A week-long session of the 53rd World Health Assembly closed in Geneva today. Referring to HIV/AIDS, World Health Organization (WHO) Director-General said in her closing remarks, "We have a resolution that gives us a new vision of what we can do, and therefore what we should do, to counter HIV/AIDS. Through the enhancing of care and strengthening its linkages to prevention, we are about to give new directions and a new energy to an expanded, revitalized response to the HIV/AIDS pandemic. We have rekindled a spirit of global solidarity, and together, we will work to take it forward."

A comprehensive resolution on HIV/AIDS is among the high-lights of the Assembly. Nearly 34 million people world-wide are currently living with HIV/AIDS, and 95% of them are in developing countries. In many countries, the development gains of the past 50 years, including the increase in child survival and in life expectancy are being wiped out by the HIV/AIDS epidemic. In sub-Saharan Africa, where over 23 million people are infected, HIV/AIDS is the leading cause of death with more women now being infected than men. HIV infection is increasing rapidly in Asia, particularly in south and south-east Asia, with six million people currently infected. A special UN Security Council meeting on HIV/AIDS crisis in Africa referred to it as a unique modern-day plague that threatens the political, economic ands social stability of sub-Saharan Africa and Asia.

The resolution urges WHO Member States to increase access to treatment and prophylaxis of HIV-related illnesses and to make drugs both available and affordable. It requests WHO to develop a global health-sector strategy as part of the United Nations system's strategic plan for HIV/AIDS for 2001-2005. The Organization is to "further support the implementation of drug price monitoring system in Member States" and to become "fully involved in the International Partnership against AIDS in Africa, particularly at country level."

Non-communicable diseases such as cardiovascular diseases, cancer, diabetes and chronic respiratory diseases are a cause of enormous human suffering and a threat to the economies of many countries. The most prominent non-communicable diseases are linked to common risk factors, namely, tobacco use, alcohol abuse, unhealthy diet, physical inactivity and environmental carcinogens. The global strategy for the prevention and control of non-communicable diseases is directed at reducing premature mortality and improving quality of life. The Assembly resolution urges WHO Member States to develop "a national policy framework taking into account healthy public policies creating a conducive environment for healthy lifestyles; fiscal and taxation policies towards healthy and unhealthy goods and services" and to establish programmes for the prevention and control of non-communicable diseases and to assess and monitor mortality and morbidity attributable to non-communicable disease. The resolution requests the WHO Director-General to put a special emphasis on the prevention and control of non-communicable diseases "in developing countries and other deprived populations" by providing technical support and appropriate guidance to WHO Member States.

The Health Assembly adopted its first resolution on food safety for many years, emphasizing the growing threat posed to health from foodborne illnesses. Delegates also emphasized the high volume of global food trade today and new technologies used in food production. They called for cooperation with the food industry and consumer associations, and establishment of a databank of scientific evidence, and a rapid WHO response to international and national food safety emergencies.

Prolonged discussions on infant and young child nutrition revealed a variety of positions on a critical subject. It was decided that the best of scientific evidence is needed to guide strategies in this field. Hence, the WHO Executive Board will establish an open-ended working group to prepare a resolution for next year's Assembly. In the meantime, discussions of this issue are encouraged in regions and countries "with a view towards gathering the broadest possible inputs".

Many countries with substantial tuberculosis burdens have an uphill struggle to contain the disease effectively. This spurred the delegates to adopt a resolution on Stop Tuberculosis Initiative. It was noted that tuberculosis control is not feasible without "broad and long-lasting high-level political support". WHO Member States are encouraged to use as widely as possible the strategy of directly observed treatment, short course (DOTS). They are invited to participate with WHO in the global partnership to stop tuberculosis. In particular, they are urged to assess the magnitude of the impact of AIDS on the tuberculosis epidemic and to "speed up coordination between prevention and treatment programmes for the two epidemics".

Delegates also discussed the temporary retention of variola (smallpox) virus stocks. They were informed that, in October 1999 and February 2000, WHO teams of international experts inspected the conditions of biological safety and physical security in which the remaining stocks are held at the two WHO Collaborating Centres in the Russian Federation and in the United States of America. The conditions in both centres were found to be fully satisfactory. The next session of the WHO Executive Board will be discussing the time frame for possible further research and temporary retention of the remaining stocks of the virus.

Time and again, the delegates stressed the need to accelerate polio eradication. Last winter, 800 million doses of polio vaccine were administered in the course of several National Immunization Days in India. In Pakistan, cabinet ministers are actively participating in immunization campaigns. In China, epidemiological surveillance is being beefed up in the border areas searching for possible cases of cross-border re-introduction of the virus. Japan is standing ready to send its experts to polio-endemic countries. The Netherlands announced generous financial contribution to strengthen epidemiological surveillance. Democratic Republic of Congo and Sierra Leone had their first ever National Immunization Days. But there is still a lot of work to be done before the world becomes polio-free. As of February 2000, there was a financial shortfall of US$ 300 million and that is in spite of increased significant donations from governments, nongovernmental organizations and the industry. Once polio has been eradicated, the world will be saving US$ 1.5 billion annually.

Discussions on the revised drug strategy focused on quality, safety and availability of medicines. The delegates highlighted the need for WHO to provide price information on essential drugs, to support broader approaches to drug financing, and to address the growing dangers of unregulated sale of medicines on the Internet.

For further information, please contact Mr Valery Abramov, Office of the Spokesperson, WHO, Geneva. Telephone (+41 22) 791 25 43. Fax (+41 22) 791 4858. Email : abramovv@who.int. 

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