PHM-Exch> WHO Exec Bd 130 Report Day 5

[Claudio Schuftan]

From: Alice Fabbri <alealifab at gmail.com>


Report of the WHO watchers just upoladed; prepared on the fifth day of the
130th Executive Board.
The report is available at: http://www.ghwatch.org/who-watch/eb130

*Highlights from the fifth day of the 130th Executive Board*
*Geneva, 20.01.12*

*
*
*Implementation of the International Health Regulation (2005)
*

*Summary of the session*
Under this Agenda Item, Executive Board Members discussed the Report by the
Director General . The Secretariat was requested by the US to prepare a
paper with an update onprogress in International Health Regulation (IHR)
implementation, factors obstructing countries
from meeting their obligations, and what WHO can offer to assist these
countries. This request was supported by non-EB Members: Australia and UK.
On the other hand, a large number of developing countries acknowledged the
difficulty of meeting the deadline of implementing IHR by mid-2012. They
requested technical support by WHO, and asked to extend the deadline untill
2014.
The Secretariat clarified that they currently have information from
150 countries, whereas the report reflects information on 117 only, because
not all country information has been analysed. Updated information will be
available by the World Health Assembly. The Secretariat explained that
countries can apply for extension following the
procedure in the IHR. The Secretariat acknowledged the social and economic
differences between countries. They encouraged bilateral cooperation,
pointing to the Bahamas and the US, and regional and
horizontal networking, mentioned by Thailand, noting that these efforts are
quite complementary to the IHR work.

*Details of the discussion*
Syria, speaking on behalf of EMRO, expressed its support to the use of IHR
internationally as during the Fukushima nuclear accident. Syria noted that
there are still countries which will need assistance from WHO on the
implementation of IHR, and asked these countries to be allowed an
extension of the deadline (mid-2012).
Burundi, on behalf of AFRO, highlighted some challenges in the process of
implementing the IHRsuch as annual reporting, financial resources, and
intersectoral approach cooperation. Burundi stated that it is impossible
for AFRO countries to meet the deadline and urged that extension be allowed.
The US positioned itself as a “partner” to the process and expressed its
willingness to support  WHO, Member States and he global community on IHR
implementation in times of financial constraints. Later, Bahamas, a non-EB
Member, said they benefited greatly from the technical
support by the US.
Estonia, on behalf of EU, was of the view that many countries will not be
able to respect the deadline of mid 2012, noting that the 2009 H1N1
Pandemic has shown that the world is not ready to face a public health
emergency. Estonia called upon WHO for strengthening national
core capacities in countries in need.
India asked for an extension of its deadline, because it was not possible
to implement core capacity by 2012, and requested WHO to facilitate
mechanisms of implementation noting the importance of complementary
regional planning.
France, supported Estonia statement, and requested that the technical
documents on vectorial situation be made publicly available.
Japan noted the problem of absence of a legal framework to govern this
process.
Morocco, aligned itself to EMRO statement, and noted the different social
and economic levels among countries, which necessitate that financial and
technical support be provided to countries to implement IHR.
Mexico requested a full assessment of countries in term of compliance to
IHR.As for non-EB Members, Thailand called for adequate information sharing
and supported the formation of horizontal regional networks and South-South
cooperation.
The Russian Federation asked the Secretariat to address the “inadequacy” of
delayed upload of information on the WHO website and their translation into
all official languages of the WHO.
Iran noted that it was recognised as one of the most prepared in the region
after the WHO mission in 2011. Iran said it is ready to share its
experiences with other Member States.


*Pandemic Influenza Preparedness
*
*
*
*Summary of the session*
EB Members discussed the “Pandemic influenza preparedness: sharing of
influenza viruses and access to vaccines and other benefits: report of
the Advisory Group”.
Transparency in the work of the Advisory Group, particularly in terms of
its involvement with industry, was stressed in the statements of several EB
Members such as Estonia, speaking onbehalf of the EU, China, and Brazil, a
non-EB Member.
Along those lines, a joint statement by Health Action international, Third
World Network and Bern Declaration requested that the CVs and declarations
of interests of the Members of the Advisory Group to be made public. The
Secretariat responded saying that they have been
appointed in their individual capacity, and that this information is
available on the WHO website.
The Secretariat responded to Member States comments saying that there will
be separate meetings with the civil society and industry in the process of
implementing the framework. The  future report will include more
information on the negotiation with industries.
*
*
*Details of the discussion*
Estonia speaking on behalf of EU stressed the importance of transparency in
all work of the advisory group including content of work, renewal process
of its members, and discussions with industry.
Canada viewed the PIP Framework as an example of how Member States and
industries can work together, noting that the process of preparing the
Framework was difficult but well done. Canada requested a clear definition
of the role of Advisory group and the industries.
While Chile did not mind WHO taking opinion from industry, it was also of
the view that priority should be given to opinions expressed by developing
countries from different regions.
Sierra Leone, speaking on behalf of AFRO, noted the challenges which the
region faces, particularly the need for awareness during the post pandemic
period, and called upon WHO to take the needs of the region into account,
and monitor the implementation of the Framework.
In the context of PIP, Mexico mentioned that their campaign called “Wash
Your Hands” was very helpful as a preventive measure. From Mexico’s
experience, there is a need to boost capacities in hospitals, not
necessarily with specific equipment but rather by training staff.
US believed that active consultation with the Civil Society and industries
is important during PIP.
US would be happy to participate in working groups to support on PIP.
Brazil highlighted the key role of the Advisory Group in the implementation
of the PIP Framework, particularly that it will be directly involved with
industry. Brazil called on Member States to have the “zeal” for transparent
and effective implementation, and to make the process
more democratic.
Thailand raised some concerns, including the need for concrete actions,
noting that the commitment of flu-vaccine manufactures should be continuous
and sustained.
*
*
**
*Poliomyelitis: intensification of the global eradication initiative
*

India was the star of the day as its milestone of zero polio diagnosis for
year 2011 verified success in eradication through deploying innovative
methods of engaging multi-stakeholders, integrating elements of primary
care like sanitation and hygiene, targeting migrating populations
and maintaining full vaccination coverage and surveillance in a climate of
intense political commitment. To this end, India was exhorted by delegates
who urged the remaining four endemic zones to use it as a case study
considering that only two years ago, India had
approximately 50% of the global burden of new cases and was widely regarded
as a retractable scenario.
The prioritization of the issue as a global public health emergency was
reaffirmed by India, the 46 countries of the African Regional Office, the
US and others, who also urged reciprocal prioritization at national level
with adequate mobilization of financial, technical and human resources to
its eradication. Japan urged the Secretariat to explain why the 2012 goals
were not extended, stated its pact with Pakistan to fund vaccination
campaigns and asked for amendments to consider polio eradication as a
national priority not only an emergency, to plan for the “renewed”
implementation not “continued” implementation and for establishing a
special polio program in the organization. The UK asked for extension of
the six year plan and Brazil affirmed that, despite achieving success in
1989, it is still immunizing for polio.
Nigeria trying to explain failures, stressed that previous gains were
bungled in 2005 by harmful political manoeuvrings that saw deliberate
misinformation to communities. Renewed efforts were cited with the
allocation of a further 30 USD million, the setting up of a presidential
task force to hold local leaders liable and use of incentives for mother
and child to mold immunization success. The delegate expressed concern for
the presence of newer viral strain and called for technical support. Based
on these, AFRO sided with Nigeria.
Rotary International announced meeting a fund raising target of 200 USD
million early and urged focus on Nigeria. The Organization of Islamic
Countries asked all International Financial Institutions and G8 donors to
expand contribution to bridge gaps and scale up eradication. The
Secretariat and the DG noted that failure of eradication would be the
largest and costliest ever for global action stressing the need for
political leadership, government ownership, adequate investment, good
planning, national oversight and accountability. The Secretariat was
confident
that both countries had oversight mechanisms in place and ensured that the
endgame strategy will run under a public process promising a plan by early
2013 ready for next WHA.
In summary, the exportation of polio to China, Uganda, Kenya and other
parts of the world by Nigeria and Pakistan was acknowledged as a threat to
global health security, with calls to increase funding and cross-border
eradication efforts. It was to be retained as a global health emergency and
eradication action was to be operated as such.
*
*
**
*Elimination of schistosomiasis
*

The discussion was mainly animated by endemic countries (China, Thailand,
Sierra Leone, Somalia), US and UK. Morocco was the first in taking the
floor presenting the successful results they achieved in the
elimination of schistosomiasis. While Somalia drew the attention on the
importance of control activities and drug provision, Thailand broadened the
picture recalling the socio-economic roots of this neglected
tropical disease. The Thai delegate explained that people suffering from
schistosomiasis are fishermen, irrigation workers, children playing and
women washing clothes in contaminated water, and stated that
”they share a common ground: they are poor”.
Also UK stressed the need for integrated strategies such as water and
sanitation improvements for optimizing results and resources.
On a technical side, US stated that it is premature to talk about
elimination of the disease in some countries and suggested to use the word
“control” in the draft resolution.
Among civil society organizations, the only one who took the floor was the
“International Federation of Pharmaceutical Manufacturers and Associations
(IFPMA)” which is actively engaged through donation
programmes. The speaker reminded the generous donation of Praziquantel by
Merk Sharp & Dohme and emphasized the need for this drug to become
available in big quantity. He also announced that next month more drug
donations will be made.
After Dr Nakatani from the Secretariat had summarized the main points of
the discussion, the resolution was adopted with few amendments, in
particular the words “water, sanitation, and hygiene interventions”
were introduced in paragraph 3.
Despite this small change, the draft resolution is quite disappointing.
Indeed, it is focused almost entirely on scaling up preventive mass
praziquantel treatment without recognizing that the elimination of such a
disease calls for a more broadly based strategy than continuing periodic
mass treatments.
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