A civil society guide to the 73rd World Health Assembly #WHA73

Outlook to the resumed 73rd Session of the World Health Assembly, 9-14 November 2020 (date to be confirmed)

While we still wait for a formal information on the timing and agenda of the resumed 73th World Health Assembly, we informally heard from a WHO Secretariat staff that the Assembly will take place from Monday 9 to Saturday 14 November 2020

On 7 August, the WHO Secretariat published a communication on “73rd World Health Assembly Decisions” adopted via “written silence procedure” (here) and also added the related resolutions and decisions to the WHA documentation. Find them integrated, below.

The documentation for the resumed WHA73 can be found here, with only a few documents added after the first WHA session in May.

Follow the preparation of the World Health Assembly and related civil society assessments on the “WHO Tracker” website provided by David Legge (and colleagues), People’s Health Movement: https://who-track.phmovement.org/wha73-resumed. That page includes a helpful overview of the agenda items for which a decision has already been taken via silence procedure (see below).

73rd World Health Assembly:  Decisions taken via “written silence procedure”

The Member States of the World Health Organization (WHO) have adopted a number of decisions to advance global public health that had been proposed to the 73rd World Health Assembly in May 2020, via a “Written Silence Procedure”. 

The written silence procedure is outlined in WHA73(7)

Strengthening global immunization efforts to leave no one behind

The Immunization Agenda 2030 strategic proposal envisions a world where everyone, everywhere, at every age, fully benefits from vaccines to improve health and well-being. The key goal is to extend the benefits of vaccines to everyone, everywhere. The strategy is people-centric, led by countries, implemented through broad partnerships and driven by data. It systematically applies these 4 core principles across a set of key priorities, highlighting that immunization is an investment for the future, creating a healthier, safer and more prosperous world for all.

Vaccines are available to prevent more than 20 life-threatening diseases, helping people of all ages live longer, healthier lives. Immunization currently prevents well over 3 million deaths every year from diseases like diphtheria, tetanus, pertussis, influenza and measles; yet far too many people around the world – including nearly 20 million infants each year – have insufficient access to vaccines.

WHA73 agenda item 11.3
Documentation: WHA website and PHM WHO Tracker
Decision taken under silence procedure, 3 August 2020: Document WHA73(9)

Cervical cancer prevention and control

The WHO global strategy to accelerate the elimination of cervical cancer as a public health problem establishes goals and targets for 2020 to 2030. It focuses on 3 key pillars: prevention through HPV vaccination; screening and treatment of pre-cancerous lesions; and management of invasive cervical cancer, including access to palliative care. All pillars must be pursued collectively to reach elimination.

To eliminate cervical cancer, all countries must reach (and maintain) an incidence below 4 per 100 000 women-years.  To get on the path to elimination, the strategy urges all countries to achieve the following targets by 2030: 90% of girls fully vaccinated (by 15 years of age); 70% coverage of screening with a high-performance test (once by the age of 35 and again by 45 years); and 90% of women who are identified with cervical disease receive treatment (90% of women with pre-cancer treated; 90% of women with invasive cancer managed). Achieving the 90-70-90 targets will yield impact on 2 fronts: we will see reductions in incidence and in mortality.  By 2030, the median cervical cancer incidence rate would fall by 10%, setting the world on the path to avert 70 million cases in the century.

Cervical cancer currently kills more than 300 000 women each year. The fourth most common cancer among women globally, its burden is greatest in low- and middle-income countries, where access to public health services is limited.

WHA73 agenda item 11.4
Documentation: WHA website and PHM WHO Tracker
Resolution adopted under silence procedure, 3 August 2020: Document WHA73.2

Tuberculosis research and innovation

The global strategy for TB research and innovation was developed to support efforts by governments and other partners to accelerate progress and to improve equitable access to the benefits of research in line with the commitments made in the WHO End TB Strategy, the Moscow Declaration to End TB and the political declaration of the United Nations high-level meeting on TB.

It highlights 4 major areas for action are highlighted in the strategy: creating an enabling environment for TB research and innovation; increasing financial investments in TB research and innovation; promoting and improving approaches to data sharing; and promoting equitable access to the benefits of research and innovation. The strategy also makes the case for a unified and aligned response in which key partners and affected communities support Member States by undertaking the investments and partnerships that are necessary for accelerating innovation.

The resolution requests WHO to report biennially, until 2030, on the implementation of the strategy.  The resolution calls for the support of the scientific community, international partners and other relevant stakeholders to undertake research and innovation aligned with the needs of the countries most affected by TB; to strengthen public-private partnerships; and to facilitate knowledge sharing. Furthermore, it calls on WHO to provide technical and strategic assistance to Member States in the implementation of the strategy.

WHA73 agenda item 11.5
Documentation: WHA website and PHM WHO Tracker
Resultion adopted under silence procedure, 3 August 2020: Document WHA73.3

Integrated people centred eye care

A new World Health Assembly resolution focuses on the need to integrate people-centred eye care services into health systems. The first ever WHO report on vision (published in 2019) predicts a substantial increase in the number of people with eye conditions and vision impairment in the coming years. The resolution highlights 4 key strategies for Member States to improve access to services and reduce inequities.  The first is to better engage people and communities by raising awareness of the importance of early identification of eye conditions and simplifying access to care for underserved populations. The second is to strengthen eye care in primary health care so people can access services closer to their homes. The third is to improve coordination of eyecare services with other health services and with other sectors such as education and labour. The final recommendation is to integrate eye care into national health strategic plans and universal health coverage schemes. Member States recalled that preventing and addressing vision impairment not only improves quality of life for patients, it also enables them to remain economically productive.

WHA73 agenda item 11.7
Documentation: WHA website and PHM WHO Tracker
Resolution adopted under silence procedure, 3 August 2020: Document WHA73.4

Strengthening efforts on Food Safety

A new resolution urges Member States to apply a “One Health” approach that promotes the sustainability and availability of safe, sufficient and nutritious food for all populations. Recognizing food safety threats, including foodborne antimicrobial resistance and climate change, the resolution also calls upon Member States to invest in national food safety systems and innovations, and to share timely data and evidence on foodborne disease outbreaks and hazards to the International Network of Food Safety Authorities (INFOSAN).

The Secretariat is requested to update the Global strategy for food safety to address current and emerging challenges and incorporate new technologies and innovative strategies for strengthening food safety systems. It also calls on the WHO Director-General to strengthen the Organization’s leadership in the Codex Alimentarius Commission and INFOSAN, and produce updated foodborne disease estimates by 2025.

Around the world, an estimated 600 million – almost 1 in 10 people – fall ill after eating contaminated food each year, resulting in 420 000 deaths and the loss of 33 million healthy life years (DALYs). The burden of disease falls disproportionately on the most vulnerable, especially children and those living in developing countries.

WHA73 agenda item 15.3
Documentation: WHA website and PHM WHO Tracker
Resolution adopted under silence procedure, 3 August 2020: Document WHA73.5

Global strategy and plan of action on public health, innovation and intellectual property

The Global strategy and plan of action on public health, innovation and intellectual property urges Member States to reinforce implementation in line with the recommendations of an overall programme review panel. The decision also calls on Member States to further discuss, in informal consultations to be convened by the Director-General, the recommendations of the review panel on promoting and monitoring transparency of medicines prices and actions to prevent shortages. The decision emphasizes the necessity to allocate resources for WHO Secretariat implementation and further requests the Director-General to submit a report on progress made in implementing the decision to the Seventy-fourth World Health Assembly in 2021, through the Executive Board.

WHA73 agenda item 11.9
Documentation: WHA website and PHM WHO Tracker
Decision under silence procedure, 3 August 2020: Document WHA73(11)

Decade of Healthy Ageing

Member States endorsed a proposal for a Decade of Healthy Ageing 2020–2030 and asked the Director-General to report back on progress on its implementation every 3 years during the Decade. The Health Assembly also asked the Director-General to transmit this decision to the Secretary-General of the United Nations for consideration of the proposal for the Decade by the United Nations General Assembly.

Populations around the world are ageing at a faster pace than in the past and this demographic transition will have an impact on almost all aspects of society. Already, there are more than 1 billion people aged 60 years or older, with most living in low- and middle-income countries. Many do not have access to even the basic resources necessary for a life of meaning and dignity. Many others confront multiple barriers that prevent their full participation in society.

The Decade of Healthy Ageing is an opportunity to bring together governments, civil society, international agencies, academia, the media, and the private sector for ten years of concerted, catalytic and collaborative action to improve the lives of older people, their families, and the communities in which they live.

WHA73 agenda item 15.1
Documentation: WHA website and PHM WHO Tracker
Decision under silence procedure, 3 August 2020: Document WHA73(12)

Influenza Preparedness

Member States requested the Secretariat to continue its support for WHO’s Global Influenza Strategy 2019–2030. They also requested the promotion of synergies, where relevant and appropriate, with the International Health Regulations (2005), implementation of national plans for influenza preparedness and response, and immunization programmes. The Secretariat is requested to report back on progress through the Executive Board to the 75th World Health Assembly.

WHA73 agenda item 13.3
Documentation: WHA website and PHM WHO Tracker
Decision under silence procedure, 3 August 2020: Document WHA73(14)

…………………………..

Source: Communication by WHO Secretariat, 7 August 2020.
Annotations in italics: G2H2 Secretariat

…………………………..
The following  decisions are not explicitly reported in the WHO Secretariat communication, above:

Geneva buildings renovation strategy

WHA73 agenda item 18.3
Documentation: WHA website and PHM WHO Tracker
Decision under silence procedure, 3 August 2020: Document WHA73(10)

WHO reform: travel and other entitlements of the Chair of the Executive Board and other Board members

WHA73 agenda item 18.4
Documentation: WHA website and PHM WHO Tracker
Decision under silence procedure, 3 August 2020: Document WHA73(13)

WHO reform: governance

WHA73 agenda item 18.4
Documentation: WHA website and PHM WHO Tracker
Decision under silence procedure, 3 August 2020: Document WHA73(15)

Evaluation of the election of the Director-General of the World Health Organization

WHA73 agenda item 18.5
Documentation: WHA website and PHM WHO Tracker
Decision under silence procedure, 3 August 2020: Document WHA73(16)

Coverage of the “de minimis” session of the 73 World Health Assembly, 18-19 May 2020

Due to Covid-19, the first “de minimis” session of the 73rd World Health Assembly was a very special one and took place virtually, using video conference technology. 

Latest updates (*see below for details):

20 May 2020: The Covid World Health Assembly: A People’s Assessment*
20 May 2020: Selected media coverage of the WHA*
20 May 2020: WHO DG: Closing remarks in final session on 19 May
20 May 2020: US explanation of their position regarding the “COVID-19 Response” Resolution

19 May 2020: “No-show”: Taiwan issue as proposed supplementary agenda item*
19 May 2020: New reports and assessments of the state of the Covid-19 resolution*
19 May 2020: Our WHA highlight: 
Address to 73rd World Health Assembly by Honourable Mia Mottley
19 May 2020: …and a letter by Mr Trump
19 May 2020: WHA Journal 2 (schedule and reports)

Our coverage of the first session of WHA73 is closed now; hope you liked it. See you again in better times!
Author: Thomas Schwarz, MMI Network

World Health Assembly: Basics

WHA documentation

WHA webcast and public relations

“De minimis” session

The first “de minimis” session of the World Health Assembly started on 18 May at 12 hrs CEST and ended on 19 May at the latest. The “abridged provisional agenda” of the World Health Assembly included only four agenda items:

1. Opening of the Health Assembly
3. Address by Dr Tedros Adhanom Ghebreyesus, Director-General
4. Invited speaker(s)
6. Executive Board: election

The provisional abridged agenda is annotated as follows:

“In the context of the restrictions imposed in response to the pandemic of coronavirus disease (COVID-19), and through a written silence procedure, the Executive Board has approved the arrangements for a virtual World Health Assembly to be held, using video conferencing technology. This de minimis session will only consider an abridged version of the provisional agenda.

During the opening of the Health Assembly, Member States will be invited to also consider the adoption of special procedures, the verification of credentials and the adoption of a written silence procedure.

The Committees of the Health Assembly will not convene.

Under the item ‘Closure of the Health Assembly’, Member States will be invited to consider suspending the Health Assembly until it can meet in a resumed session later in 2020.”

The WHA documentation is introduced as follows: “The May 2020 session of the Health Assembly will be a virtual de minimis meeting, with the intention to defer consideration of most items of the Health Assembly to written procedure or a resumed meeting later in the year. In light of this and given the ongoing resource requirements related to the COVID-19 pandemic, some documents that are not required for items to be considered at the virtual de minimis meeting in May 2020 will be published at a later date. This will only take place when the work of the Assembly would not be adversely impacted. We believe this represents a prudent use of resources and reflects the current priorities of the Organization.”

A World Health Assembly dominated by Covid-19

There was no formal WHA agenda item on Covid-19, but all attention and the entire World Health Assembly focused on it.

Ahead of the session, there was a long debate whether a World Health Assembly would makes sense at all as all Ministries of Health were busy with Covid-19. Yet there seemed to be given strong voices in particular from some foreign ministries saying that a WHA could bring an important signal for the relevance of WHO in these difficult times.

An EU sponsored resolution on Covid-19 was negotiated behind the closed doors of a “Member States process” and was approved by the WHA, on Tuesday 19 May, by consensus, but with some countries (USA, others?) dissassociating themselves from some statements.

Drafts of the resolution

Reports and assessments

David Pilling and Demetri Sevastopulo: “According to several people familiar with the situation, the US was planning to disassociate itself from part of the resolution, but talks are continuing. Although the US will make its objections clear, the resolution is expected to pass. The White House declined to comment on the negotiations.”

Priti Patnaik: “Depending on who you talk to, or what you read, the COVID19 resolution is being described as positive or weak. But it appears, most experts who work on issues of access to medicines are of the view that the text of the resolution as it stands now, is weak. By noon today, May 14th, the silence procedure ended (the “silence period” was extended last night illustrating the difficulty in reaching consensus). It is unclear whether negotiations will continue, although the silence period is over. If the text is not up for consultation again, it will come up for formal adoption at the assembly next week.”

Elaine Ruth Fletcher: “The world seems set to make at least a symbolic display of unity in the battle against the COVID-19 pandemic  at the upcoming World Health Assembly (WHA), which begins on Monday. The WHO’s 194 member states are expected to overwhelmingly approve a European Union-led resolution that aims to step up the global COVID-19 response, and ensure equitable access to treatments and future vaccines. Along with EU member states, the resolution, published Friday on the WHO website, is supported by an impressive list of 28 other countries worldwide.”

The Taiwan issue (no-show)

And yes, the heat was on before the opening of the WHA. Not only since the attacks by the US president and administration on the WHO’s management of the Covid-19 pandemic that triggered a lot of support for the WHO.

We were worried to see a World Health Assembly dominated and distorted by the polarity (new Cold War?) between the US and China, with the Taiwan issue and the demand for an independent investigation into the origin of the Coronavirus as proxy battlefields, and little space and commitment for dealing with the burning issues of how to overcome the pandemic.

  • The WHA documentation included  proposal for supplementary agenda item on ““Inviting Taiwan to participate in the World Health Assembly as an observer” (A73/1 Add.2 ). 
  • See also the draft resolution published as “Background on proposed supplementary agenda item
  • In his report (A73/1 Add.2), the WHO DG stated: “In accordance with Rule 12 of the Rules of Procedure of the World Health Assembly, this proposal for a supplementary agenda item is submitted to the General Committee for its consideration. Supplementary documentation accompanying this proposal will be distributed if a corresponding agenda item is added by the Health Assembly.” This still leaves open if there will be a lengthy Taiwan debate at the beginning of WHA (if the item is added by the General Committee) or not.

Background:

…and then: no-show. As a result of “intensive consultation with the interested parties”, the President of the World Health Assembly stated, when introducing the WHA agenda, that the resolution requesting to invite Taiwan as an observer to the WHA would be dealt with only in the resumed session later in the year. So the agenda was adopted without an the additional item initially requested.

If you like it or now: This is a lesson in smart diplomacy.

Selected coverage

20 May

19 May

18 May

Attending the World Health Assembly:
Registration and civil society statements

Non-State actors in official relations with WHO (including civil society organizations) have the “exceptional possibility” to “post written statements, under provisional agenda item 3 Address by Dr Tedros Adhanom Ghebreyesus, Director-General, which will be devoted to the Covid-19 pandemic response in advance of the opening of the Health Assembly.” This implies that oral civil society statements will not be allowed.

NSA in official relations are also requested to “register delegates” to “receive the log in details to access the virtual meeting”. This contradicts with our expectation that the World Health Assembly will be publicly accessbile, via webcast.

Having asked the WHO secretariat for clarification, they reacted immediately (thank you!) and confirmed that the World Health Assembly will indeed be publicly webcast: “However, the advantage of a formal registration will allow posting of statements on the dedicated  webpage and also have the organization reported as a participant to WHA.”

  • See, as reference, a “cleaned” version of the WHA invitation to NSA, without contact and login details, as received from a G2H2 member: WHA73 NSAs English no details
  • Statements of “non-state actors” (mainly civil society) are published here: nonstateactorsstatements
  • Special procedures: A73/33 

Civil society meetings on Friday, 15 May and Tuesday, 26 May 2020

A World Health Assembly in times of a dual crisis: Covid-19 and the collapse of multilateralism as we have known it

The civil society meeting on 15 May allowed members of the Geneva Global Health Hub and other civil society colleagues to share their views of the World Health Assembly in the current crisis of multilateralism that is accentuated by the Covid-19 pandemic. The discussion were  structured along two (interrelated) thematic fields:

  1. Looking ahead to WHA73: Can the World Health Assembly uphold its status as the most relevant forum to negotiate global public health particularly in a major global health crisis?
  2. Beyond the World Health Assembly: How successfully is WHO defending and shaping its role as the “leading and coordinating global health authority”? Or is the Covid19 pandemic the last straw for this multilateral institution in the middle of a wider crisis of multilateralism?

Our discussions will be continued and deepened at a second civil society meeting, on 26 May, based on civil society assessments of the outcomes of WHA73.

WHA side events

On 18 and 19 May, we recommend to civil society colleagues to focus all your attention on the deliberations and debates of the WHO Member States on the COVID-19 pandemic and response and NOT to hold any “virtual” side events during the working hours of the World Health Assembly. For this reason, we will also not publish a regular issue of our traditional “WHA TODAY” events calendar. 

WHA73: The Palais will be empty for once...

“Our” guide to WHA73

This informal guide to the 73rd World Health Assembly and the 147th session of the WHO Executive Board is provided by the Geneva Global Health Hub (G2H2) as a service to its members and partners.

G2H2 Civil society meeting ahead of WHA73, Friday, 15 May 2020

A World Health Assembly in times of a dual crisis: Covid-19 and the collapse of multilateralism as we have known it

The Covid19 World Health Assembly: A People’s Assessment. Webinar on Thursday 21 May 2020

The World Health Assembly 2020, which was held amidst the challenges posed by the COVID 19 pandemic, concluded on May 19. The two-day virtual Assembly did hear voices of solidarity and support in the fight against the global pandemic, but also saw some geo-political theatrics.  Despite limitations, the  Resolution on COVID 19 Response was unanimously adopted. However a number of concerns remain on issues such as access to medical products, socio-economic impact of lock down measures, strengthening public health systems among others.

The webinar was organized by the People’s Health Movement (PHM), the Tricontinental Institute of Social Research, India, and the Geneva Global Health Hub (G2H2). For G2H2 it replaced the initially planned “looking back at the WHA” meeting on 26 May.

Interested in G2H2?

Consider joining us, and help us to build a strong civil society space in Geneva for more democratic global health.

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