New resolutions on:
- Local production of medicines
- Ending violence against children
- Addressing social determinants of health
Strengthening local production of medicines and other health technologies to improve access
Member State requests for WHO’s support in strengthening local production have been increasing in recent years. The COVID-19 pandemic has only served to highlight even more the urgent need for enhancing quality manufacturing capacity in all regions of the world, including for innovative, highly effective health products such as mRNA technologies. Such capacity is necessary to address or even avert future public health emergencies and to improve access to health products in general through stronger health systems.
Sponsored by more than 100 countries, today’s resolution specifically calls for a more comprehensive, all-of-government approach, national strategies and action plans, an enabling business environment, human capital development, multi-stakeholder collaboration and engagement in regional and global networks.
WHO has already committed to holding the first ever World Local Production Forum in June this year, convening countries, partners and other stakeholders to discuss strategies to promote local production to improve access to health products during the current pandemic and beyond.
Ending violence against children
Today’s resolution on Ending violence against children through health systems strengthening and multisectoral approaches aims to strengthen health sector capacity to prevent and respond to violence against children.
The health sector plays a major role in documenting the extent of the problem of violence against children; delivering and monitoring prevention approaches and providing services to mitigate the consequences of exposure to violence.
The new resolution lists a range of actions to be taken by governments and the WHO Secretariat, in collaboration with other stakeholders, to ensure the health and well-being of children.
Every year, about 1 billion children are affected by physical, sexual or psychological violence, suffering injuries, disabilities and death as well as the negative impact of witnessing violence between parents or caregivers. In addition to the immediate and lifelong harmful consequences to individuals and families, violence against children undermines investments in health and education and erodes the productive capacity of future generations. COVID-19-related stay-at-home measures have highlighted children’s vulnerability to violence within family settings.
The new resolution invites countries to scale-up the implementation of two WHO-led technical packages, INSPIRE: Seven strategies for ending violence against children and RESPECT women: a framework for preventing violence against women, developed to help countries achieve the Sustainable Development Goals (SDG) on ending violence against children (SDG 16.2) and violence against women and girls (SDG 5.2).
The first-ever Global status report on preventing violence against children 2020 measured countries’ progress on preventing and responding to violence against children. The report highlighted substantial achievements at global, regional and country levels, while also emphasizing an urgent need to accelerate prevention efforts if the SDG targets to end violence are to be achieved. The resolution invites the WHO Secretariat to prepare the second and third global status reports on violence against children in 2025 and 2030.
Tackling social determinants of health
The goal of this resolution is to reduce the glaring health inequities recently highlighted by the COVID-19 pandemic, through stronger action to tackle the social determinants that play such a prominent role in defining people’s ability to live healthy lives.
These include the conditions people live in, as well as their access to power, money, and resources, including healthcare. They are often driven by discrimination and persecution, such as racism, sexism, classism and war. And they impact every aspect of health.
Children from the poorest households in low- and middle-income countries (LMICs) are twice as likely to die before their 5th birthday as those from the richest households. People in rich countries live as many as 16 years longer than those in poor ones.
The World Health Assembly adopted resolutions on social determinants of health in 2009 (following the report of the WHO Commission on Social Determinants of Health) and in 2012 (following the World Conference on Social Determinants of Health and the Rio Political Declaration on the Social Determinants of Health).
The social and health inequalities exposed by COVID-19 have led to renewed interest by Member States in WHO’s work on social determinants of health, and this new resolution.
The resolution aims to strengthen action globally and within countries on the social determinants of health; to reduce health inequities by involving all sectors in taking concrete action to improve living conditions and reduce social inequalities; and improve monitoring of social determinants and health inequities. The resolution lists actions to be taken by governments, civil society, international organizations, intergovernmental organizations, the private sector and the WHO Secretariat, including in continuing efforts to combat the COVID-19 pandemic and in future recovery efforts.
- New resolutions on the health and care workforce and strategic directions for nursing and midwifery
- Decisions on patient safety; health, environment and climate change; chemicals management; coordination of work on noncommunicable diseases
- Global Action Plan for Healthy Lives and Wellbeing for All
- Prevention of sexual exploitation, abuse and harassment
Protect, safeguard and invest in the health and care workforce
The COVID-19 pandemic has underscored the critical role of all health and care workers at the forefront of the pandemic, who have faced multiple risks related to their health, well-being and safety.
The resolution on Protecting, safeguarding and investing in the health and care workforce calls for action to guarantee that investments in our workforce ensure they are: skilled, trained, equipped, supported and enabled. It stresses the need for decent pay, recognition, a safe working environment, and protection of their rights.
The resolution highlights the need to:
- enable all health and care workers to access COVID-19 vaccines, Personal Protective Equipment, decent work conditions, and equitable labour protection that is free from all forms of discrimination
- accelerate multisectoral collaboration and sustained investments in health workforce education, skills and jobs
- drive the implementation, measurement and reporting on the WHO Global Strategy on Human Resources for Health and the WHO Global Code of Practice on International Recruitment of Health Personnel
- prepare a global health and care worker compact.
It mandates the Director-General to update and strengthen implementation of WHO’s action plan on health employment and inclusive economic growth, working with Member States and relevant partners.
The Global Strategic Directions for Nursing and Midwifery 2021–2025 and its accompanying resolution provide policy recommendations on education, jobs, leadership, and service delivery that will help countries ensure that their nurses and midwives have maximum impact on population health outcomes. These policies are derived from the evidence published in the State of the World’s Nursing Report (2020) and the State of the World’s Midwifery Report (2021).
2021 is the International Year of the Health and Care Workers. At the heart of this Year is the recognition that in order to manage the pandemic, maintain health services, improve health workforce readiness, education and learning, and roll out COVID-19 vaccination equitably, the world must protect and invest in health and care workers.
Decision on Patient Safety aims to eliminate avoidable harm in health care globally
Delegates agreed on concrete action to eliminate avoidable harm in health care by adopting the first ever “Global Patient Safety Action Plan 2021–2030”. Every year, millions of patients suffer injuries or die due to unsafe health care globally, with 134 million adverse events occurring annually in low- and middle-income countries alone, contributing to 2.6 million deaths. Even in high-income countries, about 1 in 10 patients is harmed while receiving hospital care. It is estimated that almost half of these events can be prevented.
In 2019 a WHA resolution on global action on patient safety recognized patient safety as a key global health priority, requesting WHO to consult with countries and stakeholders to formulate a global patient safety action plan.
Today’s decision provides strategic and practical direction to countries to formulate policies and implement interventions at all levels and settings aimed at improving patient safety. The action plan outlines priority actions to be taken by governments, civil society, international organizations, intergovernmental organizations, WHO and, most importantly, by health care facilities across the world. WHO will work in cooperation with Member States in the development of their respective implementation plans, according to their national context.
Global strategy on health, environment and climate change
Important steps have already been taken to implement the 2019 WHO global strategy on health, environment and climate change: the transformation needed to improve lives and well-being sustainably through healthy environments.
These include the manifesto for a green and healthy recovery from COVID-19, a plan of action on biodiversity and health; advocacy for water, sanitation and hygiene in health-care facilities; launch of the Hand Hygiene for All Global Initiative; health messages for the upcoming COP-26 (UN Climate Change Conference of Parties); the global campaign to prevent lead poisoning; various regional action plans and fora to support country action on health and environment. WHO has provided support to a number of countries on health and environment related projects.
Delegates at the WHA have now decided to report on progress on the strategy in 2, 4, and 8 years’ time.
- WHO global strategy on health, environment and climate change: the transformation needed to improve lives and wellbeing sustainably through healthy environments
International Chemicals Management and the role of the health sector
Delegates also decided to report again in 2 years’ time on progress towards the implementation of the WHO Chemicals Road Map, highlighting the critical role of health in sound chemicals management, and need to mainstream chemicals management into all health programmes. They also requested the Secretariat to update the road map to prepare recommendations regarding the Strategic Approach and the sound management of chemicals and waste beyond 2020.
Extension of the Global Coordination Mechanism for Noncommunicable Diseases
The Global Coordination Mechanism (GCM) for Noncommunicable Diseases will be extended until 2030. The GCM was established in 2014.
A number of measures have been recommended to improve its effectiveness. These include development of a workplan for the delivery of the 5 functions for which the GCM has responsibility. The plan will include a clear vision, a robust results framework, performance and outcome indicators and clarity on how the mechanism will carry out its functions in a way that is integrated with WHO’s ongoing work on NCDs. The plan will be submitted to the World Health Assembly in 2022, after consideration by the Executive Board.
Practical tools for sharing knowledge and disseminating information about innovative activities from a variety of stakeholders working at country level will be developed. So will a global stock-take of action from various stakeholders at country level, together with guidance to Member States on engagement with non-State actors, including on the prevention and management of potential risks. Advice will be provided to civil society on how to develop national multi-stakeholder responses to NCDs and hold governments to account; and the capacity of people living with NCDs to participate in the co-creation of whole-of-society responses to NCDs will be strengthened.
- Final evaluation of the global coordination mechanism on the prevention and control of noncommunicable diseases. Executive summary – April 2021
- Options paper on the global coordination mechanism on the prevention and control of noncommunicable diseases
- Mid-point evaluation of the implementation of the WHO global action plan for the prevention and control of noncommunicable diseases 2013–2020
- Global Coordination Mechanism on the Prevention and Control of NCDs
- More on noncommunicable diseases
Global Action Plan for Healthy Lives and Wellbeing for All – SDG GAP
Delegates highlighted that the COVID-19 pandemic has reversed a decade of progress on SDG targets and underscored the need to redouble efforts by accelerating implementation of SDG3 GAP, WHO’s 13th general programme of work, and the Primary Health Care special programme.
There was wide support for the SDG3 GAP and WHO's convening role. Delegates noted the GAP’s key role in strengthening primary health care and advancing progress towards the targets set out in the Global Strategy on Women's, Children's and Adolescents' health. They also emphasized its focus on country-level impact and its critical role in supporting equitable and resilient recovery.
- 2021 Progress report on the Global Action Plan for Healthy Lives and Well-being for All
- Information on The Global Action Plan for Healthy Lives and Well-being for All
Prevention of sexual exploitation and abuse
At the Strategic briefing Preventing sexual exploitation and abuse: from policy to practice in health emergencies, the Secretariat outlined what WHO is doing across all levels of the organization to prevent sexual exploitation and abuse (PSEA) and harassment.
WHO is committed to taking a comprehensive, holistic and survivor-centred approach to PSEA and sexual harassment, and is taking actions in the areas of policy, capacity-development and operations. PSEA focal points in Ukraine, Guinea and Bangladesh informed Member States of their work in crisis settings for communities and staff, including regular and mandatory PSEA training for WHO staff, implementation of hotlines to safely report complaints, designation of trusted community focal points, and continued liaison with partner agencies in prevention efforts.
The Director-General addressed the 5th meeting of Committee B on Agenda item 30.2 – the report of the Internal Auditor on preventing sexual exploitation, abuse and harassment (A74/36). The Director-General assured Delegates that they will receive regular monthly updates on the investigations of the Independent Commission on allegations of sexual misconduct during the response to the 10th Ebola outbreak in the Democratic Republic of the Congo.
The Secretariat will also provide quarterly briefings to Member States, as required by the Executive Board, and have dedicated agenda items on this topic for future WHO governance meetings. In addition, WHO will:
- establish a WHO task team, led by a senior female staff member, to accelerate the implementation of organization-wide WHO policies and procedures, adopting a holistic approach to prevention and management of sexual exploitation and abuse and sexual harassment. The task team will also oversee the implementation of the Independent Commission recommendations;
- establish an informal consultative group of external experts who can advise on ‘best in class’ approaches, recognizing that Member States and other entities have valuable experience and expertise that WHO can draw upon.
Thursday, 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
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.
- Draft Resolution on reducing the burden of noncommunicable diseases through strengthening prevention and control of diabetes – May 2021
- More on diabetes
- Global Diabetes Compact
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.
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.
- Updated WHO global malaria strategy
- WHO Guidelines for malaria
- Malaria fact sheet
- World malaria report 2020
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.
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.
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.
- The Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021 was released earlier this month and contains updated estimates for Hepatitis and STIs and key recommendations for countries to accelerate progress.
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.
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.
- Mid-point evaluation of the implementation of the WHO global action plan for the prevention and control of noncommunicable diseases 2013–2020: executive summary – April 2021
- Political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases – January 2021
- More on noncommunicable diseases
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.