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World Health Assembly closes

Agreement reached on influenza virus sharing, intellectual property

The World Health Assembly (WHA), the supreme decision-making body of the World Health Organization (WHO), wrapped-up its sixtieth session today, reaching last-minute agreement on two key resolutions on Pandemic influenza preparedness and Public health, innovation and intellectual property. More than 2400 people from WHO's 193 Member States, nongovernmental organizations and other observers attended the meeting which took place from 14-23 May.

The Assembly approved the largest-ever budget for the Organization and adopted a record number of resolutions on public health issues and on the technical and administrative work of WHO.

Member States agreed a resolution which will help all countries better prepare for the global public health threat which an influenza pandemic presents. The resolution, "Sharing of Influenza viruses and access to vaccines and other benefits," restates the general principles of the necessity of sharing both in the preparations for an influenza pandemic and the benefits that will flow from improved international cooperation and preparation, such as greater quantities of and equitable access to H5N1 and pandemic vaccines.

In her closing remarks, the Director-General Dr Margaret Chan told the delegates, "All countries need to be aware of their obligations under the revised International Health Regulations. When collective security is at stake, public opinion can carry great weight. After very considerable discussion, you have adopted a resolution on the sharing of influenza viruses and access to pandemic vaccines and other benefits. I want to underscore the importance of this decision. My responsibilities in implementing the IHR depend on this sharing."

The resolution requests WHO to establish an international stockpile of vaccines for H5N1 or other influenza viruses of pandemic potential, and to formulate mechanisms and guidelines aimed at ensuring fair and equitable distribution of pandemic-influenza vaccines at affordable prices in the event of a pandemic.

It also tasks an interdisciplinary working group with drawing up new Terms of Reference (TORs) for the WHO Influenza Collaborating Centre Network, and its H5 reference laboratories, for the sharing of influenza viruses. The new TORs will take into account the origin of influenza viruses going into the WHO Global Influenza Surveillance Network, and will make their use more transparent. Once finalized, these TORs will be submitted to a special Intergovernmental Meeting of WHO Member States and regional economic organizations.

The Assembly reached a last-minute agreement on public health, innovation and intellectual property. The resolution expressed appreciation to the Director-General for her commitment to the process of the Intergovernmental Working Group on the issue and encouraged her to guide the process to draw up a global strategy and plan of action. The resolution also requested the Director-General to provide technical and policy support to countries.

Dr Chan said, "I am fully committed to this process and have noted your desire to move forward faster ... We must make a tremendous effort. We know our incentive: the prevention of large numbers of needless deaths and suffering."

Summary of additional decisions and issues discussed at the 60th World Health Assembly

The Assembly approved a budget for 2008-2009 of $4.2 billion, an increase of nearly $1 billion from the $3.3 billion approved for 2006-2007. The new budget highlights the continued trend of increased investment in global public health. For WHO it means being able to provide more support to countries, in close collaboration with UN and other partners. For the first time, this budget is part of a six-year strategic plan for the Organization, which Member States also adopted at the Assembly.

Member States expressed their concern that malaria continues to cause more than one million preventable deaths every year. The Assembly passed a resolution to intensify access to affordable, safe and effective antimalarial combination treatments, to intermittent preventive treatment in pregnancies, to insecticide treated mosquito nets, and indoor residual spraying for malaria control with suitable and safe insecticide. Member States requested that donors adjust their policies so as to progressively cease to fund the provision and distribution of oral artemisinin monotherapies, and to join in campaigns to prohibit the marketing, distribution and use of counterfeit antimalarial medicines.

All Member States were urged to develop and implement long-term plans for tuberculosis (TB) prevention and control, in line with the WHO Stop TB Strategy. The actions the resolution are aimed at accelerating progress towards halving TB deaths and prevalence by 2015, through the full implementation of the Global Plan to Stop TB, 2006-2015. WHO is requested to strengthen its support to countries affected by TB, in particular those heavily affected by Multidrug-resistant and Extensively Drug-Resistant TB (MD/XDR-TB) as well as TB/HIV.

Indigenous polio survives in parts of only four countries. Member States resolved to step up their efforts to eradicate the virus swiftly, while taking steps to minimize the risk of its international spread. Stressing the financial and humanitarian gains to be made from completing eradication and the ongoing dividends of the highly-developed polio infrastructure, the Director-General presented the 'Case for Completing Polio Eradication', outlining a clear justification for the international donor community to rapidly fill a global funding gap of US$540 million for 2007-2008. Insufficient funding is currently imperilling the 20-year, US$5.3 billion international effort.

The Assembly adopted a resolution on integrating gender analysis and actions into the work of WHO, demonstrating the importance Member States place on including gender perspectives such as disaggregation of data based on sex in all publications and reports.

The WHA adopted a resolution expressing concern over the continuous deterioration of the health and economic conditions of the populations in the occupied Palestinian territory. The need for universal coverage of health services was reaffirmed while recognizing that the acute shortage of financial and medical resources is jeopardizing access of the population to curative and preventive services. The Assembly requested the WHO Director-General to report on the health and economic situation in the occupied Palestinian territory and to continue to provide the necessary technical assistance to meet the health needs of the Palestinians.

The Assembly passed a resolution on better medicines for children, requesting the Director-General to undertake a program of work to improve access to essential medicines for children. This year, WHO will develop a Model List of Essential Medicines for Children, as well as evidence-based medicines information for prescribers and carers, and identify key research and development requirements for producing better medicines for children.

In a resolution on health technologies, in particular medical devices, the Assembly urged Member States to draw up national guidelines and plans for the assessment, procurement and management of technologies used in healthcare.

A resolution on rational use of medicines promotes an integrated, health systems approach to promoting more appropriate use of medicines - specifically, national multidisciplinary bodies to monitor medicines use and promote rational use. The Assembly agreed that a comprehensive review of all research undertaken on the variola virus, which causes smallpox, be undertaken beginning in 2010. The WHA asked that the results of that research - and conclusions concerning the need for any further research - be presented to the 64th World Health Assembly in 2011. The economic burden of oral disease is predicted to grow rapidly worldwide, particularly in disadvantaged and poor populations, unless oral preventive programmes are implemented. The WHA resolution urges WHO to provide advice and technical support for strengthening oral health programmes at country, regional and global levels, in collaboration with other UN organizations, WHO collaborating centres and NGOs.

The WHA passed a resolution urging Member States and the Secretariat to increase investment in, and strengthen efforts towards health promotion as the cornerstone of primary health care and a core function of public health.

The Assembly adopted a resolution on emergency trauma care systems, which draws the attention of governments to the need to strengthen pre-hospital and emergency trauma care systems (including mass casualty management efforts) and describes a number of steps governments could take. It also invites WHO to scale up its efforts to support countries.

Member States approved the resolution on strengthening of health information systems and enhancing WHO's work on health statistics in general. They also called on the DG to strengthen the information and evidence culture of WHO itself, and ensure the use of accurate and timely health statistics in order to generate evidence for major policy decisions and recommendations within WHO.

Member States approved a resolution and reiterated the importance of a coherent research strategy for WHO which will help to disseminate the outcomes of research and its utilization in decision- and policy-making for more effective health policies.

Member States approved a resolution on the control of leishmaniasis, which is recognized as one of the most neglected tropical diseases. Member States were urged to encourage research on leishmaniasis control, to identify appropriate and effective methods of control of vectors and reservoirs and find alternative safe, effective and affordable medicines.

The Assembly endorsed the Global Plan of Action on Workers' Health, which aims to devise policy instruments on workers health; protect and promote health at the workplace; improve the performance of and access to occupational health services; provide and communicate evidence for preventive action; and incorporate workers health into other policies. During this year's opening plenary, the United Nations declared the Palais des Nations a smoke-free environment indoors, recognizing the major contribution of tobacco use to non-communicable diseases and preventable, premature death. A progress report to the Assembly describes noncommunicable disease activities in advocacy, surveillance and population-based prevention since the year 2000. A resolution urges Member States to strengthen national efforts in noncommunicable disease (NCD) prevention and control and also calls for an action plan for the prevention and control of NCDs to be presented to the 61st WHA in 2008.

The Assembly held lengthy discussions on public-health problems caused by the harmful use of alcohol. Delegates agreed that the issue will be discussed again at the WHO Executive Board in January, 2008.

Keynote speakers at the Assembly were the Prime Minister of Norway, Jens Stoltenberg, and the Executive Director of UNFPA, Thoraya Obaid. The Prime Minister spoke of Norway's focus on Millennium Development Goals 4 (child mortality) and 5 (maternal mortality), and announced the establishment of a "Global Business Plan", to accelerate the progress towards these MDGs. The UNFPA Executive Director Thoraya Obaid underlined the areas of cooperation with WHO and urged delegates to focus on improving the sexual and reproductive health of their populations.

Ms Jane Halton, Secretary of the Department of Health and Ageing, Australia was the Assembly President. The Chair of Committee A was Dr Robinson Jean-Louis, Minister of Health and Family Planning, Madagascar and the Chair of Committee B was Mr Thomas Zeltner, Secretary of State and Director of the Federal Office of Public Health, Switzerland.

For more information contact:

WHO Department of Communications, Geneva

Fadéla Chaib
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Christine McNab
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E-mail: mcnabc@who.int

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