Throughout the discussion documents and side events, the UICC team has identified three key drivers for the discussions which we think will be influential in 2019. We have used these to help shape and priorities our statements and advocacy messages, and would welcome your thoughts and feedback to email@example.com.
Once again, the UICC team will work throughout the week to raise the profile of cancer control in official and unofficial discussions and we are delighted that seven different UICC members will be travelling to Geneva to join the delegation and help up champion global cancer control on the international stage.
The documents up for discussion and adoption are report A72/12 and resolution EB144.R9. The initial report and resolution were presented at the 144th Executive Board, and following on from the discussions, the WHO team updated the report to include language on:
The resolution calls on Member States to adopt and internalise the Astana Declaration on PHC, and for the WHO to develop an operational framework for PHC by the 73rd WHA.
Agenda 11.5 is a blockbuster and the second part which will be important for the cancer community is the discussion on preparations for the high-level meeting (HLM) on UHC, report A72/14 and resolution EB144.R10.
The report provides an overview of the current scale and burden of inequitable access to health and, while WHO continues to support a disease-focused approach, the report notes need for space for ‘additional challenges’ including the need to strengthen health systems to successfully deliver UHC. The report also highlights that UHC is both a goal itself and a means of implementation for the a suite of the Sustainable Development Goals (SDG) 3.
The resolution associated with the report calls on member states to attend the HLM on UHC at the highest level of government and to work towards a concise, action oriented political declaration. Within this, the resolution notes the importance of strengthening decision making, including the need for improvements in integrated health information systems in order to promote equitable, affordable and universal health. The resolution also tasks WHO with developing a report on UHC as an input to the meeting, and to submit biennial reports on progress in implementing the resolution between 2020 and 2030.
Find out more about UICC’s engagement in the UHC discussions here.
At its core, WHO is committed to addressing global health inequities, and this has come out very strongly in Dr Tedros’ 13th General Programme of Work. After initial discussions at the 144th EB on proposed budget (A72/4) and the impact framework (A72/5), the WHO has refined the indicators and is proposing the introduction a scorecard to better capture the outcomes of its work. Alongside this, the WHO has also developed information note A71/INF./2 which helps map out how current funding will be re-allocated under the GPW13 targets.
The report (A72/11) provides an update on progress towards the health-related Sustainable Development Goals and resolution WHA69.11. The discussion on NCDs recognises that the burden of NCDs continues to grow and discusses the global trends in alcohol and tobacco consumption as well as mental health, focusing particularly on suicides. In the discussion on UHC, the report notes the current status of spending on health and coverage of essential health services, including access to essential medicines for palliative care and pain management.
The update on resolution WHA69.11 details actions taken by WHO to further the 2030 agenda, including the establishment of the Regional Healthy City Network, the development of the Global Action Plan on SDG3+, regional plans on UHC, the development of the SCORE package and collaborations beyond health.
Not all the documents for this agenda item are currently available, but discussions will build on report A72/19 which provides a summary of the current burden of NCDs, the lack of progress at national level, and the outcomes from the 2018 HLM on NCDs. It highlights the limited data to track progress against the nine voluntary NCD targets and identifies follow-up actions including commitments by WHO to strengthen technical support, such as identifying a subset of NCD accelerators from the ‘best buys’, promotion of special initiatives (including cervical cancer elimination), the promotion of fiscal measures to address risk factors and the development industry dialogues.
Following on from discussions at the 144 Executive Board a number of amendments have been made, including the addition of further evidence on fiscal measures for NCD prevention (Annex 2), update to the proposed workplan of the GCM, and an analysis of NCD surveillance globally (Annex 7). In addition to this report, Member States will be invited to adopt resolution EB144.R10 which proposes to extend the Global Action Plan (GAP) on NCDs through to 2030 to align with the Sustainable Development Goals, charges WHO with updating the Best Buys for NCDs and strengthen monitoring and accountability.
The WHA is invited to note the draft road map (A72/17) which has a dual focus: to ensure the quality, safety and efficacy of medicines and vaccines via regulatory system strengthening, assessment, market surveillance and to improve equitable access by matching R&D to public health needs, affordability and pricing and reducing waste, procurement and supply chain management, appropriate prescribing and rational use.
Following on from discussions at the 144th Executive Board, the draft roadmap has been revised with the addition of Appendix 2 to show linkages between the GPW13 and roadmap activities, actions, deliverables and milestones, and to reflect the global goods planning process. The report recognises the high percentage of health spending on medicines (up to 20-60% in some LMICs) as a barrier to UHC. Recognising the growing burden of NCDs, and the knock-on impacts for medicines and vaccine spending, the WHO is working to develop a list of agreed indicators to improve access to quality health products, which will contribute to the SDG indicator for access to medicines under development.
Following on from the cancer medicines price report at the 144th Executive Board (EB144/18) a number of member states have called for a specific resolution on the transparency of prices for medicines, vaccines and health-related technologies. Going into the WHA week, this resolution is still under negotiation, but we understand that it urges member states to share information to increase transparency of prices of medicines, vaccines and health technologies. It calls on governments to require information on R&D costs and sources of funding and results of clinical trials to be made publicly available. It asks the WHO to support governments in collecting information on prices, reimbursement, clinical trials outcomes and a webtool to share information, including on public investments and subsidies for R&D.