<br>From: <b class="gmail_sendername">chiarezza</b> <span dir="ltr"><<a href="mailto:chiarabodini@hotmail.com">chiarabodini@hotmail.com</a>> PHM WHA Watch</span><br><div class="gmail_quote"><br><br><div bgcolor="#ffffff" text="#000099">
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<p style="margin-bottom:0.1cm;line-height:115%" align="CENTER"><font face="Arial, sans-serif"><font style="font-size:11pt" size="2"><b>Dr.
Margaret
Chan opens 64</b></font></font><sup><font face="Arial,
sans-serif"><font style="font-size:11pt" size="2"><b>th</b></font></font></sup><font face="Arial, sans-serif"><font style="font-size:11pt" size="2"><b>
World Health Assembly... (to the private sector!)</b></font></font></p>
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<font face="Arial, sans-serif"><font style="font-size:11pt" size="2">The
64</font></font><sup><font face="Arial, sans-serif"><font style="font-size:11pt" size="2">th</font></font></sup><font face="Arial, sans-serif"><font style="font-size:11pt" size="2">
World Health Assembly started yesterday, Monday 16</font></font><sup><font face="Arial, sans-serif"><font style="font-size:11pt" size="2">th</font></font></sup><font face="Arial,
sans-serif"><font style="font-size:11pt" size="2">
May 2011, in Geneva. The opening speech made by the Ministry
of
Health of El Salvador, Maria Isabel Rodriguez, strongly called
for a
return to the values and principles of the Alma Ata
Declaration. She
blamed the structural adjustment plans, forced on many low and
middle
income countries by the World Bank and the International
Monetary
Fund, for their devastating impact on the health of the
people. She
advocated for social justice as the basic principle that
should guide
the struggle for health for all. She also specifically
addressed and
thanked former WHO Director Dr. Halfdan Mahler, who was
present in
the room.</font></font></p>
<p style="text-indent:1.25cm;margin-bottom:0.1cm;line-height:115%">
<font face="Arial, sans-serif"><font style="font-size:11pt" size="2">The
following opening speech by WHO Director General (DG), Dr.
Margaret
Chan, extensively covered the successes achieved by the
Organisation
in the field of communicable diseases (including neglected
tropical
disease), with emphasis put on the development of new vaccines
(for
meningitis and pneumonia) as well as new technologies to
diagnose TB.
Significantly, the collaboration with the Bill and Melinda
Gates
Foundation was mentioned twice, and more generally
multistakeholder
action was praised as the way to go in order to mobilise
private
funds for the people's good. The work of the Commission on the
Social
Determinants of Health was quickly mentioned once, and no
referral
was made to the growing health inequalities within and between
countries. Dr. Chan then moved to the current global financial
crisis, stating that WHO has been advised to “prepare for an
era of
enduring economic austerity” and therefore justifying the need
to
“introduce cost-saving measures” and “cut back on traditional
areas of work, with deep regret”. She foreshadowed what she
called
“the most extensive administrative, managerial and financial
reform” in the history of WHO, aimed at giving “a bigger voice
to
the many partners that work in health”. The “new” WHO will
pursue excellence, as well as effectiveness, efficiency,
responsiveness, objectivity, transparency and accountability.
Finally, Dr. Chan invited Member States to join her on “this
journey to reaffirmation, remembrance, reform and
revitalisation”.
“Remember the people” is how she opened and closed her speech,
however it's not clear how the foreshadowed reform will help
WHO to
accomplish this task.</font></font></p>
<p style="text-indent:1.25cm;margin-bottom:0.1cm;line-height:115%">
<font face="Arial, sans-serif"><font style="font-size:11pt" size="2">In
the afternoon, the plenary session continued with the
statements from
the national delegates, who were asked to focus particularly
on
non-communicable diseases (NCDs). Nearly all contributions
addressed
mainly lifestyles and behaviours, mentioning in particular
alcohol
and tobacco use. With the exception of Brazil, France and
Iran,
nobody mentioned the unequal exposition to risk factors, such
as
unhealthy nutrition or poor life and working conditions, which
explains the differential burden that NCDs have among the rich
and
the poor, at both the national and the global level.
Similarly,
little or no mention was made on the broader and structural
determinants which underlie NCDs epidemiology and the need to
address
them. Strikingly out of context, the statement from the US
delegate
addressed almost entirely the issue of smallpox virus. The
need to
keep viral strains within US-based laboratories, in order to
continue
the research on vaccines as well as on diagnostic and
therapeutic
tools, was emphasised. The delegate strongly opposed the WHA
resolution, which will be discussed in the coming days and
which
proposes a destruction of all viral strains.</font></font></p>
<p style="text-indent:1.25cm;margin-bottom:0.1cm;line-height:115%">
<font face="Arial, sans-serif"><font style="font-size:11pt" size="2">Simultaneously
with the discussion on NCDs that was happening in the main
plenary
room, the first session of Committee A (which will be
discussing
technical and health matters during the Assembly) started
addressing
the Health System Strengthening agenda point (see</font></font>
<font color="#000080"><span lang="zxx"><u><a href="http://www.ghwatch.org/node/223" target="_blank"><font face="Arial,
sans-serif"><font style="font-size:11pt" size="2">http://www.ghwatch.org/node/223</font></font></a></u></span></font><font face="Arial, sans-serif"><font style="font-size:11pt" size="2">
for background resolutions, reports and the PHM comment). In
general,
the challenge of universal coverage was the main issue
addressed.
However, as many delegates made their statements from the
floor,
nothing new came up: words of support to the WHO reports as
well as
quotes from these, mentions to the challenge of universal
coverage,
health system financing, health workforce policies, health
information systems, and so on. The principles of the Paris
Declaration on Aid Effectiveness were brought up by many
member
states: alignment, harmonisation and accountability. Chile
underlined
the need for disaster and emergency situation preparedness. In
brief,
amongst so many repetitive statements, Thailand was the only
country
making a more critical intervention: the delegate expressed
great
concern to see that health has not been treated by WHO in the
sense
of well being, rather it has been addressed in the context of
a
limited view aligned with the biomedical perspective only; WHO
is
seeing health systems mainly as health CARE systems, not as a
systems
to achieve well being; in addition, WHO is clearly being
influenced
by biomedical researchers funded by pharmaceutical industries
and by
the corporate sector. In summary, regarding Health System
Strengthening, we saw a very repetitive session with many
commandments to WHO for its reports and for its 2010 World
Health
Report, with only Thailand speaking up about some crucial
concerns.</font></font></p>
<p style="text-indent:1.25cm;margin-bottom:0.1cm;line-height:115%" align="LEFT">
<font face="Arial, sans-serif"><font style="font-size:11pt" size="2">Among
the relevant evening events, a joint seminar from the WHO and
the
Brazilian government announced the upcoming world Conference
on the
Social Determinants of Health, which will take place in Rio de
Janeiro from the 19</font></font><sup><font face="Arial,
sans-serif"><font style="font-size:11pt" size="2">th</font></font></sup><font face="Arial, sans-serif"><font style="font-size:11pt" size="2">
to the 21</font></font><sup><font face="Arial, sans-serif"><font style="font-size:11pt" size="2">st</font></font></sup><font face="Arial, sans-serif"><font style="font-size:11pt" size="2">
of October 2011. Dr. Margaret Chan, Dr. Mirta Roses (PAHO
Director),
Dr. Alexandre Padilha (Brazilian Minister of Health) and Paulo
Buss
(Brazilian delegate from Fundação Oswaldo Cruz, taking the
lead on
the organization of the Conference) were on the panel. Dr.
Nila
Heredia (Health Minister of Bolivia) and Dr. Eduardo Espinoza
(Health
vice-minister of El Salvador), as well as numerous PHM
members, were
present in the audience. The Conference has the ambition to
put into
practice the recommendations stated in the final report of the
WHO
Commission on Social Determinants of Health (CSDH), although
it has
to be noticed that the proposed subthemes in the agenda are
not at
present strongly linked to the Commission’s recommendations.
The
expected output of the Conference is a strong political
document,
which asks for governments' commitment to address SDH through
long-term multisectoral plans. The need for civil society
participation has been stressed several times, however it is
not yet
clear by which mechanisms civil society will be invited and
allowed
to participate in the works. The effort to guarantee a
participatory,
transparent and open process is currently relying on an online
consultation on the Conference platform, open to public
comments
until June 3</font></font><sup><font face="Arial, sans-serif"><font style="font-size:11pt" size="2">rd
</font></font></sup><font face="Arial, sans-serif"><font style="font-size:11pt" size="2">(see
</font></font><font color="#000080"><span lang="zxx"><u><a href="http://www.who.int/sdhconference/en/" target="_blank"><font face="Arial, sans-serif"><font style="font-size:11pt" size="2">http://www.who.int/sdhconference/en/</font></font></a></u></span></font><font face="Arial, sans-serif"><font style="font-size:11pt" size="2">).
Several
PHM members were able to raise critical voices at the end of
the presentations, highlighting in particular the need to
address the
structural macroeconomic determinants of the SDH, related to
the
global economic order. Serious concern was raised on the role
of
“civil society”, which might well include philanthropic
foundations and the private sector, representing the interests
of
their founders or share-holders and not the broader public
interest.</font></font></p>
<p style="text-indent:1.25cm;margin-bottom:0.1cm;line-height:115%">
<font face="Arial, sans-serif"><font style="font-size:11pt" size="2">Simultaneously,
a side event on non-communicable diseases (NCDs) took place,
organised by The Lancet in collaboration with a partnership of
scientific societies and NGOs and financed by the Rockefeller
Foundation and the main pharmaceutical companies.
Public-private-partnerships (PPPs) have once again been
mentioned as
“the way to go” in order to address prevention and treatment
of
NCDs. Critical questions from the audience, including PHM
members,
were not addressed by the speakers.</font></font></p>
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