Delegates at the on-going World Health Assembly have reached new agreements on dementia; immunization; refugee and migrant health; substandard and falsified medical products, and the world drug problem.
Dementia
Delegates at the World Health Assembly, Tuesday, endorsed a global action plan on the public health response to dementia 2017-2025 and committed to developing ambitious national strategies and implementation plans. The global plan aims to improve the lives of people with dementia, their families and the people who care for them, while decreasing the impact of dementia on communities and countries. Areas for action include: reducing the risk of dementia; diagnosis, treatment and care; research and innovative technologies; and development of supportive environments for carers.
They called on the WHO Secretariat to offer technical support, tools and guidance to Member States as they develop national and subnational plans and to draw up a global research agenda for dementia. Delegates recognized the importance of WHO’s Global Dementia Observatory as a system for monitoring progress both within countries and at the global level.
Delegates emphasized the need to integrate health and social care approaches, and to align actions to tackle dementia with those for other aspects of mental health, as well as noncommunicable diseases and ageing. They also highlighted the importance of ensuring respect for the human rights of people living with dementia, both when developing plans and when implementing them.
Worldwide, around 47 million people have dementia, with nearly 9.9 million new cases each year. Nearly 60% of people with dementia live in low- and middle-income countries.
Immunization
Delegates agreed to strengthen immunization to achieve the goals of the Global Vaccine Action Plan (GVAP). In 2012, the Health Assembly endorsed GVAP, a commitment to ensure that no one misses out on vital immunization by 2020. However, progress towards the targets laid out in that plan is off track. Halfway through the decade covered by the plan, more than 19 million children were still missing out on basic immunizations.
Today’s resolution urges Member States to strengthen the governance and leadership of national immunization programmes. It also calls on them to improve monitoring and surveillance systems to ensure that up-to-date data guides policy and programmatic decisions to optimize performance and impact. It calls on countries to expand immunization services beyond infancy; mobilize domestic financing, and strengthen international cooperation to achieve GVAP goals. It requests the WHO Secretariat to continue supporting countries to achieve regional and global vaccination goals. It recommends scaling up advocacy efforts to improve understanding of the value of vaccines and of the urgent need to meet the GVAP goals. The Secretariat will report back in 2020 and 2022 on achievements against the 2020 goals and targets.
Immunization averts an estimated 2 to 3 million deaths every year from diphtheria, tetanus, pertussis (whooping cough), and measles. An additional 1.5 million deaths could be avoided if global vaccination coverage were improved.
Refugee and migrant health
Delegates asked the Director-General to provide advice to countries in order to promote the health of refugees and migrants, and to gather evidence that will contribute to a draft global action to be considered at the 72nd World Health Assembly in 2019. They also encouraged Member States to use the framework of priorities and guiding principles to promote the health of refugees and migrants developed by WHO, in collaboration with IOM and UNHCR, to inform discussions among Member States and partners engaged in the development of the UN global compact on refugees and the UN global compact for safe, orderly and regular migration.
There are an estimated 1 billion migrants in the world – one in seven of the world’s population. This rapid increase of population movement has important public health implications, and requires an adequate response from the health sector. International human rights standards and conventions exist to protect the rights of migrants and refugees, including their right to health. But many refugees and migrants often lack access to health services and financial protection for health.
Health problems faced by newly-arrived refuges and migrants can include accidental injuries, hypothermia, burns, cardiovascular events, pregnancy and delivery-related complications. Women and girls frequently face specific challenges, particularly in maternal, newborn and child health, sexual and reproductive health, and violence. Children are prone to acute infections such as respiratory infections and diarrhoea because of poor living conditions and deprivation during migration and forced displacement. Lack of hygiene can lead to skin infections.
Refugees and migrants are also at risk of psychosocial disorders, drug abuse, nutrition disorders, alcoholism and exposure to violence. Those with noncommunicable diseases (NCDs) can also suffer interruption of care, due either to lack of access or to the decimation of health care systems and providers.
Substandard and falsified medical products
“Substandard” medical products (also called “out of specification”) are authorized by national regulatory authorities, but fail to meet either national or international quality standards or specifications – or in some cases, both. “Falsified” medical products deliberately or fraudulently misrepresent their identity, composition or source.
The Assembly also agreed a definition of “unregistered or unlicensed medical products”. These have not been assessed or approved by the relevant national or regional regulatory authority for the market in which they are marketed, distributed or used.
The new terminology aims to establish a common understanding of what is meant by substandard and falsified medical products and to facilitate a more thorough and accurate comparison and analysis of data. It focuses solely on the public health implications of substandard and falsified products, and does not cover the protection of intellectual property rights.
Substandard and falsified medical products can harm patients and fail to treat the diseases for which they were intended. They lead to loss of confidence in medicines, healthcare providers and health systems, and affect every region of the world. Anti-malarials and antibiotics are amongst the most commonly reported substandard and falsified medical products, but all types of medicines can be substandard and falsified. They can be found in illegal street markets, via unregulated websites, and in pharmacies, clinics and hospitals.
Delegates agreed to adopt the new name of “substandard and falsified” (SF) medical products for what have until now been known as “substandard/spurious/falsely-labelled/falsified/counterfeit (SSFFC)” medical products.
The world drug problem and public health
Delegates agreed on the need for intensified efforts to help Member States address the world drug problem. They asked the WHO Secretariat to strengthen its collaboration with the United Nations Office on Drugs and Crime and the International Narcotics Control Board to implement the health-related recommendations of in the outcome document of the 2016 Special Session of the United Nations General Assembly on the world drug problem (UNGASS).
It has been 26 years since the Health Assembly made a decision on this topic. The Secretariat is asked to report back on progress in 2018, 2020 and 2022.
According to WHO’s latest estimates, psychoactive drug use is responsible for more than 450 000 deaths each year. The drug-attributable disease burden accounts for about 1.5% of the global burden of disease. Furthermore, injecting drug use accounts for an estimated 30% of new HIV infections outside sub-Saharan Africa and contributes significantly to hepatitis B and C epidemics in all regions.
