Tuesday, May 20, 2008
Yesterday the 61st World Health Assembly took place in Geneva with some 193 countries assembled for the purposes of reviewing progress and setting new priorities for global public health. The reported mood at the event was sombre as representatives reflected on the enormous loss of life and impending health crises that probably awaits after the Myanmar cyclone and the China earthquake.
"We are meeting at a time of tragedy," WHO Director-General Dr Margaret Chan told the 2500 delegates in the Assembly Hall of the Palais des Nations as she opened the meeting.
Chan noted that alongside the recent disasters are other looming crises including rising food prices which could undermine the foundation of health and adequate nutrition, climate change which is expected to bring more droughts, floods and tropical storms, and demands for humanitarian assistance (with the poor, in both cases, at greatest risk), and a third crisis, pandemic influenza, lurks in the future. In addition Dr. Chan reflected on the state of of other major health concerns.
A staggering 33.2 million people are living with HIV, and 2.5 million were infected just last year. Progress in tuberculosis control remains steady but multi-drug resistant TB has reached historic levels. Polio eradication efforts are also complicated. In Asia, polio type 1, the most dangerous strain, is on the verge of elimination. But in Africa, a dramatic upsurge in this strain has been seen in the northern states of Nigeria, while other countries in Africa are struggling to eliminate viruses reintroduced two years ago.
On the positive side long struggles against many diseases are in fact seeing progress and positive results. Malaria control is finally showing solid progress with rapid improvements in morbidity and mortality documented in Ethiopia, Kenya, Rwanda and Zambia. Immunization programmes have been able to drive childhood mortality below 10 million per year for the first time. Home-based treatment of pneumonia -- the number one killer of young children -- has been shown to be as effective as, and possibly safer than, hospital care, according to research coordinated by WHO and published this year. And new resources, such as those provided by the Bill and Melinda Gates Foundation, are bringing guinea-worm eradication within reach.
According to the WHO, the best opportunities for big strides in global health are in the fight against neglected tropical diseases. Safe and effective drugs have been identified to fight many of these diseases. These drugs are being donated through public-private partnerships or being sold at discount. And a new strategy of providing these drugs widely, to an entire population at risk, is proving as protective as immunization. Dr Chan noted that funding modestly and in a time-limited manner would control many of these diseases, and even eliminate some, by 2015.
Dr. Chan concluded the presentation with a few sobering words on the state of global public health. "This is a time of unprecedented global interest and investment in health. But it is also a time of unprecedented challenges."