The World Health Assembly
, the supreme decision-making body of the World Health Organization, has raised global public health to a new level, by resolving to take more action to prevent death and illness resulting from heart disease, diabetes, cancers, road safety, and lack of access to health services as well as from diseases spread by viruses, bacteria and other dangerous microbes.
"This World Health Assembly clearly raised the bar for improving public health of all people. The Assembly agreed to tackle diseases which can spread from the environment, or from person to person, and also those linked to the foods we eat, the amount we exercise and the safety of our roads." said Dr LEE Jong-wook, Director-General of the World Health Organization. "I also welcome the resolve to take action to improve the reproductive health of women and men."
The 57th World Health Assembly, which met from 17-22 May 2004, attracted more than 2,000 delegates from WHO's 192 Member States as well as those from official observers and non-governmental organizations. Invited speakers included former Presidents and Nobel Peace Prize winners Kim Dae-jung of the Republic of Korea, and Jimmy Carter of the United States of America, who both spoke about the challenges presented by the growing gap between the world's rich and poor. Ms Anastasia Karmylk, of Belarus, also spoke passionately about the need to do more to prevent and treat HIV/AIDS, including overcoming the stigma and discrimination faced by people living with the HIV/AIDS. This press release summarizes decisions taken at the 57th World Health Assembly, including several resolutions as well as recognition for progress made in several important health areas. Please note that full texts of all documents and decisions taken are available at www.who.int/gb .
The WHO Global Strategy on Diet, Physical Activity and Health was unanimously endorsed by Member States. The strategy addresses two of the major risk factors responsible for the heavy and growing burden of noncommunicable diseases (NCDs), which now account for some 60% of global deaths and almost half (47%) of the global burden of disease. NCDs include cardiovascular disease, type 2 diabetes, cancers and obesity-related conditions.
The strategy emphasizes the need to limit the consumption of saturated fats and trans fatty acids, salt and sugars, and to increase consumption of fruit and vegetables and levels of physical activity. It also addresses the role of prevention in health services; food and agriculture policies; fiscal policies; surveillance systems; regulatory policies; consumer education and communication including marketing, health claims and nutrition labelling; and school policies as they affect food and physical activity choices.
Recognizing that health promotion is important for attaining the health-related United Nations Millennium Development Goals, the World Health Assembly adopted a resolution encouraging all Member States to strengthen existing policies and programmes related to health promotion and healthy lifestyles . The resolution calls for countries to give high priority to promoting healthy lifestyles for children and young people, to focus on poor and marginalized groups, and to give attention to the prevention of alcohol-related harm.
The Assembly adopted the WHO's first strategy on reproductive health , intended to help countries stem the serious repercussions of reproductive and sexual ill-health, which accounts for 20% of the global burden of ill-health for women, and 14% for men. The strategy targets five priority aspects of reproductive and sexual health: improving antenatal, delivery, postpartum and newborn care; providing high-quality services for family planning, including infertility services; eliminating unsafe abortion; combating sexually transmitted infections, including HIV, reproductive tract infections, cervical cancer and other gynaecological illness and disease; and promoting sexual health. The Assembly also adopted a resolution on the family and health in the context of the 10th anniversary of the International Year of the Family.
The Assembly welcomed the Director-General's "3 by 5 strategy" to support developing countries in their response to HIV/AIDS by increasing access to prevention, care and treatment and securing access to antiretroviral treatment for three million people living with HIV/AIDS by the end of 2005. The Assembly confirmed WHO's leading role in supporting countries in delivering prevention, care, support and treatment for HIV/AIDS within strengthened national health systems. Member States urged the Director-General to improve the access of developing countries to antiretroviral medicines and other products used in the diagnosis, treatment and care of HIV/AIDS, including by strengthening the WHO prequalification project. WHO should also help countries strengthen their supply chain management and procurement of good quality products. The resolution also encouraged countries entering into bilateral trade agreements to take into account the flexibilities relating to public health as laid down in TRIPS agreement of the World Trade Organization and the Doha Ministerial Declaration on the TRIPS Agreement and Public Health. The 57th World Health Assembly also unanimously approved a resolution on road safety and health . The resolution seeks to address the lack of safety on the world's roads, responsible for 1.2 million deaths and as many as 50 million injuries annually. The resolution follows the widely celebrated World Health Day 2004, dedicated to road safety. As invited by the United Nations General Assembly through its resolution on improving global road safety, issued during a historic plenary session on the topic on 14 April 2004, the World Health Assembly resolution also accepts the invitation for WHO to serve as coordinator on road safety issues within the United Nations system.
The WHA learned that the global effort to eradicate polio is on track in Asia and north Africa, with India, Pakistan, Egypt and Afghanistan reporting only 22 polio cases to date this year. At the same time, African Union Ministers reported their alarm that in 2004 the number of cases in west and central Africa was already five times that for the same period in 2003, due to the continuing outbreak originating from Kano, Nigeria. WHO announced that it would launch an emergency appeal for resources for a massive immunization campaign across west and central Africa. Dracunculiasis, or guinea-worm disease , remains endemic in 12 countries, all in sub-Saharan Africa. In a bid to complete eradication, the World Health Assembly passed a resolution urging endemic countries to intensify eradication efforts and for the global community to continue its commitment, collaboration and cooperation to assure resources are mobilized for these efforts.
The World Health Assembly adopted a resolution on increasing surveillance and control of Buruli ulcer , a poorly understood disease that can severely affect the skin and cause serious disabilities. The resolution urges all Member States to intensify research to develop tools to diagnose, treat and prevent the disease and encourages active participation in WHO's Global Buruli Ulcer Initiative.
Human African trypanosomiasis, also known as "sleeping sickness" , remains a major public health problem, due to its epidemic potential and its 100% fatality rate if untreated. Delegates unanimously adopted a resolution to make the control of this disease a priority, and to direct more resources to endemic areas.
Outstanding progress in reducing measles deaths was reported to Assembly delegates. Global measles mortality decreased by an estimated 30% between 1999 and 2002, with an even greater reduction (35%) in Africa. Continued implementation of a WHO/UNICEF comprehensive strategy can keep Member States on track to achieve the 2005 target of reducing measles deaths by half from 1999 levels.
Genomics and world health
There have been remarkable advances in the science of genomics, or the study of genes, their functions and related techniques. The World Health Assembly adopted a resolution to address concerns about the safety as well as ethical, legal and economic implications of this relatively new science.
The Assembly adopted a resolution on human organ and tissue transplantation to encourage the development of recommendations and guidelines to harmonize global practices and ensure the ethical practice of organ and tissue transplant. The delegates agreed to take measures to protect the poorest and vulnerable groups from "transplant tourism" and the sale or trafficking of tissues and organs. The resolution also addressed the practice of transplanting animal tissue or organs to humans and the need for clear national regulations on the practice and for surveillance of potential infections caused by these transplants.
Health conditions of, and assistance to, the Arab population in the occupied territories, including Palestine
The Assembly adopted a resolution addressing concerns about the deterioration of health conditions and the humanitarian crises resulting from military activities in the occupied Arab territories, including Palestine. The resolution calls for Israel to immediately halt activities that affect the health conditions of civilians under occupation and also urges the WHO Director-General to dispatch a fact-finding team to the occupied territories and to continue providing technical assistance for improving health.
Mental Health - A call for action
In his address to the Assembly, Mr Jimmy Carter, former President of the United States of America, stressed that despite the availability of treatment, too many people simply have no access. The message was reinforced during a technical briefing on Mental Health and Substance Abuse by a number of countries, and by former First Lady Rosalynn Carter, who is a leader for mental health issues and founder and chairperson of the Carter Centrers Mental Health Task Force.
The Assembly adopted a resolution meant to address countries' concerns about the international migration of health personnel . This resolution urges Member States to develop strategies to mitigate the adverse effects of migration of health workers; to develop policies that could provide incentive for health workers to remain in their countries; and, among other issues, requests WHO to help Member States set up information systems to monitor the movement of health resources for health, and to include human resources for health development as a top-priority programme at WHO from 2006-2015.
A detailed progress report was presented on the Framework Convention on Tobacco Control . So far, 114 countries and the European Community have signed, and 16 countries have ratified the Convention. The Assembly also received and debated reports from WHO on progress made on a number of health issues , including: research on the variola virus that causes smallpox; the recently established Commission on Intellectual Property Rights, Innovation and Public Health, which will now present its report to the Executive Board in January 2006 ; the quality and safety of medicines and blood products, on the follow-up to the SARS outbreaks in 2003 and 2004; on measures to protect the safety of patients; and on the importance of strengthening health systems, including primary health care.
Next year's World Health Assembly is scheduled to convene from 16-25 May, 2005.