152nd session of the WHO Govt Board, Geneva, Switzerland, January 30 to February 7, 2023. Photograph: Pierre Albouy/WHO
The just-concluded 152nd session of the Govt Board of the World Well being Group coated a broad vary of points within the world well being coverage panorama. The company’s work in well being emergencies, together with in Ukraine and now in Türkiye and Syria, took middle stage because the curtain raised on what may very well be a watershed 12 months for world well being.
Annually in January, the Govt Board (EB) of the World Well being Group (WHO) meets to organize for the annual World Well being Meeting in Could. The Board, which contains a rotating group of 34 WHO Member States, units the agenda and agrees on resolutions for consideration on the Meeting, the place representatives of all 194 Member States collect. Because of this, EB conferences sometimes cowl an expansive agenda.
At this 12 months’s seven-day assembly, world preparedness for well being emergencies, sustainable financing for WHO, and the well being disaster ensuing from the battle in Ukraine all featured prominently. In the course of the assembly, diplomats tussled over a report detailing the well being state of affairs in Ukraine. The report documented greater than 14,000 civilian casualties and 448 assaults with heavy weapons on Ukrainian well being care amenities.
The Russian Federation contested the report, contending that it was not goal. Different Member States additionally known as for information within the report back to be up to date, for the reason that figures had been from October 2022. Dr. Tedros Adhanom Ghebreyesus, WHO’s Director-Normal, mentioned the report was written “in truth and in good religion.” The Secretariat assured that work would proceed on the report with a view to offering “complete, balanced, and validated information.”
Simply because the board was wrapping up its deliberations, the earthquake struck in Türkiye and Syria, imperiling well being and well being care there. WHO rapidly established incident administration groups within the affected areas and is activating its community of emergency medical groups to supply look after individuals who had been critically injured.
“We’ll work intently with all companions to assist authorities in each international locations within the important hours and days forward, and within the months and years to return, as each international locations get better and rebuild,” Dr. Tedros mentioned.
These sudden developments, along with the deliberate EB agenda, successfully raised the curtain on the 2023 world well being coverage agenda. This 12 months, international locations are set to have interaction in key negotiations on a brand new pandemic accord and amendments to the Worldwide Well being Rules (IHR). They’re additionally anticipated to carry seminal conferences in New York in September on common well being protection and pandemic preparedness, response, and resilience. With these high-stakes moments throughout the calendar and sturdy dialogue kicking off on the EB stage, 2023 may very nicely grow to be a watershed 12 months for world cooperation on well being.
9-year-old Berat waits for his pal to be rescued from beneath the particles in Kahramanmaraş after the Türkiye-Syria earthquake on February 6, 2023.
Photograph: Fatih Isci/UNICEF
Strengthening the structure for well being emergency preparedness, response, and resilience
Given the vigorous world discourse about how you can finest put together for the subsequent pandemic, one of the vital intensely anticipated discussions on the EB assembly was associated to WHO’s 10 proposals for strengthening the worldwide structure for well being emergency preparedness, response, and resilience. The proposals are distilled from greater than 300 suggestions that emerged from a number of impartial evaluations of the worldwide response to the COVID-19 pandemic. Collectively, the proposals present a imaginative and prescient for a way varied pandemic preparedness initiatives may interrelate in a single complete framework.
The proposals replicate ongoing efforts, such because the negotiation of the pandemic accord and IHR amendments. New proposals are additionally within the bundle, amongst them an end-to-end logistics provide chain for well being emergencies and a brand new high-level world well being emergencies council to control future well being emergencies beneath the aegis of WHO.
The ten proposals had been launched final 12 months, and the EB assembly was the primary alternative for Member States to share their views on the document. They supported sure elements of the well being emergency preparedness, response, and resilience plan, particularly the IHR modification and pandemic accord negotiations, which they see as the first channels for strengthening the norms of worldwide governance for well being emergencies. Member States are extremely invested in these negotiations as a result of they’re essentially the most politically viable pathways to create game-changing insurance policies that result in extra equitable and efficient responses to future well being emergencies. They had been additionally within the proposals for the logistics provide chain and for a brand new peer evaluation course of for Member States to judge one another’s pandemic readiness capacities.
Different proposals had been much less warmly obtained, together with the concept for a world well being emergency council based mostly at WHO and for a brand new governance committee on well being emergencies inside the EB. Many Member States typically thought it was untimely to debate such concepts and warned that creating these new our bodies would possibly solely additional fragment the worldwide well being ecosystem.
Though the well being emergency preparedness, response, and resilience plan was met with blended evaluations, Member States agreed that the Secretariat ought to proceed creating the proposals for dialogue amongst all Member States at WHA in Could.
Recognition for major well being care and the well being workforce
An space of labor that’s having fun with broad assist from Member States is common well being protection (UHC). With a high-level assembly on UHC happening on the UN Normal Meeting in September, the EB assembly set the stage for major well being care to be the star of the present. The need of a skilled and capacitated well being workforce additionally continues to crystallize as a coverage precedence for the UHC agenda. Member States emphasised that stronger major well being care supply and a strong well being workforce had been drive multipliers that might collectively serve UHC and pandemic preparedness, response, and resilience objectives and the Sustainable Improvement Objectives writ massive. The adoption of a choice on preparation for the high-level assembly of the UN Normal Meeting on common well being protection paves the way in which for an enormous UHC calendar second in September. Along with major well being care and a well being workforce, key points embody:
- Prioritizing fiscal area for well being by political management.
- Guaranteeing common entry to sexual and reproductive well being care providers, together with for household planning.
- Integrating important public well being capabilities into major well being care, together with surveillance and outbreak management, and supporting a One Well being strategy.
- Guaranteeing synergies among the many three conferences on well being throughout the UN Normal Meeting in 2023 and selling coherent, built-in, and action-oriented world well being agendas.
A briefing on the margins of the WHO Govt Board assembly coated the state of affairs in Türkiye and Syria after a devastating earthquake and a number of aftershocks hit the areas on February 6, 2023. Photograph: Pierre Albouy/WHO
Financing the Way forward for WHO
One other vital dialogue within the EB assembly involved Member States’ ongoing effort to enhance WHO’s financing construction. The 194 member governments of WHO have lengthy acknowledged that the group’s financing is inadequate and unsustainable to hold out its mandate. The COVID-19 pandemic spurred pressing motion on the problem when WHO was thrust into the worldwide highlight and the world realized the important significance of its coordinating perform.
Since 2021, Member States have been negotiating a plan to refresh WHO’s monetary flows, primarily by altering the situations beneath which funding is offered by Member States relatively than merely rising the dimensions of the finances. In a landmark resolution final 12 months, Member States agreed to start shifting away from unpredictable and closely earmarked voluntary contributions and to slowly enhance the proportion of the bottom finances that’s funded by assessed contributions (membership dues). This 12 months at WHA, Member States will probably be anticipated to make the primary incremental enhance (20%) in assessed contributions. The EB assembly largely featured optimistic and affirming feedback about this step, however the difficult fiscal setting globally left some governments questioning their earlier commitments.
A replenishment mannequin was mentioned as a second technique to enhance the sustainability of WHO’s financing. The intent of a WHO replenishment is for Member States to commit their voluntary contributions to WHO originally of every new Normal Programme of Work (WHO’s multiyear technique), which might enhance the predictability and probably the pliability of these sources. On the EB assembly, Member States expressed large assist for the strategy and agreed to maneuver ahead with discussions at WHA in Could.
2023 Look Forward
As the primary discussion board for intergovernmental policymaking on well being annually, the Govt Board assembly usually previews what’s to return within the months forward. This 12 months was no exception. With the COVID-19 pandemic waning, many reforms to the worldwide well being structure are actually nicely underway. Governments are wrestling this 12 months with thorny points on fairness, financing, governance, and way more. On the similar time, WHO faces a spread of challenges in delivering the strongest attainable efficiency amid rising want.
Extremely charged geopolitical affairs, comparable to Russia’s battle in Ukraine, are manifesting in world well being diplomacy at WHO. Compounding crises, such because the earthquake in Türkiye and Syria, require WHO to reply in new and pressing methods. Because the COVID-19 pandemic begins to maneuver off middle stage, it stays as vital as ever that Member States empower WHO to hold out its mandate by sustainably financing the group and reinforcing its authority to set world norms on well being.