis control, to identify appropriate and effective methods of control of vectors and reservoirs and find alternative safe, effective and affordable medicines.
The Assembly endorsed the Global Plan of Action on Workers' Health, which aims to devise policy instruments on workers health; protect and promote health at the workplace; improve the performance of and access to occupational health services; provide and communicate evidence for preventive action; and incorporate workers health into other policies. During this year's opening plenary, the United Nations declared the Palais des Nations a smoke-free environment indoors, recognizing the major contribution of tobacco use to non-communicable diseases and preventable, premature death. A progress report to the Assembly describes noncommunicable disease activities in advocacy, surveillance and population-based prevention since the year 2000. A resolution urges Member States to strengthen national efforts in noncommunicable disease (NCD) prevention and control and also calls for an action plan for the prevention and control of NCDs to be presented to the 61st WHA in 2008.
The Assembly held lengthy discussions on public-health problems caused by the harmful use of alcohol. Delegates agreed that the issue will be discussed again at the WHO Executive Board in January, 2008.
jeudi 24 mai 2007
mercredi 23 mai 2007
Wednesday 23rd, MAY 2007
Committee A
The draft fifth report of Committee A is examined. The draft document A60/61 contains seven resolutions that are entitled: 12.14 Health systems: emergency-care systems, 12.8 Prevention and control of noncommunicable diseases: implementation of the global strategy, 12.11 Health promotion in a globalized world, 12.12 Integrating gender analysis and actions into the work of WHO: draft strategy, 12.13 Workers’ health: draft global plan of action, 12.15 Strengthening of health information systems, 12.1 Pandemic influenza preparedness: sharing of influenza viruses and access to vaccines and other benefits.
This draft is adopted.
Item 12.7 on Evidence-based strategies and interventions to reduce alcohol-related harm is discussed. Doctor Blumfield’s stated that there was a great interest on the topic as there were 5 changes of the resolution through the amendments. Although there was no sufficient time to work through the paper, the members showed flexibility and good will to write a short paper to work on, which was conference paper 15. But consensus remained hard to reach. Few corrections are made according to what has been agreed on. Resolution will be submitted to the Executive Board. The delegate representative of Cuba said that some changes of the working group had not been taken into account by the Doctor Chairman of the working group. According to the Chairman, the Executive Board will be studying the issue. Brazil reminds that this issue is very important and expresses its will to act immediately. Be more dynamic on this topic that cannot wait longer. Progress has to be made in Sweden’s view, and the conference paper 15.1 doesn’t reflect their will anymore, they propose the reintroduction of paper 10. Cuba finally agrees with paper 15.1 going to the EB. The DGO proposed its version; there were no objections to it.
Work of the 60th World Health Assembly is ending today. The Chairman thanks all the members for their contributions to the debates of this Committee, for the solidarity and collaboration between the member states during the assembly which helped to enhance the work of the World Health Assembly. Thanks were expressed to Director General Mrs Chan, the representatives of the secretariat, the vice presidents, and the “rapporteur” for their support, who were very professional. Interpreters and translators were very useful as well for the communication between member states, thanks to them.
Delegate of Senegal’s had the last word. He expressed his admiration for the way the work has been achieved. According to him courtesy, patience, constancy and a sense of compromise were present through the Committee. And the Chairman was specifically thanked for his work by the Senegalese delegate as he represented Madagascar and the African Region.
Therefore a very good overall impression had emerged from the work of the fourteenth meetings of Committee B during the WHA.
COMMITTEE B
Draft fourth report of Committee B
Document (draft) A60/62, containing one resolution entitled:
Health technologies
After a consultation of the assembly, no opposition was expressed to the adoption then declared by the Chairperson of the committee.
Item 12 (continued) Technical and health matters
Item 12.20 (continued) Public health, innovation and intellectual property: progress made by the Intergovernmental Working Group
Documents A60/27 and A60/B/Conf.Paper No.3 Rev.2
The Distinguished Delegate of Namibia presented the result of the work of the drafting group on the issue of Public health, innovation and intellectual property. He congratulated his co-workers in the draft group underlying the fact that the strength of such a group came from its diversity. He concluded by underlying the remaining sentence in brackets from line 3 to line 5 in paragraph 3 of operative clauses.
The efforts of the D.D. of Namibia were also thanked by the Chairperson.
The floor was then opened to comments and discussion. The D.D. of the U.S.A. took first the floor saying that his delegation was ready to make consensus provided certain changes in the text of the draft resolution. The D.D. of the U.S.A. proposed in fact several modifications:
• Preamble part of the draft resolution: change proposed in §2 (expression "diagnostic tools" on line 2 should be removed, becoming: "diagnostic TRIPS"). Such proposal received the support of the Australian Delegation.
• Operative clauses: §2 (second line, the expression "continue to" should precede the end of the sentence; "and continue to provide adequate resources to WHO"), §3.4 (a reformulation of the whole sentence is proposed). This last proposal was supported by the D.D. of Japan saying that the Delegation of Japan could not accept the statement in brackets.
The changes proposed by the American Delegation raised the opposition of several states among which were: Brazil, Chile, Kenya on behalf of the 46 African States, Thailand. The Delegation of Switzerland proposed to replace §3.4 in the text and to underlying that a compromise was reached yesterday. The Delegation has previously stated that the drat resolution, a very important and complex text was the result of a hazardous process and he added that the efforts done should not be underscored. According to his Delegation, the proposal from the D.D. of the U.S.A. can improve the reading of the text but are absolutely different from the draft document. He asked for a withdrawal of U.S.A.'s proposal.
Finally, as no agreement seemed to be reach between the two different positions the Chairman proposed to adopt the draft resolution as it was including the change on §2 of preamble. The D.D. of the U.S.A. declared that his Delegation reserved itself the right to express its opposition during the plenary.
The Resolution was adopted.
Draft fifth report of Committee B
The draft report was adopted without any comment or opposition in the committee.
Plenary Session
Item 8 : the draft reports of Committtee A (3rd, 4th, 5th and 6th) were adopted. Reports of Committee B (2nd, 3rd, 4th, 5th) were adopted.
However the US delegation declared that it couldn’t accepte the resolution contained in the 5th report of committee B : Public health, innovation and intellectual property as announced, as it cannot be considered as a consensus text. However the US did not intend to block to process.
In the closing Item, Dr. Robinson, chairman of Committe A took the floor to thank the delagations fir the good work accomplished during this 60th WHA. He particularly noted the constructive atmosphere in the dabate. His committe adopted 15 resolutions. 2 on the strategic medium plan and 13 on technical and healt issues. Only 2 working group were needed to discuss the draft reports. Dr. Robinson congratulate the Presidency and the DG Margaret Chan for her first WHA as director general.
Thomas Zeltner, the president of Committee B and swiss secretary of state for Public health, adresses the audience to acknoledge the work of the Assembly. He precised, that depite the comments, there is not yet a complete ban for smoking in public places in Switzerland, but a poposal is submitted to the Parliament and shall be submitted to approval. M. Zeltner said that his committee has been very effiecient and that its rapid work allowed to transfert some items from committee A. He thanked all delegations and the work of the Secretariat, the presidency, WHO staff and DG Dr. Chan.
The draft fifth report of Committee A is examined. The draft document A60/61 contains seven resolutions that are entitled: 12.14 Health systems: emergency-care systems, 12.8 Prevention and control of noncommunicable diseases: implementation of the global strategy, 12.11 Health promotion in a globalized world, 12.12 Integrating gender analysis and actions into the work of WHO: draft strategy, 12.13 Workers’ health: draft global plan of action, 12.15 Strengthening of health information systems, 12.1 Pandemic influenza preparedness: sharing of influenza viruses and access to vaccines and other benefits.
This draft is adopted.
Item 12.7 on Evidence-based strategies and interventions to reduce alcohol-related harm is discussed. Doctor Blumfield’s stated that there was a great interest on the topic as there were 5 changes of the resolution through the amendments. Although there was no sufficient time to work through the paper, the members showed flexibility and good will to write a short paper to work on, which was conference paper 15. But consensus remained hard to reach. Few corrections are made according to what has been agreed on. Resolution will be submitted to the Executive Board. The delegate representative of Cuba said that some changes of the working group had not been taken into account by the Doctor Chairman of the working group. According to the Chairman, the Executive Board will be studying the issue. Brazil reminds that this issue is very important and expresses its will to act immediately. Be more dynamic on this topic that cannot wait longer. Progress has to be made in Sweden’s view, and the conference paper 15.1 doesn’t reflect their will anymore, they propose the reintroduction of paper 10. Cuba finally agrees with paper 15.1 going to the EB. The DGO proposed its version; there were no objections to it.
Work of the 60th World Health Assembly is ending today. The Chairman thanks all the members for their contributions to the debates of this Committee, for the solidarity and collaboration between the member states during the assembly which helped to enhance the work of the World Health Assembly. Thanks were expressed to Director General Mrs Chan, the representatives of the secretariat, the vice presidents, and the “rapporteur” for their support, who were very professional. Interpreters and translators were very useful as well for the communication between member states, thanks to them.
Delegate of Senegal’s had the last word. He expressed his admiration for the way the work has been achieved. According to him courtesy, patience, constancy and a sense of compromise were present through the Committee. And the Chairman was specifically thanked for his work by the Senegalese delegate as he represented Madagascar and the African Region.
Therefore a very good overall impression had emerged from the work of the fourteenth meetings of Committee B during the WHA.
COMMITTEE B
Draft fourth report of Committee B
Document (draft) A60/62, containing one resolution entitled:
Health technologies
After a consultation of the assembly, no opposition was expressed to the adoption then declared by the Chairperson of the committee.
Item 12 (continued) Technical and health matters
Item 12.20 (continued) Public health, innovation and intellectual property: progress made by the Intergovernmental Working Group
Documents A60/27 and A60/B/Conf.Paper No.3 Rev.2
The Distinguished Delegate of Namibia presented the result of the work of the drafting group on the issue of Public health, innovation and intellectual property. He congratulated his co-workers in the draft group underlying the fact that the strength of such a group came from its diversity. He concluded by underlying the remaining sentence in brackets from line 3 to line 5 in paragraph 3 of operative clauses.
The efforts of the D.D. of Namibia were also thanked by the Chairperson.
The floor was then opened to comments and discussion. The D.D. of the U.S.A. took first the floor saying that his delegation was ready to make consensus provided certain changes in the text of the draft resolution. The D.D. of the U.S.A. proposed in fact several modifications:
• Preamble part of the draft resolution: change proposed in §2 (expression "diagnostic tools" on line 2 should be removed, becoming: "diagnostic TRIPS"). Such proposal received the support of the Australian Delegation.
• Operative clauses: §2 (second line, the expression "continue to" should precede the end of the sentence; "and continue to provide adequate resources to WHO"), §3.4 (a reformulation of the whole sentence is proposed). This last proposal was supported by the D.D. of Japan saying that the Delegation of Japan could not accept the statement in brackets.
The changes proposed by the American Delegation raised the opposition of several states among which were: Brazil, Chile, Kenya on behalf of the 46 African States, Thailand. The Delegation of Switzerland proposed to replace §3.4 in the text and to underlying that a compromise was reached yesterday. The Delegation has previously stated that the drat resolution, a very important and complex text was the result of a hazardous process and he added that the efforts done should not be underscored. According to his Delegation, the proposal from the D.D. of the U.S.A. can improve the reading of the text but are absolutely different from the draft document. He asked for a withdrawal of U.S.A.'s proposal.
Finally, as no agreement seemed to be reach between the two different positions the Chairman proposed to adopt the draft resolution as it was including the change on §2 of preamble. The D.D. of the U.S.A. declared that his Delegation reserved itself the right to express its opposition during the plenary.
The Resolution was adopted.
Draft fifth report of Committee B
The draft report was adopted without any comment or opposition in the committee.
Plenary Session
Item 8 : the draft reports of Committtee A (3rd, 4th, 5th and 6th) were adopted. Reports of Committee B (2nd, 3rd, 4th, 5th) were adopted.
However the US delegation declared that it couldn’t accepte the resolution contained in the 5th report of committee B : Public health, innovation and intellectual property as announced, as it cannot be considered as a consensus text. However the US did not intend to block to process.
In the closing Item, Dr. Robinson, chairman of Committe A took the floor to thank the delagations fir the good work accomplished during this 60th WHA. He particularly noted the constructive atmosphere in the dabate. His committe adopted 15 resolutions. 2 on the strategic medium plan and 13 on technical and healt issues. Only 2 working group were needed to discuss the draft reports. Dr. Robinson congratulate the Presidency and the DG Margaret Chan for her first WHA as director general.
Thomas Zeltner, the president of Committee B and swiss secretary of state for Public health, adresses the audience to acknoledge the work of the Assembly. He precised, that depite the comments, there is not yet a complete ban for smoking in public places in Switzerland, but a poposal is submitted to the Parliament and shall be submitted to approval. M. Zeltner said that his committee has been very effiecient and that its rapid work allowed to transfert some items from committee A. He thanked all delegations and the work of the Secretariat, the presidency, WHO staff and DG Dr. Chan.
mardi 22 mai 2007
Tuesday 22nd, MAY 2007
Committee B (morning)
The third draft report of Committe B (A60/609 was adopted).
Item 12.21 (continued) Technical and health matters: Progress reports
J. Reducing global measles mortality
Japan took the floor first to underline the need for more vaccine availability, especially in developing countries (DCs).
Iran said, on behalf of the Eastern Mediterranean countries, that special aid was still needed to maintain measles mortality reduction in DCs. The common goal is the eradication of measles within 2010 as the Millennium development goals (MDGs) state.
However, routine vaccination is still low in certain countries.
Guinea-Bissau, on behalf of the African region, reaffirmed its commitment to fight against measles and to reduce related mortality. The delegation also said, that maintaining the financing is necessary to preserve what has been done.
The Thai delegation: declared to have reduced by 60% its measles related mortality within 6 years. However measles rate remains at a high level and vaccine coverage needs to be further enhanced.
Oman suggested to double the dose of vaccine and to implement the catch up strategies.
The delegation of Bahamas said that the reduction of global measles mortality was the best investment to achieve goal 4 of the MDGs. Bahamas is now measles free, so could be the world.
K. Health metric Network
Benin, on behalf of the African region, asked for more data communication. Statistics should be improved in order to provide clear and updated information. The network and a good cooperation are necessary to achieve this.
Thailand asked for a better follow up of data and control. The network should also be used to reinforce the link between the regions, the cities and the Land.
The WHO Secretariat, responded to the interrogations and stated, that the partnership a t the country and institutional level should be strengthen. The program has made great progress and is been adopted by a good amount of countries.
Item 12.20 Public health, innovation and intellectual property: progress made by intergovernmental working group.
After the general debate on Friday and Monday, it was decided to create an intergovernmental working group to work on the draft resolution proposed by Brazil. Namibia was appointed chair of the group.
The delegation of Namibia reported that despite the willingness of the delegation to come to an agreement on a common text, the group after 4 hours of consultation did not come to a compromise on the text. The issue of Intellectual property being highly sensible!
Namibia proposed to close the session and to start consultations within the working group to come to an agreement on the text before the end of the WHA.
Some delegation (US, EU, Australia wanted to follow the agenda and first finish item 12.19 as scheduled before starting negotiations, as their delegations were not ready to debate due to other meetings going on)
Finally the Chairperson decided to back up the Namibian proposal to start immediately consultation of the working group and begin item 12.19 at 14:30 the afternoon.
Technical Meeting: 20th Anniversary of Safe Motherhood 13:00
The meeting was to keep inform delegations of the importance of the mother health and maternity issues. One woman dies every minute due to maternity linked issue.
What strikes us is that lives can very easily be saved because we know the causes and the remedies. I f we can save the mother we save the child.
The centrality of maternity health and reducing infant mortality is a central point in the development strategies.
Several invited speakers took the floor to express their views and actions. An British MP coordinating maternity health issues at the Parliament said that the MPs could undertake 3 actions: 1) lobbying decision makers 2) building up public supports 3) raising women’s expectations.
DG Margaret Chan was present and took the floor the underline her commitment to this important cause.
Different countries express their views in sustaining WHO and civil society actions.
The anniversary conference is to be held in London in October 18th- 20th 2007.
Special attention will be given to the link mother-child as a Nation’s health is defined by women’s health. The main idea is “Invest in women: it pays”.
COMMITTEE B (Afternoon)
Item 12
The purpose of the meeting was to discuss about the amendment made by the delegation of Mexico. This amendment consists, inter alia, in stressing the importance of medical devices. So, the distinguished delegate proposed to add "in particular medical devices" in the end of each paragraph of the second point dedicated to the requests.
The representative also proposed to delete the paragraph number (7) of the document.
Then, the representative of United States expressed his disagreement with this proposal and said he wanted to adopt the document as it is.
However, he made a proposal giving a new definition in the item 1 paragraph (5).
Mexico took the floor again to say that he accepted the US modifications.
As no objections has been made after this intervention, the chairman decided to adopt the amendments.
Thus, the meeting stopped at 16h00 and started again at 17h00
The second part of the meeting was consecrated to the adoption of the document A 60/A/conf. paper number 16.
The ambassador from Thailand (the president of the working group in the origin of the amendments) rejoiced with the spirit of compromise arising from the previous debates. While H.E. warmly called upon member states to adopt this document, he suggested bringing few modifications, inter alia, concerning centres collaborators.
As no objections has been made despite of these changes, the chairman decided to adopt the resolution.
Dr M. Chan ended the meeting by making a statement. The director-general began by congratulating those who had contributed to the adoption of this resolution. She also gave thanks to the whole delegation for the work they done, in particular H.E. the ambassador from Thailand.
Finally, the representative of Indonesia took the floor to say that this collaboration should carry on for other issues WHO related.
The third draft report of Committe B (A60/609 was adopted).
Item 12.21 (continued) Technical and health matters: Progress reports
J. Reducing global measles mortality
Japan took the floor first to underline the need for more vaccine availability, especially in developing countries (DCs).
Iran said, on behalf of the Eastern Mediterranean countries, that special aid was still needed to maintain measles mortality reduction in DCs. The common goal is the eradication of measles within 2010 as the Millennium development goals (MDGs) state.
However, routine vaccination is still low in certain countries.
Guinea-Bissau, on behalf of the African region, reaffirmed its commitment to fight against measles and to reduce related mortality. The delegation also said, that maintaining the financing is necessary to preserve what has been done.
The Thai delegation: declared to have reduced by 60% its measles related mortality within 6 years. However measles rate remains at a high level and vaccine coverage needs to be further enhanced.
Oman suggested to double the dose of vaccine and to implement the catch up strategies.
The delegation of Bahamas said that the reduction of global measles mortality was the best investment to achieve goal 4 of the MDGs. Bahamas is now measles free, so could be the world.
K. Health metric Network
Benin, on behalf of the African region, asked for more data communication. Statistics should be improved in order to provide clear and updated information. The network and a good cooperation are necessary to achieve this.
Thailand asked for a better follow up of data and control. The network should also be used to reinforce the link between the regions, the cities and the Land.
The WHO Secretariat, responded to the interrogations and stated, that the partnership a t the country and institutional level should be strengthen. The program has made great progress and is been adopted by a good amount of countries.
Item 12.20 Public health, innovation and intellectual property: progress made by intergovernmental working group.
After the general debate on Friday and Monday, it was decided to create an intergovernmental working group to work on the draft resolution proposed by Brazil. Namibia was appointed chair of the group.
The delegation of Namibia reported that despite the willingness of the delegation to come to an agreement on a common text, the group after 4 hours of consultation did not come to a compromise on the text. The issue of Intellectual property being highly sensible!
Namibia proposed to close the session and to start consultations within the working group to come to an agreement on the text before the end of the WHA.
Some delegation (US, EU, Australia wanted to follow the agenda and first finish item 12.19 as scheduled before starting negotiations, as their delegations were not ready to debate due to other meetings going on)
Finally the Chairperson decided to back up the Namibian proposal to start immediately consultation of the working group and begin item 12.19 at 14:30 the afternoon.
Technical Meeting: 20th Anniversary of Safe Motherhood 13:00
The meeting was to keep inform delegations of the importance of the mother health and maternity issues. One woman dies every minute due to maternity linked issue.
What strikes us is that lives can very easily be saved because we know the causes and the remedies. I f we can save the mother we save the child.
The centrality of maternity health and reducing infant mortality is a central point in the development strategies.
Several invited speakers took the floor to express their views and actions. An British MP coordinating maternity health issues at the Parliament said that the MPs could undertake 3 actions: 1) lobbying decision makers 2) building up public supports 3) raising women’s expectations.
DG Margaret Chan was present and took the floor the underline her commitment to this important cause.
Different countries express their views in sustaining WHO and civil society actions.
The anniversary conference is to be held in London in October 18th- 20th 2007.
Special attention will be given to the link mother-child as a Nation’s health is defined by women’s health. The main idea is “Invest in women: it pays”.
COMMITTEE B (Afternoon)
Item 12
The purpose of the meeting was to discuss about the amendment made by the delegation of Mexico. This amendment consists, inter alia, in stressing the importance of medical devices. So, the distinguished delegate proposed to add "in particular medical devices" in the end of each paragraph of the second point dedicated to the requests.
The representative also proposed to delete the paragraph number (7) of the document.
Then, the representative of United States expressed his disagreement with this proposal and said he wanted to adopt the document as it is.
However, he made a proposal giving a new definition in the item 1 paragraph (5).
Mexico took the floor again to say that he accepted the US modifications.
As no objections has been made after this intervention, the chairman decided to adopt the amendments.
Thus, the meeting stopped at 16h00 and started again at 17h00
The second part of the meeting was consecrated to the adoption of the document A 60/A/conf. paper number 16.
The ambassador from Thailand (the president of the working group in the origin of the amendments) rejoiced with the spirit of compromise arising from the previous debates. While H.E. warmly called upon member states to adopt this document, he suggested bringing few modifications, inter alia, concerning centres collaborators.
As no objections has been made despite of these changes, the chairman decided to adopt the resolution.
Dr M. Chan ended the meeting by making a statement. The director-general began by congratulating those who had contributed to the adoption of this resolution. She also gave thanks to the whole delegation for the work they done, in particular H.E. the ambassador from Thailand.
Finally, the representative of Indonesia took the floor to say that this collaboration should carry on for other issues WHO related.
lundi 21 mai 2007
Monday 21st, MAY 2007
Committee A (Morning)
Item 12.1 (continued) – Avian and pandemic influenza
Draft resolution has been adopted.
Item 12.10 (continued) – Working towards universal coverage of maternal, newborn and child health interventions: biennial report
Analysis of family planning services in low-income areas or countries indicates a lack of progress in their use. In many countries, particularly in Africa, fertility rates, population growth and unmet needs for family planning remain high. Continued high fertility rates and the demographic consequences of increasing numbers of births complicate attempts to improve health. Major gaps remain in the coverage of post-partum care; in some countries as many as 80% of women who give birth at home receive no such care. The urgent need for action to improve maternal, newborn and child health is commanding increased attention among other organizations in the United Nations system and partners and in global forums in general. The recommendation by the United Nations Secretary-General to the General Assembly at its sixtyfirst session, in September 2006,2 “to achieve universal access to reproductive health by 2015” as a new target under Millennium Development Goal 5 should also stimulate improvement in the rates of coverage.
Secretariat: collaboration with World Bank, UNICEF and NGO’s… is needed; A lot of progress has been achieved but it is not enough…
Item 12.5 (continued) – Malaria, including proposal for establishment of Malaria Day
Draft resolution has been adopted.
Item 12.6 (continued) – Tuberculosis control: progress and long-term planning
Draft resolution has been adopted.
Item 12.11 – Health promotion in a globalized world
Health promotion is a cornerstone of primary health care and a core function of public health.
Its value is increasingly recognized; it is both effective and cost-effective in reducing the burden of disease and in mitigating the social and economic impact of diseases. The links between health promotion, health, and human and economic development are widely acknowledged.
The Bangkok Charter confirms the need to focus on use of health promotion to address the determinants of health and identify action. Its four key commitments are to make promotion of health:
• Central to the global development agenda: strong intergovernmental agreements that improve health and collective health security and effective mechanisms for global governance for health are needed;
• A core responsibility for government as a whole: the determinants of health need to be addressed by all ministries at all levels of government;
• A key focus of communities and civil society: well-organized and empowered communities are highly effective in determining their own health, and are capable of encouraging governments and the private sector to be accountable for the health consequences of their policies and practices;
• A requirement for good corporate practice: the private sector has a responsibility to ensure health and safety in the workplace and to promote the health and well-being of employees, their families and communities, and to contribute to lessening wider impacts on global health
Germany underlined the great problem with the new migrations and their sanitary stakes. To reduce the disparities allows improving health conditions.
Cuba: Wish to enhance the collaboration with Medias - Modify the behavior to reduce the risks
Trinidad and Tobago: Prevention is one thing, but we don’t have to forget the “health consciousness”. Communication and Information will play a great role
Morocco: intellectual flexibility was not guaranteed, as promised in Doha. Innovation must not lead to monopoly. North-South cooperation is vital.
Ghana underlined the lack of financing the promotion of healthy environments and its promotion in the draft resolution.
Committe B (morning)
Item 12.20 on Public health, innovation and intellectual property was discussed as the general debate continued. The central points made by member states were to define clear objectives for R&D, for the secretariat to facilitate regional meetings, to translate the matrix draft (African region), to increase collaboration through the creation of an on going forum, the consultation and the elaboration of the document on intellectual property, and to facilitate access to medical support (Russia), making sure that the important resolutions are more clear and prioritized, to ensure access to necessary drugs in developing countries (China), finding ways and means to render the public health more accessible (Iran), finding ways to lower the prices of the medicines (Vietnam, Thailand). The NGOs, the FPMA and the MCM, that made statement during the meeting emphasized on the need of the IGWG to base itself on precise factual information in order to avoid mistakes and to license pattern pools to permit more affordable prices, try to convince the developers of the second generation of drugs. The doctors’ conclusions on the issues were:
_The working texts will be provided in July and will address the concerns formulated above as there was a high interest of the member states on the issue.
_As soon as the document will be provided the discussion will be more fruitful.
_There is a need to expand the pool of experts. 15 states have already contributed in proposing 42 experts.
Concerning the draft resolution A60/B/conf.paper no.3 Rev1, many member states expressed their gratitude to the director general’s support over the issue. Some amendments were proposed by Brazil who wished to add two paragraphs at the end of the preamble but the European Union showed her preoccupation towards these amendments and wished to know what would be the process followed by the WHO in this sense. Canada showed its anxiety to see the resolution narrow the IGWG work. The Chairman said that a redaction group would be in charge of this matter.
Item 12.19 Health technologies and the resolution EB120.R21. The Executive Board recommends the adoption of the resolution. An overall support to the resolution was stated by the member states. The need to reinforce the directives, to prevent the misuse of technical devices, to strengthen the WHO capacities in this area, and the necessity for equity were expressed. Five amendments to the resolution were proposed and the secretariat will take those into account by the 22nd of May. Hopefully the resolution will be adopted tomorrow.
Item 12.18 concerning Better medicines for children and the resolution EB120.R13 discussed during the last 30 minutes of the meeting. Russia stated that paediatric practice needs an extended number of medicines adapted to the children and under different forms.
Brazil wanted to assure more guarantees over the issue with the TRIPs work, but the United States of America expressed their desire for a moderated and measured approach for this complex problem, they prefer the word “promotion” to “guarantee”.
Technical Briefing – “WHO global action plan against Cancer”:
Cancer is a leading cause of death worldwide. From a total of 58 millions death worldwide in 2005, cancer accounts for 7.6 million (or 13%) of all deaths.
More than 70% of all cancer deaths in 2005 occurred in low and middle income countries. Deaths from cancer in the world are projected to continue rising, with an estimated 9 million people dying from cancer in 2015 and 11.4 million dying in 2030.
40% of cancer can be prevented (by a healthy diet, physically activity and not using tobacco). Another third of the cancer burden could be cured if detected early and treated adequately. For all remaining cancers, palliative care can improve quality of life.
WHO has adopted a global approach: “Prevent, cure, care, and manage for success”.
It is very important to access to healthy environments and the member states have to create nation plan action against the cancer.
COMMITTEE A (Afternoon)
Item 12 Technical health matters
Item 12.12
Integrating gender analysis and actions into the work of WHO
The majority of the member states welcomed the integration of gender analysis and actions in the work of WHO. They also thanked the Secretariat for its work and the quality of its report.
However, various states proposed amendments to the draft strategy. The Distinguished Delegate of Thailand proposed to include the "study" as a determining factor of gender inequality. The D.D. of Sweden proposed to replace "gender family health care" in paragraph 2.4 by "agenda equality perspective"; to replace "too" in paragraph 2.6 by "as providers of" and to add after "publication" on paragraph 3.5: "including relevant documentation presented to the Executive Board and the World Health Assembly". The D.D. of Switzerland also proposed some changes (§2.1, §2.4, §3.4).
The D.D. of Japan expressed the viewpoint of his country concerning the need to take into consideration the cultural background of each country in the implementation of the strategy. He also insisted on the necessary quality of indicators in that sensitive field. The D.D. of South Africa insisted on the establishment of strong capacity-building partnerships and a share of skills in monitoring and evaluation of the strategy's implementation.
The Chairman proposed that the Secretariat would provide a new draft resolution that includes the amendments proposed so that the whole assembly would have access to the new version as a work basis.
Item 12.13
Workers' health: draft global plan of action
Once again, the delegations warmly welcomed the report proposed by the Secretariat.
The D.D. of Germany, on behalf of the European Union emphasized the benefits of ILO/WHO cooperation, particularly in the field of workers' health. He also proposed two friendly amendments.
Some delegations proposed to remove or add some expressions in the draft resolution: Philippines, Thailand, The Sultanate of Oman, Cameroun, the Russian Federation, Greece and Kenya.
The D.D. of Portugal after having stressed the alignment of his delegation on the E.U. statement, highlighted the particular situation of migrant workers and the effect of their working conditions on their health.
On behalf of Saudi Arabia, Kuwait, Qatar, Bahrain, Yemen, Syria, Jordan, Liban, the D.D. of the Sultanate of Oman proposed to add in the 2007-2013 Action Plan the expression "travaillleurs sous contrats" as those Gulf countries have in common that category to distinguish the migrant.
As for the previous item, the Secretariat will provide a new draft document that will include the proposed amendements.
Item 12.14
Health systems: emergency-care systems
This item was only introduced explaining the choice of the expression "emergency-care systems" as an expression covering a wider scope than "emergency-care" alone. There was no time left to keep the discussions on that item and the meeting was adjourned.
Committee B (afternoon)
This seventh meeting of the Committee B was essentially a discussion to follow up past resolutions on technical and health matters.
Before beginning the review, item 12.20 on public health (innovation and intellectual property) after amendment has been adopted.
Item 12.21 Technical and health matters: Progress reports
G. sustaining the elimination of iodine deficiency disorders (resolution WHA 58.22)
Peru took the floor to underline the importance of the issue. Reaffirming that a lack of iodine in alimentation causes serious health damages such as brain disturbance, vision impairment….
A special care should be given to pregnant women who are particularly vulnerable and also because the baby can also greatly suffer from a low iodine alimentation.
Iran emphasizes the need the build up national capacities but also insisted on institutional cooperation between the WHO and relevant partner organizations.
The Canadian delegation found, that the key was the systemic distribution of iodized salt to needed population.
A. Improving the containment of antimicrobial resistance (resolution WHA58.27)
Denmark insisted on the information need and the elaboration of a global response to this issue.
Iran sees this issue of medicine ineffectiveness as a health system issue. Many medicines are not properly used and too often are given without precautions.
B. Implementation by WHO of the recommendation of the Global Task Team on improving AIDS Coordination among multilateral institutions and international donors. (Resolutions WHA59.12)
The South African delegation said it was important to make “money work”, in other words we need effective cooperation and follow up of the aid. There is also a need for more experience sharing among countries and institutions. This is important to have a better global understanding but then apply local skills and approaches.
The ICRC says that the battle of AIDS should be tackled at the community level.
C. World report on violence and health implementation of recommendations
The Jordanian delegation underlines the scourge of violence, which seems to be universal and part of the human condition. The delegation ask for money resources on that particular issue, that is sometimes forgotten, as it not a ‘diseases’ but which can cause serious physical and mental sufferings.
Norway recommended a more close work with the UNICEF concerning the issue of children and violence.
D. Promotion of road safety (resolution WHA57.10)
E. Disability, including prevention (resolution WHA58.23)
Angola reaffirmed the need to tackle this issue, which is another source of discrimination between rich and poor countries. Disability is tightly linked for poverty and other development issues. There is also a need in developing countries for better information data on disability. Resources mobilization should be a priority!
F. Cancer prevention and control (resolution WHA58.22)
Uganda reaffirmed the need to universal access to prevention an control. But also the importance of cancer research on diagnostic.
Bahrain on behalf of the Eastern Mediterranean countries says that some countries were left apart. Knowledge and experience should be made available for any country.
An effective control and prevention is particularly needed for breast cancer.
H. Strengthening active and healthy ageing
I Emergency preparedness and response (resolution WHA59.22)
Congo insisted on the importance of emergency health. It can be because of a natural disaster or as the result of an armed conflict, which has dramatic consequences for civilians, creating internally displaced persons (IDP) or refugees in other countries.
Botswana said that this issue was to be underlined in the perspective of the development agenda and that a sector approach was needed.
Item 12.1 (continued) – Avian and pandemic influenza
Draft resolution has been adopted.
Item 12.10 (continued) – Working towards universal coverage of maternal, newborn and child health interventions: biennial report
Analysis of family planning services in low-income areas or countries indicates a lack of progress in their use. In many countries, particularly in Africa, fertility rates, population growth and unmet needs for family planning remain high. Continued high fertility rates and the demographic consequences of increasing numbers of births complicate attempts to improve health. Major gaps remain in the coverage of post-partum care; in some countries as many as 80% of women who give birth at home receive no such care. The urgent need for action to improve maternal, newborn and child health is commanding increased attention among other organizations in the United Nations system and partners and in global forums in general. The recommendation by the United Nations Secretary-General to the General Assembly at its sixtyfirst session, in September 2006,2 “to achieve universal access to reproductive health by 2015” as a new target under Millennium Development Goal 5 should also stimulate improvement in the rates of coverage.
Secretariat: collaboration with World Bank, UNICEF and NGO’s… is needed; A lot of progress has been achieved but it is not enough…
Item 12.5 (continued) – Malaria, including proposal for establishment of Malaria Day
Draft resolution has been adopted.
Item 12.6 (continued) – Tuberculosis control: progress and long-term planning
Draft resolution has been adopted.
Item 12.11 – Health promotion in a globalized world
Health promotion is a cornerstone of primary health care and a core function of public health.
Its value is increasingly recognized; it is both effective and cost-effective in reducing the burden of disease and in mitigating the social and economic impact of diseases. The links between health promotion, health, and human and economic development are widely acknowledged.
The Bangkok Charter confirms the need to focus on use of health promotion to address the determinants of health and identify action. Its four key commitments are to make promotion of health:
• Central to the global development agenda: strong intergovernmental agreements that improve health and collective health security and effective mechanisms for global governance for health are needed;
• A core responsibility for government as a whole: the determinants of health need to be addressed by all ministries at all levels of government;
• A key focus of communities and civil society: well-organized and empowered communities are highly effective in determining their own health, and are capable of encouraging governments and the private sector to be accountable for the health consequences of their policies and practices;
• A requirement for good corporate practice: the private sector has a responsibility to ensure health and safety in the workplace and to promote the health and well-being of employees, their families and communities, and to contribute to lessening wider impacts on global health
Germany underlined the great problem with the new migrations and their sanitary stakes. To reduce the disparities allows improving health conditions.
Cuba: Wish to enhance the collaboration with Medias - Modify the behavior to reduce the risks
Trinidad and Tobago: Prevention is one thing, but we don’t have to forget the “health consciousness”. Communication and Information will play a great role
Morocco: intellectual flexibility was not guaranteed, as promised in Doha. Innovation must not lead to monopoly. North-South cooperation is vital.
Ghana underlined the lack of financing the promotion of healthy environments and its promotion in the draft resolution.
Committe B (morning)
Item 12.20 on Public health, innovation and intellectual property was discussed as the general debate continued. The central points made by member states were to define clear objectives for R&D, for the secretariat to facilitate regional meetings, to translate the matrix draft (African region), to increase collaboration through the creation of an on going forum, the consultation and the elaboration of the document on intellectual property, and to facilitate access to medical support (Russia), making sure that the important resolutions are more clear and prioritized, to ensure access to necessary drugs in developing countries (China), finding ways and means to render the public health more accessible (Iran), finding ways to lower the prices of the medicines (Vietnam, Thailand). The NGOs, the FPMA and the MCM, that made statement during the meeting emphasized on the need of the IGWG to base itself on precise factual information in order to avoid mistakes and to license pattern pools to permit more affordable prices, try to convince the developers of the second generation of drugs. The doctors’ conclusions on the issues were:
_The working texts will be provided in July and will address the concerns formulated above as there was a high interest of the member states on the issue.
_As soon as the document will be provided the discussion will be more fruitful.
_There is a need to expand the pool of experts. 15 states have already contributed in proposing 42 experts.
Concerning the draft resolution A60/B/conf.paper no.3 Rev1, many member states expressed their gratitude to the director general’s support over the issue. Some amendments were proposed by Brazil who wished to add two paragraphs at the end of the preamble but the European Union showed her preoccupation towards these amendments and wished to know what would be the process followed by the WHO in this sense. Canada showed its anxiety to see the resolution narrow the IGWG work. The Chairman said that a redaction group would be in charge of this matter.
Item 12.19 Health technologies and the resolution EB120.R21. The Executive Board recommends the adoption of the resolution. An overall support to the resolution was stated by the member states. The need to reinforce the directives, to prevent the misuse of technical devices, to strengthen the WHO capacities in this area, and the necessity for equity were expressed. Five amendments to the resolution were proposed and the secretariat will take those into account by the 22nd of May. Hopefully the resolution will be adopted tomorrow.
Item 12.18 concerning Better medicines for children and the resolution EB120.R13 discussed during the last 30 minutes of the meeting. Russia stated that paediatric practice needs an extended number of medicines adapted to the children and under different forms.
Brazil wanted to assure more guarantees over the issue with the TRIPs work, but the United States of America expressed their desire for a moderated and measured approach for this complex problem, they prefer the word “promotion” to “guarantee”.
Technical Briefing – “WHO global action plan against Cancer”:
Cancer is a leading cause of death worldwide. From a total of 58 millions death worldwide in 2005, cancer accounts for 7.6 million (or 13%) of all deaths.
More than 70% of all cancer deaths in 2005 occurred in low and middle income countries. Deaths from cancer in the world are projected to continue rising, with an estimated 9 million people dying from cancer in 2015 and 11.4 million dying in 2030.
40% of cancer can be prevented (by a healthy diet, physically activity and not using tobacco). Another third of the cancer burden could be cured if detected early and treated adequately. For all remaining cancers, palliative care can improve quality of life.
WHO has adopted a global approach: “Prevent, cure, care, and manage for success”.
It is very important to access to healthy environments and the member states have to create nation plan action against the cancer.
COMMITTEE A (Afternoon)
Item 12 Technical health matters
Item 12.12
Integrating gender analysis and actions into the work of WHO
The majority of the member states welcomed the integration of gender analysis and actions in the work of WHO. They also thanked the Secretariat for its work and the quality of its report.
However, various states proposed amendments to the draft strategy. The Distinguished Delegate of Thailand proposed to include the "study" as a determining factor of gender inequality. The D.D. of Sweden proposed to replace "gender family health care" in paragraph 2.4 by "agenda equality perspective"; to replace "too" in paragraph 2.6 by "as providers of" and to add after "publication" on paragraph 3.5: "including relevant documentation presented to the Executive Board and the World Health Assembly". The D.D. of Switzerland also proposed some changes (§2.1, §2.4, §3.4).
The D.D. of Japan expressed the viewpoint of his country concerning the need to take into consideration the cultural background of each country in the implementation of the strategy. He also insisted on the necessary quality of indicators in that sensitive field. The D.D. of South Africa insisted on the establishment of strong capacity-building partnerships and a share of skills in monitoring and evaluation of the strategy's implementation.
The Chairman proposed that the Secretariat would provide a new draft resolution that includes the amendments proposed so that the whole assembly would have access to the new version as a work basis.
Item 12.13
Workers' health: draft global plan of action
Once again, the delegations warmly welcomed the report proposed by the Secretariat.
The D.D. of Germany, on behalf of the European Union emphasized the benefits of ILO/WHO cooperation, particularly in the field of workers' health. He also proposed two friendly amendments.
Some delegations proposed to remove or add some expressions in the draft resolution: Philippines, Thailand, The Sultanate of Oman, Cameroun, the Russian Federation, Greece and Kenya.
The D.D. of Portugal after having stressed the alignment of his delegation on the E.U. statement, highlighted the particular situation of migrant workers and the effect of their working conditions on their health.
On behalf of Saudi Arabia, Kuwait, Qatar, Bahrain, Yemen, Syria, Jordan, Liban, the D.D. of the Sultanate of Oman proposed to add in the 2007-2013 Action Plan the expression "travaillleurs sous contrats" as those Gulf countries have in common that category to distinguish the migrant.
As for the previous item, the Secretariat will provide a new draft document that will include the proposed amendements.
Item 12.14
Health systems: emergency-care systems
This item was only introduced explaining the choice of the expression "emergency-care systems" as an expression covering a wider scope than "emergency-care" alone. There was no time left to keep the discussions on that item and the meeting was adjourned.
Committee B (afternoon)
This seventh meeting of the Committee B was essentially a discussion to follow up past resolutions on technical and health matters.
Before beginning the review, item 12.20 on public health (innovation and intellectual property) after amendment has been adopted.
Item 12.21 Technical and health matters: Progress reports
G. sustaining the elimination of iodine deficiency disorders (resolution WHA 58.22)
Peru took the floor to underline the importance of the issue. Reaffirming that a lack of iodine in alimentation causes serious health damages such as brain disturbance, vision impairment….
A special care should be given to pregnant women who are particularly vulnerable and also because the baby can also greatly suffer from a low iodine alimentation.
Iran emphasizes the need the build up national capacities but also insisted on institutional cooperation between the WHO and relevant partner organizations.
The Canadian delegation found, that the key was the systemic distribution of iodized salt to needed population.
A. Improving the containment of antimicrobial resistance (resolution WHA58.27)
Denmark insisted on the information need and the elaboration of a global response to this issue.
Iran sees this issue of medicine ineffectiveness as a health system issue. Many medicines are not properly used and too often are given without precautions.
B. Implementation by WHO of the recommendation of the Global Task Team on improving AIDS Coordination among multilateral institutions and international donors. (Resolutions WHA59.12)
The South African delegation said it was important to make “money work”, in other words we need effective cooperation and follow up of the aid. There is also a need for more experience sharing among countries and institutions. This is important to have a better global understanding but then apply local skills and approaches.
The ICRC says that the battle of AIDS should be tackled at the community level.
C. World report on violence and health implementation of recommendations
The Jordanian delegation underlines the scourge of violence, which seems to be universal and part of the human condition. The delegation ask for money resources on that particular issue, that is sometimes forgotten, as it not a ‘diseases’ but which can cause serious physical and mental sufferings.
Norway recommended a more close work with the UNICEF concerning the issue of children and violence.
D. Promotion of road safety (resolution WHA57.10)
E. Disability, including prevention (resolution WHA58.23)
Angola reaffirmed the need to tackle this issue, which is another source of discrimination between rich and poor countries. Disability is tightly linked for poverty and other development issues. There is also a need in developing countries for better information data on disability. Resources mobilization should be a priority!
F. Cancer prevention and control (resolution WHA58.22)
Uganda reaffirmed the need to universal access to prevention an control. But also the importance of cancer research on diagnostic.
Bahrain on behalf of the Eastern Mediterranean countries says that some countries were left apart. Knowledge and experience should be made available for any country.
An effective control and prevention is particularly needed for breast cancer.
H. Strengthening active and healthy ageing
I Emergency preparedness and response (resolution WHA59.22)
Congo insisted on the importance of emergency health. It can be because of a natural disaster or as the result of an armed conflict, which has dramatic consequences for civilians, creating internally displaced persons (IDP) or refugees in other countries.
Botswana said that this issue was to be underlined in the perspective of the development agenda and that a sector approach was needed.
samedi 19 mai 2007
Saturday 19th, MAY 2007
COMMITTEE A (Morning)
The ninth meeting of the Commission A opened with the adoption of the resolutions considered under item 12.7. The item 12.8 (prevention and control for noncommunicable diseases: implementation of the global strategy) was then opened to discussion. According to the WHO, 60% of diseases are noncommunicable. The focuses of the discussion was on the issue of alimentation and obesity, but other diseases were considered. Thailand and Norway proposed amendments. Consumers International and the Association Internationale de Conseils en Allaitement then took the floor. The former asks for encouraging the “breath feeding” as a protection against noncommunicable disease while the second proposed a convention on commercialisation of child food. The Resolution EB120.R.17 will finally be considered as a Conference Paper at the next meeting of the Committee.
The assembly then discussed the item 12.9 (Oral health : action plan for promotion and integrated disease prevention). All the countries recognized the necessity to consider the issue of oral health. Almost all States gave their consent to the Resolution, except Micronesia, Philippines and Kenya. Micronesia in particular pleads for taking into consideration the specific needs of low incomes countries. The Resolution EB120.R.5 will finally be considered during next meeting of the Committee.
The Commission finally turned to the item 12.10 (Working towards universal coverage of maternal, newborn and child health interventions : biennial report). All countries presented the steps they have taken in this direction. The United States didn’t want to include the question of abortion in the report. The meeting closed at 13.00 ; seven countries will therefore take the floor next Monday on the same topic.
The ninth meeting of the Commission A opened with the adoption of the resolutions considered under item 12.7. The item 12.8 (prevention and control for noncommunicable diseases: implementation of the global strategy) was then opened to discussion. According to the WHO, 60% of diseases are noncommunicable. The focuses of the discussion was on the issue of alimentation and obesity, but other diseases were considered. Thailand and Norway proposed amendments. Consumers International and the Association Internationale de Conseils en Allaitement then took the floor. The former asks for encouraging the “breath feeding” as a protection against noncommunicable disease while the second proposed a convention on commercialisation of child food. The Resolution EB120.R.17 will finally be considered as a Conference Paper at the next meeting of the Committee.
The assembly then discussed the item 12.9 (Oral health : action plan for promotion and integrated disease prevention). All the countries recognized the necessity to consider the issue of oral health. Almost all States gave their consent to the Resolution, except Micronesia, Philippines and Kenya. Micronesia in particular pleads for taking into consideration the specific needs of low incomes countries. The Resolution EB120.R.5 will finally be considered during next meeting of the Committee.
The Commission finally turned to the item 12.10 (Working towards universal coverage of maternal, newborn and child health interventions : biennial report). All countries presented the steps they have taken in this direction. The United States didn’t want to include the question of abortion in the report. The meeting closed at 13.00 ; seven countries will therefore take the floor next Monday on the same topic.
vendredi 18 mai 2007
Friday 18th, MAY 2007
PLENARY ASSEMBLY of the WHO (Morning)
Item 6 The plenary meeting opened at 9:00. The election of 12 members entitled to designate a person to serve on the Executive Board (EB) was adopted. The countries elected are: Bahamas, Indonesia, Malawi, New Zeland, Paraguay, Peru, Republic of Moldova, Republic of Korea, Sao Tome and Principe, Tunisia, United Arab Emirates, United Kingdom of Great Britain end Northern Ireland.
Item 8 The First report of Committee A (Technical health matters and small pox eradication) was unanimously adopted by the Assembly.
COMMITTEE A (Morning)
Item 12.7 Technical and Health matters: Evidence-based strategies and interventions to reduce alcohol-related harm
This particular issue raised a lot of comments and the importance of a resolution on alcohol-related harm wax emphasised.
However, many delegations wanted to amend the draft paper like New Zeeland, Grenada, Barbados who whished to remove the mention of the creation of an expert committee able to make recommendation. Another amendment proposed was the replacement of the word plan by strategy, considered much more adapted to the issue context. New Zeeland also proposed the mention of the alcohol traffic issue in the resolution’s preamble.
Furthermore, the delegation of the Federation of Russia emphasised the short term positive effect of the anti-alcohol campaign in Russia. The new should take into consideration the deep social and contextual roots and also state consequences of such disease in order to form effective polities. Vulnerable groups should also be mentioned. In the future measures to be taken, one should pay attention to the particularity of each region, in recognizing the importance of the individual approach. Russia also clearly stated that it was against the increase of alcohol prices, which would only have for consequence to give incentives to illicit alcohol sales.
Canada proposed the mention of harmful consumption of alcohol during pregnancy. The Canadian delegation also proposed to take into consideration the addiction causes into consideration. Like Slovenia, who reaffirmed the special social conditions of this issue, in particular with youngsters.
Burundi also emphasised the fact, that despite alcohol related problems were considered as a non-communicable disease, it could certainly lead to communicable diseases such as HIV/ AIDS.
The US delegation took the floor to denounce the fact that the two draft proposals were not submitted to the Executive Bureau as the common procedure requires and that for more transparency and to end the amendment debate, calls for an representative open-ended drafting committee on this special matter. (…) Discussion was then suspended.
COMMITTEE B, (Morning)
ITEM 18: Collaboration within the United Nations system and with other intergovernmental organizations, Doc. A60/39
The member states congratulated the WHO for the reforms of Doc. A60/39 which was accepted, and the WHO General Secretariat promised to share information on the progress of these reforms with members. However some states commented on the text.
Switzerland reminded the Assembly of the necessity for the WHO to take a global leadership role in the issue of health. It must cooperate with other agencies but it has to maintain a certain independence.
India expressed its worries and disappointment concerning the absence of a South East Asian country among the pilot countries (apparently, there’s a problem with Vietnam that is part of the list of the eight pilot countries). It also asked for more details on the structure of the regional mechanisms.
China asked the WHO to avoid political issues and concentrate on health ones.
Belgium encouraged the harmonization of national health systems.
Iraq asked for a greater decentralization of power towards national offices.
Doc. A60/INF.DOC/2, Joint report of the Director-General and the President of the International Narcotic Control Board.
Accepted without any intervention
ITEM 12.16: WHO’s role and responsibilites in health research
Philippines proposed the creation of a mechanism, on the model of the Philippines’ research mechanism, to improve the communication and use of research.
Japan ecouraged the WHO to maintain its work on tropical diseases.
Cameroon emphasized that health research is always at the lowest level of priority in Africa and asked for more support from WHO and foreign investors.
Sweden thinks that the WHO should coordinate all the results of global research.
Non aligned Movement Meeting (NAM) 14:00
This meeting was a very short informative one and further meetings on the same matter are to be held soon.
Cuba, as the chair of the non aligned movement organised consultations on the Meeting of NAM Health Ministers during the 61st session of the World Health Assembly (2008).
The purpose of the meeting was to keep inform the NAM delagation of the 2008 NAM Ministers Meeting at the occasion of the next WHA, in Geneva.
The Cuban delegate recalls us the last NAM Meeting in Havana in September 2006, and particularly its final declaration. Paragraphs 266, 267 and 269 reaffirm the importance of health issues for NAM countries. Some further consultations before the 2008 WHA NAM meeting are to be hold either in Geneva or in New York.
Meeting of the delegation of Member States of the South-East Asia Region 13:00
The session began with Thailand’s proposal to add a mention of Southeast Asia in the Item 12.17 concerning the Progress in the rational use of medicines. They presented a new draft which was welcomed by all the countries of the group. Therefore Timor is standing aside Thailand and other Southeast Asian countries on this issue.
The importance of showing the solidarity of the region was reminded to all by the Chairperson.
A significant discussion on the statement that will be made in Committee B on behalf of the South-East Asia Region was started. India stated at once that the most important line to follow was the one of consensus between the States. They made the assertion that individual statements made by countries of the group during the Committee wouldn’t undermine the region’s unity but only strengthen the consensus between the Asian Nations. They asked States to try not to contradict another State from the group when speaking, in order to reinforce the solidarity of the region.
Bhutan expressed the will to raise the question of drugs in the Private sector issue and of the responsibility of the States towards this matter. And Indonesia urged member States to develop an empowerment system.
The Chairperson reminded the assembly that amendments, if presented at the end of a Committee session, could do more harm than good. According to him, it is better to only propose the draft resolution. And this behaviour would permit the region as a whole to be effective and show a great unity during the Committee.
There were three components that they hoped the Assembly would agree on. It was the Interim guidelines which are the:
_Revise term of reference
_Overside mecanism
_Benefit sharing package
The drafters were India supported by Thailand, Maldives and Indonesia. The question raised by the Chairperson was the following: How are we going to consider the draft presented by Brazil? 3 options were presented.
_ Support Brazil’s draft resolution.
_ No support to Brazil on the matter.
_ Support Brazil’s draft resolution but add amendments to it.
Indonesia expressed it full supports, and the Maldives as well. Bhutan made a good point to the assembly of Southeast region countries as he showed that there was a tacit support in the draft made for the region. This was clear in this sentence: “The countries of the South-East Asia Region support many points in the resolution by Brazil, and while we are not sure whether a resolution is needed at this stage, we do not object to having one”. So if the countries accept this draft, they indirectly support the Brazilian resolution.
The present States were in accordance concerning the fact that they refuse an extension of the timeframe of the Inter-Governmental Working Group (IGWG). They want to stick to the timeline in order for the process to move on. Region will therefore not support an extension of the timeframe of the IGWG.
Technical Meeting: Health and Migration 13:00
This meeting proposed to raise the question of the health of migrants, especially with respect to the migration of health workers (doctors, nurses, midwives). According to Anders Nordström, one of the lecturers, this issue is a really important one because many poor or developing countries are currently experiencing a critical shortage of health workers. The South-East Asia is concerned, and in particular Timore-Leste.
Some “push factors” were discussed, which explain that these countries suffer from a lack of health workers : poor working conditions, few opportunities for professional development, violence and insecurity. The “pull factors” were remuneration, work opportunities and diaspora links. According to the lecturers, any strategies in this field must stand on three pillars : (1) improving education and practice, (2) developing recruitment and (3) developing the governance of migrations (database, human resources, observatories). The role of the International Organization of Migration (IOM) in this field was also highlighted. The IOM can help states to harmonize their policies, to cooperate and to develop partnerships at all phases of the migration process.
Committee A (afternoon)
The Committee discussed Technical and Health Matters. The item 12 was therefore continued. The first debate was brought by the United States for whom the session was badly prepared as the Committee of experts’ report was accessible only on the web and was available only in English.
Item 12.3 the resolution on the Control of Leishmaniasis was to be approved. Amendments were raised by different States. India wanted to add in the preamble that the Members of the Southeast Asian region were collaborating to eliminate the disease by 2015. The Canadian will was to eliminate §11, and Thailand wanted to take out the words “including information” from §6(bis). As there was no objection to these amendments, the resolution EB118.R3 was approved.
Item 12.4 concerning the Poliomyelitis: the mechanism for management of potential risks to eradication and its resolution were discussed. As there were no demands for amendments, the resolution EB120.R1 was approved at once.
The tuberculosis issue in item 12.6 was examined. Kuwait and Ethiopia asked for some changes to be made in §2. The United States asked for Thailand’s clarification over the necessity of the word resources in §1(e). And Benin wanted to know if the French translation of the resolution was correct. The subject will be reviewed.
The afternoon debate lied on the issue of Non Communicable Diseases (NCDs). It important to remind here that Timor-Leste actually isn’t concerned about those diseases. The resolution on the matter received an important support from the present Member States. About 35 States made statements. The central points that were mentioned by the States were the necessity to label the food, control the imported food, the importance of the lifestyle behaviour and the economic and social situations of populations in order to fight the NCDs,
the necessity to fight the diseases when children are still young to be more effective and to have appropriate primary healthcare, to have laws in order to limit tobacco consumption, and finally the necessity to promote physical activities. It was reminded to all that it is important to collaborate on this issue.
Some changes were demanded as some following examples illustrate this. Japan proposed three changes: the combination of §6 and 8 as they are overlapping, a change in §10, and adding the words “health eating habits” and “health diet” in §6. The Philippines recommended the adoption of a treaty over the NCDs. And Mexico asked for the incorporation of a new paragraph urging the States to promote the dialogue between Member States in order to deal with diabetes and obesity.
Commission B (afternoon)
This was the fifth meeting of the Commission B. Item 12.17 concerning the progress in the rational use of medicines was continued as it had been left unfinished the day before. Twelve countries made a statement: Japan, Burkina Faso, China, Thailand, Great-Britain, United States of America, Namibia, Argentina, South Africa, Botswana, Republic of Korea and Kuwait. They all stressed the importance of an action on this issue. The resolution was adopted.
The Item 12.18 about the issue of better medicines for children was then discussed. Brazil was took the floor first and it emphasizes the importance to guarantee the access of essential medicines. It proposed a first amendment to the Resolution EB120.R13 which was opened for discussion, insisting on States to take effective measures. The delegation of Philippines then asks for a second amendment; they want medicines to be available and affordable. A third and last amendment was proposed by Thailand, concerning collaboration with States, international organizations, OMC, WIPO, ONG and pharmaceutical industries in order to secure the financing. All the other states supported the resolution.
In accordance with Rule 49 of Procedure of the WHO, the floor was given to two international organizations: the International Paediatric Association and the Union national de pharmacologie clinique de base. They consider the resolution to be acceptable, but they want it to be followed by action. The Chairman then announced that the draft resolution including the amendments will be considered as a Conference Paper at the next meeting of the Committee.
Item 12.20 (Public health, innovation and intellectual property : progress made by the Intergovernmental Working Group) was then opened to discussion. It should have been discussed on Monday, but the delegation of Brazil asks for discussing it today and this proposition was accepted. Ms. Chan highlighted the complexity of the issue. The delegation of Switzerland first took the floor and said that the issue should be discussed once the report (global strategy) of the secretariat is finished. The delegation of Brazil didn’t agree to wait until July (probably) and wanted to discuss some keys elements. The delegations of Surinam and Argentina proposed amendments to the draft resolution. India, in name of South-East Asia countries, including Timor-Leste, gave its support to the delegation of Brazil.
Discussion on this issue will resume at the next meeting of the Committee.
Item 6 The plenary meeting opened at 9:00. The election of 12 members entitled to designate a person to serve on the Executive Board (EB) was adopted. The countries elected are: Bahamas, Indonesia, Malawi, New Zeland, Paraguay, Peru, Republic of Moldova, Republic of Korea, Sao Tome and Principe, Tunisia, United Arab Emirates, United Kingdom of Great Britain end Northern Ireland.
Item 8 The First report of Committee A (Technical health matters and small pox eradication) was unanimously adopted by the Assembly.
COMMITTEE A (Morning)
Item 12.7 Technical and Health matters: Evidence-based strategies and interventions to reduce alcohol-related harm
This particular issue raised a lot of comments and the importance of a resolution on alcohol-related harm wax emphasised.
However, many delegations wanted to amend the draft paper like New Zeeland, Grenada, Barbados who whished to remove the mention of the creation of an expert committee able to make recommendation. Another amendment proposed was the replacement of the word plan by strategy, considered much more adapted to the issue context. New Zeeland also proposed the mention of the alcohol traffic issue in the resolution’s preamble.
Furthermore, the delegation of the Federation of Russia emphasised the short term positive effect of the anti-alcohol campaign in Russia. The new should take into consideration the deep social and contextual roots and also state consequences of such disease in order to form effective polities. Vulnerable groups should also be mentioned. In the future measures to be taken, one should pay attention to the particularity of each region, in recognizing the importance of the individual approach. Russia also clearly stated that it was against the increase of alcohol prices, which would only have for consequence to give incentives to illicit alcohol sales.
Canada proposed the mention of harmful consumption of alcohol during pregnancy. The Canadian delegation also proposed to take into consideration the addiction causes into consideration. Like Slovenia, who reaffirmed the special social conditions of this issue, in particular with youngsters.
Burundi also emphasised the fact, that despite alcohol related problems were considered as a non-communicable disease, it could certainly lead to communicable diseases such as HIV/ AIDS.
The US delegation took the floor to denounce the fact that the two draft proposals were not submitted to the Executive Bureau as the common procedure requires and that for more transparency and to end the amendment debate, calls for an representative open-ended drafting committee on this special matter. (…) Discussion was then suspended.
COMMITTEE B, (Morning)
ITEM 18: Collaboration within the United Nations system and with other intergovernmental organizations, Doc. A60/39
The member states congratulated the WHO for the reforms of Doc. A60/39 which was accepted, and the WHO General Secretariat promised to share information on the progress of these reforms with members. However some states commented on the text.
Switzerland reminded the Assembly of the necessity for the WHO to take a global leadership role in the issue of health. It must cooperate with other agencies but it has to maintain a certain independence.
India expressed its worries and disappointment concerning the absence of a South East Asian country among the pilot countries (apparently, there’s a problem with Vietnam that is part of the list of the eight pilot countries). It also asked for more details on the structure of the regional mechanisms.
China asked the WHO to avoid political issues and concentrate on health ones.
Belgium encouraged the harmonization of national health systems.
Iraq asked for a greater decentralization of power towards national offices.
Doc. A60/INF.DOC/2, Joint report of the Director-General and the President of the International Narcotic Control Board.
Accepted without any intervention
ITEM 12.16: WHO’s role and responsibilites in health research
Philippines proposed the creation of a mechanism, on the model of the Philippines’ research mechanism, to improve the communication and use of research.
Japan ecouraged the WHO to maintain its work on tropical diseases.
Cameroon emphasized that health research is always at the lowest level of priority in Africa and asked for more support from WHO and foreign investors.
Sweden thinks that the WHO should coordinate all the results of global research.
Non aligned Movement Meeting (NAM) 14:00
This meeting was a very short informative one and further meetings on the same matter are to be held soon.
Cuba, as the chair of the non aligned movement organised consultations on the Meeting of NAM Health Ministers during the 61st session of the World Health Assembly (2008).
The purpose of the meeting was to keep inform the NAM delagation of the 2008 NAM Ministers Meeting at the occasion of the next WHA, in Geneva.
The Cuban delegate recalls us the last NAM Meeting in Havana in September 2006, and particularly its final declaration. Paragraphs 266, 267 and 269 reaffirm the importance of health issues for NAM countries. Some further consultations before the 2008 WHA NAM meeting are to be hold either in Geneva or in New York.
Meeting of the delegation of Member States of the South-East Asia Region 13:00
The session began with Thailand’s proposal to add a mention of Southeast Asia in the Item 12.17 concerning the Progress in the rational use of medicines. They presented a new draft which was welcomed by all the countries of the group. Therefore Timor is standing aside Thailand and other Southeast Asian countries on this issue.
The importance of showing the solidarity of the region was reminded to all by the Chairperson.
A significant discussion on the statement that will be made in Committee B on behalf of the South-East Asia Region was started. India stated at once that the most important line to follow was the one of consensus between the States. They made the assertion that individual statements made by countries of the group during the Committee wouldn’t undermine the region’s unity but only strengthen the consensus between the Asian Nations. They asked States to try not to contradict another State from the group when speaking, in order to reinforce the solidarity of the region.
Bhutan expressed the will to raise the question of drugs in the Private sector issue and of the responsibility of the States towards this matter. And Indonesia urged member States to develop an empowerment system.
The Chairperson reminded the assembly that amendments, if presented at the end of a Committee session, could do more harm than good. According to him, it is better to only propose the draft resolution. And this behaviour would permit the region as a whole to be effective and show a great unity during the Committee.
There were three components that they hoped the Assembly would agree on. It was the Interim guidelines which are the:
_Revise term of reference
_Overside mecanism
_Benefit sharing package
The drafters were India supported by Thailand, Maldives and Indonesia. The question raised by the Chairperson was the following: How are we going to consider the draft presented by Brazil? 3 options were presented.
_ Support Brazil’s draft resolution.
_ No support to Brazil on the matter.
_ Support Brazil’s draft resolution but add amendments to it.
Indonesia expressed it full supports, and the Maldives as well. Bhutan made a good point to the assembly of Southeast region countries as he showed that there was a tacit support in the draft made for the region. This was clear in this sentence: “The countries of the South-East Asia Region support many points in the resolution by Brazil, and while we are not sure whether a resolution is needed at this stage, we do not object to having one”. So if the countries accept this draft, they indirectly support the Brazilian resolution.
The present States were in accordance concerning the fact that they refuse an extension of the timeframe of the Inter-Governmental Working Group (IGWG). They want to stick to the timeline in order for the process to move on. Region will therefore not support an extension of the timeframe of the IGWG.
Technical Meeting: Health and Migration 13:00
This meeting proposed to raise the question of the health of migrants, especially with respect to the migration of health workers (doctors, nurses, midwives). According to Anders Nordström, one of the lecturers, this issue is a really important one because many poor or developing countries are currently experiencing a critical shortage of health workers. The South-East Asia is concerned, and in particular Timore-Leste.
Some “push factors” were discussed, which explain that these countries suffer from a lack of health workers : poor working conditions, few opportunities for professional development, violence and insecurity. The “pull factors” were remuneration, work opportunities and diaspora links. According to the lecturers, any strategies in this field must stand on three pillars : (1) improving education and practice, (2) developing recruitment and (3) developing the governance of migrations (database, human resources, observatories). The role of the International Organization of Migration (IOM) in this field was also highlighted. The IOM can help states to harmonize their policies, to cooperate and to develop partnerships at all phases of the migration process.
Committee A (afternoon)
The Committee discussed Technical and Health Matters. The item 12 was therefore continued. The first debate was brought by the United States for whom the session was badly prepared as the Committee of experts’ report was accessible only on the web and was available only in English.
Item 12.3 the resolution on the Control of Leishmaniasis was to be approved. Amendments were raised by different States. India wanted to add in the preamble that the Members of the Southeast Asian region were collaborating to eliminate the disease by 2015. The Canadian will was to eliminate §11, and Thailand wanted to take out the words “including information” from §6(bis). As there was no objection to these amendments, the resolution EB118.R3 was approved.
Item 12.4 concerning the Poliomyelitis: the mechanism for management of potential risks to eradication and its resolution were discussed. As there were no demands for amendments, the resolution EB120.R1 was approved at once.
The tuberculosis issue in item 12.6 was examined. Kuwait and Ethiopia asked for some changes to be made in §2. The United States asked for Thailand’s clarification over the necessity of the word resources in §1(e). And Benin wanted to know if the French translation of the resolution was correct. The subject will be reviewed.
The afternoon debate lied on the issue of Non Communicable Diseases (NCDs). It important to remind here that Timor-Leste actually isn’t concerned about those diseases. The resolution on the matter received an important support from the present Member States. About 35 States made statements. The central points that were mentioned by the States were the necessity to label the food, control the imported food, the importance of the lifestyle behaviour and the economic and social situations of populations in order to fight the NCDs,
the necessity to fight the diseases when children are still young to be more effective and to have appropriate primary healthcare, to have laws in order to limit tobacco consumption, and finally the necessity to promote physical activities. It was reminded to all that it is important to collaborate on this issue.
Some changes were demanded as some following examples illustrate this. Japan proposed three changes: the combination of §6 and 8 as they are overlapping, a change in §10, and adding the words “health eating habits” and “health diet” in §6. The Philippines recommended the adoption of a treaty over the NCDs. And Mexico asked for the incorporation of a new paragraph urging the States to promote the dialogue between Member States in order to deal with diabetes and obesity.
Commission B (afternoon)
This was the fifth meeting of the Commission B. Item 12.17 concerning the progress in the rational use of medicines was continued as it had been left unfinished the day before. Twelve countries made a statement: Japan, Burkina Faso, China, Thailand, Great-Britain, United States of America, Namibia, Argentina, South Africa, Botswana, Republic of Korea and Kuwait. They all stressed the importance of an action on this issue. The resolution was adopted.
The Item 12.18 about the issue of better medicines for children was then discussed. Brazil was took the floor first and it emphasizes the importance to guarantee the access of essential medicines. It proposed a first amendment to the Resolution EB120.R13 which was opened for discussion, insisting on States to take effective measures. The delegation of Philippines then asks for a second amendment; they want medicines to be available and affordable. A third and last amendment was proposed by Thailand, concerning collaboration with States, international organizations, OMC, WIPO, ONG and pharmaceutical industries in order to secure the financing. All the other states supported the resolution.
In accordance with Rule 49 of Procedure of the WHO, the floor was given to two international organizations: the International Paediatric Association and the Union national de pharmacologie clinique de base. They consider the resolution to be acceptable, but they want it to be followed by action. The Chairman then announced that the draft resolution including the amendments will be considered as a Conference Paper at the next meeting of the Committee.
Item 12.20 (Public health, innovation and intellectual property : progress made by the Intergovernmental Working Group) was then opened to discussion. It should have been discussed on Monday, but the delegation of Brazil asks for discussing it today and this proposition was accepted. Ms. Chan highlighted the complexity of the issue. The delegation of Switzerland first took the floor and said that the issue should be discussed once the report (global strategy) of the secretariat is finished. The delegation of Brazil didn’t agree to wait until July (probably) and wanted to discuss some keys elements. The delegations of Surinam and Argentina proposed amendments to the draft resolution. India, in name of South-East Asia countries, including Timor-Leste, gave its support to the delegation of Brazil.
Discussion on this issue will resume at the next meeting of the Committee.
jeudi 17 mai 2007
Thursday 17th, MAY 2007
COMMITTEE A (Morning)
Item 11 was briefly continued as it had been left unfinished the day before. Issues on the Draft medium-term strategic plan, including proposed programme budget 2008-2009, were discussed. The central points were the need of monitoring its implementation, the requirement for more financial support, and the necessity for a clear division between authority and resources. The Islamic republic of Iran asked for periodic reporting, Liberia demanded a strengthening of the partnership between States, and the Russian Federation emphasized on the necessity of increasing the dialogue between States and with other organizations such as NGOs. WHO thanked the support from all States and reminded that the Medium-term strategic plan was very complementary with the 11 General Programme Work.
Item 12, Technical and health matters, over Malaria, the consideration of the resolution EB120/R16, and the proposal of including a Malaria Day, was examined. The States were invited to speak, either to make a contribution, to ask for an amendment, or to express their points of view over the matter. 37 States intervened in the discussion. It was reminded that some regions are disturbed by the magnitude of the burden created by the existence of Malaria and that the illness is causing problem on a social level as well as on an economic level. The challenge would be to find new anti-malaria drugs as the resistance to existing drugs and to insecticide is increasing therefore posing a new challenge. A will for the increasing of Research was clearly stated throughout this meeting by many States. An increase support to high burdened countries and the prevailing of the re-emergence of Malaria in certain regions was mentioned.
China proposed to eliminate taxes, USA supported this idea, over the medication and tools that are used to fight the disease. At the Abuja summit, the African countries, which are the most severely touched be the disease, reaffirmed their commitment to fight Malaria. The African region wants to channel more resources in preventive therapies and alternative tools to fight the Malaria. Switzerland made the proposition of adding police and repression to the interdiction of counterfeit medication. Thailand did raise an important concern about the use of DDT which can have great environmental issues and argued that the information on the impact of DDT is still inadequate, in Thailand it is considered as toxic. The doctors replied that according to the WHO the DDT can be used in some States in Africa where it is needed and it will be under WHO guidelines.
The World Malaria Day was wholly admitted as a useful idea to promote the prevention of the disease more actively worldwide. The only sceptical State was Mexico who argued that a World Day could not surely help the battle against the disease.
The Africa Malaria day, observed in April 25, was chosen to become the World Malaria Day. Here some States made reserves. China started by saying that Malaria was a disease depending on seasons and that April doesn’t correspond to the epidemiological calendar on her territory. And she added that the 25th of April was already the day of infantile vaccines in China and therefore the Malaria day would have less positive impacts if chosen to be on this date. The Venezuela Bolivarian Republic prefers the date to be in November as do other South American states. But it was reminded that Africa is suffering the most from Malaria and that the all continent, with other States such as for example Indonesia or Bhutan, support the idea of having the World Malaria Day on the 25th of April, day of the Africa’s Malaria day.
The resolution EB120/R16 received overall a large support.
The Committee will think of the issues discussed and report the changes in the week.
COMMITTEE B (Morning)
Item 14: During this second meeting of Committee B, the debate on the issue of health conditions in the occupied Palestinian territory, which was led during le first session, has been carried on during this second session. Several state representatives took the floor to express their views on the health situation in the Gaza strip, West Bank, East Jerusalem and the Syrian Golan.
The D.D of Senegal pointed out the numerous difficulties of implementation of health services in the occupied territories. He called for a more effective promotion of health services and a more effective technical assistance.
The D.D of Malaysia expressed his preoccupation concerning the degrading health situation in the occupied territories, reaching a critical level. He called for a stronger collective reaction in order to ensure a better general health situation.
The D.D of Cuba expressed his concern regarding the deterioration of the situation due to the Israeli policy of occupation, leading to serious health problems. Cuba evoked the obstacles to free circulation, the degrading infrastructure of health system, increasing unemployment, precariousness, and the problems of malnutrition and food supply.
Therefore, Cuba asserted that the basic rights of Palestinians are being denied, supports the creation of an independent state of Palestine with East Jerusalem for capital, and reaffirms the illegal nature of the Israeli settlement in the territories.
Finally, Cuba sponsors the draft resolution and calls for the support of the other members of the international community.
The D.D of China expresses his concern regarding the shortage of access to food and fuel for the population, the degrading health and medical infrastructure. Moreover, China condemns the oppressive Israeli policy, obstructing the aid of the international community addressed to the Palestinian population.
China reaffirms its support to the draft resolution.
The D.D of the United Arab Emirates recalled the humanitarian crisis that characterizes the situation in the occupied territories, considering the high level of poverty and the weak implantation of health assistance. The UAE condemned the increasing presence of check points, security measures implemented by Israel. Besides, the UAE expressed their regret regarding the lack of interest of the international community on this issue.
The D.D of Algeria supports the previous views made on the deterioration of the health situation in the Palestinian territories. He observed the fact that Palestinians can’t reach minimum health standards upheld by the international community. In addition, Algeria approved previous reports of the Human Rights Council on the matter and supports the plan of sending a fact-finding mission. Finally, Algeria called for all the members’ consideration of the situation to avoid further violations.
The D.D of Venezuela deplores the lack of health assistance for the Palestinian population, calls for Israel to stop restriction on mobility, including the construction of the wall.
The D.D of South Africa affirmed that this human crisis should receive more attention and assistance on the basis of the reports made by the fact finding group. South Africa condemns the constraints imposed by Israel regarding access to health care for chronic diseases.
The D.D of Indonesia expressed his concern concerning the deteriorating health conditions as previously mentioned, calls for increased assistance and supports the draft resolution.
The D.D of Kuwait evoked the importance of removing all political considerations and focus on humanitarian factors. Kuwait expressed its concern regarding the health situation in the occupied territories, supports the draft resolution, and calls for health for all, for the need to put pressure on Israel to stop any further measure which would worsen the situation.
The D.D of Tunisia expressed his concern regarding the rapid deterioration of the situation, calls for the instauration of more effective medical institutions to provide health care. Tunisia reaffirms its support to the draft resolution.
The D.D of Syria intervened again, condemning Israel for flattening the gravity of the violations reported. Moreover, Syria deplored several practices on the Syrian Golan, such as testing drugs on detainees, or using landmines. Syria calls for all states’ support of the draft resolution.
The D.D of Israel briefly responded by condemning Syria assertions (despising tone).
The draft resolution was adopted: For: 106, against: 7, Abstention/Absence: 55
Item 15: the session was followed by debates and adoption of resolutions regarding financial matters
Committee A (afternoon)
The item discussed was the fight against tuberculoses (TB). This is the item 12.6 of the agenda. The title is “Tuberculosis control: Progress and long term planning.”
Iraq was the first country to speech. It emphasized the fact that the situation regarding TB has worsen after the war in 2003. India highlighted the fact that more than 1000 people die in India every day due to TB. Gambia said that it has made significant progress. Germany spoke on behalf of the European Union. The EU wants to support initiatives of WHO member states financially. Senegal talked about its national programme. Eritrea raised the issue of the need of a quality control system. Thailand wants to work more closely with international donors and agencies. Botswana has a successful national fight programme against TB; especially its TV programme regarding TB gives good results. The Netherlands and the following other EU member states linked their opinion to the German statement. The Netherlands more specifically wants to give more attention to vulnerable people such as migrants and ethnic minorities. Papua New Guinea considers TB as a development problem. Bangladesh mentioned its efforts to include the TB in the broader framework of MDGs. Swaziland said that Africa is the continent which still has a raising number of TB cases. One of the amendments of Swaziland aims to link TB and HIV/Aids more closely. Micronesia referred to its limited resources and geographical constraints. Malta talked about the influx of migrants to its island. 65 percent of the TB cases are imported cases. Kenya and the following African countries referred to the statement made by Swaziland. Portugal referred to the fact that specific population groups and areas are especially endangered of TB. It made also the link to migrants of countries with a high TB danger. Malawi declared TB as urgency. Africa is sitting on a time bomb, the representative of Malawi said. Ethiopia linked the issue of TB to the disease of HIV. The Bahamas talked on the behalf of 14 members of the Caribbean. It raised the issue of increased migration from countries with high TB rates. Zambia said that 70 percent of the people infected of TB are also infected of HIV. Burundi considers TB as one of its priorities of its health policy. The representative of a NGO said that TB is still a leading factor of mortality world wide. But generally, the pandemic is on decline. One of the regional directors said that powerful partnerships of countries and agencies need to be formed.
The chairman asked the secretariat to prepare a paper with the different recommendations of the member states. Totally, 43 countries made a statement.
COMMITTEE B (Afternoon)
Item 15 (continued)
Financial matters
Item 15.7
Appointment of the External Auditor
There was three countries with nominated candidates to be considered as the next auditor of the WHO. India, Indonesia and Philippines. The candidate of India is the current external auditor of WHO and he is appointed since 2004.
Each of the candidates was given the floor so as to make a brief personal introduction.
The results of the vote are the following ones:
Countries entitled to vote: 180
Absent: 55
Abstention: 1
Null: 0
Present and voting: 124
Simple majority reached with 63 votes
INDIA: 80 votes = >Re-election of the Indian external auditor
INDONESIA: 26 votes
PHILIPPINES: 18
Item 17
Staffing matters
Item 17.1
Human resources: annual report
The D.D. of Canada and of the Russian Federation welcomed the efforts made by the Secretariat and the Human Resources department for the quality of their annual report.
The Russian Federation expressed his concerns as for. The issue of the mobility policies and asked the Secretariat to show clearly the progress achieved in that field. He also stressed the lack of human resources in European office and finally asked for a clarification of the situation of implementation of WHO standards.
The D.D. of Namibia and U.S.A. raised the issue of the employment of female within the WHO asking for a clear objective.
A Representative of the Secretariat answered positively to all the remarks.
For the following items, no state member took the floor and the president has declared those points as approved.
Item 17.2
Amendments to the Staff Regulations and Staff Rules
Item 17.3
Report of the United Nations Joint Staff Pension Board
Item 17.4
Appointment of representatives to the WHO Staff Pension Committee
Dr J. de la Rivière (Canada) and Dr Youssouf (Maldives) were appointed until May 2010.
Item 12
Technical and Health Matters
Item 12.16
WHO'§s role and responsibilities in Health Research
Item 11 was briefly continued as it had been left unfinished the day before. Issues on the Draft medium-term strategic plan, including proposed programme budget 2008-2009, were discussed. The central points were the need of monitoring its implementation, the requirement for more financial support, and the necessity for a clear division between authority and resources. The Islamic republic of Iran asked for periodic reporting, Liberia demanded a strengthening of the partnership between States, and the Russian Federation emphasized on the necessity of increasing the dialogue between States and with other organizations such as NGOs. WHO thanked the support from all States and reminded that the Medium-term strategic plan was very complementary with the 11 General Programme Work.
Item 12, Technical and health matters, over Malaria, the consideration of the resolution EB120/R16, and the proposal of including a Malaria Day, was examined. The States were invited to speak, either to make a contribution, to ask for an amendment, or to express their points of view over the matter. 37 States intervened in the discussion. It was reminded that some regions are disturbed by the magnitude of the burden created by the existence of Malaria and that the illness is causing problem on a social level as well as on an economic level. The challenge would be to find new anti-malaria drugs as the resistance to existing drugs and to insecticide is increasing therefore posing a new challenge. A will for the increasing of Research was clearly stated throughout this meeting by many States. An increase support to high burdened countries and the prevailing of the re-emergence of Malaria in certain regions was mentioned.
China proposed to eliminate taxes, USA supported this idea, over the medication and tools that are used to fight the disease. At the Abuja summit, the African countries, which are the most severely touched be the disease, reaffirmed their commitment to fight Malaria. The African region wants to channel more resources in preventive therapies and alternative tools to fight the Malaria. Switzerland made the proposition of adding police and repression to the interdiction of counterfeit medication. Thailand did raise an important concern about the use of DDT which can have great environmental issues and argued that the information on the impact of DDT is still inadequate, in Thailand it is considered as toxic. The doctors replied that according to the WHO the DDT can be used in some States in Africa where it is needed and it will be under WHO guidelines.
The World Malaria Day was wholly admitted as a useful idea to promote the prevention of the disease more actively worldwide. The only sceptical State was Mexico who argued that a World Day could not surely help the battle against the disease.
The Africa Malaria day, observed in April 25, was chosen to become the World Malaria Day. Here some States made reserves. China started by saying that Malaria was a disease depending on seasons and that April doesn’t correspond to the epidemiological calendar on her territory. And she added that the 25th of April was already the day of infantile vaccines in China and therefore the Malaria day would have less positive impacts if chosen to be on this date. The Venezuela Bolivarian Republic prefers the date to be in November as do other South American states. But it was reminded that Africa is suffering the most from Malaria and that the all continent, with other States such as for example Indonesia or Bhutan, support the idea of having the World Malaria Day on the 25th of April, day of the Africa’s Malaria day.
The resolution EB120/R16 received overall a large support.
The Committee will think of the issues discussed and report the changes in the week.
COMMITTEE B (Morning)
Item 14: During this second meeting of Committee B, the debate on the issue of health conditions in the occupied Palestinian territory, which was led during le first session, has been carried on during this second session. Several state representatives took the floor to express their views on the health situation in the Gaza strip, West Bank, East Jerusalem and the Syrian Golan.
The D.D of Senegal pointed out the numerous difficulties of implementation of health services in the occupied territories. He called for a more effective promotion of health services and a more effective technical assistance.
The D.D of Malaysia expressed his preoccupation concerning the degrading health situation in the occupied territories, reaching a critical level. He called for a stronger collective reaction in order to ensure a better general health situation.
The D.D of Cuba expressed his concern regarding the deterioration of the situation due to the Israeli policy of occupation, leading to serious health problems. Cuba evoked the obstacles to free circulation, the degrading infrastructure of health system, increasing unemployment, precariousness, and the problems of malnutrition and food supply.
Therefore, Cuba asserted that the basic rights of Palestinians are being denied, supports the creation of an independent state of Palestine with East Jerusalem for capital, and reaffirms the illegal nature of the Israeli settlement in the territories.
Finally, Cuba sponsors the draft resolution and calls for the support of the other members of the international community.
The D.D of China expresses his concern regarding the shortage of access to food and fuel for the population, the degrading health and medical infrastructure. Moreover, China condemns the oppressive Israeli policy, obstructing the aid of the international community addressed to the Palestinian population.
China reaffirms its support to the draft resolution.
The D.D of the United Arab Emirates recalled the humanitarian crisis that characterizes the situation in the occupied territories, considering the high level of poverty and the weak implantation of health assistance. The UAE condemned the increasing presence of check points, security measures implemented by Israel. Besides, the UAE expressed their regret regarding the lack of interest of the international community on this issue.
The D.D of Algeria supports the previous views made on the deterioration of the health situation in the Palestinian territories. He observed the fact that Palestinians can’t reach minimum health standards upheld by the international community. In addition, Algeria approved previous reports of the Human Rights Council on the matter and supports the plan of sending a fact-finding mission. Finally, Algeria called for all the members’ consideration of the situation to avoid further violations.
The D.D of Venezuela deplores the lack of health assistance for the Palestinian population, calls for Israel to stop restriction on mobility, including the construction of the wall.
The D.D of South Africa affirmed that this human crisis should receive more attention and assistance on the basis of the reports made by the fact finding group. South Africa condemns the constraints imposed by Israel regarding access to health care for chronic diseases.
The D.D of Indonesia expressed his concern concerning the deteriorating health conditions as previously mentioned, calls for increased assistance and supports the draft resolution.
The D.D of Kuwait evoked the importance of removing all political considerations and focus on humanitarian factors. Kuwait expressed its concern regarding the health situation in the occupied territories, supports the draft resolution, and calls for health for all, for the need to put pressure on Israel to stop any further measure which would worsen the situation.
The D.D of Tunisia expressed his concern regarding the rapid deterioration of the situation, calls for the instauration of more effective medical institutions to provide health care. Tunisia reaffirms its support to the draft resolution.
The D.D of Syria intervened again, condemning Israel for flattening the gravity of the violations reported. Moreover, Syria deplored several practices on the Syrian Golan, such as testing drugs on detainees, or using landmines. Syria calls for all states’ support of the draft resolution.
The D.D of Israel briefly responded by condemning Syria assertions (despising tone).
The draft resolution was adopted: For: 106, against: 7, Abstention/Absence: 55
Item 15: the session was followed by debates and adoption of resolutions regarding financial matters
Committee A (afternoon)
The item discussed was the fight against tuberculoses (TB). This is the item 12.6 of the agenda. The title is “Tuberculosis control: Progress and long term planning.”
Iraq was the first country to speech. It emphasized the fact that the situation regarding TB has worsen after the war in 2003. India highlighted the fact that more than 1000 people die in India every day due to TB. Gambia said that it has made significant progress. Germany spoke on behalf of the European Union. The EU wants to support initiatives of WHO member states financially. Senegal talked about its national programme. Eritrea raised the issue of the need of a quality control system. Thailand wants to work more closely with international donors and agencies. Botswana has a successful national fight programme against TB; especially its TV programme regarding TB gives good results. The Netherlands and the following other EU member states linked their opinion to the German statement. The Netherlands more specifically wants to give more attention to vulnerable people such as migrants and ethnic minorities. Papua New Guinea considers TB as a development problem. Bangladesh mentioned its efforts to include the TB in the broader framework of MDGs. Swaziland said that Africa is the continent which still has a raising number of TB cases. One of the amendments of Swaziland aims to link TB and HIV/Aids more closely. Micronesia referred to its limited resources and geographical constraints. Malta talked about the influx of migrants to its island. 65 percent of the TB cases are imported cases. Kenya and the following African countries referred to the statement made by Swaziland. Portugal referred to the fact that specific population groups and areas are especially endangered of TB. It made also the link to migrants of countries with a high TB danger. Malawi declared TB as urgency. Africa is sitting on a time bomb, the representative of Malawi said. Ethiopia linked the issue of TB to the disease of HIV. The Bahamas talked on the behalf of 14 members of the Caribbean. It raised the issue of increased migration from countries with high TB rates. Zambia said that 70 percent of the people infected of TB are also infected of HIV. Burundi considers TB as one of its priorities of its health policy. The representative of a NGO said that TB is still a leading factor of mortality world wide. But generally, the pandemic is on decline. One of the regional directors said that powerful partnerships of countries and agencies need to be formed.
The chairman asked the secretariat to prepare a paper with the different recommendations of the member states. Totally, 43 countries made a statement.
COMMITTEE B (Afternoon)
Item 15 (continued)
Financial matters
Item 15.7
Appointment of the External Auditor
There was three countries with nominated candidates to be considered as the next auditor of the WHO. India, Indonesia and Philippines. The candidate of India is the current external auditor of WHO and he is appointed since 2004.
Each of the candidates was given the floor so as to make a brief personal introduction.
The results of the vote are the following ones:
Countries entitled to vote: 180
Absent: 55
Abstention: 1
Null: 0
Present and voting: 124
Simple majority reached with 63 votes
INDIA: 80 votes = >Re-election of the Indian external auditor
INDONESIA: 26 votes
PHILIPPINES: 18
Item 17
Staffing matters
Item 17.1
Human resources: annual report
The D.D. of Canada and of the Russian Federation welcomed the efforts made by the Secretariat and the Human Resources department for the quality of their annual report.
The Russian Federation expressed his concerns as for. The issue of the mobility policies and asked the Secretariat to show clearly the progress achieved in that field. He also stressed the lack of human resources in European office and finally asked for a clarification of the situation of implementation of WHO standards.
The D.D. of Namibia and U.S.A. raised the issue of the employment of female within the WHO asking for a clear objective.
A Representative of the Secretariat answered positively to all the remarks.
For the following items, no state member took the floor and the president has declared those points as approved.
Item 17.2
Amendments to the Staff Regulations and Staff Rules
Item 17.3
Report of the United Nations Joint Staff Pension Board
Item 17.4
Appointment of representatives to the WHO Staff Pension Committee
Dr J. de la Rivière (Canada) and Dr Youssouf (Maldives) were appointed until May 2010.
Item 12
Technical and Health Matters
Item 12.16
WHO'§s role and responsibilities in Health Research
mercredi 16 mai 2007
WHA- 16th May- Committee A: Morning by PM
WHA- 16th May- Committee A: Morning by PM
Chairman : Dr Robinson R. Jean Louis (Madagascar)
Provisional agenda item 12.2 - Smallpox eradication: destruction of
variola virus stocks
Resolution WHA49.10 (1996) recommended that the remaining stocks of live variola virus maintained by WHO since 1984 should be destroyed on 30 June 1999, after a final decision to be taken by the Health Assembly in May 1999. The Fifty-second World Health Assembly decided by resolution WHA52.10 to authorize temporary retention of the remaining variola virus stocks, subject to annual review, but up to no later than 2002, for the purpose of carrying out a programme of essential public-health research. By resolution WHA55.15 it authorized further temporary retention of these stocks for the purpose of continuing further international research.
The great stake for the destruction of variola virus stocks lies in the fight against the bioterrorist threat. But some States underline the necessity to retain temporarily stocks for the purpose of research (Australia, Thailand, Barbados)
The draft resolution contained in resolution EB120.R8 is adopted, with some substantially amendments.
Provisional agenda item 12.3 - Control of leishmaniasis
Leishmaniasis is endemic in 88 countries in the world and 350 million people are considered at risk. An estimated 14 million people are infected, and each year about two million new cases occur.
The disease contributes significantly to the propagation of poverty, because treatment is expensive and hence either unaffordable or it imposes a substantial economic burden, including loss of wages.
Leishmaniasis with HIV coinfection is an emerging condition that demands urgent attention.
Even when coinfected patients receive proper treatment, they relapse repeatedly and the outcome frequently is fatal. Leishmaniasis is caused by a protozoal parasite of the genus Leishmania which multiplies in certain vertebrates that act as reservoirs of the disease. The parasite is transmitted to humans through the bite of sandflies that have previously fed on an infected reservoir. Expression of the two basic forms of the disease, namely cutaneous and visceral leishmaniasis, depends on the species of Leishmania responsible and the immune response to infection. The cutaneous form tends to heal spontaneously leaving scars which, depending on the species of Leishmania responsible, may evolve into diffuse cutaneous leishmaniasis, recidivans leishmaniasis, or mucocutaneous leishmaniasis, with disastrous aesthetic consequences for the patient. Visceral leishmaniasis, the most severe form, is fatal in almost all cases if left untreated. It may cause epidemic outbreaks with high mortality.
Many countries are satisfied by the fact that this disease, relatively unknown, is registered in the provisional agenda of the WHA.
The great stake is the distribution of the disease, e.g. with the flows of refugees (Morocco).
Thailand: underlined the need of monitoring.
India : beginning of a collaboration with Nepal and Bangladesh to eradicate this disease in South East Asia (90% in Bangladesh, Brazil ,India, Nepal and Sudan).
Kuwait : need to expend the collaboration with threatened countries.
The Secretary underlined the decline of the 90 % price of the medicine, by the action of the WHO
Resolution EB118.R3 will be examined later, once the amendments taken in account.
Provisional agenda item 12.4 - Poliomyelitis: mechanism for management of potential risks to eradication
In 2006, the remaining 6% of all new cases of poliomyelitis occurred in countries into which
poliovirus has been reintroduced. In order to reduce the risk of further international spread of wild poliovirus in 2006, countries judged to be at high risk of importing viruses (because of previous importations or having borders with areas where polioviruses are circulating) conducted additional campaigns against poliomyelitis. In order to protect individual travellers, WHO updated its guidance on international travel and health so as to recommend that all travellers to countries where poliovirus is known to be circulating should be fully vaccinated against poliomyelitis in accordance with the national immunization policy in their country of origin.
Great Issues discussed:
- Interrupting transmission of endemic wild poliovirus in Afghanistan, India, Nigeria and Pakistan
- Limiting the risk of international spread of wild poliovirus
- Initiating a process to minimize and manage the risks of re-emergence of poliomyelitis in the post-eradication era
Greece: need to organize some media campaigns, public opinion sensitization
Ecuador: Migration of virus is a big problem
Swaziland: Money troubles do not allow to arrive at good results
To be continued this afternoon
Chairman : Dr Robinson R. Jean Louis (Madagascar)
Provisional agenda item 12.2 - Smallpox eradication: destruction of
variola virus stocks
Resolution WHA49.10 (1996) recommended that the remaining stocks of live variola virus maintained by WHO since 1984 should be destroyed on 30 June 1999, after a final decision to be taken by the Health Assembly in May 1999. The Fifty-second World Health Assembly decided by resolution WHA52.10 to authorize temporary retention of the remaining variola virus stocks, subject to annual review, but up to no later than 2002, for the purpose of carrying out a programme of essential public-health research. By resolution WHA55.15 it authorized further temporary retention of these stocks for the purpose of continuing further international research.
The great stake for the destruction of variola virus stocks lies in the fight against the bioterrorist threat. But some States underline the necessity to retain temporarily stocks for the purpose of research (Australia, Thailand, Barbados)
The draft resolution contained in resolution EB120.R8 is adopted, with some substantially amendments.
Provisional agenda item 12.3 - Control of leishmaniasis
Leishmaniasis is endemic in 88 countries in the world and 350 million people are considered at risk. An estimated 14 million people are infected, and each year about two million new cases occur.
The disease contributes significantly to the propagation of poverty, because treatment is expensive and hence either unaffordable or it imposes a substantial economic burden, including loss of wages.
Leishmaniasis with HIV coinfection is an emerging condition that demands urgent attention.
Even when coinfected patients receive proper treatment, they relapse repeatedly and the outcome frequently is fatal. Leishmaniasis is caused by a protozoal parasite of the genus Leishmania which multiplies in certain vertebrates that act as reservoirs of the disease. The parasite is transmitted to humans through the bite of sandflies that have previously fed on an infected reservoir. Expression of the two basic forms of the disease, namely cutaneous and visceral leishmaniasis, depends on the species of Leishmania responsible and the immune response to infection. The cutaneous form tends to heal spontaneously leaving scars which, depending on the species of Leishmania responsible, may evolve into diffuse cutaneous leishmaniasis, recidivans leishmaniasis, or mucocutaneous leishmaniasis, with disastrous aesthetic consequences for the patient. Visceral leishmaniasis, the most severe form, is fatal in almost all cases if left untreated. It may cause epidemic outbreaks with high mortality.
Many countries are satisfied by the fact that this disease, relatively unknown, is registered in the provisional agenda of the WHA.
The great stake is the distribution of the disease, e.g. with the flows of refugees (Morocco).
Thailand: underlined the need of monitoring.
India : beginning of a collaboration with Nepal and Bangladesh to eradicate this disease in South East Asia (90% in Bangladesh, Brazil ,India, Nepal and Sudan).
Kuwait : need to expend the collaboration with threatened countries.
The Secretary underlined the decline of the 90 % price of the medicine, by the action of the WHO
Resolution EB118.R3 will be examined later, once the amendments taken in account.
Provisional agenda item 12.4 - Poliomyelitis: mechanism for management of potential risks to eradication
In 2006, the remaining 6% of all new cases of poliomyelitis occurred in countries into which
poliovirus has been reintroduced. In order to reduce the risk of further international spread of wild poliovirus in 2006, countries judged to be at high risk of importing viruses (because of previous importations or having borders with areas where polioviruses are circulating) conducted additional campaigns against poliomyelitis. In order to protect individual travellers, WHO updated its guidance on international travel and health so as to recommend that all travellers to countries where poliovirus is known to be circulating should be fully vaccinated against poliomyelitis in accordance with the national immunization policy in their country of origin.
Great Issues discussed:
- Interrupting transmission of endemic wild poliovirus in Afghanistan, India, Nigeria and Pakistan
- Limiting the risk of international spread of wild poliovirus
- Initiating a process to minimize and manage the risks of re-emergence of poliomyelitis in the post-eradication era
Greece: need to organize some media campaigns, public opinion sensitization
Ecuador: Migration of virus is a big problem
Swaziland: Money troubles do not allow to arrive at good results
To be continued this afternoon
Wednesday 16th, MAY 2007 WHA
PLENARY ASSEMBLY (Morning) = > Youcef
Item 3
General Discussion:
Bolivia begun by claiming that the poverty rate reach 27 % of the population whereas her country is not poor (Bolivia is a great silver exporter).
Moreover, the country is facing huge difficulties concerning cares access because of the privatization.
Afghanistan insisted on the importance of health policy in his country which is affected by war. The commitments in favour of the eradication of polio were beneficial. Then, he expressed his concerns about the situation of the refugees and entreated Iran to take care of them.
Iceland emphasized that HIV threats the growth of developing countries.
Bangladesh said that health should be the central point of all men activities. He added that while is country is not very affected by HIV, Bangladesh must remain vigilant. Furthermore, if the authorities had led efficient policies to fight against influenza, nevertheless, malaria still remain a threat.
Sri Lanka have the highest rate of breast feeding of south Asia region. The representative also claimed that Sri Lanka succeed in curbing the HIV epidemic.
Kazakhstan ensured the willingness of his government to integrate WHO recommendations in health policies. He ended by congratulating the initiative of Argentina that propose to organise a meeting concerning the basic cares.
Monaco welcomed the creation of an emergency crisis department within WHO. He reminded the interest of his country in health issues, notably through the commitment of the princess Stephanie towards ONU-SIDA.
Congo reminded that influenza, malaria and polio are still present. The representative also considered travels or migrations as health insecurity factors. He welcomed the work done by WHO in favour of women.
Norway said that investments in the field of health are essentials for development. The representative emphasized the issues of nutrition at school and would like to reduce inequality in the area of health.
Denmark ended the morning by expressing that non communicable diseases should be a priority because 60 % of deaths in the world are resulting from such diseases.
PLENARY ASSEMBLY (Afternoon) = > Christine
Item 3
General discussion
Nepal stresses the importance to ensure health security and of pandemics, as well as natural disasters.
Cameroon calls the attention that there must be a global response to the emerging problems of globalization. New actors have appeared as well. Thus, WHO has the duty, as the leader in health issues, to guide those new actors. Cameroon has focused on the control of HIV/Aids, malaria and polio.
Sao Tomé and Principe wants to ameliorate the sanitary conditions and calls special attention on noncommunicable diseases.
Djibouti concentrates on the eradication of HIV/Aids, malaria and Tuberculosis. It criticizes pharmaceutical concerns which set financial gain as their primary target and are not ready to sell drugs to cheaper prices what could safe a lot of lives.
Timor-Leste reminds of its poor health and low levels of education. This new independent country with limited resources lacks of well-trained health staff. It faces a high maternal and child mortality, as well as many incidences of infectious diseases like Tuberculosis, Malaria, Dengue and leprosy. With WHO support it tries to improve health care by decentralization and integrated control of communicable diseases. Furthermore, it is planning to distribute Vitamin A to children under five years of age. To continue its effort, Timor-Leste calls WHO for additional resources and support to achieve the MDGs.
Uzbekistan is reforming the financing of health care branches. Its priority lies in the protection of mothers and children. It has projects for the eradication of malaria incidences.
Tuvalu, as a small island, highlights its vulnerability to natural disasters. Its most common problem is the limited budget for health. Medical supplies and drugs are allocated by New Zealand, Australia and Taiwan. Tuvalu is concerned about the spread of Avian Influenza and considers HIV/Aids as a big challenge.
Iraq’s main objective is to enable every individual to get access to medical treatment.
Nigeria reminds of its first incidence of H5N1 in April 2006. The number of polio incidences has dropped due to measures taken by the Health Ministry and the reform of its health care system has been a success.
Malta highlights its efforts in humanitarian aid in totally 120 countries.
COMMITTEE A (Morning) = > Paul
Chairman : Dr Robinson R. Jean Louis (Madagascar)
Provisional agenda item 12.2
Smallpox eradication: destruction of variola virus stocks
Resolution WHA49.10 (1996) recommended that the remaining stocks of live variola virus maintained by WHO since 1984 should be destroyed on 30 June 1999, after a final decision to be taken by the Health Assembly in May 1999. The Fifty-second World Health Assembly decided by resolution WHA52.10 to authorize temporary retention of the remaining variola virus stocks, subject to annual review, but up to no later than 2002, for the purpose of carrying out a programme of essential public-health research. By resolution WHA55.15 it authorized further temporary retention of these stocks for the purpose of continuing further international research.
The great stake for the destruction of variola virus stocks lies in the fight against the bioterrorist threat. But some States underline the necessity to retain temporarily stocks for the purpose of research (Australia, Thailand, Barbados)
The draft resolution contained in resolution EB120.R8 is adopted, with some substantially amendments.
Provisional agenda item 12.3
Control of leishmaniasis
Leishmaniasis is endemic in 88 countries in the world and 350 million people are considered at risk. An estimated 14 million people are infected, and each year about two million new cases occur.
The disease contributes significantly to the propagation of poverty, because treatment is expensive and hence either unaffordable or it imposes a substantial economic burden, including loss of wages.
Leishmaniasis with HIV coinfection is an emerging condition that demands urgent attention.
Even when coinfected patients receive proper treatment, they relapse repeatedly and the outcome frequently is fatal. Leishmaniasis is caused by a protozoal parasite of the genus Leishmania which multiplies in certain vertebrates that act as reservoirs of the disease. The parasite is transmitted to humans through the bite of sandflies that have previously fed on an infected reservoir. Expression of the two basic forms of the disease, namely cutaneous and visceral leishmaniasis, depends on the species of Leishmania responsible and the immune response to infection. The cutaneous form tends to heal spontaneously leaving scars which, depending on the species of Leishmania responsible, may evolve into diffuse cutaneous leishmaniasis, recidivans leishmaniasis, or mucocutaneous leishmaniasis, with disastrous aesthetic consequences for the patient. Visceral leishmaniasis, the most severe form, is fatal in almost all cases if left untreated. It may cause epidemic outbreaks with high mortality.
Many countries are satisfied by the fact that this disease, relatively unknown, is registered in the provisional agenda of the WHA.
The great stake is the distribution of the disease, e.g. with the flows of refugees (Morocco).
Thailand: underlined the need of monitoring.
India : beginning of a collaboration with Nepal and Bangladesh to eradicate this disease in South East Asia (90% in Bangladesh, Brazil ,India, Nepal and Sudan).
Kuwait : need to expend the collaboration with threatened countries.
The Secretary underlined the decline of the 90 % price of the medicine, by the action of the WHO
Resolution EB118.R3 will be examined later, once the amendments taken in account.
Provisional agenda item 12.4
Poliomyelitis: mechanism for management of potential risks to eradication
In 2006, the remaining 6% of all new cases of poliomyelitis occurred in countries into which
poliovirus has been reintroduced. In order to reduce the risk of further international spread of wild poliovirus in 2006, countries judged to be at high risk of importing viruses (because of previous importations or having borders with areas where polioviruses are circulating) conducted additional campaigns against poliomyelitis. In order to protect individual travellers, WHO updated its guidance on international travel and health so as to recommend that all travellers to countries where poliovirus is known to be circulating should be fully vaccinated against poliomyelitis in accordance with the national immunization policy in their country of origin.
Great Issues discussed:
- Interrupting transmission of endemic wild poliovirus in Afghanistan, India, Nigeria and
Pakistan
- Limiting the risk of international spread of wild poliovirus
- Initiating a process to minimize and manage the risks of re-emergence of poliomyelitis in the post-eradication era
Greece: need to organize some media campaigns, public opinion sensitization
Ecuador: Migration of virus is a big problem
Swaziland: Money troubles do not allow to arrive at good results
To be continued this afternoon
COMMITTEE A (Afternoon) = > Marina
Item 11
Draft medium-term strategic plan, including proposed programme budget 2008-2009
Introductory speech of a representative of the Executive Board
The Representative of the Executive Board introduced two draft financial documents by stressing the new approach adopted by the World Health Organization concerning the guidelines of its budget. He expressed the E.B. satisfaction concerning the result based approach of the budgets but he also expressed his concerns about the use of an historical perspective for the budget attribution rather than the efficiency that might guide such an exercise.
The report on the 2008-2009 budgets was voted at the 100th session of the E.B. and it focuses mainly on strategic purposes following a result-based approach.
The floor was then given to the state members so that the Secretariat of the World Health Organization would welcome their comments, remarks and concerns. The discussions concerned both items 11.1, 11.2 and 11.3 (only referred to by the Distinguished Delegate of Switzerland). Before expressing their remarks, the member states all agreed that the different documents provided by the Secretariat of the WHO reflect a serious work and commitment to the effort of rationalisation (from 16 to 13 Strategic Objectives in the Draft Medium-term Strategic Plan or DMTSP) of WHO's functioning.
Item 11.1
Draft Medium-term strategic plan 2008-2009
Item 11.2
Proposed Programme budget 2008-2009
Item 11.3
Real estate: draft capital master plan
By regarding the whole discussions, some issues have been frequently invoked by the member states. Those issues can be shared between those concerning the nature of the funding (the different kinds of resources, part A) and the structure of the budget itself (as reflect of choices in terms of Strategic Objectives and their allocations, part B).
A. The balance between regular budget and voluntary contributions
The common worry of a majority of member states seems to be the preservation of WHO's integrity. The WHO should be granted a budget that guarantees its independence and that would allow it to keep on acting independently from the identity of donors. Many states among which were Canada, the Netherlands, France, Norway, Belgium, the Russian Federation, Surinam and the Islamic Republic of Iran deplored the increasing part of voluntary contributions in the global budget. They expressed their concern as they did not want the WHO to become progressively a U.N. fund. According to the Netherlands, all member states should take this into account and even if the proposals increase the budget of 15%, such a situation should not be mainly due to unforeseeable voluntary contributions. The D.D. of Belgium also asked for the establishment of priority in term of resources' allocation in case of financial problems and he deplored the absence of reference to the Declaration de Paris on the efficacy of the public aid for development. Other remarks were done by countries such as France or Greece asking for more precision in terms of budget attribution for each programme. The Russian Federation also asked for precision concerning evaluation tools or processes that would be use in order to compare the progress of the different countries and their contributions to the Strategic Objectives' achievement. The D.D. of Japan also insisted on a better mainstreaming of WHO's activities.
B. The specific demands concerning allocations of resources
The D.D. of the United States of America, supported by Malta, El Salvador, asked to the Secretariat to modify the formulation of Strategic Objective 4 concerning sexual and reproduction health services. They asked for an amendment in the DMTSP with the introduction of a statement in the official report of Committee A that would insist on the fact that providing services for abortion cannot be interpreted as an obligation regarding to the legislation of each country.
Then, on behalf of the African region, the D.D. of Liberia deplored the decrease in the budget dedicated to the second Strategic Objective of the DMTSP, namely the struggle against HIV/Aids, tuberculosis and malaria. The D.D. of Sao Tome and Principe supported such a viewpoint insisting on the fact that the Caribbean region was the second area touched by these diseases. The D.D. of Liberia also deplored the decrease of WHO budget (2008-2009) dedicated to the African region (from 28.7% to 28.2%).
Finally, the D.D. of Switzerland made a comment on the third document (Item 11.3) recalling the duty of the state members of international organizations in terms of financing real estate. She stressed that instead of investing money once the different infrastructures are damaged, the state members must contribute annually for keeping those infrastructures in good conditions. She also said that a part of the budget should be annually save for those purposes.
COMMITTEE B (Afternoon) = > Youcef
Election of vice-presidents of the committee:
Mr Francis (Trinidad et Tobago)
Dr Yussouf (Maldives)
Dr Al-Faquiri (Saudi Arabia)
Item 14
Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan
The Distinguished Delegate of the Arab Republic of Egypt, as co-sponsor of a draft resolution (A60/B/Conf.Paper No 1) supported by 19 state members. The D.D. of Egypt has denounced the violation of human rights committed by Israel in the occupied territories. He officially asked for the suspension of the building of the wall in the Gaza area and stressed the fact that such an action does not respect international law. The WHO should pay a particular attention to the providing of a technical assistance to the Palestinian people as occupied people. According to him and the states on behalf of which he spoke, the WHO must strengthen its action in order to improve the current situation in Palestine. The D.D. of Egypt particularly emphasized that the aim of the resolution he presented there was totally guided by sanitary concerns and not by specific political aims.
The D.D. of the Syrian Arab Republic stressed that the occupation of Israel on the Syrian Golan has consequences on the living conditions of populations in that area. According to his country, the Gaza strip has become a giant jail. He brought his support to the D.D. of Egypt statement concerning human right violations and international law. The occupied villages are suffering from lack of infrastructures, transports and human resources for health. Doctors and more generally health staff are denied the right to get a labor authorization in occupied territories. He ended his declaration by expressing his deep concern as for the conditions in which the Arab prisoners are maintained in jail in Israeli's jails.
The D.D. of Israel considered the draft resolution proposed by the previous state members as partial and inexact. He declared that Israel is frequently attacked by Hamas' rockets. The adoption of the proposed resolution would not improve the current situation in the region, it is through cooperation and mutual help that the situation will improve and not with unfunded and inexact resolutions.
The D.D. of the United States of America expressed his regrets as this resolution seemed to be more a political one rather than a sanitary resolution. The D.D. of U.S.A. said that his country is deeply concerned by the health of the Palestinian people. Indeed the country has spent $US 12m in 2006-2007 in public aids dedicated to health projects.
However, the Palestinian government must stop its action through violent means and recognize the Israeli's state.
The floor was finally given to the Palestinian authority: Its Representative declared that his people were faced to a severe situation. He added that the number of check points (547) has increased once again in 2006 that block the access of patients and ambulances to hospitals.
TECHNICAL MEETING
Technical briefing at the 60th World Health Assembly = > Alice
1:00 to 2:30
The purpose of the meeting was to draw the Members States attention over the importance of the International Health Regulations (IHR) in the context of International Public Health Security and encourage multisectoral action within States to implement IHR before the entry into force in June.
Director-General WHO, Dr Margaret Chan, introduced the meeting by reminding that the pandemic influenza threat was to be the most difficult to deal with. The most important point made, according to her, was the necessity to share virus samples in order to track the mutations worldwide and to find the new resistance patterns. As the pandemic influenza is a virus that is very hard to deal with, Dr. Chan insisted on the fact that IHR needs a wide collective response. She also emphasized the need to support non pharmaceutical interventions effort as everyone can participate in that.
The Canadian Minister of Health, Mr. T. Clement, showed the significance of IHR as it permits to have policies defined before the crisis occur, and therefore the response is not a reaction but a real adaptation of the policy through the emergency. He insisted on collaboration and capacity building.
The Minister of Health from Côte d’Ivoire, Mr. A.K. Rémi, illustrated the problem of chemical pollution by giving the example of the crisis in Abidjan, August to November 2006. He reminded us of the help the WHO is able to give in such circumstances through the sending of experts, materials, and so on.
The Deputy Chief Executive, Food Safety Authority in Ireland, Mr. Alan Reilly, emphasized on the diseases transmitted through the food. He focused on the necessity of a genuine collaboration and teamwork between international and national agencies.
The overview of the IHR implementation stressed the following facts: IHR is evolving from focusing on boarder controls only to at the source containment. There are four principles issues to keep in mind which are International travel and transports, National surveillance and response, Global alert and response system, Threat specific control programmes. Their efficacy will be relying on legal procedures and monitoring in the implementation of the IHR.
_ The National Focal Point guidelines can be found on the WHO website.
_ Only 52 states have nominated an expert accordingly to art 47 (it remains voluntary).
Between 2007 and 2009 the national plans need to be defined.
Between 2009 to 2012 or 2014 depending on the success, is the time given to implement the national plans.
Partnership remains essential, with other organizations like the FAO, regional organizations like ASEAN, collaborating centres of the WHO, development agencies, academics and professionals associations, industry associations such as Iata, and NGOs.
The most notable difficulties are technical (like defining ground crossings), the timelines, the intersectoral nature of IHR, and the need of resources.
Simulation exercises, open to Member States, will take place by mid-June to test the collective ability of response.
Item 3
General Discussion:
Bolivia begun by claiming that the poverty rate reach 27 % of the population whereas her country is not poor (Bolivia is a great silver exporter).
Moreover, the country is facing huge difficulties concerning cares access because of the privatization.
Afghanistan insisted on the importance of health policy in his country which is affected by war. The commitments in favour of the eradication of polio were beneficial. Then, he expressed his concerns about the situation of the refugees and entreated Iran to take care of them.
Iceland emphasized that HIV threats the growth of developing countries.
Bangladesh said that health should be the central point of all men activities. He added that while is country is not very affected by HIV, Bangladesh must remain vigilant. Furthermore, if the authorities had led efficient policies to fight against influenza, nevertheless, malaria still remain a threat.
Sri Lanka have the highest rate of breast feeding of south Asia region. The representative also claimed that Sri Lanka succeed in curbing the HIV epidemic.
Kazakhstan ensured the willingness of his government to integrate WHO recommendations in health policies. He ended by congratulating the initiative of Argentina that propose to organise a meeting concerning the basic cares.
Monaco welcomed the creation of an emergency crisis department within WHO. He reminded the interest of his country in health issues, notably through the commitment of the princess Stephanie towards ONU-SIDA.
Congo reminded that influenza, malaria and polio are still present. The representative also considered travels or migrations as health insecurity factors. He welcomed the work done by WHO in favour of women.
Norway said that investments in the field of health are essentials for development. The representative emphasized the issues of nutrition at school and would like to reduce inequality in the area of health.
Denmark ended the morning by expressing that non communicable diseases should be a priority because 60 % of deaths in the world are resulting from such diseases.
PLENARY ASSEMBLY (Afternoon) = > Christine
Item 3
General discussion
Nepal stresses the importance to ensure health security and of pandemics, as well as natural disasters.
Cameroon calls the attention that there must be a global response to the emerging problems of globalization. New actors have appeared as well. Thus, WHO has the duty, as the leader in health issues, to guide those new actors. Cameroon has focused on the control of HIV/Aids, malaria and polio.
Sao Tomé and Principe wants to ameliorate the sanitary conditions and calls special attention on noncommunicable diseases.
Djibouti concentrates on the eradication of HIV/Aids, malaria and Tuberculosis. It criticizes pharmaceutical concerns which set financial gain as their primary target and are not ready to sell drugs to cheaper prices what could safe a lot of lives.
Timor-Leste reminds of its poor health and low levels of education. This new independent country with limited resources lacks of well-trained health staff. It faces a high maternal and child mortality, as well as many incidences of infectious diseases like Tuberculosis, Malaria, Dengue and leprosy. With WHO support it tries to improve health care by decentralization and integrated control of communicable diseases. Furthermore, it is planning to distribute Vitamin A to children under five years of age. To continue its effort, Timor-Leste calls WHO for additional resources and support to achieve the MDGs.
Uzbekistan is reforming the financing of health care branches. Its priority lies in the protection of mothers and children. It has projects for the eradication of malaria incidences.
Tuvalu, as a small island, highlights its vulnerability to natural disasters. Its most common problem is the limited budget for health. Medical supplies and drugs are allocated by New Zealand, Australia and Taiwan. Tuvalu is concerned about the spread of Avian Influenza and considers HIV/Aids as a big challenge.
Iraq’s main objective is to enable every individual to get access to medical treatment.
Nigeria reminds of its first incidence of H5N1 in April 2006. The number of polio incidences has dropped due to measures taken by the Health Ministry and the reform of its health care system has been a success.
Malta highlights its efforts in humanitarian aid in totally 120 countries.
COMMITTEE A (Morning) = > Paul
Chairman : Dr Robinson R. Jean Louis (Madagascar)
Provisional agenda item 12.2
Smallpox eradication: destruction of variola virus stocks
Resolution WHA49.10 (1996) recommended that the remaining stocks of live variola virus maintained by WHO since 1984 should be destroyed on 30 June 1999, after a final decision to be taken by the Health Assembly in May 1999. The Fifty-second World Health Assembly decided by resolution WHA52.10 to authorize temporary retention of the remaining variola virus stocks, subject to annual review, but up to no later than 2002, for the purpose of carrying out a programme of essential public-health research. By resolution WHA55.15 it authorized further temporary retention of these stocks for the purpose of continuing further international research.
The great stake for the destruction of variola virus stocks lies in the fight against the bioterrorist threat. But some States underline the necessity to retain temporarily stocks for the purpose of research (Australia, Thailand, Barbados)
The draft resolution contained in resolution EB120.R8 is adopted, with some substantially amendments.
Provisional agenda item 12.3
Control of leishmaniasis
Leishmaniasis is endemic in 88 countries in the world and 350 million people are considered at risk. An estimated 14 million people are infected, and each year about two million new cases occur.
The disease contributes significantly to the propagation of poverty, because treatment is expensive and hence either unaffordable or it imposes a substantial economic burden, including loss of wages.
Leishmaniasis with HIV coinfection is an emerging condition that demands urgent attention.
Even when coinfected patients receive proper treatment, they relapse repeatedly and the outcome frequently is fatal. Leishmaniasis is caused by a protozoal parasite of the genus Leishmania which multiplies in certain vertebrates that act as reservoirs of the disease. The parasite is transmitted to humans through the bite of sandflies that have previously fed on an infected reservoir. Expression of the two basic forms of the disease, namely cutaneous and visceral leishmaniasis, depends on the species of Leishmania responsible and the immune response to infection. The cutaneous form tends to heal spontaneously leaving scars which, depending on the species of Leishmania responsible, may evolve into diffuse cutaneous leishmaniasis, recidivans leishmaniasis, or mucocutaneous leishmaniasis, with disastrous aesthetic consequences for the patient. Visceral leishmaniasis, the most severe form, is fatal in almost all cases if left untreated. It may cause epidemic outbreaks with high mortality.
Many countries are satisfied by the fact that this disease, relatively unknown, is registered in the provisional agenda of the WHA.
The great stake is the distribution of the disease, e.g. with the flows of refugees (Morocco).
Thailand: underlined the need of monitoring.
India : beginning of a collaboration with Nepal and Bangladesh to eradicate this disease in South East Asia (90% in Bangladesh, Brazil ,India, Nepal and Sudan).
Kuwait : need to expend the collaboration with threatened countries.
The Secretary underlined the decline of the 90 % price of the medicine, by the action of the WHO
Resolution EB118.R3 will be examined later, once the amendments taken in account.
Provisional agenda item 12.4
Poliomyelitis: mechanism for management of potential risks to eradication
In 2006, the remaining 6% of all new cases of poliomyelitis occurred in countries into which
poliovirus has been reintroduced. In order to reduce the risk of further international spread of wild poliovirus in 2006, countries judged to be at high risk of importing viruses (because of previous importations or having borders with areas where polioviruses are circulating) conducted additional campaigns against poliomyelitis. In order to protect individual travellers, WHO updated its guidance on international travel and health so as to recommend that all travellers to countries where poliovirus is known to be circulating should be fully vaccinated against poliomyelitis in accordance with the national immunization policy in their country of origin.
Great Issues discussed:
- Interrupting transmission of endemic wild poliovirus in Afghanistan, India, Nigeria and
Pakistan
- Limiting the risk of international spread of wild poliovirus
- Initiating a process to minimize and manage the risks of re-emergence of poliomyelitis in the post-eradication era
Greece: need to organize some media campaigns, public opinion sensitization
Ecuador: Migration of virus is a big problem
Swaziland: Money troubles do not allow to arrive at good results
To be continued this afternoon
COMMITTEE A (Afternoon) = > Marina
Item 11
Draft medium-term strategic plan, including proposed programme budget 2008-2009
Introductory speech of a representative of the Executive Board
The Representative of the Executive Board introduced two draft financial documents by stressing the new approach adopted by the World Health Organization concerning the guidelines of its budget. He expressed the E.B. satisfaction concerning the result based approach of the budgets but he also expressed his concerns about the use of an historical perspective for the budget attribution rather than the efficiency that might guide such an exercise.
The report on the 2008-2009 budgets was voted at the 100th session of the E.B. and it focuses mainly on strategic purposes following a result-based approach.
The floor was then given to the state members so that the Secretariat of the World Health Organization would welcome their comments, remarks and concerns. The discussions concerned both items 11.1, 11.2 and 11.3 (only referred to by the Distinguished Delegate of Switzerland). Before expressing their remarks, the member states all agreed that the different documents provided by the Secretariat of the WHO reflect a serious work and commitment to the effort of rationalisation (from 16 to 13 Strategic Objectives in the Draft Medium-term Strategic Plan or DMTSP) of WHO's functioning.
Item 11.1
Draft Medium-term strategic plan 2008-2009
Item 11.2
Proposed Programme budget 2008-2009
Item 11.3
Real estate: draft capital master plan
By regarding the whole discussions, some issues have been frequently invoked by the member states. Those issues can be shared between those concerning the nature of the funding (the different kinds of resources, part A) and the structure of the budget itself (as reflect of choices in terms of Strategic Objectives and their allocations, part B).
A. The balance between regular budget and voluntary contributions
The common worry of a majority of member states seems to be the preservation of WHO's integrity. The WHO should be granted a budget that guarantees its independence and that would allow it to keep on acting independently from the identity of donors. Many states among which were Canada, the Netherlands, France, Norway, Belgium, the Russian Federation, Surinam and the Islamic Republic of Iran deplored the increasing part of voluntary contributions in the global budget. They expressed their concern as they did not want the WHO to become progressively a U.N. fund. According to the Netherlands, all member states should take this into account and even if the proposals increase the budget of 15%, such a situation should not be mainly due to unforeseeable voluntary contributions. The D.D. of Belgium also asked for the establishment of priority in term of resources' allocation in case of financial problems and he deplored the absence of reference to the Declaration de Paris on the efficacy of the public aid for development. Other remarks were done by countries such as France or Greece asking for more precision in terms of budget attribution for each programme. The Russian Federation also asked for precision concerning evaluation tools or processes that would be use in order to compare the progress of the different countries and their contributions to the Strategic Objectives' achievement. The D.D. of Japan also insisted on a better mainstreaming of WHO's activities.
B. The specific demands concerning allocations of resources
The D.D. of the United States of America, supported by Malta, El Salvador, asked to the Secretariat to modify the formulation of Strategic Objective 4 concerning sexual and reproduction health services. They asked for an amendment in the DMTSP with the introduction of a statement in the official report of Committee A that would insist on the fact that providing services for abortion cannot be interpreted as an obligation regarding to the legislation of each country.
Then, on behalf of the African region, the D.D. of Liberia deplored the decrease in the budget dedicated to the second Strategic Objective of the DMTSP, namely the struggle against HIV/Aids, tuberculosis and malaria. The D.D. of Sao Tome and Principe supported such a viewpoint insisting on the fact that the Caribbean region was the second area touched by these diseases. The D.D. of Liberia also deplored the decrease of WHO budget (2008-2009) dedicated to the African region (from 28.7% to 28.2%).
Finally, the D.D. of Switzerland made a comment on the third document (Item 11.3) recalling the duty of the state members of international organizations in terms of financing real estate. She stressed that instead of investing money once the different infrastructures are damaged, the state members must contribute annually for keeping those infrastructures in good conditions. She also said that a part of the budget should be annually save for those purposes.
COMMITTEE B (Afternoon) = > Youcef
Election of vice-presidents of the committee:
Mr Francis (Trinidad et Tobago)
Dr Yussouf (Maldives)
Dr Al-Faquiri (Saudi Arabia)
Item 14
Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan
The Distinguished Delegate of the Arab Republic of Egypt, as co-sponsor of a draft resolution (A60/B/Conf.Paper No 1) supported by 19 state members. The D.D. of Egypt has denounced the violation of human rights committed by Israel in the occupied territories. He officially asked for the suspension of the building of the wall in the Gaza area and stressed the fact that such an action does not respect international law. The WHO should pay a particular attention to the providing of a technical assistance to the Palestinian people as occupied people. According to him and the states on behalf of which he spoke, the WHO must strengthen its action in order to improve the current situation in Palestine. The D.D. of Egypt particularly emphasized that the aim of the resolution he presented there was totally guided by sanitary concerns and not by specific political aims.
The D.D. of the Syrian Arab Republic stressed that the occupation of Israel on the Syrian Golan has consequences on the living conditions of populations in that area. According to his country, the Gaza strip has become a giant jail. He brought his support to the D.D. of Egypt statement concerning human right violations and international law. The occupied villages are suffering from lack of infrastructures, transports and human resources for health. Doctors and more generally health staff are denied the right to get a labor authorization in occupied territories. He ended his declaration by expressing his deep concern as for the conditions in which the Arab prisoners are maintained in jail in Israeli's jails.
The D.D. of Israel considered the draft resolution proposed by the previous state members as partial and inexact. He declared that Israel is frequently attacked by Hamas' rockets. The adoption of the proposed resolution would not improve the current situation in the region, it is through cooperation and mutual help that the situation will improve and not with unfunded and inexact resolutions.
The D.D. of the United States of America expressed his regrets as this resolution seemed to be more a political one rather than a sanitary resolution. The D.D. of U.S.A. said that his country is deeply concerned by the health of the Palestinian people. Indeed the country has spent $US 12m in 2006-2007 in public aids dedicated to health projects.
However, the Palestinian government must stop its action through violent means and recognize the Israeli's state.
The floor was finally given to the Palestinian authority: Its Representative declared that his people were faced to a severe situation. He added that the number of check points (547) has increased once again in 2006 that block the access of patients and ambulances to hospitals.
TECHNICAL MEETING
Technical briefing at the 60th World Health Assembly = > Alice
1:00 to 2:30
The purpose of the meeting was to draw the Members States attention over the importance of the International Health Regulations (IHR) in the context of International Public Health Security and encourage multisectoral action within States to implement IHR before the entry into force in June.
Director-General WHO, Dr Margaret Chan, introduced the meeting by reminding that the pandemic influenza threat was to be the most difficult to deal with. The most important point made, according to her, was the necessity to share virus samples in order to track the mutations worldwide and to find the new resistance patterns. As the pandemic influenza is a virus that is very hard to deal with, Dr. Chan insisted on the fact that IHR needs a wide collective response. She also emphasized the need to support non pharmaceutical interventions effort as everyone can participate in that.
The Canadian Minister of Health, Mr. T. Clement, showed the significance of IHR as it permits to have policies defined before the crisis occur, and therefore the response is not a reaction but a real adaptation of the policy through the emergency. He insisted on collaboration and capacity building.
The Minister of Health from Côte d’Ivoire, Mr. A.K. Rémi, illustrated the problem of chemical pollution by giving the example of the crisis in Abidjan, August to November 2006. He reminded us of the help the WHO is able to give in such circumstances through the sending of experts, materials, and so on.
The Deputy Chief Executive, Food Safety Authority in Ireland, Mr. Alan Reilly, emphasized on the diseases transmitted through the food. He focused on the necessity of a genuine collaboration and teamwork between international and national agencies.
The overview of the IHR implementation stressed the following facts: IHR is evolving from focusing on boarder controls only to at the source containment. There are four principles issues to keep in mind which are International travel and transports, National surveillance and response, Global alert and response system, Threat specific control programmes. Their efficacy will be relying on legal procedures and monitoring in the implementation of the IHR.
_ The National Focal Point guidelines can be found on the WHO website.
_ Only 52 states have nominated an expert accordingly to art 47 (it remains voluntary).
Between 2007 and 2009 the national plans need to be defined.
Between 2009 to 2012 or 2014 depending on the success, is the time given to implement the national plans.
Partnership remains essential, with other organizations like the FAO, regional organizations like ASEAN, collaborating centres of the WHO, development agencies, academics and professionals associations, industry associations such as Iata, and NGOs.
The most notable difficulties are technical (like defining ground crossings), the timelines, the intersectoral nature of IHR, and the need of resources.
Simulation exercises, open to Member States, will take place by mid-June to test the collective ability of response.
mardi 15 mai 2007
Plenary session of WHO 15th May AM session DJ
ITEM 2
Reports of the Executive Board on its 118th, 119th and 120th sessions:
The Executive Board summarised the decisions and discussions from the 118th (May 2006), 119th (November 2006) and the 120th sessions (January 2007).
This information can be found in Document A60/2.
Address by Dr Margaret Chan, Director-General:
Document to be distributed tomorrow A60/3.
ITEM 3
General Discussion:
China emphasized the importance of supporting health care improvement in Africa and encouraged the WHO to keep on working towards this. Indeed, the health situation in Africa is hindering their economic development. China also made three propositions:
1. Increase the role of the WHO and encourage states to fully support it. Health has repercussions in issues of security, economics, etc issue and WHO has to have a bigger role in this context.
2. Put in force a global disease control mechanism as well as an early warning system.
3. Help to improve health security in developing countries, because diseases don't respect physical borders. Health is a global issue.
Indonesia justified its decision to stop providing H5N1 samples to the WHO earlier this year by blaming the abusive use of samples by private actors. It advocated a fair and equal distribution of these samples. It wants a guarantee that the results of the research made possible by these samples will be redistributed fairly to developing countries. While providing these virus samples for free to the WHO, it wants to be sure that it will then have access to the vaccine produced for a reasonable price. It recommended the creation of a mechanism to allow it.
Algeria, talking on behalf of the health ministers of Arab countries, reminded the assembly that the situation in Palestine is problematic because infrastructure is lacking or has been destroyed by Israeli forces. It compared this situation to the one in Lebanon after the conflict of last summer. It also detailed the problematic health situations in Darfur, Somalia, Libya, as well as in Iraq and its neighbours, like Jordan, which welcome a significant number of refugees, and so put the balance of their health service in danger.
Zimbabwe complained about the international community’s lack of support for health matters in the country that could make the country even more vulnerable.
The Cook Islands, talking for the Pacific Islands, highlighted the link between poverty and health. It also expressed its concern about non-transmissible diseases, in particular obesity and mental illnesses.
Brazil asked for more cooperation on health issues that have a strong influence on the fight against poverty and hunger started by the President Lula. It also warned against the danger of the TRIPS and said that it should not limit health policies.
ITEM 4
Invited speakers:
The Prime Minister of Norway, Mr. Jens Stoltenberg, insisted that States should do more to achieve goals 4 and 5 of the Millennium Development Goals, to improve the health of children and mothers. He also called for better coordination and efficiency between the UN agencies.
The Executive Director of UNFPD, Mrs Nafis Sadik, expressed her wish to stop all unsafe abortion practices and affirmed that abortion should never be an official family planning policy. Women’s empowerment should also be encouraged in health issues as well as gender perspectives. Finally she asked for short-term solutions in addition to long-term ones and for more cohesion in the UN system.
Reports of the Executive Board on its 118th, 119th and 120th sessions:
The Executive Board summarised the decisions and discussions from the 118th (May 2006), 119th (November 2006) and the 120th sessions (January 2007).
This information can be found in Document A60/2.
Address by Dr Margaret Chan, Director-General:
Document to be distributed tomorrow A60/3.
ITEM 3
General Discussion:
China emphasized the importance of supporting health care improvement in Africa and encouraged the WHO to keep on working towards this. Indeed, the health situation in Africa is hindering their economic development. China also made three propositions:
1. Increase the role of the WHO and encourage states to fully support it. Health has repercussions in issues of security, economics, etc issue and WHO has to have a bigger role in this context.
2. Put in force a global disease control mechanism as well as an early warning system.
3. Help to improve health security in developing countries, because diseases don't respect physical borders. Health is a global issue.
Indonesia justified its decision to stop providing H5N1 samples to the WHO earlier this year by blaming the abusive use of samples by private actors. It advocated a fair and equal distribution of these samples. It wants a guarantee that the results of the research made possible by these samples will be redistributed fairly to developing countries. While providing these virus samples for free to the WHO, it wants to be sure that it will then have access to the vaccine produced for a reasonable price. It recommended the creation of a mechanism to allow it.
Algeria, talking on behalf of the health ministers of Arab countries, reminded the assembly that the situation in Palestine is problematic because infrastructure is lacking or has been destroyed by Israeli forces. It compared this situation to the one in Lebanon after the conflict of last summer. It also detailed the problematic health situations in Darfur, Somalia, Libya, as well as in Iraq and its neighbours, like Jordan, which welcome a significant number of refugees, and so put the balance of their health service in danger.
Zimbabwe complained about the international community’s lack of support for health matters in the country that could make the country even more vulnerable.
The Cook Islands, talking for the Pacific Islands, highlighted the link between poverty and health. It also expressed its concern about non-transmissible diseases, in particular obesity and mental illnesses.
Brazil asked for more cooperation on health issues that have a strong influence on the fight against poverty and hunger started by the President Lula. It also warned against the danger of the TRIPS and said that it should not limit health policies.
ITEM 4
Invited speakers:
The Prime Minister of Norway, Mr. Jens Stoltenberg, insisted that States should do more to achieve goals 4 and 5 of the Millennium Development Goals, to improve the health of children and mothers. He also called for better coordination and efficiency between the UN agencies.
The Executive Director of UNFPD, Mrs Nafis Sadik, expressed her wish to stop all unsafe abortion practices and affirmed that abortion should never be an official family planning policy. Women’s empowerment should also be encouraged in health issues as well as gender perspectives. Finally she asked for short-term solutions in addition to long-term ones and for more cohesion in the UN system.
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