Resolutions and highlights from the 2011 World Health Assembly

An interesting synopsis of key resolutions, decisions and highlights from the 2011 World Health Assembly, courtesy of World Health Advocacy.  The World Health Assembly, held in Geneva Switzerland, started May 16th and closed today.

This year’s World Health Assembly saw an unprecedented social engagement, with updates and discussions being shared via twitter, facebook and other media. The global discussion was significant enough to cause Dr. Chan to comment on it in her closing speech – “tweets about events over the past several days, on topics ranging from the reform agenda for WHO to pandemic influenza preparedness, reached more than three million people.”

More than 2700 delegates, including Health Ministers and senior health officials from 192 WHO Member States, NGOs and civil society groups attended the World Health Assembly in person. Following a week’s worth of discussions, the following are some of the key resolutions and highlights:

Non-communicable diseases

Countries unanimously approved a resolution on the preparations for the United Nations General Assembly high-level meeting on the prevention and control of non-communicable diseases being held this September. Some 47 countries and 16 observers, including civil society, commented on the resolution, which urges heads of state and governments to attend the UN meeting in New York and calls for steps against the NCD challenge through an action-oriented outcome document.

Read the WHO report.

Working together to stop HIV/AIDS

The Global Health Sector Strategy on HIV/AIDS, 2011-2015 was approved, and will guide actions by WHO and governments around the world to dramatically increase innovation, integration and efficiencies of HIV programmes. If all countries implement these guidelines, at least 4.2 million new HIV infections could be prevented and 2 million lives saved between 2011-2015.

Global immunization vision and strategy

In a great show of support, many delegates and global health partners in Committee A spoke in favour of the Global Immunization Vision and Strategy. Delegates applauded strides in saving lives around the world through vaccines, noting key challenges such as eradicating polio and increasing measles vaccination coverage to prevent dangerous outbreaks.

Read the report and strategic direction for the Decade of Vaccines.

The final mile in polio

Delegates described significant advances in polio eradication over the past year. In India and Nigeria, polio cases plummeted by 95% between 2009 and 2010. Highlighting the necessity of routine immunization, delegates pointed to the funding gap of US$ 665 million, and warned that a lack of resources could lead to dangerous backslide. Several delegates called for political and financial commitments, noting that low-income countries could save US$ 40-50 billion over the next 25 years.

Maternal, infant and young child nutrition

More than 100 million children under five were underweight in 2010. Additionally, more women are becoming overweight, increasing the risk of birth complications. Delegates in Committee B discussed a progress report on a plan to tackle problems of poor nutrition through awareness campaigns, and policies involving health, education and agriculture.

Resolutions and reports support health-related MDGs

Health-related MDGs received support with resolutions and reports on immunization strategy, infant and young child nutrition, child injury prevention, safe management of drinking water, malaria, and the presentation of the final report of the Commission on Information and Accountability for Women’s and Children’s Health.

Cholera: mechanism for control and prevention

Delegates agreed that cholera is a public health threat for many countries and the incidence is on the rise. They expressed the urgent need for effective public health interventions, such as solid surveillance systems, improved environmental management, access to clean water and proper sanitation, and the adequate use of cholera vaccines as a complementary measure. Cholera was recognized as a clear marker of environmental management. Member States underscored the need to revitalize the Global Task Force on Cholera Control and emphasized the need to scale up advocacy measures.

Annual report on the eradication guinea-worm disease

The delegates adopted a resolution paving the way for an annual report on the eradication of dracunculiasis (more commonly known as guinea-worm disease) to be presented every year beginning with the next Health Assembly. Dracunculiasis is the second disease which is approaching eradication (the first being smallpox) and it occurs only after people drink contaminated water. Previously it was responsible for millions of infections across Africa and Asia. The disease mainly occurs in remote poverty-stricken areas, with limited or no access to safe drinking water.

Sources:

• Sixty-fourth World Health Assembly: daily notes on proceedings
• Historical agreements at the Sixty-fourth World Health Assembly

Stem cell transplant has cured HIV infection in ‘Berlin patient’

National AIDS Manual (NAM) reports that doctors who carried out a stem cell transplant on an HIV-infected man with leukaemia in 2007 say they now believe the man to have been cured of HIV infection as a result of the treatment, which introduced stem cells which happened to be resistant to HIV infection.

The man received bone marrow from a donor who had natural resistance to HIV infection; this was due to a genetic profile which led to the CCR5 co-receptor being absent from his cells. The most common variety of HIV uses CCR5 as its ‘docking station’, attaching to it in order to enter and infect CD4 cells, and people with this mutation are almost completely protected against infection.

The case was first reported at the 2008 Conference on Retroviruses and Opportunistic Infections in Boston, and Berlin doctors subsequently published a detailed case history in the New England Journal of Medicine in February 2009.

They have now published a follow-up report in the journal Blood, arguing that based on the results of extensive tests, “It is reasonable to conclude that cure of HIV infection has been achieved in this patient.”

Read more.

World AIDS Day 2010

December 1, 2010 marks World AIDS Day — an opportunity to raise awareness and celebrate victories such as increased access to treatment and prevention services.

A recently released UNAIDS report gives us reason to celebrate:  the world is beginning to reverse the spread of HIV. New HIV infections have fallen by nearly 20% in the last 10 years, AIDS-related deaths are down by nearly 20% in the last five years, and the total number of people living with HIV is stabilizing.

Despite these encouraging results, there remains much to be done in the fight against HIV/AIDS.

• A total of 33 million people now live with HIV/AIDS. Two million of them are under the age of 15.
• More than two-thirds (67 percent) of all people living with HIV, 22 million, live in sub-Saharan Africa—including 90 percent of the world’s HIV-positive children.

WHO unveils new global plan to stop TB

The World Health Organization laid out a new plan on Wednesday to combat tuberculosis and the nearly 2 million deaths it causes each year through a combination of better testing, diagnosis and drugs.  (Source:  Reuters)

“The Global Plan to Stop TB 2011-2015″ will cost about $47 billion, with money going to fund more testing labs and research projects to develop and deliver medicine to treat the disease, it said in its plan.

“The stakes are high: without rapid scale-up of TB prevention and treatment, some 10 million people will die of a curable disease by 2015,” said Marcos Espinal, the partnership’s executive secretary.

All countries are affected but most of the cases occur in Asia and Africa. India and China account for 35 percent of all cases. TB ranks as the eighth-leading cause of death in low- and middle-income countries, it said.

The WHO is looking for about half the money for the programme to come from high-income countries and said if fully implemented, it could save about 5 million lives.

It is aiming for a 90 percent treatment success rate by 2015, up from 86 percent in 2008/09 and to have all TB patients tested for HIV.  About one-fourth are tested now and TB is a leading killer of those infected with HIV.

The plan also calls for more testing and better treatment strategies for multi-drug resistant strains of TB. The WHO first launched its plan to end TB in 2001 and adjusted its strategy in 2006.

Global Fund to combat AIDS, TB and malaria receives $11 billion boost

Donor countries, private foundations, corporations and individuals meeting at the United Nations have pledged over $11.5 billion in new funding over the next three years for the global partnership to fight three killer diseases – HIV/AIDS, tuberculosis and malaria. (UN News)

“At a time when so many Governments are tightening their belts, these commitments send a powerful message. It shows that many world leaders want to do the right thing beyond their borders, too,” said Secretary-General Ban Ki-moon, who chaired the two-day replenishment meeting for the Global Fund to Fight AIDS, TB and Malaria.

Over the past eight years, programmes supported by the Global Fund have saved an estimated 5.7 million lives, provided AIDS treatment for 2.8 million people and TB treatment for 7 million people, and distributed 122 million bed nets to prevent malaria.

The Global Fund was created in 2002 to scale up resources to fight three of the world’s most devastating diseases, and to direct those resources to areas of greatest need.  To date, it has committed $19.3 billion in 144 countries to support large-scale prevention, treatment and care programmes against the three diseases.

Gates Foundation – 60 Minutes Interview

A very interesting interview on 60 minutes with Bill and Melinda Gates highlighting the work and priorities of the Gates Foundation.

Asked what the foundation’s global priorities are, Melinda Gates said, “HIV/AIDS, malaria, mother-and-child deaths, in that order.”

Expediting access to pediatric HIV/AIDS drugs in Guyana; a new public-private partnership

A very interesting announcement from the U.S. Department of State.

The U.S. Government, Government of Guyana, and Pharmaceutical Companies Partner to Expedite the Registration of HIV/AIDS Drugs for Children

Office of the Spokesman
Washington, DC
September 22, 2010

Ambassador Eric Goosby, U.S. Global AIDS Coordinator, announced a new public-private partnership between the Government of Guyana and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to make safe pediatric HIV medications available faster in Guyana by expediting the country’s drug registration process. Through the Pre-approval Access for HIV/AIDS Therapies (PaATH) mechanism, the Government of Guyana will grant provisional approval to pediatric HIV medicines approved by the U.S. Food and Drug Administration within the U.S. Department of Health and Human Services. These antiretroviral drugs will then be available for purchase and use in Guyana while they await full approval through the Government of Guyana’s drug approval process.

In most countries, drug registration can be a long process. While the U.S. Government has taken steps to “fast track” approval for antiretroviral drugs through the U.S. Food and Drug Administration, slow registration processes and limited infrastructure in partner countries can be barriers to access to antiretroviral treatment and other life-saving drugs. Variations from country to country in the drug registration process also result in delays to access. Access to pediatric antiretroviral treatment is further complicated by the fact that there are fewer formulations of antiretroviral drugs for children than there are for adults.

In Guyana, an estimated 18,000 people are living with HIV, and approximately six percent of these HIV infections are in children. Recognizing the impact of HIV/AIDS in Guyana, the Government of Guyana has embraced the PaATH to further their country’s fight against the virus. Guyana has long been regarded as an innovator and global leader addressing regulatory issues specific to the developing world, particularly in the area of HIV/AIDS. Guyana’s experience with the PaATH will provide best practices and lessons learned for other PEPFAR countries interested in expediting their drug approval process. Based on the success in Guyana, the project will expand to other PEPFAR-supported countries.

The PaATH was developed through a public-private partnership that brings together the U.S. Government, the pharmaceutical industry, and non-government organizations to promote scientific and technical discussions on solutions for pediatric HIV treatment, formulations and access. The partnership includes the U.S. Government, Bristol-Myers Squibb, Gilead Sciences, Inc., and the Partnership for Supply Chain Management.

Sub-Saharan countries are leading the way in HIV prevention

Between 2001 and 2009, 22 countries in sub-Saharan Africa have seen a decline of more than 25% in new HIV infections.  According to new UNAIDS data, the number of new HIV infections is steadily falling or stabilising in most parts of the world.

The data shows that countries with the largest epidemics in Africa—Côte d’Ivoire, Ethiopia, Nigeria, South Africa, Zambia and Zimbabwe—are leading the drop in new HIV infections.

There are now 5.2 million people on HIV treatment, which is a 12-fold increase in six years. AIDS deaths have dropped significantly since the widespread availability of treatment—there were 200,000 fewer deaths in 2008 than in 2004. Young people are leading the prevention revolution by choosing to have sex later, having fewer multiple partners and using condoms, resulting in significantly fewer new HIV infections in many countries highly affected by AIDS.

Among adults, male condom use has doubled in the past five years. Tradition is giving space to pragmatism, as communities embrace male circumcision. Research has shown that male circumcision has the potential to reduce HIV infection among men by nearly 60%. New HIV prevention research reported efficacy in a microbicide controlled and initiated by women.

WSJ opinion – Africa’s Health Crisis

An interesting opinion from the Wall Street Journal about challenges and barriers to improving public health in Africa.

How to Worsen Africa’s Health Crisis: Killing off drug patents will kill off innovation and patients.

By ALEC VAN GELDER

Faced with Africa’s devastation by HIV/AIDS, people are looking for scapegoats. Global pressure groups and now the World Health Organization are targeting “Big Pharma.” The drug companies do make easy targets but that doesn’t make them villains. The life-saving treatments they create remain Africa’s best hope. The misguided battle against pharmaceutical companies’ patent rights will only make Africa’s health crisis worse.

Intellectual property rights for AIDS drugs are “the biggest public health challenge” as they make them too costly for most Africans, Hans Hogerzeil, head of the WHO’s Essential Medicines program, recently said. They are “a barrier to access,” he previously claimed, but the real barriers are the lack of infrastructure and the diversion of aid money. Fewer than 5% of WHO’s 423 Essential Medicines are currently protected by patents; mostly advanced “second-line” anti-AIDS medicines.

WHO launches stakeholder consultation on global HIV/AIDS Strategy

The World Health Organization has recently released a draft of their Global Health Sector Strategy for HIV/AIDS (2011-2015) for stakeholder review and commentary.  The WHO is hosting an online consultation to solicit feedback on key issues as well as general commentary on the strategy.

The Global Health Sector Strategy for HIV/AIDS 2011‐2015 aims to:

1. Set global goals for the health sector response to HIV/AIDS;

2. Guide national HIV responses; and

3. Provide a framework for concerted WHO action at global, regional and country levels.

The strategy builds on the achievements and experiences of the ”3 by 5″ initiative and the WHO HIV/AIDS Universal Access Plan 2006‐2010 and aims to align with broader strategic frameworks, including the Millennium Development Goals, primary health care renewal, Universal Access commitments and the UNAIDS Strategy for 2011‐2015.

A selection of submitted comments will be made available on the WHO web site. Official comments submitted by Member States will not be posted on the web site.

The submission form for comments on the WHO Global Health Sector Strategy on HIV/AIDS 2011-2015 is online at:  http://www.who.int/hiv/aboutdept/strategy_form/en/index.html.