World Health Assembly opens
Countries set health priorities amid tragedies, crises and opportunities
19 May 2008 | Geneva - As the 61st World Health Assembly opened today in Geneva, officials from 193 countries began the annual task of reviewing progress and setting new priorities for one of the most powerful tools in global public health, the World Health Organization (WHO). The event marks the 60th year of the international collaborative effort to relieve the burden of disease globally. But the mood of the anniversary meeting was sombre as the loss of life in the Myanmar cyclone and the China earthquake remained uncertain but certainly immense.
"We are meeting at a time of tragedy," WHO Director-General Dr Margaret Chan told the 2500 delegates in the Assembly Hall of the Palais des Nations as she opened the meeting.
Dr Chan provided the delegates with a stark survey of health challenges -- from ancient afflictions like leprosy to future human health impacts of climate change. She reported on the mixed progress towards polio eradication and expressed the hope of overcoming the legal barriers in the way of future public health achievements. With this atlas of illness and avoidable death laid before them, the delegates have six days to set priorities for WHO.
In the wake of recent disasters, Dr Chan looked ahead at three looming crises. Already apparent is a crisis of soaring food prices which could undermine the foundation of health, adequate nutrition. Climate change is a crisis on the horizon which is expected to bring more droughts, floods and tropical storms, and greater demands for humanitarian assistance. In both cases, the poor are at greatest risk. A third crisis, pandemic influenza, lurks in the future. Said Dr Chan, "The threat has by no means receded, and we would be very unwise to let down our guard or slacken our preparedness measures."
The existing list of health problems still press nations and strain resources. A staggering 33.2 million people are living with HIV, and 2.5 million were infected just last year. Progress in tuberculosis control remains steady but multi-drug resistant TB has reached historic levels. Polio eradication efforts are also complicated. In Asia, polio type 1, the most dangerous strain, is on the verge of elimination. But in Africa, a dramatic upsurge in this strain has been seen in the northern states of Nigeria, while other countries in Africa are struggling to eliminate viruses reintroduced two years ago.
On the positive side, long struggles against many diseases are yielding results. Malaria control is finally showing solid progress with rapid improvements in morbidity and mortality documented in Ethiopia, Kenya, Rwanda and Zambia. Immunization programmes have been able to drive childhood mortality below 10 million per year for the first time. Home-based treatment of pneumonia -- the number one killer of young children -- has been shown to be as effective as, and possibly safer than, hospital care, according to research coordinated by WHO and published this year. And new resources, such as those provided by the Bill and Melinda Gates Foundation, are bringing guinea-worm eradication within reach.
Perhaps the best opportunities for big strides in global health are in the fight against neglected tropical diseases. Safe and effective drugs have been identified to fight many of these diseases. These drugs are being donated through public-private partnerships or being sold at discount. And a new strategy of providing these drugs widely, to an entire population at risk, is proving as protective as immunization. Dr Chan noted that funding modestly and in a time-limited manner would control many of these diseases, and even eliminate some, by 2015.
"The World Health Organization was established 60 years ago," Dr Chan said in closing her tour of global health challenges. "The landscape of public health is vastly different now. WHO is not alone in the drive to improve health. Leadership is not mandated. It is earned. This is a time of unprecedented global interest and investment in health. But it is also a time of unprecedented challenges."
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