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The World Health Assembly (WHA) meets this year against a backdrop of socioeconomic upheaval caused by the Covid-19 pandemic. And, despite the success of global vaccination programmes allowing most countries to get back to a so-called ‘new normal’ way of life, civilisation continues to be affected by a plethora of issues, including non-communicable disease, antimicrobial resistance, malnutrition, mental illness and infectious disease.
The World Health Assembly is a critical convening of global health leaders and stakeholders from all Member States of the World Health Organisation (WHO). As the decision-making body of the WHO, the WHA plays a pivotal role in shaping the future of global health by governing the conversations by which the WHO sets new norms and standards for individual health and healthcare, and takes global action to promote public health measures that benefit all countries. to promote public health measures that benefit all countries.
Held annually, the WHA focuses primarily on the specific health agenda prepared by the Executive Board. Its main functionsinclude determining the policies of the WHO, appointing a Director-General, supervising the financial policies, and reviewing the proposed programme budget, all of which, in part, govern various WHO activities such as; the implementation of Global Action Plans and initiatives; addressing health concerns such as non-communicable disease, antimicrobial resistance, vaccination and food systems; and setting the scope of country-specific health coverage to all WHO countries.
This year’s gathering, the Assembly’s seventy-sixth, will determine the targets to promote longevity and prevent ill health, as well as better prepare us for pandemics after our battle with Covid-19.
This year’s WHA theme is WHO at 75: Saving lives, driving health for all, the goal of which will be to discuss four key pillars:
Achieving universal health coverage lies at the forefront of the WHA’s priorities. The presentation of prevalent health inequalities and disparities across the globe at the assembly will drive conversations around the strategies that should be used to improve access to quality healthcare services, and ensure financial protection for all individuals, equipping us to battle any future health emergencies. There is an ongoing need for preparedness as highlighted by our response to the Covid-19 pandemic, and discussions around response mechanisms will be vital in ensuring effective mitigation of public health catastrophes going forward.
Strengthening the WHO’s support to member countries will also form a significant focus of this year’s WHA. Discussions surrounding improving technical assistance, capacity building, and resource allocation to address health challenges at a national level are likely to be the focus of the discussions, including the unique health challenges faced by women and children worldwide.
Four pivotal conversations, outlined in the Assembly’s provisional agenda, are likely to have a lasting impact on the future of global health:
Non-communicable diseases(NCDs) account for close to three-quarters of all deaths around the world, each year, and include conditions such as, cardiovascular disease, chronic respiratory disease, cancer, and diabetes, which are among some of the leading causes of death worldwide. As long term, chronic conditions, NCDs are predominantly driven by unhealthy lifestyle choices and socioeconomic factors that can be improved at both an individual and a policy level.
However, insufficient action has been taken against NCDs during the past two decades, failing to reduce their burden against the targets of the WHO’s Global Action Plan.
Of all NCD deaths, 77% occur in middle to low income countries. Around one third of the world’s population is still cooking over open fires and using solid fuels. This exposes individuals to harmful household air pollution, which can lead to NCDs such as stroke, ischaemic heart disease, chronic obstructive pulmonary disease (COPD) and lung cancer, and when combined with ambient air pollution, accounts for 6.7 million premature deaths each year.
We therefore expect the discussions around NCDs during the WHA to identify the health systems that must be reorientated to respond to the needs of those affected, and we expect a greater emphasis on disease awareness and prevention for these populations.
In 2015, the WHO Member States unanimously approved the Global Action Plan to tackle AMR, with hopes to ensure longevity in antibiotic effectiveness. AMR occurs when bacteria change over time, in such a way that the very medicines designed to treat them become ineffective. Consequently, infections become harder to treat, spread more readily and increase the mortality associated with our inability to treat such disease effectively.mortality associated with our inability to treat such disease effectively.
Despite all efforts being made to tackle antimicrobial resistance, it remains an imminent threat to modern medicine. The sixty-eighth WHA endorsed the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in October 2015, to standardise antimicrobial surveillance and better understand prevalence of resistant strains at any given time. This year, the WHA will review the implementation of the Global Action Plan on AMR in the upcoming weeks to address the remaining gaps and ensure a more robust pipeline of treatments that combat AMR.
With the scars of the Covid-19 pandemic still fresh, global health leaders are likely to discuss and deliberate on how we can enhance our readiness for future health crises. In the opening remarks of a briefing earlier this month, the WHO Director-Governor highlighted that: “We have the tools and the technologies to prepare for pandemics better, to detect them earlier, to respond to them faster, and to mitigate their impact”. But despite the creation of the Pandemic Fund, to finance critical elements of pandemic prevention so that we can be more prepared to face pandemics in the (hopefully very distant) future, the Director-Governor stated that we “still do not have all of the financing tools we need to tackle the next pandemic”, even if we do have the tools and technology.
Central to the discussions to be had around pandemic preparedness are the ways we can improve the structure of the Pandemic Fund so that it can be effectively used when needed. We also expect discussions around the enhancement of emergency care in lower-income countries, where rapid access to effective treatment is a greater necessity. By pooling resources and coordinating efforts, WHO may be able to address critical gaps in funding that previously hindered a timely and effective response to Covid-19, and that have ultimately left hundreds of millions of people unable to access or afford essential health services.
Women’s and children’s health has long been a critical focus area for the WHO, despite its lack of funding. All WHO member states recognise the pivotal role women play in society, both as health decision-makers for their families and as essential contributors to socioeconomic development, as well as the disproportional effect the pandemic, NCDs and climate change have had on the health women.
We’re expecting conversations to be centred around enhancing maternal health services and addressing the significant gaps in antenatal, delivery, and post-natal care across the globe, to reduce maternal morbidity rates. As around 44% of women around the world in relationships still don’t have the final say in the choices surrounding their healthcare and sex lives, the Assembly will also be advocating for reproductive health rights and services. This will likely include family planning, contraception, and managing sexually transmitted diseases to promote gender equality, giving women and those born with a womb the ability to control their reproductive health, and to reduce gender-based violence.
Moreover, we’re hoping for greater emphasis on children’s health. Recognising the critical interlinkages between women’s and children’s health may allow members of the WHA to focus on a more comprehensive approach to healthcare provision for these groups. The United Nations Decade of Action on Nutrition will address the global burden of malnutrition and explore strategies to improve nutritional interventions, such as the promotion of breastfeeding, addressing food insecurity, and tackling the double burden of the prevalence of both undernutrition and overweight children.
As highlighted by the Covid-19 pandemic, we also need to focus on ensuring the robustness of childhood immunisation programmes to protect children against vaccine-preventable diseases. This may include working on how to better vaccine coverage across the globe and improve access for those in greatest need.
Lastly, we’re expecting conversations to be had around improvements to childhood mental health services in light of the growing prevalence of adolescent mental health problems.
The decisions and resolutions made during the WHA have far-reaching implications for the future of global health by shaping the way countries and organisations work together to prevent, detect, and respond to health emergencies that pose a risk to global health security. By setting shared targets and commitments, a guiding framework can be implemented for individual countries, thereby directing their healthcare policies and activities.
Previous transformational changes brought by the WHA, such as the Framework Convention on Tobacco Control and the Global Vaccine Action Plan have yielded substantial improvements in disease prevention and control, thus giving us hope that the 2023 WHA can build on these successes and create new milestones in disease management and health promotion.
We’re embracing the air of optimism regarding the proposed changes this year’s WHA can bring to global health. We’re expecting to see more stringent AMR policies in place, and we’re excitedly anticipating a much greater emphasis on women’s and children’s health. We hope that the tragedies we were forced to face during Covid will serve as a lesson to be better prepared for health emergencies, and an incentive to motivate all of us to implement healthier behaviours to ease the global burden of disease.