NCDs addressed extensively by the 140th WHO Executive Board
01st February 2017
01st February 2017
High on the agenda of the Executive Board was the selection of the final three candidates for the post of WHO Director General, with the deciding vote to be taken at the 70th World Health Assembly. The EB also discussed the preparatory process for the 2018 UN High-Level Meeting on NCDs (2018 UN HLM on NCDs), and considered a number of NCD-related agenda items including the draft implementation plan on ending childhood obesity, the draft action plan on the public health response to dementia, a report and resolution on cancer prevention and control, and the health of migrants. NCDA, together with partners, submitted statements on a number of agenda items, which can be found in the resources section of our website. An overview of some of the outcomes of these agenda items is included below, and will be discussed in further detail during our next webinar.
Member States welcomed EB140/27 focusing in their statements predominantly on the updated Appendix 3 of the WHO Global NCD Action Plan, the preparations for the 2018 UN High-Level Meeting on NCDs and the proposed approached to register contributions from Non-State Actors (NSAs). Several governments emphasised that the 2018 UNHLM was a top priority for their government and spoke out in support for its preparation but did not provide detailed guidance on the preparatory process. While most Member States endorsed Appendix 3 in their statements, Canada, backed by the USA and New Zealand requested a technical briefing on Appendix 3 and WHO CHOICE modelling analysis ahead of the 70th WHA. In response, reference to endorsement of Appendix 3 in Resolution EB140.R7 was bracketed.
Several Member States, in particular LMICs, mentioned industry interference extending beyond the tobacco to the alcohol and food and beverage industry as an obstacle to successful national responses and highlighted to critical importance of international technical assistance. Member States agreed that the proposed approach to register contributions from NSAs would have to be further refined and that it was more important that the register was based on a sound approach and appropriately resourced, rather than finished quickly.
The Board recommended EB140.R7 for adoption by the 70th World Health Assembly in May.
The Board considered the draft global action plan on the public health response to dementia 2017-2025. Member States emphasised the importance of a human rights perspective; to reduce the stigma associated with dementia and to maintain the dignity of people living with the condition; to support family caregivers; and to increase investment into research to find a cure and to improve care. The Board recommended to the 70th WHA to adopt decision EB140(7) to endorse the global action plan; to urge Member States to develop ambitious national responses to the overall implementation of the global action plan; and request the Director-General to submit progress reports to the WHA in 2020, 2023 and 2026.
The Board noted report EB140/30 which presents the draft implementation plan on ending childhood obesity. Overall Member States welcomed the report acknowledging the serious impact of childhood obesity on the health outcomes of their populations, in particular in the context of heavy NCD burdens. Several Member States highlighted the importance of regulatory and population-based approaches to curb the obesity epidemic, including restrictions on marketing, nutrient profiles, front-of-pack food labelling and taxation of unhealthy commodities. The USA requested additional opportunities to review the plan ahead of its endorsement at the 70th WHA and Member States including Sweden and Japan called for an improved monitoring and evaluation framework.
Member States expressed strong support for the draft cancer resolution, emphasising its role in supporting national implementation of cancer plans and the elevation of funding for cancer prevention and control as a priority. UICC submitted a statement, along with 8 other NGOs, and contributed suggested amendments to the draft resolution. It is understood that these were taken forward during discussions of a drafting group, made up of 20 Member States, coordinated by Canada. The group has developed a revised white paper and consensus has been achieved on the majority of the text. Final consultations will take place until May, with the aim of adopting the final resolution at the 70th WHA.
On the first day of the meeting, the Board added a dedicated item on physical activity to the agenda. The late addition of the item meant that it was only briefly addressed, however in a testament to the committed efforts of dedicated Member States led by Thailand, a proposal to request the Director-General to prepare a draft action plan on Physical Activity for consideration at EB142 (January 2018) and WHA71 (May 2018) was endorsed with no objections. NCD Alliance and the International Society for Physical Activity for Health (ISPAH) welcomed this decision. Read more here
The Board also announced that rheumatic heart disease (RHD) will be included as an Agenda Item at the next Executive Board Meeting in May 2017. The Executive Board made this decision following extensive advocacy by the RHD community, led by RHD Action, for a coordinated global response to RHD. Following the announcement, all Member States will convene to debate RHD at the 141st Executive Board in May 2017. Discussions are set to revolve around the adoption of a draft Resolution to mandate WHO to address RHD on a global scale.
The Board noted report EB140/32 emphasising the importance of integration of health into wider sustainable development priorities underlining that health is a prerequisite for Sustainable Development; that the SDGs should not be seen as ‘add on’ but should shape the existing work of WHO; and the fundamental role of multisectoral action. The Secretariat built on this latter priority, noting the importance not only of building better health systems, but also ‘better systems for health’.
The Board took note of EB140/33 and considered the draft road map, which is due to be finalised in time for adoption by the 70th WHAS. Member States discussed the need to promote rigorous scientific assessment of both hazardous chemicals (including endocrine active chemicals and certain pesticides) and safe alternatives; and for use of the latter to be promoted. Multiple Member States expressed concern that illegal chemicals are still present in many markets and frequently in use, and reiterated the importance of stringent regulation. Challenges were noted to be especially great in developing countries. The Secretariat requested any final suggested edits to the draft road map to be shared by the 10th February.
The Board took note of EB140/34. Member States highlighted the triple dividend of investing in adolescent health, including improved access to services, positive impact on health later in life, and intergenerational impact on the next generation. The issue of safe abortions was mentioned by a number of Member States. Member States reiterated the challenges of data collection due to the current lack of strong CRVS systems, and the Secretariat acknowledged that they may not be able to provide data for all 60 indicators in the monitoring framework for the Global Strategy. The Secretariat also hopes to include the issue of palliative care in report from the High Level Working Group for the Health and Human Rights of Women, Children and Adolescents.
Member State statements emphasised the importance of promoting the health of migrants in light of overarching priorities of the right to health and to ‘leave no-one behind’. The particular vulnerabilities of migrants and refugees to physical and mental conditions due to conflicts in their places of origin and hazardous journeys were highlighted. Calls were made for ongoing collaboration with the International Office of Migration (IOM) and the UN Refugees Agency (UNHCR), in particular as related to a global compact on refugees and on the global compact for safe, orderly and regular migration. The Secretariat affirmed its intention to do so. The Secretariat also gave particular thanks to Member States who had emphasised the importance to consider mental health of migrants and refugees, and reiterated the underlying importance of efforts towards health systems strengthening and attaining universal health coverage in order to maximise preparedness.
The Board conducted screenings of the six candidates nominated by Member States for the position of WHO Director-General, and subsequently voted to determine a shortlist of five candidates. In a second step the Board then interviewed the remaining candidates, and further shortened the list to three nominees: Dr Tedros Adhanom Ghebreyesus of Ethiopia (30 votes), Dr Sania Nishtar of Pakistan (28 votes) Dr David Nabarro of the UK (18 votes). Member States will vote the next WHO Director-General among these three final candidates at the 70th WHA. The new Director-General will take office on 1 July.
The Board noted EB140/41 which provides an overview of FENSA implementation via the WHO Regional Offices to date. Decision EB140(10) admitted into official relations the following organisations: Bill & Melinda Gates Foundation; Grand Challenges Canada; International Rescue Committee; Knowledge Ecology International; and The Fred Hollows Foundation. Leading up to this decision health and public interest NGOs expressed their strong concerns over admitting the Bill & Melinda Gates Foundation because of the Foundation trust’s investments in business ventures such as Coca-Cola. According to the Foundation, which is the biggest private donor of the WHO, the trust is a separate entity from the foundation, rejecting thus accusations of conflicts of interest.
The EB also noted EB140/47 which list criteria and principles for secondments from NGOs, philanthropic foundations and academic institutions.
More information on the Board’s discussions of report EB140/41 can be found here.
The provisional agenda for the 70th World Health Assembly can be found in EB140/44. The Assembly is scheduled to take place 22 to 31 May at the UN Palais des Nations. The 141st Session of the WHO Executive Board will be held 1 to 2 June 2017 at WHO Headquarters.