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20 May 2014

67th World Health Assembly

Rolling summary of events surrounding the 67th WHA. For immediate updates please follow @UICC @NCDAlliance #WHA67 on Twitter.

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23 May 2014: 20h00 | Today, Ministers of Health gave their support to a groundbreaking resolution on palliative care that will help drive national action to reduce barriers to the accessibility and availability of palliative care. 

UICC delivered a joint statement (click here to read in full) supported by the European Society for Medical Oncology, the NCD Alliance and a coalition of palliative care and health advocacy groups welcoming the adoption of a comprehensive resolution. In particular, we highlighted the critical importance of:

  • Developing palliative care standards and policies, integrating them into health systems, at all levels, across the life course, and embedding them in national NCD plans;
  • Offering on-going basic, intermediate and specialist training and education in palliative care – that can be built on existing curricula adapted to local settings;
  • Reviewing legislation and policy for controlled medicines (including formulary and patient restrictions, supplementary prescribers, prescription limits, and emergency prescriptions) to improve access and rational use of pain management medicines; and
  • Updating national essential medicine lists in light of the new sections on pain medicines in the WHO EML.

Framework of engagement with non-state actors
The framework of engagement with non-state actors was discussed in Committee A, moved forward from its scheduled time tomorrow.

The draft decision of the working group from yesterday was agreed (click here to read), but with the deadline for questions of 6th June changed to 17th June. A report following the Regional Consultations this Autumn will then be circulated by mid-December in preparation for the Executive Board.

Discussions are continuing this evening on Agenda item 14 on promoting health through the lifecourse, beginning with newborn health.

11h00 | The NCD agenda item continues this morning with the Global Disability Action Plan, autism spectrum disorders, and psoriasis in Committee A, and with the progress report on child injury prevention addressed in Committee B.

New WHO proposals for Post-2015


Capitalising on the interest in the post-2015 development agenda, WHO convened a technical briefing at WHA 67 yesterday for Member States, observers, and civil society focused on Goals and targets for health in the post-2015 agenda. Director-General Margaret Chan began the session by emphasizing the need to keep health, including financing and social protection, at the centre of the future agenda. Dr Marie-Paule Kieny recapped the consultations and technical work thus far, followed by a brief summary of WHO’s proposals for the health goal in the post-2015 framework:

  • Proposed overarching goal: Ensure healthy lives and universal health coverage at all ages
  • Proposed Sub-goals:
    • Achieve the health-related MDGs (including ending preventable maternal and child deaths, and ending infectious disease epidemics)
    • Address the burden of NCDs, injuries, and mental disorders (including the proposed target to reduce by 2030 preventable deaths from NCDs by one third)
    • Achieve universal health coverage (UHC) including financial risk protection
    • Address the social and environmental determinants of health 

Some welcomed the proposals, but noted the absence of critical issues including antimicrobial resistance, sexual and reproductive health and rights, and universal access to family planning. Several notable voices emphasized their support for an overarching health goal focused on maximizing healthy life expectancy. Member States are expected to adopt a resolution on health in post-2015 at the end of the session this week.

22 May 2014: 16h45 | Discussion continued this afternoon with the NCD Agenda Item. Key decisions in today’s sessions included: 

  • The adoption of global action plan indicators
  • The adoption of Terms of Reference for the Global Coordination Mechanism for NCDs. The ToRs include the purpose, functions, structure, and lifespan for this new global mechanism
  • Agreement to submit the Terms of Reference of the UN Task Force on NCDs to the UN Economic and Social Council (ECOSOC)
  • Support for the Global Coordination Mechanism (GCM) work plan
  • Member States noted the report on WHO’s role in the preparation, implementiation and follow-up of the 2014 UN review and assessment of the progress achieved in the prevention and control of NCDs.

In total, 53 Member States made interventions, with several drawing attention to:

  • The need for additional technical support and guidance from WHO to translate global NCD targets and indicators into regional and national level targets and indicators

  • The importance of a multisectoral approach to NCDs, and the need for meaningful engagement of non-state actors, including civil society and private sector in the Global Coordination Mechanism for NCDs.

  • The fact that in response to the Global Action Plan on NCDs (2013-2020) many had already developed national action plans and strategies to address NCDs and allocated specific resources to NCD prevention and control.

During the civil society interventions, Mr Cary Adams, CEO of UICC and Chair of NCD Alliance (NCDA), delivered a statement on behalf of UICC and the NCD Alliance “regretfully expressing disappointment with the final Terms of Reference.” He went on to read: “the GCM falls significantly short of the vision and commitments in the 2011 Political Declaration. Instead, it reinforces a “business as usual” approach to NCDs and is a missed opportunity.” Read the full statement here.

12h00 | Just before midday, the agenda has moved to non-communicable diseases (NCDs) with discussion expected to continue into the afternoon session. 

Just prior to this, the earlier agenda item saw Member States approved a resolution to improve the prevention, diagnosis and treatment of viral hepatitis in the morning session. 

21 May 2014 | The NCD agenda item has been further postponed until Thursday morning, where we hope to deliver a statement.

Today, UICC co-hosted a lunchtime side-event entitled ‘Strengthening of palliative care as a component of integrated treatment within the continuum of care’, with Permanent Missions to the UN of Australia, Chile, Ghana, Libya, Kenya, Malaysia, Panama, South Africa, Spain, Switzerland, USA, as well as thirteen civil society organisations.

The objective of this side event was to share concrete and successful models of integration of palliative care into health systems, and to encourage an exchange of experiences between countries to facilitate the development of palliative care throughout the world. The event brought together over 150 representatives from government, UN Agencies and civil society. Dr Marie-Paule Kieny, Assistant Director General, Health Systems and Innovation, World Health Organization opened the meeting by highlighting that palliative care is an integral component of Universal Health Coverage. 

Professor Suri Suryawati from the International Narcotics Control Board (INCB) joined via video link from Vienna and drew attention to the startling facts surrounding access to palliative care: “The consupmption of narcotic drugs for pain relief if concentrated in a handful of countries. 92% of the world’s morphine is consumed by only 17% of the global population. This is particularly concerning given that 70% of cancer deaths occurred in low- and middle-income countries.” She went on to encourage governments to implement recommendations as outlined in 2010 INCB report.

Panellists highlighted in-country examples of where palliative care has been successfully integrated into health systems.

  • In South Africa, palliative care is embedded in their Integrated Chronic Disease Management strategy, with patient-centred palliative care services being delivered at the primary care level.
  • In Panama, they have a multidisciplinary approach to palliative care, building teams of experts to conduct training with pharmacists, social workers, teachers and nurses.
  • In India, they have allocated 10% of cancer programme budget to palliative care and developed a national strategy, with six objectives, including: increasing capacity for delivery, refining regulatotry systems and raising public awareness.
  • Malaysia is taking a multi-sectoral approach to palliative care, working closely with civil society, private sector and government.

The NCD Alliance also held a side event in collaboration with the Permanent Missions of New Zealand and Malaysia, and the World Heart Federation. With opening remarks given by Dr Margaret Chan, the high level panel discussed ‘Addressing the NCD Challenge in the Post-2015 Development Agenda: the Life-Course Approach’.

20 May 2014 | Geneva – Discussions continued this morning with the WHO reform, and a focus on the framework for WHO’s engagement with non-State actors. The NCD agenda item has been pushed to Wednesday morning, followed by discussion on health post-2015.

19 May 2014 | Geneva – The World Health Assembly (WHA), the world's health policy-making body, opened its 67th Session

In her opening address to the Health Assembly, WHO Director-General Dr Margaret Chan drew attention to the rising cancer burden, noting that “The number of new cancer cases has reached an all-time high and is projected to continue to rise. Developing countries now account for around 70% of all cancer deaths. Many of these people die without treatment, not even pain relief."Her reference to the issue of pain relief is significant given that the palliative care resolution is due to be discussed on Thursday, which we hope will receive the full support of Member States.

Speaking about cancer and NCD risk factors more generally, Dr Chan voiced her deep concern about the increase worldwide of childhood obesity, with numbers climbing fastest in developing countries. “As the 2014 World Health Statistics report bluntly states, ‘Our children are getting fatter’,” she said.To gather the best possible advice on dealing with this crisis, Dr Chan announced that she has established a high-level Commission on Ending Childhood Obesity. The Commission - co-chaired by Sir Peter Gluckman, Chief Science Advisor to New Zealand’s Prime Minister, and Dr Sania Nishtar, founder of Pakistan’s health policy think tank, Heartfile – will produce a consensus report specifying which approaches are likely to be most effective in different contexts around the world. The recommendations of the report will be announced at next year’s Health Assembly. For more information and to read the full address, please visit: http://www.who.int/en.

Marking it’s fifth anniversary, the NCD Alliance held a side event entitled ‘NCD Countdown 2025: Measuring progress, accelerating action’, with a high-level panel discussion on strengthening accountability in the global NCD response. Speakers included Dr Ties Boerma, World Health Organization, Sir George Alleyne, Chancellor, University of the West Indies and Director Emeritus, PAHO, Professor Robert Beaglehole, The Lancet NCD Action Group, Ms Ann Starrs, Countdown to 2015, Dr William A. Zoghbi, Global CVD Taskforce.

To watch the recording of the event, please visit: http://t.co/VTpBcCYlQi

Main image © WHO/Violaine Martin

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