News on NCDs from the 72nd World Health Assembly
04th June 2019
04th June 2019
WHA72 was dominated by the theme of Universal Health Coverage (UHC), as a cornerstone of the WHO’s work programme 2019-2023 and Director-General Dr Tedros’ commitment to leaving no one behind when it comes to accessing essential health services. The vast majority of events during the week debated how to achieve this vision, ensuring that coverage becomes truly universal for all health conditions and population groups. The Assembly adopted resolutions presented to the Executive Board in January 2019 on Primary Health Care, Community Health Workers and Preparations for the HLM on UHC in September 2019. The zero draft of the political declaration(link is external) to be adopted during the HLM was published during WHA, ahead of Member State negotiations in New York.
The WHA noted the draft roadmap on access to medicines and vaccines. However the most contentious discussion of WHA72 was around a proposed resolution on transparency of prices and development costs of medicines, vaccines and health products. Negotiations between a large group of member states continued over the weekend and into the second week, with a resolution finally adopted on the last day of the Assembly. The resolution was initially tabled by Italy, and the final consensus text gathered 19 co-sponsor countries in all regions. Dr Tedros hailed the resolution as a landmark agreement in his closing speech. The resolution urges Member States to publicly share information on net prices of health products and results of clinical trials, along with their costs - the latter on a voluntary basis. It calls on WHO to support governments in their efforts to increase transparency of relevant data as a contribution to curbing excessive prices and improving access. Three countries - Germany, Hungary and the UK - disassociated themselves from the resolution on procedural grounds. Thailand disassociated from one paragraph, reiterating the possibility of mandating some transparency requirements at national level.
The WHA noted the report and adopted the decision, both of which outline follow up actions for the WHO Secretariat to the 2018 High Level Meeting on NCDs. There was some last minute negotiation in relation to the decision, as Thailand proposed an amendment with support from 11 ASEAN countries, to establish a working group on alcohol and challenged serving of alcohol on WHO premises and at WHO events. The decision was adopted without the amendment, but with the WHO Secretariat pledging to report back in 2020 after full consultation and engagement with Member States. The decision importantly calls for WHO to define recommended policy interventions on air pollution and mental health and extends the timeframe of the current global action plans on NCDs and mental health to 2030, bringing them into alignment with the SDGs.
Member States finally approved the programme budget for the next biennium, after several weeks of technical briefings for Missions and further explanatory documents allayed concerns, including that resources would be cut for the NCD response. The confirmed budget would seek to increase impact orientation for the WHO’s work programme and increase resources for national level activities, monitoring and reporting, particularly with regard to achieving the “triple billion” targets. Specific indicators are to be included for NCDs. There are increases across NCD-relevant budget lines, with 5% more for NCDs specifically, and more significantly an increase of 24% foreseen for health systems strengthening, compared to the previous budget.
Member States agreed a new global strategy on health, environment and climate change: the transformation needed to improve lives and well-being sustainably through healthy environments. The strategy provides a vision and way forward on how the world and its health community need to respond to environmental health risks and challenges until 2030. They also agreed a plan of action on climate change and health in small island developing States with four strategic lines of action: empowerment (supporting health leadership in small island developing States); evidence (building the business case for investment); implementation (preparedness for climate risks, adaptation and health-promoting mitigation policies); resources (facilitating access to climate and health finance).
Member States agreed a five-year global action plan to promote the health of refugees and migrants, which focuses on achieving universal health coverage and the highest attainable standard of health for refugees and migrants, and for host populations. The plan includes short and long-term steps to mainstream refugee and migrant health care; enhance partnerships; strengthen health monitoring and information systems and counter misperceptions about migrant and refugee health. Member States requested the Director-General report back on progress at the 74th World Health Assembly. Reports to the 74th and 76th World Health Assemblies will also include information provided by Member States on a voluntary basis, and UN agencies as appropriate.
WHA noted the report which provides an update on progress towards achieving the health-related Sustainable Development Goals. A section on NCDs notes trends in alcohol consumption, tobacco use and suicides. The section on UHC notes problems with access to essential medicines for pain and palliative care, increasing HPV vaccine coverage, and poor alignment between global public health needs and R&D spending. A section on environmental risks is also highly relevant for NCDs. The report briefly summarises key outcomes from the NCD HLM and intra-UN work towards a Global Health Action Plan for SDG3. A comprehensive review of SDG indicators is due in 2020.
In his opening remarks to the Seventy-second World Health Assembly, Dr Tedros announced the appointment of Her Excellency Ellen Johnson Sirleaf, former President of Liberia, as Goodwill Ambassador for the health workforce. The Secretariat noted that 40 Member States requested support to implement the global strategy, and called upon all stakeholders to increase investment to advance this critical priority in order to realise UHC. Member States noted the report and were encouraged to report their national data on human resources for health through an online platform.
Member State opinions on the value and means to engage civil society and other non-State Actors in WHO governing body meetings varied considerably. It was generally agreed current ways of operating are not satisfactory for Member States, nor for non-State Actors, and that ways forward must ensure that engagement is meaningful, relevant and efficient. The diversity of non-State Actors was recognised. The Secretariat will provide an updated proposal to the Executive Board in January. Brazil requested clear specification as to the scope of the web-based consultation with non-State Actors which will inform the report, and for an in person consultation of Member States in Geneva. Dr Tedros noted the benefits of engaging with civil society, for example throughout the WHO Civil Society Working Group on NCDs.
You can access to recordings of key NCD events held by NCDA and partners during WHA72 week by clicking on the images below: