TWN Info Service on Health Issues No. 5

WHA committee approves resolution on health regulations

By Martin Khor
Geneva, 20 May 2005

The World Health Assembly on Friday passed the half-way mark of its 2005 meeting (held on 16-25 May), with the adoption of several resolutions after five days of work on a range of issues.

The resolutions that have been approved, at the committee stage, were on the revision of international health regulations, malaria control, health action on crises and disasters, and health conditions in the occupied Palestinian territory. The resolutions will come up for adoption by the WHA on 25 May.

Resolutions on tuberculosis prevention and control, pandemic influenza, antimicrobial resistance and an immunization strategy were still being debated at press-time Friday.

An interesting discussion took place Thursday afternoon and Friday morning on the contentious issue of smallpox research, with many countries expressing concern about recommendations by a WHO scientific committee to conduct research on remaining smallpox virus stocks making use of genetic engineering.

At the close of the discussion, the WHO secretariat's head of Communicable Diseases said the WHO took special note of the concerns and caution expressed, and specially welcomed the recommendations of member states that WHO ask the scientific committee to revisit and review their recommendations.

After four days of work by a drafting group, the resolution on international health regulations was approved by Committee A. It will accompany the International Health Regulations 2005, which had been finalized on 14 May. Eventual adoption of the resolution and the IHR 2005 by the Assembly on 25 May will be the landmark event of the 58th WHA.

The 56-page IHR 2005 is aimed at preventing, protection, control and provision of a public health response to the international spread of disease. It contains obligations for countries to inform and notify WHO of public health emergencies and to develop capacities to respond effectively to public health risks and emergencies of international concern.

The WHO is mandated to issue recommendations on health measures to be taken by countries in the event of public health emergencies. These obligations and recommendations include measures at points of entry (airports, ports and ground crossings) and provisions for travellers, goods and containers.

Under the resolution, the WHA adopts the IHR 2005, underscoring the importance of WHO's role in global outbreak alert and response to public health events and the continued importance of the IHR as the key global instrument for protection against the international spread of disease.

It decided that the first report by the states parties and the WHO Director General on implementation of the regulations will be submitted at the 61st WHA (in 2008), which will also decide on schedule for further reports and the first review on the functioning of the regulations.

The resolution urged member states to build capacities required under the IHR 2005 and mobilize resources for that purpose, and provide support to developing countries to build capacities.

It requested the WHO Director General to take ten measures, including notifying member states of the regulations, inform intergovernmental and international organizations and cooperate with them to update their norms and standards to ensure measures to protect health and strengthen global response to the international spread of disease.

The DG is also asked to set up a review committee under Article 50 to give technical advice on recommendations and their modification and on the functioning of the regulations; and to immediately prepare guidelines to implement the "decision instrument" in Annex B. That Annex contains a flowchart representing steps to be taken by governments to assess and notify events that may constitute a public health emergency of international concern.

The resolution on health conditions in the occupied Palestinian territory was adopted by Committee B on Thursday after a politically-charged debate and a vote with 95 countries in favour, 8 against and 11 abstaining.

It expressed concern at the deterioration of the economic and health conditions and humanitarian crises resulting from Israeli occupation, deplored the impact on Palestinian water resources of Israeli waste disposal in the West Bank, and health effects on Palestinians of the "enhanced X ray machine" used by Israel at Palestinian border-crossing points.

The resolution called on Israel to immediately halt its practices, policies and plans which affect the health conditions of civilians under occupation, and demanded that Israel reverse its practice of dumping waste in the occupied territory.

It requested the WHO Director General to submit a fact-finding report on the health and economic situation in the occupied territory; undertake an independent health-impact assessment of the "enhanced X-ray machine" used by Israel at Palestinian border-crossing points; support the Palestinian health ministry overcome the current difficulties and in particular guarantee the free movement of health personnel and patients and provision of medical supplies to Palestinian medical premises; and provide technical assistance to Palestinians and to Arab population in the occupied Syrian Golan; and support the development of the health system in Palestine.

A resolution on malaria was agreed to by Committee A on Thursday. Expressing concern that malaria continues to cause over a million preventable deaths a year, it urges member states to ensure that at least 80% of those at risk of malaria benefit from preventive and curative measures by 2010 so as to reduce the burden of malaria by at least 50% by 2010 and 75% by 2015; and to scale up prevention through free or subsidized materials and medicines to vulnerable groups (with the aims of giving preventive treatment to 60% of pregnant women, and 60% of those at risk using insecticide-treated nets).

The resolution also urged governments to support expanded access to artemisinin-based combination therapy (including through new funds) and the scaling up of artemisinin production. Countries should also support the development of new medicines, diagnostic tests, vaccines, new insecticides and delivery modes, in order to enhance effectiveness and delay the onset of resistance.

The WHO Secretariat was requested to expand its work on assisting malaria-affected countries, ensure sufficient mosquito nets and effective antimalarial medicines are made available (including possible WHO bulk purchases on behalf of members states).

The WHO was also asked to collaborate to develop affordable products for malaria control, including rapid, easy-to-use diagnostic tests, an effective malaria vaccine, novel antimalarial medicines and new and environmentally friendly insecticides.

On health action in crises and disasters (especially the Asian tsunami), the resolution adopted by Committee A said over 30 countries face major crises, with 500 million people at risk and another 20 countries are at high risk of serious natural or man-made events, increasing the persons at risk to 2,000 to 3,000 million.

It urged members states to establish global, regional and national preparedness plans to respond to health crises, provide backing to tsunami-affected countries and all other states affected by disasters, and ensure all affected people have equitable access to health care in times of crisis, and improve mechanisms for humanitarian assistance. The WHO secretariat was requested to intensify support for tsunami-affected states and others affected by crises, provide accurate information to the media to counter rumours and prevent public panic and conflicts, and enhance capacity to respond to health needs in crises and post-crisis recovery.