Monika Arora at WHA77 © G Lontro

WHA77: Bridging global health priorities and geopolitical realities

18th June 2024

WHA77 concluded in Geneva amidst a flurry of discussions, debates, and landmark decisions that highlighted both the triumphs and challenges of global health diplomacy in today’s complex geopolitical landscape.

Navigating geopolitical divides

In his opening address to the assembly, WHO Director-General Dr. Tedros prepared delegations for a challenging week, stating, “Multilateralism is not easy, but it is the only way forward.” to the assembly.

True to his words, running through WHA77 were deep-seated geopolitical tensions that often overshadowed technical health discussions. The Assembly saw an unprecedented number of voting rounds, with eight addressing contentious issues ranging from health emergencies in Palestine and Ukraine to the wording of previously well-established language on gender. This shift towards voting reflects a growing struggle to achieve consensus on critical global health issues, emphasizing the need for robust diplomatic efforts in future assemblies.

More time secured for Pandemic Accord negotiations

Despite these challenges, WHA77 achieved significant milestones, including the adoption of a package of key amendments to the International Health Regulations (2005) after more than two years of negotiation. These amendments aim to enhance global health security by improving emergency information sharing, ensuring equitable access to vital health resources, and strengthening global health preparedness. However, the much-anticipated Pandemic Agreement remains unresolved, with negotiations to extend until as late as WHA78 in 2025, primarily due to disagreements over issues of intellectual property and the sharing of pandemic-related medical products.

Promoting better health and well-being for all

Delegates at WHA77 highlighted key priorities in addressing NCDs, emphasizing the importance of health taxes and stricter regulations on the digital marketing of breast-milk substitutes, supported by calls to hold transnational corporations accountable for their marketing practices. Discussions also underscored the mental health benefits of physical activity and the use of sport events to promote well-being. Furthermore, echoing NCD Alliance’s call to frame prevention as an investment, the Assembly adopted a resolution on economics of health for all, advocating for a sustainable economy that integrates health, environmental, and social factors. It mandates the WHO to develop a health economics and finance strategy by 2026, guiding countries to see health spending as a long-term investment rather than a short-term cost. Additionally, the Assembly passed its first-ever resolution on climate change and health, broadening Member States’ and health sectors’ roles in shaping future challenges. However, it lacked terms like “fossil fuels” or “clean energy” in the text, a concern raised by civil society organizations such as World Heart Federation and some Member States.

The importance of integrating NCDs into Universal Health Coverage benefit packages and Primary Health Care was also stressed by many delegates. There was a strong call to enhance data systems and surveillance of NCDs to track progress, identify gaps, and inform policy decisions, alongside allocating adequate resources for NCD financing.

Mental health emerged as a major focus during the Assembly, underscored by a joint statement delivered by the Dominican Republic, which highlighted its global impact on nearly one billion people, including one in seven young people. Urgent calls were made for improved access, coverage, and financial support for mental health care, and many Member States supported addressing mental health as a specific item on the agenda of the WHA.

With these priorities closely aligned to NCD Alliance’s advocacy priorities for the 4th UN High-Level Meeting on NCDs in 2025, soft-launched during our WHA77 panel event, we are hopeful that a unified approach among Member States with finally bear the results we have been working towards for the past decades.

Strategic planning and financial commitments

The WHA77 endorsed WHO’s 14th General Programme of Work (GPW14), outlining ambitious targets to prevent millions of deaths and strengthen health systems globally by 2028. Importantly, the final version incorporates targets, informed by input from the NCD Alliance, focusing on addressing NCD risk factors, promoting equitable access to quality NCD services, and improving health financing while reducing out-of-pocket payments. This strategic plan underscores WHO’s commitment to addressing health inequities, advancing preventive health measures, and mitigating the impacts of climate change on global health outcomes.

Moreover, the launch of WHO’s Investment Round, seeking $11.1 billion, highlighted the urgent need for flexible funding to support these far-reaching health initiatives in an increasingly uncertain global economic landscape. With only 5% of WHO’s budget currently allocated to NCD prevention and control, it is imperative that the NCD burden is better reflected with adequate funding.

Gender and policy impacts

However, WHA77 was not without its controversies. The Assembly witnessed intense debates over the increasingly contentious issue of sexual and reproductive health and rights, with disagreements specifically over gender language in the resolution on strengthening health emergency preparedness for disasters resulting from natural hazards. Supporters argued for tailored gender-responsive approaches to address vulnerabilities, while opponents cited cultural and legal objections, emphasizing the need for universally accepted terminology to avoid ambiguities and challenges in implementation at the national level.

This recurring debate prompts reflection: Are Member States, WHO, civil society and including the NCD community, collectively prepared to navigate these complexities? Some emphasize the critical role of language, while others advocate a pragmatic focus on substance. Moving forward, fostering constructive dialogue will be crucial in navigating these challenges while upholding WHO’s mandate to promote evidence-based global health, equity and rights for all individuals.

Looking ahead: the road to 2025

WHA77 has been dubbed one of the most politicized of recent times, highlighting the pervasive influence of geopolitical tensions. For the NCD community, it signals that preparations for the UNHLM are well underway, with just over a year remaining. Maintaining momentum through key milestones including UNGA79, G20, and WHA 2025 is crucial for advancing our goals. Successfully navigating these geopolitical tensions and promoting dialogue will pave the way for meaningful progress in the prevention and control of NCDs.

About the author:

Anne-Marie Andreasen is NCDA’s Policy and Advocacy Officer based in Geneva, responsible for covering care policy and WHO advocacy. With a diverse background in public and global health policy and advocacy, she has provided public affairs services to healthcare companies in the EU market, advocated for sexual and reproductive health and rights at the UNFPA Representation Office in Geneva, contributed to patient advocacy groups focused on HIV/AIDS, Parkinson’s disease, and oncology, worked on Nutrition, Physical Activity, and Obesity initiatives with the WHO Regional Office for Europe, and served as a Political Assistant to an MP in the Danish Parliament.