WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTÉ
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU RÉGIONAL DU PACIFIQUE OCCIDENTAL
REGIONAL COMMITTEE Sixty-third session Hanoi, Viet Nam 24–28 September 2012 Provisional agenda item 17
WPR/RC63/12 23 July 2012 ORIGINAL: ENGLISH
COORDINATION OF THE WORK OF THE WORLD HEALTH ASSEMBLY, THE EXECUTIVE BOARD AND THE REGIONAL COMMITTEE
Six resolutions and one decision adopted by the Sixty-fifth World Health Assembly are presented with an explanation of their implications for the work of WHO in the Western Pacific Region. Members of the Regional Committee are requested to express their views on the relevance of these resolutions to WHO’s programme of cooperation with countries and areas in the Region. A complete list of resolutions and decisions adopted by the World Health Assembly is attached as Annex 1. The draft provisional agenda of the 132nd session of the Executive Board is attached as Annex 2.
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1. WORLD HEALTH ASSEMBLY RESOLUTIONS OF INTEREST TO THE REGION
The Sixty-fifth World Health Assembly adopted 23 resolutions and 11 decisions, which are listed at the end of this paper (see Annex 1). The attention of the Regional Committee for the Western Pacific is drawn to six resolutions and one decision: • • WHA65(9) WHO reform WHA65.4 Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level; • WHA65.7 Implementation of the recommendations of the Commission on Information and Accountability for Women’s and Children’s Health; • • WHA65.8 Outcome of the World Conference on Social Determinants of Health; WHA65.19 Substandard/spurious/falsely-labelled/falsified/counterfeit medical products • WHA65.20 WHO’s response, and role as the health cluster lead, in meeting the growing demands of health in humanitarian emergencies; and • WHA65.22 Follow up of the report of the Consultative Expert Working Group on Research and Development: Financing and Coordination. The decision and six resolutions are discussed below. The agenda of the 132nd session of the Executive Board is attached as Annex 2. Decision WHA65(9) WHO reform Background A consolidated report on WHO reform by the Director-General was presented to the Sixty-fifth World Health Assembly (see Annex 3). The report provided Member States with a comprehensive overview of the reform programme, which consists of three main areas of reform with 16 proposed decision points. The three main areas are: • programmes and priority-setting
WPR/RC63/12 page 3 • • governance, and management reform.
The reform programme was discussed at several global and regional meetings in 2011 and 2012, including the sixty-second session of the Regional Committee for the Western Pacific in October 2011 and a special session of the Executive Board in November 2011. In February 2012, Member States met to agree on criteria, categories and a timeline for setting priorities, which were welcomed by the Sixty-fifth World Health Assembly and are now guiding the development of the 12th General Programme of Work and the Programme Budget 2014–2015. The decision WHA65(9) of 26 May 2012 requested that the regional committees address the following proposals for enhancing alignment between the regional committees and the Executive Board: • that regional committees be asked to comment and provide input to all global strategies, policies and legal instruments, such as conventions, regulations and codes; • that the World Health Assembly refer specific items to the regional committees in order to benefit from diverse regional perspectives; • • that regional committees adapt and implement global strategies as appropriate; and that chairpersons of the regional committees routinely submit a summary report of the committees’ deliberations to the Executive Board. Decision WHA65(9) of 26 May 2012 also endorsed the following proposals for increasing harmonization across the regional committees in relation to the nomination of regional directors, the review of credentials and participation of observers: Nomination of regional directors • that regional committees that have not yet done so, in line with principles of fairness, accountability and transparency, establish: (i) criteria for the selection of candidates; and (ii) a process for assessment of all candidates’ qualifications.
WPR/RC63/12 page 4 Review of credentials of Member States • that regional committees that have not yet done so, appoint credentials committees or entrust the task of reviewing credentials to the officers of the Regional Committee. Participation of observers • that regional committees that have not yet done so, ensure that their Rules of Procedure enable them to invite observers to attend their sessions, including as appropriate, Member States from other regions, intergovernmental and nongovernmental organizations. Relevance to the Region It is proposed that the Chairperson of the Regional Committee for the Western Pacific will routinely submit a summary report of the Regional Committee’s deliberations to the Executive Board. During its fifty-ninth session, a proposal was submitted to the Regional Committee for the Western Pacific for possible ways to improve the fairness of the procedure for the nomination of the Regional Director. The Regional Committee at its sixtieth, sixty-first and sixty-second sessions considered options for an interview process and a code of conduct. The Regional Committee at its sixty-first session decided to revise the procedure for the nomination of the Regional Director and amended Rule 51 of its Rules of Procedure accordingly. At this sixty-third session of the Regional Committee, a draft code of conduct is being presented in document WPR/RC63/8 (Nomination of the Regional Director: code of conduct) for consideration by the Regional Committee. In the past, the review of credentials of Member States in the Western Pacific Region has been conducted by the Secretariat. In the future, the Regional Committee could entrust the Regional Committee's Chairperson, Vice-Chairperson and Rapporteurs with the task of reviewing the credentials of Member States and reporting to the Regional Committee accordingly. With regard to participation of observers, Rule 2 of the Rules of Procedure of the Regional Committee envisages participation by regional committees of the United Nations and specialized agencies, as well as by other regional or international organizations having interests in common with WHO. In practice, Member States from other regions as well as nongovernmental organizations have been invited to attend the Regional Committee as observers. In future sessions of the Regional Committee, a more systematic approach could be introduced to categories of observers, with oversight by the Regional Committee on attendees.
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Recommended actions for Member States The Regional Committee is invited to discuss the issues related to WHO reforms and comment on the reform process. Recommended actions for WHO If endorsed by the Regional Committee, the Regional Director will propose amendments to the Rules of Procedure to assign to the officers of the Regional Committee the responsibility of reviewing the credentials of Member States and a procedure to enable the Regional Committee to invite observers to attend its sessions, including Member States from other regions, intergovernmental and nongovernmental organizations. Resolution WHA65.4 Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level Background Mental disorders fall within a wider spectrum that includes neurological and substance-use disorders. Millions of people worldwide are affected by mental disorders, which account for 13% of the global burden of disease. The treatment gap for mental disorders is large all over the world. Between 76% and 85% of people with severe mental disorders in low- and middle-income countries receive no treatment for their mental health conditions, and the corresponding figures for high-income countries are also high—between 35% and 50%. Relevance to the Region An estimated 100 million people suffer from mental disorders of various severities. Depressive disorders alone are responsible for 5.73% of the overall disease burden in the Region. Many barriers prevent people from receiving effective treatment. Mental health is considered a priority throughout the Region. In 2011, mental health was discussed during the biennial Meeting of Ministers of Health for the Pacific Island Countries and at the sixty-second session of the Regional Committee for the Western Pacific. Recommended actions for Member States Member States are requested to note the resolution and to collaborate with WHO in the development of a comprehensive global mental health action plan.
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Recommended actions for WHO WHO will work closely with Member States to support their efforts to develop and strengthen comprehensive national mental health policies. In the process of developing a global mental health action plan as requested by the Resolution WHA65.4, WHO will consult with Member States and different stakeholders and partners to ensure that the plan covers services, policies, legislation, strategies and programmes to address issues from promotion and prevention to treatment and rehabilitation. Resolution WHA65.7 Implementation of the recommendations of the Commission on Information and Accountability for Women’s and Children’s Health Background In September 2010, the Secretary-General of the United Nations launched the Global Strategy for Women’s and Children’s Health to accelerate progress of Millennium Development Goals (MDGs) 4 and 5. The Commission on Information and Accountability for Women’s and Children’s Health was established. The report of the Commission was officially published during the United Nations General Assembly in September 2011. It presented 10 recommendations with a focus on accountability for results and resources for women and children’s health. Areas included in the recommendations, among others, are monitoring of results based on 11 indicators, strengthening the use of information and communications technology, tracking resources, birth and death registration, maternal death surveillance and response, and national mechanisms for review and accountability. Relevance to the Region Of the 75 countries identified as priority countries (accounting for 98% of global maternal and child deaths), seven countries are in the Western Pacific Region: Cambodia, China, the Lao People’s Democratic Republic, Papua New Guinea, the Philippines, Solomon Islands and Viet Nam. The Regional Office for the Western Pacific in collaboration with WHO headquarters followed up on the implementation of the global strategy with a regional Workshop on Information and Accountability for Women's and Children's Health in March 2012. It involved six of the seven Western Pacific priority countries (Solomon Islands instead participated in a specific process for Pacific Island countries) and Mongolia, not a priority country but one that has made commitments to combat maternal and child deaths. All countries were supported in the development of a country road map and accountability framework for implementing the 10 recommendations of the Commission, which focuses mostly on information and accountability. Up to US$ 10 000 was made available to each country to organize a
WPR/RC63/12 page 7 national workshop to finalize the road map and build ownership among all stakeholders. In addition, seed funds of up to US$ 250 000 per country were made available for implementation of the road map during the first year. Technical support will be given to countries, when requested. Recommended actions for Member States Member States are urged to strengthen their national accountability mechanisms and capacity to monitor and evaluate progress in improving performance, based on their national workplans jointly developed by key stakeholders, including ministries of health, development partners and nongovernmental organizations. Member States also are urged to meet their commitments in women and children’s health. Recommended actions for WHO WHO, including headquarters, the Regional Office for the Western Pacific and country offices, should work with various partners to help countries to improve their information and accountability for women and children's health based on national road maps. As necessary, WHO should also provide support to the Independent Expert Review Group for Women’s and Children’s Health in its work assessing progress. Resolution WHA65.8 Outcome of the World Conference on Social Determinants of Health Background In response to the 2008 report of the Commission on the Social Determinants of Health, the World Health Assembly in resolution WHA62.14 requested the Director-General to support Member States by, among other things, convening a global event before the Sixty-fifth World Health Assembly in May 2012 to address issues related to the social determinants of health. Prior to that event, in January 2012, the WHO Executive Board in resolution EB130.R11 endorsed the Rio Political Declaration on the Social Determinants of Health. Relevance to the Region WHO has developed a draft Strategy and Global Plan of Action on Social Determinants of Health (2012–2017) to support Member States in implementing the Rio declaration and improving health equity through addressing the social determinants of health. In addition, WHO has collaborated with other United Nations agencies on a draft United Nations Plan of Action on the Social Determinants of Health (2012–2013).
WPR/RC63/12 page 8 The WHO Centre for Health Development, also known as the WHO Kobe Centre, is adapting Urban HEART (Health Equity Assessment and Response Tool) for the Pacific islands. The Regional Office also is supporting Member States and programmes on the social determinants of health, including equity-focused analyses of national health data. In addition, the Regional Office contributed to preparations for the October 2011 World Conference on the Social Determinants of Health in Rio de Janeiro that produced the Rio Political Declaration on the Social Determinants of Health. Recommended actions for Member States Member States are urged to implement the recommendations of the Rio declaration; develop policies and actions that address the social determinants of health with clearly defined goals, activities, accountability mechanisms and resources; and support the health-in-all-policies approach as a way to promote health equity. Recommended actions for WHO WHO should consider the social determinants of health in assessing global health needs, including in WHO’s reform and future work; support Member States in implementing the Rio declaration; work with other United Nations organizations on the social determinants of health; and report to the Sixty-sixth and Sixty-eighth World Health Assemblies, through the Executive Board, on progress in implementing this resolution and the Rio Political Declaration on the Social Determinants of Health.
Resolution WHA65.19 Substandard/spurious/falsely-labelled/falsified/counterfeit medical products Background Substandard/spurious/falsely-labelled/falsified/counterfeit (SSFFC) medical products are a serious risk to patient safety and public health. Due to increasing international trade and sales of these medicines, especially via the Internet, they pose a risk worldwide. Relevance to the Region International trade and illegal movements of SSFFC medical products have serious impacts in the Region and globally. The emergence of public health threats, such as the development of artemisinin-resistant malaria in the Mekong subregion, is partially the consequence of the use of SSFFC antimalarials. However, it must be noted that legally produced—but poor quality or
WPR/RC63/12 page 9 substandard—medicines also add to the problem. Production of SSFFC medicines in certain countries in the Region has a serious impact on patient safety and public health within and beyond the Region. Recommended actions for Member States A new Member State mechanism is to be established to work on the problems of SSFFC medical products “from a public health perspective, excluding trade and intellectual property considerations”. The resolution urges Member States to participate in and collaborate with the Member State mechanism on a voluntary basis and to provide sufficient financial resources to strengthen the work of the Secretariat in this area. Recommended actions for WHO WHO should support the development of the Member State mechanism and support Member States in building capacity to prevent and control SSFFC medical products. The annexed resolution describes in broad terms the goals, objectives and terms of reference of the new Member State mechanism, which will be further discussed at the first formal meeting to consider the mechanism in Buenos Aires, Argentina, on 19 November 2012. Resolution WHA65.20 WHO’s response, and role as the health cluster lead, in meeting the growing demands of health in humanitarian emergencies Background Resolution WHA65.20 called for strengthening WHO's institutional capacity to exercise its role as the Global Health Cluster lead agency and to assume the lead of the health cluster in the field. The resolution demands that WHO act faster, more effectively and more predictably in delivering higherquality health responses in humanitarian emergencies—and that WHO hold itself accountable for its performance. Member States were requested to allocate resources for health sector activities during humanitarian emergencies, as well as strengthen national-level risk management, health emergency preparedness and contingency planning processes. Relevance to the Region The Western Pacific Region is prone to earthquakes, tsunamis, typhoons, cyclones, floods, landslides and droughts. Examples include the China Wenchuan Earthquake in May 2008, the Japan earthquake, tsunami and nuclear incident in March 2011, and typhoons and floods in the Philippines
WPR/RC63/12 page 10 in 2009 and 2011. All resulted in enormous loss of life and serious damage and destruction to health infrastructure and health systems. Member States in the Region have taken action to strengthen their national-level risk management, health emergency preparedness and contingency planning processes. The WHO Regional Office for the Western Pacific has been working with Member States and partners to enhance risk management capacities and the resilience of health infrastructure and systems at both the national and regional levels. As part of rethinking of WHO's work in emergencies, a new WHO Emergency Response Framework was put in place and a global exercise was conducted. The framework serves as a common operational platform for the Organization's work in emergencies, with the goal of improving the speed, consistency and predictability of WHO's response to both humanitarian and public health emergencies. The major focuses of the new framework are: (a) a clear statement of WHO's core commitments in acute emergencies, for which the Organization will be accountable; (b) performance standards and timelines for measuring the speed and quality of WHO's work in an emergency response; (c) a process and criteria for grading local capacities to respond to emergencies; (d) common WHO emergency response procedures; and (e) WHO emergency policies. Recommended actions for Member States The full application of a new WHO corporate approach to emergencies will require further investments. These will be needed at all levels of the Organization to meet and sustain essential requirements outlined within the WHO Emergency Response Framework. Member States are requested to note the resolution and to take action on its recommendations, including national-level risk management, health emergency preparedness and contingency planning processes. Recommended actions for WHO The WHO Secretariat should continue strengthening WHO readiness for emergency response to meet and sustain essential requirements outlined within the WHO Emergency Response Framework to ensure predictable support to Member States in times of crises.
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Resolution WHA65.22 Follow up of the report of the Consultative Expert Working Group on Research and Development: Financing and Coordination Background One of eight strategic areas proposed in the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property (2008), endorsed by the Health Assembly, included "promoting sustainable financing mechanisms" to ensure access and innovation for health products and medical devices, especially for diseases that disproportionately affect developing countries. A Consultative Expert Working Group was established in January 2011 to search for enhanced and sustainable financing for research and development and submitted its final report to the Sixty-fifth World Health Assembly. Relevance to the Region Current incentives, including intellectual property rights, are insufficient to address major health priorities in low-income countries of the Region, and new approaches to research and development are needed. New approaches for funding additional research and development through a globally agreed mechanism for new antibiotics or new vaccines for influenza pandemics could also benefit higher-income countries of the Region. Recommended actions for Member States Member States are urged to hold national-level consultations on the Consultative Expert Working Group report and identify tangible actions for sustainable financing to meet research and development needs of developing countries in the overall context of the global strategy. Recommended actions for WHO The Regional Committee may further discuss the Consultative Expert Working Group report in 2012 in the overall context of the global strategy. The Director-General is expected to hold an open-ended meeting of Member States taking into account the outcomes of national consultations and Regional Committee deliberations.
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WPR/RC63/12 page 13 ANNEX 1
RESOLUTIONS AND DECISIONS ADOPTED BY THE SIXTY-FIFTH WORLD HEALTH ASSEMBLY
Resolution number WHA65.1 WHA65.2 WHA65.3 WHA65.4 WHA65.5 WHA65.6 WHA65.7 WHA65.8 WHA65.9 WHA65.10 WHA65.11
Title of resolution Appointment of the Director-General Contract of the Director-General Strengthening noncommunicable disease policies to promote active ageing The global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level Poliomyelitis: intensification of the global eradication initiative Maternal, infant and young child nutrition Implementation of the recommendations of the Commission on Information and Accountability for Women’s and Children’s Health Outcome of the World Conference on Social Determinants of Health Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan Financial report and audited financial statements for the period 1 January 2010–31 December 2011 Status of collection of assessed contributions, including Member States in arrears in the payment of their contributions to an extent that would justify invoking Article 7 of the Constitution Special arrangements for settlement of arrears Report of the External Auditor Salaries of staff in ungraded posts and of the Director-General Election of the Director-General of the World Health Organization: Report of the Working Group Agreements with intergovernmental organizations Global vaccine action plan World Immunization Week Substandard/spurious/falsely-labelled/falsified/counterfeit medical products WHO’s response, and role as the health cluster lead, in meeting the growing demands of health in humanitarian emergencies Elimination of schistosomiasis Follow up of the report of the Consultative Expert Working Group on Research and Development: Financing and Coordination Implementation of the International Health Regulations (2005)
WHA65.12 WHA65.13 WHA65.14 WHA65.15 WHA65.16 WHA65.17 WHA65.18 WHA65.19 WHA65.20 WHA65.21 WHA65.22 WHA65.23
WPR/RC63/12 page 14 Annex 1
Decision number WHA65(1) WHA65(2) WHA65(3) WHA65(4) WHA65(5) WHA65(6) WHA65(7) WHA65(8)
Title of decision Composition of the Committee on Credentials Election of officers of the Sixty-fifth World Health Assembly Establishment of the General Committee Election of officers of the main committees Adoption of the agenda Verification of credentials Election of Members entitled to designate a person to serve on the Executive Board Prevention and control of noncommunicable diseases: follow-up to the High-level Meeting of the United Nations General Assembly on the Prevention and Control of Non-communicable Diseases WHO Reform United Nations Joint Staff Pension Fund: appointment of representatives to the WHO Staff Pension Committee Selection of the country in which the Sixty-sixth World Health Assembly would be held
WHA65(9) WHA65(10) WHA65(11)