EPHA at the World Health Assembly

Whilst this year’s major themes were Universal Health Coverage and Non-communicable diseases, there was something for everyone at this year’s World Health Assembly, which took place at the UN in Geneva from 21-26 May. A small EPHA delegation attended the WHA itself as well as the packed agenda of side events during the week (and by far couldn’t cover all the action).  Here are our take-aways from #WHA71:

Trade for Health

EPHA could hardly have hoped for better awareness-raising for our just-published ‘Unhealthy Trades’ study which provides a health warning for the EU’s ongoing trade negotiations with Latin America: Professor Ilona Kickbusch pointed the finger at the EU’s lack of policy coherence and especially its insistence on tobacco as an ‘offensive interest’ in trade negotiations whilst sharing a panel with global health leaders, including former Chilean President Dr. Michelle Bachelet and Argentina’s Health Minister Prof. Adolfo Rubinstein. Both Dr Bachelet and Prof. Rubinstein have taken strong stances against commercial interests feeding chronic diseases and will return home with a strong health protection message for their respective trade negotiators.

The WHA gave us a chance to meet in person the public health groups from Latin America who signed our joint letter calling on the European Commission to drop tobacco as a trade priority and to kick their habit of meeting tobacco lobbyists. Great to meet our counterparts from the Healthy Latin America Coalition, Inter-American Heart Federation, ACT Brazil and many more. As we showed at EPHA’s 2017 annual conference, Europe has a lot to learn from Latin American civil society and some world-leading public health policies. To bring home the point, Uruguay’s President, Dr. Tabaré Vázquez, will receive the WHO Director-General’s Special Recognition Award for World No Tobacco Day this year.

Antimicrobial Resistance

There was a flurry of announcements and commitments on AMR R&D, particularly mobilized by British health champions including Chief Medical Officer Professor Dame Sally Davies and the Wellcome Trust. All very welcome, especially the CMO’s call for a ‘Paris Agreement for AMR’ – a similar global governance approach as that now in place for commitments to tackle climate change. But whilst some of the discussions shied away from the need for regulations to tackle over-consumption of antimicrobials, an excellent full day conference organized by the World Federation of Public Health Associations (which EPHA has just joined) got to the heart of the matter. It included a panel discussion, where EPHA focused on the importance of developing international regulations, governance and investment to tackle this global health threat. EPHA is supporting the WFPHA’s global Call to Action on AMR – find out more here.

Health Inequalities

Another fascinating side event by hosted by the WFPHA focused on the health gap for indigenous peoples around the world. The presentations given by the chairs representing Maori and Aboriginal communities have kicked off a global coalition for action. Check out @IndigenousWFPHA for more. The event resonated strongly with the case for action for Roma health, with similar socio-economic factors and a similar life expectancy gap to be tackled by policy action.

Access to Medicines

Whilst the medicines front was much quieter than in previous years, Health Action International and KEI kept the issue high on the agenda. President Trump’s recently announced push to try and make medicines cheaper in the US by insisting on price hikes abroad, including in Europe, fell predictably flat. During WHA week, even Switzerland spoke out for the use of compulsory licences against unaffordable medicines prices, at an event hosted by NGO Public Eye, which made the top stories on the national news.

Many governments, including the Netherlands, Portugal and Austria reiterated the need to follow up on the issues raised in High Level Panel’s report to the UN Secretary-General on access and medicines pricing. The WHO promised that the Fair Pricing Forum last hosted in Amsterdam will be back again soon.

Chronic disease prevention, commercial determinants and children’s health

In sync with WHO Director-General Dr Tedros’ top priority on UHC, the big theme for side events this year was chronic (non-communicable) diseases, ahead of a High Level Meeting taking place during the UN General Assembly for Heads of State this September.  Both #beatNCDs and #enoughNCDs were trending during the week, reflecting lively debates.

Being behind the scenes at WHA gives some fascinating insights into how the big industrial lobbies are working towards governments. The heated debate continues on how commercial actors and especially those with vested interests in stopping health protecting policies should be engaged with  This year the discussion crystallised around a proposed resolution on child and infant nutrition, which was initially vehemently opposed by the US.  See Baby Milk Action’s blog for more.

On chronic diseases, it’s interesting to note that the global champions are largely from low and middle income countries; Thailand, Ghana, Chile, Caribbean countries, Pacific Island states, Uruguay, Rwanda, South Africa and Sri Lanka were especially present during the week. With the valuable exceptions of the Netherlands, Finland and Slovenia, Europe’s presence in the chronic disease discussions was disappointing. And especially Italy, who (despite being between governments) lined up with the US in questioning the proven effectiveness of the WHO’s ‘Best Buy’ measures to curb the rise of preventable chronic diseases.

Investments for public health

Another unofficial theme of the week, as ever, was financing for public health. Several studies timed just ahead of the WHA made a strong case for investing in prevention, not least the WHO publication supported by Bloomberg Philanthropies, Saving Lives Spending Less, which shows a very affordable set of ‘Best Buy’ prevention measures will cost just $1.27 per person and yield a return on investment of 7:1 in low and middle income countries as well as the Lancet Taskforce on the Economics of NCDs.  Essential reading for Italy and the US.

This year there was also an interesting focus on how to unleash the power of private investment, also championed by Professor Kickbusch and in several panel discussions with World Bank representatives and organisations including Tobacco Free Portfolios. The investment / divestment discussion might indeed unlock potential, not only in the contexts of commercial determinants but also interesting discussions on how the looming risk of a post-antibiotic era could affect investments in pharma companies.

Watch out for: Europe stepping up in global health

We might expect more from Europe in the near future, as Germany, Finland and Romania have now been elected to the WHO’s Executive Board.  This coincides with their upcoming EU Council Presidencies in 2019-20. As rumoured before the WHA, Germany is stepping into a more active role, not least by pledging additional funds to the Ebola response, but also in their engagement against AMR by hosting the new global AMR R&D hub in Berlin. So watch this space, and in particular October’s World Health Summit in Berlin to see how that translates to action.

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