Source: Small Island Developing States
Every year, health ministers gather between August and October in regional committees to translate World Health Organization Assembly (WHA) resolutions into regional and national policies and action plans. WHA resolutions, which result from the deliberations of the health ministers of all WHO member states, are used to set global health policy. Resolutions are the mechanism to endorse reports or take a decision on a topic or direct WHO Secretariat actions for the next year. The WHO Secretariat has its main headquarters in Geneva, but much of its work is also done through six regional offices. Each region conducts a regional committee meeting. At the WHA, resolutions are adopted in whole or part and some are more specific to the region’s challenges or are more granular and obligate ministers to take certain actions. This article looks at the resolutions that the six WHO regions considered during their 2018 meetings.
The regional committee for the Eastern Mediterranean (EMRO) met in October and discussed the eradication of poliomyelitis, access to assistive technology, strengthening the health laboratory services, blood safety, tobacco control, universal health coverage and other topics that maybe of interest to readers. One issue that has been on the agenda of EMRO and other regions is that of universal health coverage (UHC). Two aspects of this topic under consideration are private sector engagement and the delineation of the service package under UHC. On the topic of “Private Sector Engagement for Advancing Universal Health Coverage”, EMRO considered an update to a 2017 WHO report titled, “Analysis of the Private Health Sector in Countries of the Eastern Mediterranean: Exploring Unfamiliar Territory.” This paper contains a proposed framework for action for effective engagement with the private health sector to move towards UHC with five strategies. The five strategies are to develop a policy framework, strategic options such as strategic purchasing, to improve the quality of services in the private health sector and ensure that regulatory mechanisms for health systems are enforced effectively and develop monitoring and reporting mechanisms for private health sector providers.
Among the agenda items for the Western Pacific (WPRO) regional committee were the topics of a new Regional Framework for Control and Elimination of NTDs (neglected tropical diseases), which health leaders endorsed, along with the Regional Action Framework on Improving Hospital Planning and Management in the Western Pacific. During this committee meeting, Takeshi Kasai, currently Director of Program Management (DPM) and Deputy to the Regional Director in WPRO (2014 to present), was nominated as the next WHO Regional Director for the Western Pacific. His nomination will be considered during the upcoming WHO 144th Executive Board meeting in January 2019 in Geneva.
According to a statement by the European Committee (EURO) Regional Director, Zsuzsanna Jakab, EURO was established to change the ways that Member States work in order to make sustainable progress on health and well-being. She explained that transformative working methods include ensuring policy coherence across different sectors and at different levels, and using inclusive and transparent governance mechanisms and partnerships. Jakab highlighted that a key area of focus is to work with industry to address the commercial determinants of health. In this regard, Jakab stated, “It is clear that today’s rise in non-communicable diseases reflects a system that prioritizes economic and financial growth and advantage over better health… I believe we should do our best to convince the food and soft drink industries to follow WHO standards and norms.”
Among the other agenda items considered was the recognition of the European Public Health Association as an accredited non-state actor to EURO. The regional committee also endorsed a resolution on universal health coverage that included text urging: “member states to support systematic monitoring of financial protection and unmet needs for health services, to support the assessment and equity impact of policy changes and to improve access and financial protection for everyone, recognizing that excessive out-of-pocket payments for outpatient services and medicines can be a significant source of financial hardship in many countries in the Region.” Europe has been a leader in the area of the pricing of health services and products, so this admonition is significant.
The subject of medicines access was also on the agenda of regional meetings, as was the case for the regional committee for Africa (AFRO). The health ministers endorsed a Five-Year Plan to Improve Access to Medicines. Called a Roadmap for Access 2019-2023, the plan sets out policies, actions and key deliverables to support improving access to health products over the next five years. The plan is pretty much a copy of the zero draft of the medicine’s roadmap put out by WHO HQ that is under revision to reflect member input in advance of the 2019 EB and WHA meetings. Also on the agenda were the adoption of a code of conduct for the election of its regional director; the rotation of Burkina Faso and Kenya to the EB in May of 2019; and a review of WHO’s new report on the “State of Health in the WHO African Region”, which includes a country-by-country analysis of health status, health services and health systems. It shows life expectancy is increasing and the disease burdens of malaria, HIV/AIDS and diarrheal disease burdens decreasing, but not so in the risk factors and burden of noncommunicable diseases.
The regional committee for South-East Asia (SEARO) went into much more detail on the topic of access to medicines, adopting the Delhi Declaration on Access to Essential Medical Products in SEARO and Beyond. Health ministers agreed to undertake 11 action items, also noting that some of the countries are producers of medicines and reaffirming several WHA resolutions on medicines access. The Ministers also decided to try to place UHC advancement in national contexts on the January 2019 EB in order to have a longer discussion period in advance of the United Nations high-level meeting on UHC planned for September 2019. The agenda was short, but packed and included the nomination of Dr. Poonam Khetrapal Singh as SEARO Regional Director.
Finally, for the Americas, the PAHO regional committee, also called the Directing Council, approved plans of action on: Human Resources for Universal Access to Health and Universal Health Coverage; Entomology and Vector Control; Women’s, Children’s, and Adolescents’ Health; and Cervical Cancer Prevention and Control. All of the plans of action cover the period from 2018-2030. PAHO DG Dr. Carissa Etienne reported that work was continuing for the development of the next PAHO Strategic Plan 2020-2025, but gave no indication of its contents in her closing remarks.
The regional groups will meet again during the World Health Assembly in May 2019 to manage regional responses to the Assembly agenda items, which will be determined during the upcoming Executive Board meeting in January.