The global response to COVID-19 was once again high on the agenda, while there were also several key reports on cancer, access to medicines, AMR, and the social determinants of health. You can access a recording of the meeting here or continue on to read UICC’s summary of the key discussions and statements below.
A WHO PULSE survey in August 2020 found 55% of countries were experience partial or severe disruption of cancer diagnosis and treatment services as a result of the global pandemic. Looking more broadly across the broader swathe of NCDs, 69% of countries reported disruptions to essential diagnosis and treatment. At the same time, the global prevalence of NCDs has been worsening COVID mortality, with a recent commentary by the Editor-in-Chief of the Lancet, called on governments and stakeholders around the world to tackle the ‘syndemic’ nature of COVID-19.
In this context, the WHO EB met to monitor progress in the global COVID-19 pandemic and discuss a resolution on improving mental health services as a core part of the pandemic response. The report contains an update on how WHO has been working to combat the pandemic, including an online COVID-19 Strategic Preparedness and Response monitoring framework. The report also notes that the WHO is undertaking a second PULSE survey to monitor the impact on essential health services, which will provide us with further information on the disruption of cancer and NCD diagnosis and treatment around the world.
During the presentation from the WHO, Dr Mike Ryan shared the latest information on the global COVID-19 response including the available data on the impacts of co-morbidities like cancer:
During the discussion Member States raised several key points including:
Looking ahead, Member States reiterated the importance of better global coordination and capacity building for health, the need to learn from mistakes in the global pandemic response, and the importance of investing in health and UHC to better protect countries from future pandemics. To help achieve this, the EU Member States put forward a proposal for a pandemic preparedness treaty which would be legally binding mechanism to support pandemic reporting and responses globally. A working group has been established to develop this and we anticipate it will be submitted to the World Health Assembly in May.
Expanding access to cancer medicines has been a hot topic at the WHO EB since the 2017 cancer resolution and the 2019 resolution on improving transparency of markets for medicines, vaccines, and other health products. The report discussed during this session explored progress that WHO has made over the past four years including support to accelerate Hepatitis B and HPV vaccine programmes, the expansion of the WHO’s prequalification programme, as well as strong support for the Fair Pricing Forum 2019 discussions on improving access and increasing transparency.
The discussions were wide ranging with a number of updates from Member States on national progress which highlighted several key points:
In addition to this discussion, Member States reviewed progress on the Global Strategy and Plan of Action in Intellectual Property (GSPoA). Discussions included a proped resolution to strengthen the local production of medicines and other health technologies, which calls for:
There are a number of outstanding issues which will be taken forward in negotations including the use of TRIPS flexibilities, the role and use of pooled funds across different regions, and the role of WHO in supporting research and development and technologies transfers internationally.
Antimicrobial resistance remains a key topic of concern amongst the global health community and the WHO prepared a report on its activities to support the global response. One of the key headlines is that 138 countries now have a national action plan on antimicrobial resistance and all WHO regions are working to raise awareness and providing training on AMR. 92 countries have enrolled in the Global Antimicrobial Resistance and Use Surveillance System (GLASS) and the GLASS team are begun to publish tools including a method to estimate the mortality from AMR bloodstream infections and guidance for national reference laboratories to identify resistant bacteria and other microbes.
The WHO has also recently published AMR stewardship programmes in health care facilities in low- and middle-income countries to share experiences and expertise and is working closely with other UN agencies as part of a Tripartite Joint Secretariat to support the global response.
Several key points emerged during the discussions which are relevant to the cancer community including:
In 2018 during the 8th Conference of the Parties, Member states commissioned a report on tobacco products regulation, focusing particularly on novel and emerging products. The WHO Study Group on met to discuss several background papers focusing on heated tobacco products (HTPs), electronic nicotine delivery systems (ENDS) and electronic-non-nicotine delivery systems (ENNDS). The papers addressed toxicology issues, attractiveness and addictive potential of products, effects on perception, flavours, marketing, and barriers to regulation. The goal of this evidence-based report was to update the WHO’s Member States’ knowledge on these products and the report included a number of recommendations:
Immunization Agenda 2030 sets out a goal of a “world where everyone, everywhere, at every age, fully benefits from vaccines to improve health and well-being”. Over the course of the COVID-19 pandemic, immunisation services have been some of the most heavily disrupted, which may have major implications for the success of cervical cancer elimination efforts and measures to reduce hepatitis B associated cancers.
This report tracks progress in how WHO is supporting governments to take ownership of national vaccinations, as well as developing accountability and monitoring frameworks globally, regionally and nationally. It makes clear calls for countries to set national targets and data baselines, use national and regional coordination mechanisms, and for civil society organisations to step-up support to rapid increase immunisation rates.
During the discussion Member States raised several key points including:
This report provides a summary of the different actions and programmes that the WHO has been pursuing to reduce the global mortality from NCDs and help Member States make progress towards the 2025 NCD targets and SDG 3.4. The report notes the substantial impact that COVID-19 has had on NCD services globally, as well as alarming increases in the prevalence of alcohol use, obesity, and air pollution. WHO’s data suggests that the probability (risk) of premature death from any one of the four main NCDs decreased by 18% globally between 2000 and 2016. The most rapid decline was seen for chronic respiratory diseases (40% lower), followed by cardiovascular diseases and cancer (both 19% lower), and while this is an important step forwards the data masks significant inequities globally, regionally, and nationally.
Included in the report annexes were several key documents for the cancer community including:
Also included was the mid-term evaluation of the WHO Global Action Plan for the prevention and control of NCDs, which has been extended through to 2030 and an evaluation of the WHO’s Global Coordination Mechanism on the prevention and control of NCDs.
Throughout the discussions several key themes emerged, including:
In follow-up the WHO has been requested to develop an operational framework to implement the Global Action Plan on NCDS from 2023 to 2030.
Following on from a recommendation by the Executive Board, the WHO developed a short report on the key social determinants of health (SDoH), which highlighted how COVID-19 has exacerbated health inequities. Accompanying the report was a resolution, which was proposed by Peru and supported by 10 Member States and the European Union (EU). The resolution put forward suggestions for Member States to strengthen the monitoring of SDoH ad for WHO to provide greater technical assistance to support the development of strategies, policies and monitoring systems, as well as facilitating the exchange of best practices and lessons learned.
During the discussions key themes emerged including:
In follow-up the WHO has been requested to develop an operational framework to collect and analyse data on the social determinants of health by Member States.
2020 presented new challenges for all stakeholders to engage in WHO meetings, and for the first time the WHO moved to hosting meetings on a virtual platform. This provided a new set of options as part of the ongoing discussions between WHO and its Member States around where, how, and when non-State actors (NSAs) (i.e., civil society organisations, business associations and philanthropic organisations) engage in meetings. One positive move was a suggestion by the WHO to organise a series of three three-hour meetings with the WHO technical teams and a further three meetings with WHO Member States to informally discuss topics at the WHO, this is a great step forward but will likely come too late in the process to really inform or shape discussions. Read UICC’s response and suggestions in our statement below.
Several common points and new suggestions emerged during the discussions: