Photo of the 142nd meeting of the WHO Executive Board

NCDs attract serious discussion, and debate, at WHO Executive Board

31st January 2018

The 142nd session of the WHO Executive Board (EB) ended on 27 January. Here are our key takeaways:

A step in the right direction: Scaling-up action on NCDs in WHO’s General Programme of Work 2019-2023

The process of revising the draft 13th General Programme of Work (GPW13) since the Special Session of the Executive Board in November continued during the EB, resulting in several amendments. Those related to NCDs included stronger reference to physical activity and nutrition as well as to the Global Coordination Mechanism for NCDs. These reflected calls made in NCDA statements and further strengthened the document’s focus on NCD prevention.

The NCD Alliance and other civil society organisations highlighted the need to balance NCD prevention and treatment, including focus on scaling-up the Best Buys for treatment under GPW13’s focus on Universal Health Coverage.

Member states agreed to forward GPW13 for consideration by the 71st World Health Assembly in May (WHA71). The EB Resolution also requests finalisation of the Programme’s impact framework, financial estimates and investment case ahead of WHA71.

Preparations for the UN High-Level Meeting on NCDs

While Member States in Geneva were discussing the UN High-Level Meeting on NCDs (UN HLM) later this year, Italy and Uruguay were appointed by the President of the UN General-Assembly in New York as co-facilitators for the process to shepherd Member States through the negotiations of a modalities resolution and Outcome Document. At the EB, Uruguay highlighted the importance of the Montevideo Roadmap as input to the UN HLM while Italy remained silent on the EB’s report on NCDs and Preparations for the HLM.

Director-General Dr. Tedros insisted in his response that progress on NCDs was not slow for want of evidence-based solutions, but for lack of action and political will.

While many Member States welcomed the serious tone of the report, the US delegation criticised it for “lacking objectivity”, taking particular issue with the detailed descriptions of barriers to progress including weak political action, lack of policy coherence and industry interference. Director-General Dr. Tedros insisted in his response that progress on NCDs was not slow for want of evidence-based solutions, but for lack of action and political will. To illustrate his point, he read aloud the list of Member States that have ratified the Protocol to Eliminate Illicit Trade on Tobacco, which will require ratification by six more countries before becoming an international treaty. He challenged Member States, in particular Executive Board members, to ratify the protocol before July’s deadline.

On the sidelines of official deliberations, many Member States expressed strong support for the UN HLM to be held back-to-back with the UN HLM on Tuberculosis in September, but voiced concern over the lack of consensus on the expected outcomes of the UN HLM on NCDs.

See the NCD Alliance's priorities for the modalities of the UN HLM and our campaign priorities.

Health, environment and climate change: a widened priority area

Following new agreements between the WHO, UN Environment and the United Nations Framework Convention on Climate Change aimed at strengthening multisectoral collaboration and coordination, Member States supported a proposal for the WHO to develop a draft action plan to address the health effects of climate change, initially in small island developing states, and a draft comprehensive global strategy on health, environment and climate change. Both will be considered at the 72nd World Health Assembly in 2019.

WHO and Member States walking the talk on physical activity

Physical Activity featured prominently during WHA70, both as an agenda item pivoting around the draft Global Action Plan for Physical Activity (GAPPA), and with the WHO ‘walking the talk’ with regular dance breaks, thanks to persistent reminders from the Thai delegation. There was strong support for GAPPA, particularly the integrated voluntary global target of a 15% relative reduction in inactivity by 2030 (an extension of the existing voluntary global target of 10%).

Many Member States acknowledged the importance of physical activity across the life course as a crucial opportunity to reduce NCDs and improve health. The EB adopted a resolution endorsing GAPPA and requesting the WHO to finalise a monitoring and evaluation framework on the implementation of the global action plan, including a recommended set of process and impact indicators. The resolution also called on the WHO to update 2010 guidelines on physical activity and prepare the first global status report on physical activity by 2020.

Moving forward (slowly) on access to medicines

United on the importance of access to medicines to achieve Universal Health Coverage, but widely diverging on how to address the issue, Member States spent long hours negotiating a decision addressing the global shortage of and access to medicines. They requested the DG to elaborate a roadmap on the programming of the WHO’s work on access to medicines and vaccines, including activities, actions and deliverables for the period 2019−2023 and the global strategy and plan of action on public health, innovation and intellectual property.  

Read more about these negotiations.

Nutrition remains a priority

Executive Board discussions elevated nutrition as a priority, strengthening the GPW13’s focus on malnutrition in all its forms and WHO and FAO-led efforts in the UN Decade of Action on Nutrition. Member States also noted the extension of the WHA Nutrition Targets from 2025 to 2030 and approved the four remaining indicators of the Global Monitoring Framework on maternal, infant and young child nutrition.

The WHO’s proposed approach to safeguard against possible conflicts of interest in nutrition programmes was noted and welcomed by a number of countries, such as Nigeria, Thailand, Philippines and India, which expressed interest in piloting the tool.

WHO working to leverage digital technologies

Member states recognised the tremendous potential of mHealth to transform health systems, by ‘bringing health closer to the people’ (EU and Thailand) and improving connectedness between hospitals and primary healthcare facilities through electronic health records. It was also noted that mHealth is a component of strong health systems and not a replacement for traditional health services.

The potential to leverage mHealth to address NCDs, both in terms of prevention and self-management, was noted. Almost all Member States emphasised the need to develop strong regulations for data protection. A resolution on mHealth, initiated by India, will be discussed at the 2018 World Health Assembly.

More, less or better: Engagement with the private sector

The WHO’s engagement with non-state actors, in particular the private sector, continues to be the subject of discussions and interventions. While some Member States took the floor repeatedly to champion public-private partnerships, others shared concern over interference from unhealthy commodities industries, particularly in the context of NCD prevention and control. The WHO DG acknowledged the need to avoid conflicts of interest, but proposed that “disengaging” the private sector wasn’t an option.

Towards World Health Assembly 71: Spotlighting Universal Health Coverage

The Board agreed the provisional agenda for the 71st World Health Assembly in May (WHA71), which will be held 21-26 May and will be themed around Universal Health Coverage. WHA 71 will be followed by the 143rd session of the EB, 28-29 May.