Update from the Seventy-fourth World Health Assembly – 27 May 2021

Update from the Seventy-fourth World Health Assembly – 27 May 2021

  • New resolutions on diabetes, health for people with disabilities; malaria; oral health
  • Decisions on eye care; HIV, Hepatitis and STIs; neglected tropical diseases, noncommunicable diseases
  • WHO programme budget approved 2022-2023

RESOLUTIONS

Diabetes

A new  resolution urges Member States to raise the priority given to the prevention, diagnosis and control of diabetes as well as prevention and management of risk factors such as obesity.

It recommends action in a number of areas including: the development of pathways for achieving targets for the prevention and control of diabetes, including access to insulin; the promotion of convergence and harmonization of regulatory requirements for
insulin and other medicines and health products for the treatment of diabetes; and assessment of the feasibility and potential value of establishing a web-based tool to share information relevant to the transparency of markets for diabetes medicines
and health products.

Delegates  asked WHO to develop recommendations and provide support for strengthening diabetes monitoring and surveillance within national noncommunicable disease programmes and to consider potential targets. WHO was also asked to make recommendations
on the prevention and management of obesity and on policies for diabetes prevention and control

More than 420 million people are living with diabetes, a number that is expected to rise to 578 million by 2030. One in two adults living with diabetes type 2 are undiagnosed. Globally, 100 years after the discovery of insulin, half of the people with
type 2 diabetes who need insulin are not receiving it.

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WHO global disability action plan 2014–2021: better health for all people with disability

Over 1 billion people currently live with some form of disability. This number is rising as populations expand and age, and due to the increasing number of people living with noncommunicable conditions.

Today’s resolution on the highest attainable standard of health for persons with disabilities aims to make the health sector more inclusive by tackling the significant barriers many people with disabilities face when they try to access health services.
These include:

  • Access to effective health services: persons with disabilities often experience barriers including physical barriers that prevent access to health facilities; informational barriers that prevent access to health information; and attitudinal barriers leading
    to discrimination which severely affects the rights of persons with disabilities.
  • Protection during health emergencies: persons with disabilities are disproportionately affected by public health emergencies such as the COVID-19 pandemic because they have not been considered in national health emergency preparedness and response plans.
  • Access to public health interventions across different sectors: public health interventions do not reach persons with disabilities because the information has not been provided in an accessible way and the specific needs and situation of persons with
    disabilities have not been reflected in the interventions.

It also aims to improve collection and disaggregation of reliable data on disability to inform health policies and programmes.

The resolution lists a range of actions to be taken by the WHO Secretariat including developing a report on the highest attainable standard of health for persons with disabilities by the end of 2022; implementing the United Nations disability inclusion strategy across all levels of the organization;
supporting the creation of a global research agenda on health and disability; and providing Member States with technical knowledge and capacity-building support necessary to incorporate a disability- inclusive approach in the health sector.

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Recommitting to accelerate progress towards malaria elimination

Today’s resolution aims to reinvigorate efforts to end malaria, a preventable and treatable disease that continues to claim more than 400,000 lives each year, mainly children under the age of 5 living in sub-Saharan Africa.

Despite a period of unprecedented success in global malaria control, with an estimated 7.6 million deaths and 1.5 billion cases averted since 2000, the global gains in combatting malaria have levelled off in recent years. In 2019, there were some 229
million new cases of malaria, an annual estimate that has remained virtually unchanged since 2015.

The new resolution urges Member States to step up the pace of progress against malaria through plans and approaches that are consistent with WHO’s updated Global technical strategy for malaria 2016-2030 and its Guidelines for malaria.  It also
calls on countries to extend investment in and support for health services, ensuring no one is left behind; sustain and scale up sufficient funding for the global response to malaria; and boost investment in the research and development of new tools.

The updated global malaria strategy reflects lessons learned and experiences from the last 5 years, including the stalling of global progress and the impact of the COVID-19 pandemic. Its guiding principles emphasize the need for country leadership of
malaria responses; equitable and resilient health systems; and interventions tailored to local data and evidence.

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Improving oral health care

A new resolution on oral health urges Member States to address key risk factors of oral diseases shared with other noncommunicable diseases  such as high intake of free sugars, tobacco use and harmful use of alcohol, and to enhance the capacities of oral health professionals.

It also recommends a shift from the traditional curative approach towards a preventive approach that includes promotion of oral health within the family, schools and workplaces, and includes timely, comprehensive and inclusive care within the primary health-care system. Delegates agreed that oral health should be firmly embedded within the noncommunicable disease agenda and that oral health-care interventions should be included in universal health coverage programmes. 

More than 3.5 billion people suffer from oral diseases – mostly in poor and socially-disadvantaged populations. Most oral diseases have been linked with other noncommunicable diseases such as cardiovascular diseases, diabetes, cancers, pneumonia, obesity and premature birth. One major problem is that oral health is not covered by many universal health coverage packages.

WHO is asked to develop a draft global strategy on tackling oral diseases for consideration in 2022 and  by 2023 to translate that strategy into an action plan and recommend “best buy” interventions.

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DECISIONS

Eye care: global targets for effective coverage of refractive errors and cataract surgery

Today’s decision to adopt the global targets for effective coverage of refractive errors and cataract surgery to be achieved by 2030  ̶  namely, a 40 per cent increase in coverage of refractive errors and a 30 per cent increase in coverage
of cataract surgery  ̶  will play a key role in increasing global eye care coverage in the future while delivering quality services.

Interventions that address the needs associated with uncorrected refractive error and unoperated cataract are among the most cost-effective and feasible health interventions available. Key challenges in meeting the growing demand for these interventions
include the ability to provide services for underserved populations and ensuring quality service delivery.

Globally, more than 800 million people have distance impairment (i.e. myopia and hypermetropia) or near vision impairment (i.e. presbyopia) that could be addressed with an appropriate pair of spectacles. An estimated 100 million people have moderate-to-severe
distance vision impairment or blindness that could be corrected through access to cataract surgery.

These figures are expected to increase since presbyopia and cataract development are an inevitable part of ageing, while projected increases in myopia in the younger population will be driven largely by lifestyle factors such as reduced time spent outdoors
and greater time spent on intensive near vision activity.

Achieving these targets requires the combined and proactive efforts of all stakeholders including governments, civil society, international organizations, intergovernmental organizations and the WHO Secretariat working together in innovative ways to address
the population eye care needs. These needs do not just relate to cataract and refractive errors but are also associated with a range of other common eye conditions such as glaucoma and diabetic retinopathy.

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Global Health Sector Strategies on HIV, Viral Hepatitis and Sexually Transmitted Infections

HIV, viral hepatitis and sexually transmitted infections present ongoing and persistent public health challenges and, combined, are responsible for more than 1 million new infections per day and 2.3 million deaths per year.

With current health sector strategies for these areas ending this year, delegates at the 74th World Health Assembly today requested the development of new strategies to bridge the gap to 2030.

Many of the health-related Sustainable Development Goals health targets have not been met, with progress further disrupted by COVID-19, yet the reduction in the incidence of hepatitis B infection is on track.  There has also been continued expansion
of HIV and hepatitis C treatment, and coverage of interventions such as syphilis screening of pregnant women in antenatal care and human papillomavirus vaccination, are increasing.

New strategies will build on these successes while also addressing significant gaps in reaching the communities most severely affected and at higher risk. WHO will now launch a series of virtual briefings and stakeholder consultations to inform the strategies’
development process.

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World Neglected Tropical Disease (NTD) Day

Delegates today agreed to dedicate 30 January as World NTD Day. The day will be an important opportunity to engage a wide range of partners at global, national, and local level to help accelerate the end of NTDs and build on the growing momentum to end
the suffering associated with these devastating diseases.  One key action will be to work with everyone to prioritize the implementation of programmes  across sectors in a cohesive and integrated manner.

World NTD Day will also be an opportunity to engage young people to scale up much-needed awareness raising and contribute to efforts in implementing the new NTD road map for 2021-2030. The roadmap aims to relieve the devastating health, social and economic
impact these diseases have on more than 1 billion people, many of them poor and living in remote rural areas, urban slums or conflict zones.

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New implementation roadmap for achieving SDG target on noncommunicable diseases

Delegates at the World Health Assembly have asked the World Health Organization to develop an implementation roadmap for 2023-2030 to support the prevention and control of noncommunicable diseases (NCDs).

The roadmap will provide a basis for countries to decide on priority activities and pathways to accelerate progress towards achievement of SDG target 3.4 in the next 10 years.

Target 3.4 of the Sustainable Development Goals is to reduce premature mortality from NCDs by one third by 2030 relative to 2015 levels. Only 17 countries are currently on track to meet that target for women and 15 for men. Actions relating to the achievement
of other SDG 3 targets, such as those relating to the reduction of tobacco use and universal health coverage, will be included in the roadmap. 

WHO will consult widely internally and externally, including with people living with NCDs, during the development of the roadmap. Lessons learned from the work of WHO and key partners already undertaken to prevent and control NCDs, including in the context
of the COVID-19 pandemic, will be taken into consideration. 

The roadmap will be submitted to the World Health Assembly in May 2022, following review by the Executive Board at its January 2022 session and subsequent consultations with Member States.

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Programme Budget 2022-2023

Today, delegates discussed and approved the Organization’s proposed 2022-2023 budget (A74/5 Rev.1) of US$6 121.7 million.

The base budget (part which covers the strategic priorities as well as the enabling functions) presents a 16% increase over the 2020-2021 one. Several delegations supported this “ambitious increase” as a reflection of the urgent need for a
strong and well-funded WHO, especially following the COVID-19 crisis.

In line with the Thirteenth Programme of Work [https://www.who.int/about/what-we-do/thirteenth-general-programme-of-work-2019—2023] and WHO’s Triple Billion Targets [https://www.who.int/data/triple-billion-dashboard], the budget supports the Organization’s
3 strategic priorities: ensuring one more billion people in each category have universal health coverage, better protection from health emergencies, and better health and well-being.

Member States also discussed the WHO Results Framework Report, as well as the updates and recent report by the Working Group on Sustainable Financing.

Delegates called for a more flexibly, predictably- and sustainably-financed WHO and stressed that an increase in resources must be accompanied by robust monitoring of progress and measurable results.

The budget will be financed by assessed (US$ 956.9 million) and voluntary contributions (US$ 5 164.8million). WHO’s increasing dependency on voluntary contributions to finance essential work was a concern to representatives of several Member States.

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