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Brendan Shaw

World Health Assembly: a change in the air?


As delegates gathered at the Palais des Nations in Geneva this week for the 71st World Health Assembly I became increasingly convinced that there's a changing tone in the conversation among stakeholders about how to progress global health. Whether it was the clear spring air of the Swiss Alps, the various anniversaries being acknowledged, or just a new constructive approach being adopted by many, I came away more optimistic that we are making progress.

Geneva can sometimes be a bit of a circus during WHA week - but it can be a constructive and engaging circus. This year marking the 70th anniversary of the World Health Organization gave the event a more reflective and forward-looking tone, which paid off in the focus of the conversation and the progress made. This year also marks the 40th anniversary of the Alma-Ata declaration on primary health care for all and the 50th anniversary of the international industry association, the IFPMA. My sense was that this year there was more constructive dialogue to solve problems and less of the hot air and ideological grandstanding that has sometimes been seen in the past. Even the music played during WHA signalled a different approach.

The tone was set by Dr Tedros, the new Director-General of the WHO, in his first opening speech to the WHA when he said that all stakeholders needed to be working together to achieve universal health coverage, including the private sector. After years of sometimes torturous negotiations within the Framework of Engagement with Non-State Actors (FENSA) on how the private sector should work with the WHO, Dr Tedros made clear that the private sector is a key player in ensuring health for all and that WHO will engage constructively with the private sector. This sentiment was echoed by several senior representatives of national governments attending WHA.

The WHO has set itself an ambitious plan to have by 2023, 1 billion more people covered by universal health coverage, 1 billion more people protected from health emergencies, and 1 billion more people enjoying better health and wellbeing.

Dr Tedros' comments set the scene for the rest of the week. A look over the agenda and papers of the 71st WHA shows some of the important work on the global health agenda. There were in-depth discussions on topics such as the WHO's future plans for responding to public health emergencies, health and climate change, addressing global shortages of medicines and vaccines, preparing for United Nations High Level Meetings later this year on tuberculosis and non-communicable diseases, addressing gaps in areas like snakebite treatment and physical activity, new technologies and mobile health, eradicating polio, the global vaccine action plan and influenza pandemic preparedness just to highlight a few. There was also debate and sign-off of the WHO's 13th general program of work, which is well worth a read if you want to get a sense of the organisation's long term agenda.

Even some of the more contentious discussion topics that have generated a lot of heat over the years, such as access to medicines and the role of intellectual property, tended towards at least constructive conversations that linked to WHO's broader global agenda for universal health coverage and ensuring health services for billions more people.

As always, current affairs influenced the longer term strategic dialogue, including the Ebola outbreak in the Democratic Republic of Congo and recent events in Palestine and Syria.

In addition, the various side events conducted around the WHA showed that, while there are many points of view and tough discussions to be had, there is a lot of progress being made and a growing sense that we are heading in the right direction. Progress in responding to issues such as anti-microbial resistance, preparing for future pandemic medical emergencies, managing non-communicable diseases and encouraging broader industry engagement with the global health community all showed real promise and progress.

Even the WHO's 'Walk the Talk' event held in the sunshine near Lake Geneva on the Sunday before WHA provided a practical demonstration of how different stakeholders can and should come together on global health .... and perhaps the benefits of getting out of the office occasionally and having a walk to clear the head.

There's still a truckload of work to do, which the world recognised through the course of WHA week. Call me an optimist, but I get the sense that we are heading in the right direction.

The challenge will be to build on this through the years ahead.

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