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 proposals relate to: strengthening global immunization efforts; cervical cancer prevention and control; a global strategy for tuberculosis research and innovation; eye care - including preventing vision impairment and blindness; strengthening efforts on food safety, a global strategy and plan of action on public health, innovation and intellectual property; a decade of healthy ageing; and influenza preparedness.
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.
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.
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.
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.
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.
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.
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.
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.