Seventy-sixth World Health Assembly – Daily update: 27 May 2023
The World Health Assembly agreed today on the first-ever global strategy on infection prevention and control (IPC), which builds on almost two decades of efforts led by WHO and partners. The strategy provides Member States with strategic directions to substantially reduce the ongoing risk of health care-associated infections (HAIs), including those that exhibit antimicrobial resistance.
HAIs are among the most frequent adverse events occurring in the context of health service delivery. The COVID-19 pandemic and recent major disease outbreaks such as Ebola virus disease, the Middle East respiratory syndrome and the Sudan virus disease have clearly exposed the existing gaps in IPC programmes in all countries.
The strategy sets a clear vision: by 2030, everyone accessing or providing health care is safe from associated infections. Its three key objectives are: to prevent infection in health care; act to ensure IPC programmes are in place and implemented; and coordinate IPC activities with other areas and sectors.
The strategy is focused on any setting where health care is delivered, across the health system; it is based on the principle of clean and safe care as a fundamental component of the right to health, which is equity driven, and which should ensure accountability and sustainability.
The global IPC strategy will be complemented by, and used in conjunction with, an associated global action plan and monitoring framework, that will be developed in 2023–2024.
Draft global strategy on infection prevention and control, Executive summary Report by the Director-General
WHO's work on infection prevention and control
Historic resolution paves the way for strengthening rehabilitation in health systems
Today the World Health Assembly agreed a landmark resolution on strengthening rehabilitation in health systems. Rehabilitation services play a key role in ensuring the enjoyment of human rights including the highest attainable standard of physical and mental health. It also promotes sexual and reproductive health, and recognizes the right to work and the right to education.
This landmark resolution aims to address the challenges in rehabilitation such as the need to:
- increase awareness of rehabilitation when setting health priorities and research agendas, allocating resources, promoting cooperation and enabling technology transfer;
- ensure countries are better equipped to respond to the sudden increase in rehabilitation needs including assistive technology due to health emergencies;
- ensure persons in marginalized and vulnerable situations have access to affordable, quality and appropriate rehabilitation services including assistive technology;
- avoid high out-of-pocket costs for people to access rehabilitation services and assistive technology that can cause financial hardships; and
- address the current insufficient level of rehabilitation workforce to serve the needs of the population.
The resolution lists a range of actions to be taken by the WHO Secretariat such as: publishing a baseline report by the end of 2026 with information on the capacity of Member States to respond to rehabilitation needs; developing targets and indicators for effective coverage of rehabilitation services by 2030; ensuring appropriate resources are allocated at WHO to support Member States in implementing technical guidance and resources; and supporting Member States to integrate rehabilitation and assistive technology in their emergency preparedness and response plan.
The WHO Secretariat will report on progress in the implementation of this resolution to the Health Assembly in 2026, 2028 and 2030.
Strengthening rehabilitation in health systems
The items above were discussed as part of the document A76/7 Rev.1 - Consolidated report by the Director-General.
Resolution on strengthening diagnostics capacity
On 26 May Member States endorsed a resolution to strengthen diagnostics capacity in countres and to improve access to diagnostic services.
The broad ranging resolution recognizes that diagnostic services are vital for the prevention, surveillance, diagnosis, case management, monitoring and treatment of communicable, noncommunicable, neglected tropical and rare diseases, injuries, and disabilities. Diagnostics allow for the precise identification of diseases, and therefore the timely initiation of the correct treatments for better health outcomes.
The resolution considers the full spectrum of “diagnostics”, thus including both “in vitro” laboratory tests e.g. rapid diagnostic tests and polymerase chain reaction (PCR) and “non in vitro” diagnostics e.g. imaging or blood pressure measurement devices. It covers actions for research and development, manufacturing (including local production and technology transfer), regulation, selection and procurement, awareness, advocacy and addressing access barriers in general.
The implementation of the resolution will build and expand on previous and current work at three levels of WHO to help countries improve access to diagnostic services. The Secretariat is requested to report on implementation progress in 2025.
Strengthening diagnostics capacity
Seventy-sixth World Health Assembly – Daily update: 26 May 2023
Member States expressed alarm that millions of people cannot access life-saving and health-enhancing interventions. Out-of-pocket spending on health catastrophically affects over 1 billion people, pushing hundreds of millions of people into extreme poverty. The situation has worsened due to the COVID-19 pandemic.
In response, Member States agreed a resolution supporting preparations for the United Nations High-Level Meeting (HLM) on Universal Health Coverage (UHC) in September 2023. UHC means that all people have access to the full range of quality health services they need without financial hardship.
In a transformative policy shift, Member States across high-, middle- and low-income countries expressed strong commitment to reorient their health systems based on primary health care (PHC) as a foundation for achieving health for all and reaching the furthest left behind first. About 90% of UHC interventions can be delivered using a PHC approach; from health promotion to prevention, treatment, rehabilitation and palliative care, potentially saving 60 million lives by 2030.
The Member States emphasized the importance of demonstrating the highest-level political commitment at the HLM in September with the aim of achieving resulting in a concise, action-oriented declaration for UHC.
Preparation for the high-level meeting of the United Nations General Assembly on universal health coverage
Stronger national plans needed for emergency care to respond to all hazards
In a new resolution agreed today, the World Health Assembly called for timely additional global efforts to strengthen the planning and provision of quality emergency, critical and operative care (ECO) services. Robust ECO services are at the foundation of national health systems, and the need to be able to respond effectively to emergency events, including all hazards.
Concerned that the COVID-19 pandemic revealed pervasive gaps in the capacity, preparedness of delivery of ECO worldwide, the Assembly urges Member States to, among other actions, create national policies for sustainable funding, effective governance and universal access to needs-based ECO care for all; and promote more coherent, inclusive and accessible approaches to safeguard effective ECO care in disasters, fragile settings and conflict-affected areas.
The Assembly requests the Secretariat to provide progress reports on implementation of this resolution in 2025, 2027 and 2029.
Integrated emergency, critical and operative care for universal health coverage and protection from health emergencies
- Clinical services and systems: Emergency and critical care
More cost-effective “best buys” endorsed to save lives from noncommunicable diseases
Delegates today endorsed a new menu of cost-effective interventions recommended by WHO recognized as “best buys” to help prevent and control noncommunicable diseases (NCDs). It includes an increased number of “best buys”, giving countries of every income level more options to save more lives from the world's top killers.
Among these are prevention interventions such as support to help people quit smoking, promotion and support for breastfeeding and policies to protect children from harmful food marketing.
The updated “best buys” also include treatment for asthma and chronic obstructive pulmonary diseases and the early diagnosis and treatment of cancers such as breast, cervical, colorectal and childhood cancers. They also integrate early detection and comprehensive treatment of cancer for people living with HIV.
The interventions will help countries to accelerate national action to prevent and control NCDs, accelerating progress towards achieving the SDG 3.4 target and paving the way for increased political commitment in the lead-up to the fourth High-level Meeting of the United Nations General Assembly on the prevention and control of NCDs in 2025.
The Health Assembly also took note of the report on the acceleration plan to support Member States in implementing the recommendations for the prevention and management of obesity over the life course. Twenty-eight countries are now rolling out the acceleration plan, the progress will be recorded and reported back to the Assembly. Their experiences will inform policies and action for all other Member States to accelerate action on obesity.
Political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases, and mental health
Refugee and migrant health global action plan extended until 2030
Refugees and migrants have a right to access health services during their journey and in the host country without experiencing financial hardship. This effort has an important place in the overall global drive for universal health coverage by 2030.
Today in Committee B Member States agreed a resolution to extend the WHO Global Action Plan on promoting the health of refugees and migrants until 2030. The global action plan addresses various challenges faced by refugees and migrants and outlines specific measures to be put in place, such as:
- reorienting health systems to include integrated and inclusive health services, programmes, and policies for refugees and migrants, within the principles of universal health coverage;
- monitoring the results of refugee and migrant health policies, plans, and interventions to allow updates and redesign of those actions in countries;
- increasing the capacity of health systems to meet the specific health needs of refugees and migrants and provide health services that are respectful of a person’s cultural, religious, and linguistic needs; and
- integrating refugee and migrant health in global, regional and national initiatives, partnerships, and health forums.
The resolution lists a range of actions to be taken by the WHO Secretariat, such as convening informal consultations at least every two years with Member States to identify and share challenges, lessons learned, and best practices for the implementation of actions within the WHO global action plan; providing technical assistance, developing guidelines and promoting knowledge sharing; as well as collaboration and coordination within and among Member States.
The decision comes ahead of the Third global consultation on the health of refugees and migrants to take place in June 2023, which aims to assess progress, build further political commitment on refugee and migrant health, inform future policy deliberations, including the upcoming 2023 General Assembly High-Level Meeting on Universal Health Coverage, and guide the continuous implementation of WHO global action plan.
The WHO Secretariat will report on the progress in implementing this resolution to the Health Assembly in 2025, 2027, and 2029.
Strengthening rehabilitation in health systems
- Fact sheet: Refugee and migrant health
WHO traditional medicine strategy extended to 2025
The World Health Assembly (WHA) today agreed to extend the WHO traditional medicine strategy 2014-2023 for an additional two years, until 2025. The Assembly requested the Director-General to draft a new global strategy 2025–2034 and present it to the 78th WHA in 2025 for consideration.
The Assembly recognized the efforts of Member States to evaluate the potential of traditional and complementary Medicine (T&CM) through an evidence-based approach, including rigorous clinical research. It also recognized the value and the diversity of the cultures of Indigenous Peoples and local communities and their holistic traditional knowledge.
The decision highlighted the importance of WHO’s role in providing technical support for the integration of evidence-based T&CM into national health systems and services, and the support to regulation of T&CM practices, products and practitioners.
Under the 2014-2023 strategy, WHO is supporting countries that wish to develop a proactive policy towards this important - and often vibrant and expanding - part of health care. WHO’s strategic policy and technical support enables countries to harness the potential of T&CM in contributing to health, well-being, and people-centred health care.
Since 2014, WHO has been focused on building the knowledge base for active management of T&CM and the appropriate integration, regulation and supervision of evidence-based, safe and quality T&CM into national health systems and services.
WHO traditional medicine strategy: 2014–2023, Report by the Director-General
Resolution on Increasing access to medical oxygen
Member States endorsed a resolution recognizing the critical role of medical oxygen for treatment of hypoxemia (blood oxygen deficiency) across many diseases, including pneumonia and tuberculosis, and in particular for older populations and other vulnerable groups, and for surgery and trauma.
In developing countries many health facilities lack uninterrupted access to medical oxygen, resulting in preventable deaths – a problem that has been exacerbated by the COVID-19 pandemic, when the need for medical oxygen has exceeded the capacities of many health systems.
Oxygen has been included on the WHO Model List of Essential Medicines (EML) since 1979 and has been included in the WHO EML for children (EMLc) since its first edition in 2007. There are no therapeutic alternatives to oxygen on the Model Lists.
This resolution recognizes that medical oxygen generation and distribution requires a specialized infrastructure. It also underscores the need for its delivery to be safely and accurately executed using good quality medical devices through interdisciplinary health workforce, including engineers.
The new resolution urges Member States to set up, as appropriate, national and subnational medical oxygen systems in order to secure the uninterrupted provision of medical oxygen to health care facilities at all levels including both rural and urban set-ups. It underlines WHO’s role in supporting Member States through developing guidelines, technical specifications, forecasting tools, training materials and other resources, and by providing technical support especially designed to improve access to medical oxygen to meet the needs of health systems in developing countries
Increasing access to medical oxygen
- Health topic: Oxygen
Delegates highlight priority actions to catch-up, restore and strengthen immunization services
Today Member States and partners participated in a Strategic Roundtable on A safer and healthier tomorrow through restoring essential immunization today. Immunization is a priority programme for WHO, particularly in 2023, following the significant setbacks resulting from the COVID-19 pandemic. With 67 million children missing at least one essential vaccine during the last three years finding these children is a matter of urgency.
Efforts to find zero-dose children (children who have not received one single dose of vaccine) will require effort from organizations and individuals at all levels – global, national and local - to catch-up on vaccination coverage, and recover and strengthen their immunization programmes. As Dr George Mwinnyaa, a community health worker pointed out “Community health workers know where the zero-dose children are, they do not need maps for their own communities”.
Today’s roundtable was a collaborative discussion about the role of community and frontline health workers in catch-up efforts, along with the funding and partnerships required to recover from programme disruptions and to strengthen systems to ensure equitable access to immunization services.
The session was introduced by Dr Kate O’Brien, WHO Director, Immunization, Vaccines and Biologicals, moderated by Renee Ngamau and featured Dr Tedros Adhanom Ghebreyesus, WHO Director-General; Dr Ali Haji Adam Abubakar, Minister of Health, Somalia; Dr Seth Berkley, CEO, Gavi, the Vaccine Alliance; Dr Yassen Tcholakov, Health worker, Canada; Dr George Mwinnya, Community health worker, Ghana; Dr Sheetal Sharma, Senior Immunization Advisor, CORE Group; and Dr Andrei Cazacu, Ministry of Health, Moldova.
“We have an emergency in front of us”, said Dr Bruce Aylward, WHO Assistant Director-General, Universal Health Coverage, Life Course, in concluding the session “the clock is ticking, we will act now and act together.”
Polio eradication and transition planning
The WHA evaluated the unique epidemiological opportunity which exists over the next six months to eradicate the remaining chains of endemic wild poliovirus transmission. Operations need to be adapted to reach the remaining un- or under-immunized children in the identified subnational consequential geographies.
The Assembly noted that the effort to eradicate polio remains a Public Health Emergency of International Concern under the auspices of the International Health Regulations and urged countries to minimize the risk and consequences of spread of disease to polio-free areas.
At the same time, delegates called for continued global support to the effort, to ensure all necessary financial and political commitments to achieve success are mobilized. Noting the role the polio infrastructure plays in broader public health efforts, delegates urged this infrastructure to be transitioned into national health plans in a context-specific manner.
In conclusion, the Assembly called for collective and global collaboration to achieve a lasting polio-free world once and for all.
Awards for outstanding contributions to public health presented during the Seventy-sixth World Health Assembly
WHO and Republic of Korea sign landmark agreement to boost biomanufacturing capacity
Seventy-sixth World Health Assembly – Daily update: 25 May 2023
The World Health Assembly delegates in Committee A discussed progress against the Global Strategy for Women’s, Children’s and Adolescent Health (2016-2030). During the discussion, which took place over two days, drawing comments from a high number of Member States, the delegates strongly reiterated their commitment to the Strategy as a priority for global health and expressed alarm about stalling progress in improving maternal and newborn survival.
The Director-General’s report on the Strategy presented to the World Health Assembly expressed alarm that maternal mortality rates have stagnated since 2016. Furthermore, if current trends continue, it said, 54 countries will fall short of meeting the Sustainable Development Goal (SDG) target for under-five mortality and 63 countries will not achieve the SDG target for neonatal mortality. Levels of violence against women and girls remain alarmingly high, while mental health challenges represent an increasing health threat for adolescents.
Delegates emphasized the importance of an integrated, life-course approach to improve outcomes, including access to sexual and reproductive health services, as well as greater efforts and investment to accelerate progress in the poorest, fragile and conflict-affected countries.
- A76/5 Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030) Report by the Director-General
- Related progress reports
Committee B this afternoon discussed the Prevention of sexual exploitation, abuse and harassment (Item 22.1) as part of the Review of and update on matters considered by the Executive Board (Item 22, Pillar 4)
The Committee heard the recommendations of the Programme, Budget and Administration Committee of the Executive Board and the Committee’s Chair opened the floor. Australia spoke on behalf of 61 Member States from across WHO’s regions; Botswana spoke on behalf of the 47 African Region Member States; Israel, India, Indonesia, Timor-Leste, United Kingdom of Great Britain and Northern Ireland, Kenya, the United States of America, South Africa, Maldives, Ecuador, Bangladesh and Peru also took the floor.
All speakers acknowledged the significant progress made by WHO in tackling sexual misconduct and welcomed both the new Policy on Addressing Sexual Misconduct (PASM), launched in March 2023, and the three-year strategy to prevent and respond to sexual misconduct, launched in January this year. Member States highlighted the need for the conclusion of the cases relating to the response to the 10th Ebola outbreak in the Democratic Republic of the Congo (2018-2019) including holding perpetrators to account and supporting victims and survivors comprehensively. They welcomed WHO’s transparency in publishing dashboards capturing both investigations and disciplinary action taken. They encouraged WHO to continue to make progress and lead by example within the UN system. Member States stressed that preventing and responding to sexual misconduct is a shared responsibility and they will continue to support WHO.
The Director-General thanked Member States for their support and reminded Member States that WHO is focusing on four areas: changing the organizational culture – a process that takes time; having safe and trusted reporting mechanisms in place; ensuring swift and credible investigations and setting deadlines for the end-to-end process (200 days); and following a victim and survivor-centered approach.
Consolidated report by the Director-General
Prevention of sexual exploitation, abuse and harassment
Report of the Programme, Budget and Administration Committee of the Executive Board to the Seventy-sixth World Health Assembly
The Seventy-fifth World Health Assembly adopted the recommendations of the Working Group on Sustainable Financing, requesting WHO to explore the feasibility of a replenishment mechanism to broaden further the financing base.
In response, WHO submitted an assessment of the feasibility of such replenishment mechanism. Member States noted the report and reaffirmed the need for more sustainable, predictable and flexible financing of WHO. The report summarizes the analysis of the six principles that are to serve as the basis for considering a WHO replenishment mechanism and proposes the major elements of a first “WHO investment round” to implement such a mechanism in 2024.
Member States adopted a decision welcoming the continued effort to sustainably finance WHO and requested a plan for the First Investment Round in 2024, in closer consultation with Member States, for the EB in January 2024.
A76/32, A76/40 and A76/40 Add.1
Financing and implementation Programme Budget 22-23 and outlook of Programme Budget 24-25
Member States welcomed the Results Report and the detailed work found therein. Further progress is needed to achieve the triple billion targets towards attaining the health-related Sustainable Development Goals and meeting other health challenges.
The mid-term review of the Programme Budget 2022–2023 shows that, despite the progress in 2022 towards the triple billion targets, outcomes and outputs, based on the GPW 13 results framework, the world is not on track to meet the targets. While much has been achieved, further urgent action is needed to achieve the goals.
In addition, key accomplishments and selected impact case studies are highlighted in the report to exemplify how the Secretariat and Member States work together to drive health impact at the country level, where it matters most.
The Health Assembly noted the Results Report.
Member States also noted the reports on financing and implementation of the Programme Budget. Despite positive trends, as of 31 March 2023, the base programmes of WHO have a funding gap of US$ 443.8 million, after including projections of voluntary contributions. The current gap is compounded by the challenge of persisting “pockets of poverty” – underscoring the urgent need for more sustainable financing.
Results Report 2022 (Programme budget 2022–2023: performance assessment)
Mid-term review of implementation of the Programme budget 2022–2023
Audited Financial Statements for the year ended 31 December 2022
Voluntary contributions by fund and by contributor, 2022
WHO presence in countries, territories and areas: 2023 report
WHO’s Contribution towards health outcomes from the Results Report
Financing and implementation of the Programme budget 2022–2023 and outlook on financing of the Programme budget 2024–2025
Financing and implementation of the Programme budget 2022–2023 and outlook on financing of the Programme budget 2024–2025
Reporting on operational efficiencies
Delegates support maintaining momentum and innovations to end TB
Today delegates at the Seventy-sixth World Health Assembly participated in a Strategic Roundtable on Ending TB by 2030: Universal access to care, multisectoral collaboration, and innovations to accelerate progress and combat antimicrobial resistance.
TB, a treatable and curable communicable disease, remains a top infectious killer, claiming 1.6 million lives and affecting millions of additional lives and livelihoods annually.
Ministers of health, leaders from civil society, partner organizations and WHO shared first-hand reflections on global and national leadership and innovations to end TB, as well as challenges and concerns, including increasing threats of antimicrobial resistance.
Dr Atul Gawande, Deputy Administrator, USAID and Ambassador Zbigniew Czech, Permanent Representative of Poland to the UN Office in Geneva, highlighted the importance of building stronger partnerships and integrating TB services into primary health care.
Delegates heard stories of halted and reversed progress; Dr Ethel Leonor Noia Maciel, Secretary of Health, Brazil noted declining rates of TB service coverage during the pandemic while also highlighting the need for shared responsibility and resources across sectors to tackle the core drivers of the TB epidemic.
There were stories of resilience too; Sylvia Masebo, Minister of Health, Zambia, which is one of the 30 high TB burden countries, reported that the country managed to maintain progress despite the impact of the COVID-19 pandemic and shared lessons learned on how combating TB and COVID-19 could strengthen pandemic preparedness. Mr Setiaji, Deputy Minister for Health Technology, Indonesia described the country’s new innovative national health financing strategy, its efforts to provide equitable TB services and the country’s commitment to advance TB research, in particular for new vaccine development.
Top leaders in the fight against TB noted the importance of the political momentum in the lead up to the upcoming second UN High-Level Meeting (HLM) on TB which will take place in September. The HLM can provide the political impetus needed to turn the tide in the fight against TB and fast-track progress to attain the critical TB related targets of the Sustainable Development Goals by 2030.
- Watch the webcast: Strategic Roundtables: Seventy-sixth World Health Assembly
- Global Tuberculosis Programme
- The second United Nations high-level meeting on the fight to end tuberculosis
Seventy-sixth World Health Assembly – Daily update: 24 May 2023
Today at the World Health Assembly, delegates in Committee A concluded discussions on Item 14 and parts of Item 15, noting the reports under these items, voting on two proposals, and agreeing to defer another for later in the week.
The WHO Secretariat responded to comments and questions from delegates, observers and other organizations received over the past day. The Chief Scientist said work would continue to strengthen clinical trials in emergencies. WHO's Executive Director of emergencies appreciated Member States’ support for WHO’s ongoing work in emergencies, and the recognition of the need to give the organization the resources it needs to continue. (WHO is currently responding to over 55 emergencies that have received official grading, 14 of which requiring support from all three levels of the organization). The Director-General said WHO would continue to work to align the various processes for pandemic prevention, preparedness and response.
Delegates noted the following reports: one from the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme which reviews WHO’s work in emergencies annually, a regular report on the implementation of the International Health Regulations, WHO’s annual report on its work in emergencies, and its work on strengthening preparedness for and response to emergencies. The latter included a paper on strengthening the global architecture for health emergency preparedness, response and resilience (known by the acronym HEPR).
Delegates voted on two proposals related to the health emergency in Ukraine. The draft decision on “Health emergency in Ukraine and refugee-receiving and -hosting countries, stemming from the Russian Federation’s aggression” was adopted (80 yes, 9 no, 52 abstentions). The draft resolution on “Health emergency in and around Ukraine” was not adopted (62 no, 13 yes, 61 abstentions).
On the Global Health for Peace Initiative, delegates agreed to consider the item later in the Assembly, following informal consultations slated to continue.
In Committee B, delegates considered a report on “Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan.” In a vote, they adopted the decision (76 yes, 13 no, 35 abstentions).
Documents A76/7 Rev.1 Add.2, A76/7 Rev.1 Add.3, A76/8, A76/9 Rev.1, A76/10, A76/11, A76/12 and A76/15
A76/7 Rev.1 Add.2
Global Health for Peace InitiativeA76/7 Rev.1 Add.3Financial and administrative implications for the Secretariat of decisions proposed for adoption by the Health AssemblyA76/7 Rev.1 Add.4Financial and administrative implications for the Secretariat of decisions proposed for adoption by the Health AssemblyA76/8Public health emergencies: preparedness and response The Independent Oversight and Advisory Committee for the WHO Health Emergencies ProgrammeA76/9 Rev.1Implementation of the International Health Regulations (2005)A76/10Strengthening WHO preparedness for and response to health emergencies Strengthening the global architecture for health emergency preparedness, response and resilienceA76/11WHO’s work in health emergencies Public health emergencies: preparedness and responseA76/12
Implementation of resolution WHA75.11 (2022)
A76/15Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan
Delegates discuss critical financing needs to address climate related health crisis
Today, Seventy-sixth World Health Assembly delegates participated in a Strategic Roundtable on The role of the health community in climate action: taking stock and moving forward, during which the critical intersections of climate change and health were discussed, including its impact on millions of people worldwide.
The meeting heard compassionate pleas from John Kerry, United States Special Presidential Envoy for Climate Change and Dr Vanessa Kerry, Chief Executive Officer of Seed Global Health. The father and daughter climate advocates highlighted the top political importance of the agenda for today’s and future generations, pushing for smarter investments and solutions to bring a catalytic impact across sectors.
As the incoming Presidency for COP28, the United Arab Emirates pledged to further elevate the importance of health by announcing the first-ever dedicated Health Day and the convening of the inaugural Health and Climate Ministerial meeting at the forthcoming Conference of the Parties (COP) in Dubai in November 2023.
Germany underscored its commitment of €2 billion additional funding for the Green Climate Fund to support efforts in low- and middle-income countries. The BBC Studios also showcased its upcoming production, entitled “Climate and Us”, underlining the importance of public communication and discussion on climate and health crisis.
The meeting heard that 70% of reporting countries identified lack of funding as a top barrier in addressing the health impacts of climate change. Through the WHO ATACH (Alliance for Transformative Action on Climate and Health) initiative, already supported by 66 countries, WHO is reviewing whether existing finance mechanisms can be adapted to meet this challenge, or whether new instruments are needed.
In concluding the strategic discussion, the WHO Director-General highlighted that climate change and health action are falling between the siloes of climate financing and health financing and emphasized the need for urgent and increased investment in the climate and health agenda.
- Watch the recording: The role of the Health Community in Climate Action: taking stock and moving forward
- News: WHO issues urgent call for global climate action to resilient create sustainable health systems
WHO urges governments to stop subsidizing life-threatening tobacco crops
FIFA and WHO extend collaboration to promote health through football
More than 7000 join the 4th edition of Walk the Talk in Geneva: Health for All Challenge
Renowned artists Renée Fleming and Pretty Yende appointed as WHO Goodwill Ambassadors for Arts and Health
Seventy-sixth World Health Assembly – Daily update: 23 May 2023
Delegates discuss WHO’s work in emergencies
Country delegates considered a number of emergencies-related items today, as Items 14 and parts of item 15 were grouped together. They provided their views on the reports from the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme (IOAC), on implementation of the International Health Regulations, on WHO’s work in emergencies, as well as in strengthening preparedness for and response to emergencies. Countries also discussed the report on the health situation in Ukraine, and the report of the Global Health for Peace Initiative.
Delegates commended WHO's work in emergencies throughout the pandemic and beyond, agreeing with the findings of the IOAC that the work was excellent, but that the Emergencies programme was underfunded and overstretched. Some delegates highlighted the role that the Contingency Fund for Emergencies has played in allowing the organization to respond quickly. They encouraged global efforts for strengthening preparedness and response to health emergencies, learning the lessons of the COVID-19 pandemic, and reiterated the importance of an aligned global health architecture, placing WHO at the centre. Several spoke of the need to align various initiatives to avoid duplication and strengthen their impact. Some noted the need for continued work to prevent sexual exploitation and abuse. Delegates spoke in support of the Global Health for Peace initiative, and the strengthening of clinical trials, asking WHO for further guidance and support to build capacities in country in this area, to improve the quality of research and interventions.
The draft resolutions and decisions will be considered on Wednesday, as currently scheduled.
Documents A76/7 Rev.1, A76/7 Rev.1 Add.2, A76/7 Rev.1 Add.3, A76/8, A76/9 Rev.1, A76/10, A76/11, A76/12
A76/7 Rev.1 Add.2
Global Health for Peace Initiative
A76/7 Rev.1 Add.3
Financial and administrative implications for the Secretariat of decisions proposed for adoption by the Health Assembly
Public health emergencies: preparedness and response
The Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme
Implementation of the International Health Regulations (2005)
Strengthening WHO preparedness for and response to health emergencies
Strengthening the global architecture for health emergency preparedness, response and resilience
WHO’s work in health emergencies
Public health emergencies: preparedness and response
Implementation of resolution WHA75.11 (2022)
Strategic discussion on global health workforce priorities for universal health coverage
A Strategic Roundtable discussion was held on Protecting and investing in the health and care workforce: An action-oriented agenda for the second half of the SDGs, underscoring the role of political leadership and intersectoral governance on this priority health agenda. The deliberations and outcomes from the Fifth Global Forum on Human Resources for Health, held recently under the theme of “Protect, Invest, Together”, provided a foundation for the roundtable discussion.
Opening the session, WHO Director-General Dr Tedros Adhanom Ghebreyesus reminded delegates that “Everything we are discussing this week - universal health coverage, global health security and the Sustainable Development Goals - all depend on health workers”.
The session was moderated by Sir David Behan, Non-Executive Director, NHS, United Kingdom, and featured key speakers including Mr Enzo Bondioni, Executive Director, FDI -World Dental Federation; Dr Alexandru Rafila, Minister of Health, Romania; Dr Lino Tom, Minister of Health, Papua New Guinea; H.E. Minata Samate Oessuma, Commissioner for Health, Humanitarian Affairs and Social Development, African Union; Ms Catherine Russell, UNICEF Executive Director; Dr Juan Pablo Uribe, Global Director for Health, Nutrition and Population, World Bank / formerly Minister of Health, Colombia; Professor Senait Fisseha, Vice President, Global Programs, Susan Thompson Buffett Foundation; and Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia.
The global health workforce shortage has been declining significantly from 18 million in 2013 to 15 million in 2020 and is projected to be around 10 million by 2030. However, the data largely depict a pre-COVID-19 trend, and masks profound regional disparities: progress is slower in the African and Eastern Mediterranean Regions and Small Island Developing States. It is clear that urgent action is needed now to close the gap.
The speakers highlighted key challenges faced by the global health workforce today, including maldistribution, inefficiencies, gender disparities, workforce ageing and poor working conditions, resulting from a lack of support, protection and respect of labour rights that further compound the challenges.
The roundtable concluded with calls to action to protect and invest in the health and care workforce and strengthen national health system capacity if the world is to attain the goals for universal health coverage and global health security. Recommended measures include:
- protect the existing health and care workforce, including all occupational health and safety measures, safe staffing and fair pay;
- protect fiscal space for social spending (education, health, social protection) and allocate the budget necessary to strengthen the health and care workforce;
- invest in increased education and supply of health professionals to meet population health needs;
- invest in job creation in the health economy: with a focus on national capacity for the essential public health functions, including emergency preparedness and response and primary health care;
- invest in reducing gender inequalities among the health and care workforce, including the gender pay gap; and
- strengthen Member States’ implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel.
Concluding the Strategic Roundtable, Dr Tedros said: “We know the problem and the solutions. What we miss is action and accountability. With a sense of urgency, it can be done.”
Landmark report charts route for reorienting economies to deliver health for all
In the first-ever report of its kind, the WHO Council on the Economics of Health for All has outlined a bold new path to reorient economies to deliver what matters - health for all.
The Council, created by WHO Director-General Dr Tedros Adhanom Ghebreyesus in November 2020 in response to the COVID-19 pandemic, and chaired by Professor Mariana Mazzucato, has spent that last two years rethinking the economy from a health for all perspective, and pushing forcefully the principle that human and planetary health must be at the heart of how we design our social, health and economic systems and policies.
The Council has put forward a bold new narrative grounded in new economic wisdom to reorient economies to deliver health for all across four interrelated themes:
- Value - valuing and measuring what matters through new economic metrics;
- Finance - how to finance health for all as a long-term investment, not a short-term cost;
- Innovation - how to advance health innovation for the common good;
- Capacity - how to strengthen dynamic public sector capacity to achieve health for all.
“Two years ago, I asked a team of the world’s leading economists and public health experts – all women – to create a paradigm shift. Now, instead of health for all being seen as the servant of economic growth, we have a roadmap for structuring economic activity in a way that will allow us to reach the goal of seeing all people with access to essential health services faster with better results,” said Dr Tedros.
“Over the past two years, the WHO Council on the Economics of Health for All has worked to craft a new economic narrative – one that transforms financing for health from an expenditure to an investment,” said the Council’s Chair, Professor Mariana Mazzucato. “We have examined the changes needed – including to the structure of patents, public-private partnerships, and budgets – to design an economy that delivers Health for All. In our final report, we call for new economic policy that is not about market fixing but about proactively and collaboratively shaping markets that prioritize human and planetary health.”
Launched today in conjunction with the Seventy-sixth World Health Assembly, the report, entitled Health for All: Transforming economies to deliver what matters (https://www.who.int/groups/who-council-on-the-economics-of-health-for-all), provides a new framework built on the above four pillars, with specific recommendations under each – drawing from the Council’s previous work.
Key recommendations include:
- We need to value and measure the things that truly matter - human and planetary flourishing - rather than pursuing economic growth and GDP maximization regardless of the consequences. To achieve health for all, governments must rethink value and reshape and redirect the economy based on social and planetary well-being, guided by new metrics.
- A fundamental overhaul of national and international systems for financing health is needed, so that spending on health is treated as a long-term investment. Delivering Health for All will require both more money, and higher quality financing.
- Innovation requires collective intelligence—it is never the fruit of just one company or government agency. But unless innovation is governed for the common good, many people remain excluded from its benefits. A new end-to-end health innovation ecosystem that prioritises the common good is needed.
- As the COVID-19 pandemic has made clear, the quality and capacity of government matters. Effective governments are not the smallest, but those that are well-designed and properly resourced, both financially and in terms of their people and infrastructure. Re-investing in government capacity is crucial to delivering Health for All.
The report also provides suggestions on what can be done in practice to implement the changes needed to reorient measures of economic value, the financing of health, innovation and building public sector capacity in the service of health for all. Among these, the report mentions several examples, including:
- The mRNA technology hub facility in South Africa: a values-driven system that tries to get the innovation, financing and capacity right ex-ante;
- Brazil’s public investment in a health-industrial complex that serves the common good;
- Regional development banks as enablers of change in the Global South;
- The Wellbeing Economy Alliance – an alliance of several governments and over 600 other organizations working together to transform economic systems in the service of life;
- Approaches to financing national action plans (NAPs) on antimicrobial resistance through multi sector joint budgeting, given that most NAPs remain unfunded.
The recommendations included in the report could change the way countries view and finance health. WHO calls on policy-makers, civil society, and members of the health and economics communities to give full consideration to the recommendations and use them as a compass to develop new economic policies and structures that can move us along the road to making health for all a reality.
Seventy-sixth World Health Assembly – Daily update: 22 May 2023
During discussions in Committee A of the Assembly, Member States agreed today the draft resolution with the proposed programme of work for the next two years (2024-2025). The budget to deliver on this programme was also agreed, at US$ 6.83 billion, the most ambitious to date, and which includes a historical 20% increase of assessed contributions (or membership fees). The Secretariat and the Director-General thanked Member States for the overwhelming strong support for the resolution, and the confidence and trust placed in WHO. Nearly forty Member States took the floor. Decisions taken during the week in the Committees, are subject to a final procedural step, of approval by the plenary at the end of the Assembly.
Financing the programme budget is essential to ensuring that WHO with its Member States can achieve the triple billion targets. Investing in WHO returns US$ 35 for every US$ 1 invested, highlights WHO’s investment case (A Healthy Return).
The budget is allocated around the following strategic priorities :
- One billion more people benefiting from universal health coverage, US$ 1966.4 million;
- One billion more people better protected from health emergencies, US$ 1214.0 million;
- One billion more people enjoying better health and well-being, US$ 437.7 million;
- More effective and efficient WHO support to countries, US$ 1350.0 million;
This makes a total of US$ 4968.2 million for the base programmes, which remains unchanged with respect the Programme budget 2022–2023;
In addition, the approved budget includes:
- Polio eradication (US$ 694.3 million), special programmes (US$ 171.7 million) totalling US$ 866.0 million;
- Emergency operations and appeals (US$ 1000 million).
With the increased assessed contributions, Member States will contribute US$ 1148.3 million towards this budget with their membership fees. The rest, US$ 5 685.8 million will be covered by voluntary contributions made by Member States and other contributors.
The 20% increase of assessed contributions was a commitment agreed by last year’s Health Assembly , one of the recommendations made by the Working Group on Sustainable Financing. Other recommendations linked to WHO’S sustainable financing covering reforms on accountability, governance and financing will be further considered this week.Related documentsDocuments A76/4, A76/4 Add.1, A76/4 Add.2 and A76/43
Proposed programme budget 2024–2025
Proposed programme budget 2024–2025
Programme budget 2024–2025
Proposed programme budget 2024–2025
Report of the Programme, Budget and Administration Committee of the Executive Board to the Seventy-sixth World Health Assembly
WHO launches global network to detect and prevent infectious disease threats
WHO and partners are launching a global network to help protect people from infectious disease threats through the power of pathogen genomics. The International Pathogen Surveillance Network (IPSN) will provide a platform to connect countries and regions, improving systems for collecting and analyzing samples, using these data to drive public health decision-making, and sharing that information more broadly.
Pathogen genomics analyzes the genetic code of viruses, bacteria and other disease-causing organisms to understand how infectious they are, how deadly they are, and how they spread. With this information, scientists and public health officials can identify and track diseases to prevent and respond to outbreaks as part of a broader disease surveillance system, and to develop treatments and vaccines.
The IPSN, with a Secretariat hosted by the WHO Hub for Pandemic and Epidemic Intelligence, brings together experts worldwide at the cutting-edge of genomics and data analytics, from governments, philanthropic foundations, multilateral organizations, civil society, academia and the private sector. All share a common goal: to detect and respond to disease threats before they become epidemics and pandemics, and to optimize routine disease surveillance.
The goal of this new network is ambitious, but it can also play a vital role in health security: to give every country access to pathogen genomic sequencing and analytics as part of its public health system,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “As was so clearly demonstrated to us during the COVID-19 pandemic, the world is stronger when it stands together to fight shared health threats.”
COVID-19 highlighted the critical role pathogen genomics plays in responding to pandemic threats. Without the rapid sequencing of the SARS-COV-2 genome, vaccines would not have been as effective, or have been made available so quickly. New, more transmissible variants of the virus would not have been as quickly identified. Genomics lies at the heart of effective epidemic and pandemic preparedness and response, as well as part of the ongoing surveillance of a vast range of diseases, from foodborne diseases and influenza to tuberculosis and HIV. Its use in monitoring the spread of HIV drug resistance, for example, has led to antiretroviral regimes that have saved countless lives.
“Global collaboration in pathogen genomic surveillance has been critical as the world fights COVID-19 together,” said Dr Rajiv J. Shah, President of The Rockefeller Foundation. “IPSN builds upon this experience by creating a strong platform for partners across sectors and borders to share knowledge, tools, and practices to ensure that pandemic prevention and response is innovative and robust in the future.”
Despite recent scale-up in genomics capacity in countries as a result of the COVID-19 pandemic, many still lack effective systems for collecting and analyzing samples or using those data to drive public health decision-making. There is not enough sharing of data, practices, and innovations to build a robust global health surveillance architecture. Budgets that soared during the pandemic, allowing a rapid build-up of capabilities, are now being slashed, even in the wealthiest countries.
“Argentina is deeply invested in building our own country capacity in pathogen genomics and the capacity of other countries,” said Josefina Campos, Director of the National Genomics and Bioinformatics Center at ANLIS Malbrán, Argentina. “Diseases do not respect borders: a disease threat in one country is also a threat to others. We look forward to collaborating with IPSN members to achieve our common goal of preventing illness and saving lives.”
The IPSN will tackle these challenges through a global network, connecting geographies and disease-specific networks, to build a collaborative system to better detect, prevent and respond to disease threats. Members will work together in dedicated groups focusing on specific challenges, supported by funding through the IPSN to scale-up ideas and projects in pathogen genomics. By connecting countries, regions, and wider stakeholders, the IPSN will help to increase critical capacity, amplify regional and country-level voices, and strengthen their priorities.
About the IPSN launch
The IPSN will be formally launched on the sidelines of the World Health Assembly in Geneva. The launch event takes place on 20 May 2023, 17:00 – 19:30h (CET) in the InterContinental Geneva, and is open to media. Please write to email@example.com for the remote link.
It includes keynote speeches from:
- Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization;
- Dr Mike Ryan, Executive Director, WHO Health Emergencies Programme; and
- Dr Chikwe Ihekweazu, Assistant Director-General, World Health Organization, Hub for Pandemic and Epidemic Intelligence.
There will also be a panel with high-level speakers from Member State and IPSN funders, including;
- Dame Jenny Harries, Chief Executive, UK Health Security Agency;
- Dr Jean Kaseya, Director-General, Africa Centers for Disease Control and Prevention;
- Dr Naveen Rao, Senior Vice President, Rockefeller Foundation;
- Dr Alexander Pym, Director of Infectious Disease, Wellcome Trust;
- Professor Tulio de Oliveira, Director, Centre for Epidemiology at Stellenbosch University, South Africa;
- Björn Kümmel, Deputy Head of Unit, Global Health, Federal Ministry of Health, Germany;
- Professor Leo Yee Sin, Executive Director of the National Centre for Infectious Diseases; Singapore;
- Dr Mario Moreira, President, Fiocruz, Brazil; and
- Dr Josefina Campos, Director of the National Genomics and Bioinformatics Center at ANLIS Malbrán, Argentina.
The event will take place in a hybrid format, providing an opportunity for IPSN members and broader audiences to engage with the IPSN and its activities.
About the IPSN
The IPSN is a new global network of pathogen genomic actors, hosted by the WHO Hub for Pandemic and Epidemic Intelligence, to accelerate progress on the deployment of pathogen genomics and improve public health decision-making. The IPSN envisions a world where every country has equitable access to sustained capacity for genomic sequencing and analytics as part of its public health surveillance system. It sets out to create a mutually supportive global network of genomic surveillance actors that amplifies and accelerates the work of its members to improve access and equity.
The IPSN consists of three main operational bodies that bring together different sets of stakeholders, supported by a Secretariat at the WHO Pandemic Hub. Partners collaborate in Communities of Practice (COPs) to solve common challenges, aiming to increase harmonization and innovation in pathogen genomics. In the Country Scale-Up Accelerator (CSUA), stakeholders work together to align efforts and enable South-South exchange to scale-up country capacity building. The COP and CSUA bring together organizations from across sectors, income levels, and geographies, with a commitment to international cooperation and equity, and deep expertise in either genomics or country scale-up of surveillance systems. The third body is the Funders Forum to coordinate philanthropic, multi-lateral and governmental donors around increased political attention and financing efficiency of pathogen genomic surveillance. The Funders Forum also catalyses additional grant funding for projects of IPSN members.
The establishment of the IPSN has been supported by German government funding to the WHO Pandemic Hub.
About the WHO Hub for Pandemic and Epidemic Intelligence
Forming part of the WHO Health Emergencies Programme, the WHO Hub for Pandemic and Epidemic Intelligence (the WHO Pandemic Hub), facilitates a global collaboration of partners from multiple sectors that supports countries and stakeholders to address future pandemic and epidemic risks with better access to data, better analytical capacities, and better tools and insights for decision-making. With support from the Government of the Federal Republic of Germany, the WHO Pandemic Hub was established in September 2021 in Berlin, in response to the COVID-19 pandemic, which demonstrated weaknesses around the world in how countries detect, monitor and manage public health threats.
The WHO Pandemic Hub works closely with Member States and WHO regional and country offices to strengthen their data-sharing capacities and enable partners from around the world to collaborate and co-create tools to gather and analyse data for early warning surveillance. With a presence in more than 150 countries, six regional offices, and its Geneva headquarters, WHO’s reach gives us the ability to treat pandemic, epidemic and public health risks with equal urgency and diligence around the globe.
By linking local, regional, and global initiatives, the WHO Pandemic Hub fosters a collaborative environment for innovators, scientists and experts from across a wide spectrum of disciplines, allowing us to leverage and share cutting-edge technology and anchoring our work in the needs of stakeholders around the world.
Building on expertise across disciplines, sectors, and regions, it will leverage WHO’s convening power to foster global solutions built on an architecture of global collaboration and trust.
Seventy-sixth World Health Assembly to focus on “saving lives, driving health for all” as WHO turns 75
As the world faces ongoing health and humanitarian emergencies, the Seventy-sixth World Health Assembly will focus on driving forward health for all.
This year’s session of the World Health Assembly will determine the immediate and longer-term future of WHO, starting with the program budget for the next two years, key decisions about the sustainable financing of the Organization and changes put in place to improve WHO’s processes and accountability. Delegates will also deliberate about the critical role that WHO has in the Global Health Emergency Architecture.
The backdrop to these issues is the organization’s 75th anniversary, with the highlights of its collective global health achievements since WHO’s creation in 1948. It will review last year’s progress, accomplishments and challenges along with future priorities across the key pillars of WHO’s work: Universal Health Coverage, Emergencies, Promoting Health and Well-being. WHA76 will convene 21-30 May at the Palais des Nations in Geneva.
“As we mark WHO’s 75th anniversary, we can be proud of our past achievements, but we must be mindful of lessons learned, as we transition from the emergency phase of COVID-19, and create a future where every person has access to the health services they need,” said Director-General Dr Tedros Adhanom Ghebreyesus. “This means strengthening the global architecture for health emergency preparedness, response and resilience, supporting countries on the road to universal health coverage, and building a stronger, sustainably-funded and accountable WHO."
To kickstart WHA76 on Sunday 21 May, the fourth edition of Walk the Talk: Health for All challenge will start at Place des Nations at 8:30 am CEST (warm-up starts at 7:30 am CEST), to promote physical and mental health and celebrate the importance of partnership during the WHO’s 75th anniversary. At about 2:00 pm CEST, following a family photo with Heads of Delegations, the Assembly high-level welcome at Palais des Nations will feature speeches from the WHO Director-General, Heads of State and special guests. List of speakers below).
During this session, the DG will present life-time achievement awards to two global health leaders.
On Monday 22 May, the Director-General will give his main address at approximately 10:00 am.
On Friday, 26 May, the WHO Director-General will be joined by representatives of five global foundations, to present five public health awards and prizes to the seven laureates for 2023. They come from Bahrain, China, Guatemala, Lebanon, Nepal, Thailand and the Philippines.Key issues
Key discussions and decisions are expected on:
- A review of WHOs work in health emergencies, including the International Health Regulations and strengthening WHO preparedness for and response to health emergencies;
- Strategies and global action on areas such as women’s, children’s and adolescents’ health, rehabilitation, universal health coverage and primary health care, traditional medicine, infection prevention and control, substandard and falsified medicines, health of refugees and migrants, non-communicable diseases, mental health, social determinants, nutrition and disabilities;
- Approval of the WHO Programme Budget for 2024-2025, including the decision to increase assessed contributions and other matters emanating from the Working Group on Sustainable Financing.
Daily Strategic roundtables will take place at lunch time from Monday to Saturday in Room XVIII. These events will host discussions among assembly delegates, partner agencies, representatives of civil society and WHO experts on public health priorities. Sessions run from 22-27 May, from 13:00 to 14:15 CEST and can be followed online.
As WHO’s highest decision-making body, the Health Assembly sets out the Organization’s policy and approves its budget. WHA is attended by delegations from all WHO 194 Member States. The Health Assembly’s agenda is preceded by the 30thmeeting of the Programme, Budget and Administration Committee of the Executive Board, which will meet on 17-19 May, 2023. After the Assembly, the 153th meeting of the Executive Board will take place from 31 May to 1 June.
The Health Assembly is open to registered and accredited Member States, Associate Members, Observers, invited representatives of the UN and other participating inter-governmental organizations and non-State actors.
WHA76 will be webcast live from the WHO website.
The provisional agenda, preliminary timetable, Assembly documents and daily journal can be accessed here.Media accreditation and updates for the World Health Assembly
Media accreditation for WHA76 will be handled by the United Nations of Geneva. Register via Indico.
To collect your badge:
On Friday 19 May (working hours: 9:00 am to 16:30 pm CEST) at Villa Feuillantines, Place des Nations . Details and address : https://unece.org/important-information-how-obtain-your-badge
On Saturday 20 May: UN Palais des Nations at Pregny Gate (opposite ICRC Building) from 13:00 to 17:00 CEST.
On Sunday 21 May, you shall collect your media badge at the UN Palais des Nations at Pregny Gate (opposite ICRC Building) from 9:00am to 16:00 pm CEST
Next week - 22-26 May- to collect the media badges: Villa Les Feuillantines at Place des Nations.
Updates on the Health Assembly will be posted on the WHO website and relevant materials will be sent to the global media list. Register for updates.Photographs and videos
WHO photos are available for media use via the WHO photo library.
Register once for media access to the WHO photo library by clicking “media registration” on this page.
For questions related to WHO photos email firstname.lastname@example.org
Recorded broadcast video material and other press content will be available for media to download on Canto. For any questions related to live video transmission please email email@example.com.Social media
WHO will provide regular updates from the World Health Assembly via Twitter –follow @WHO and hashtag #WHA76.
Follow WHO’s other social media accounts for updates from #WHA76: Facebook, Instagram, LinkedIn, YouTube
Urgent action needed to tackle stalled progress on health-related Sustainable Development Goals
WHO is releasing the 2023 edition of its annual World Health Statistics report with new figures on the impact of COVID-19 pandemic and the latest statistics on progress towards the health-related Sustainable Development Goals (SDGs).
The report with data up to 2022 underscores a stagnation of health progress on key health indicators in recent years compared with trends seen during 2000-2015. It also alerts us to the growing threat of noncommunicable diseases (NCDs) and climate change, and calls for a coordinated and strengthened response.COVID-19 cost in lost lives and health progress
The report documents updated statistics on the toll of the pandemic on global health, contributing to the ongoing decline in progress towards the SDGs. During 2020-2021, COVID-19 resulted in a staggering 336.8 million years of life lost globally. This equates to an average of 22 years of life lost for every excess death, abruptly and tragically cutting short the lives of millions of people.
Since 2000, we saw significant improvements in maternal and child health with deaths falling by one-third and one-half, respectively. The incidence of infectious diseases such as HIV, tuberculosis (TB) and malaria also declined, along with a lowered risk of premature deaths from NCDs and injuries. Together, these contributed to an increase in global life expectancy from 67 years in 2000 to 73 years in 2019.
However, the pandemic has put many health-related indicators further off-track and contributed to inequalities in access to high-quality health care, routine immunizations and financial protection. As a result, improving trends in malaria and TB have been reversed, and fewer people were treated for neglected tropical diseases (NTDs).
“The World Health Statistics is WHO’s annual check-up on the state of the world’s health. The report sends a stark message on the threat of noncommunicable diseases, which take an immense and increasing toll on lives, livelihoods, health systems, communities, economies and societies,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “The report calls for a substantial increase in investments in health and health systems to get back on track towards the Sustainable Development Goals.”NCDs ̶ an ever-increasing health threat for future generations
Despite overall health progress, the share of deaths caused annually by NCDs has grown consistently and is now claiming nearly three quarters of all lives lost each year.
If this trend continues, NCDs are projected to account for about 86% of the 90 million annual deaths by mid-century; consequently, 77 million of these will be due to NCDs – a nearly 90% increase in absolute numbers since 2019.Stagnating progress calls for acceleration
More recent trends show signs of slowdown in the annual rate of reduction (ARR) for many indicators. For example, the global maternal mortality ratio needs to decline by 11.6% per year between 2021 and 2030 to meet the SDG target. Similarly, the net reduction in TB incidence from 2015 to 2021 was only one-fifth of the way to the 2025 milestone of WHO’s End TB Strategy.
Despite a reduction in exposure to many health risks – such as tobacco use, alcohol consumption, violence, unsafe water and sanitation, and child stunting – progress was inadequate and exposure to some risks such as air pollution remains high.
Alarmingly, the prevalence of obesity is rising with no immediate sign of reversal. Furthermore, expanded access to essential health services has slowed compared to pre-2015 gains, coupled with no significant progress in reducing financial hardship due to health-care costs. This drastically limits our ability to achieve Universal Health Coverage by 2030.
“The COVID-19 pandemic is an important reminder that progress is neither linear nor guaranteed,” warns Dr Samira Asma, WHO Assistant Director-General for Data, Analytics and Delivery for Impact. “To stay on track towards the 2030 SDG agenda, we must act decisively and collectively to deliver a measurable impact in all countries.”
This year’s report includes for the first time a dedicated section on climate change and health, and we anticipate that this will be of more relevance in the report going forward. For this issue and all other areas timely, reliable and disaggregated data are critical to track progress and improve national and global health policies.
Editor’s note: The World Health Statistics report is the World Health Organization’s (WHO) annual compilation of the most recent available data on health and health-related indicators.
For inquiries, contact firstname.lastname@example.org
WHO Director-General announces Global Health Leaders Awards
Statement on the antigen composition of COVID-19 vaccines
The WHO Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC) continues to meet regularly to assess the implications of SARS-CoV-2 evolution for COVID-19 vaccine antigen composition and advise WHO on whether changes are needed to the antigen composition of future COVID-19 vaccines.
In April 2023, the TAG-CO-VAC indicated that the advisory group would convene at least twice in 2023: once in May 2023 and again, approximately 6 months later. At each meeting, recommendations to either maintain current vaccine composition or to consider updates will be issued. This frequency of evidence review by the TAG-CO-VAC is based on the kinetics of vaccine-derived immunity and the need for continued monitoring of the evolution of SARS-CoV-2, and will be adjusted if and as necessary. The TAG-CO-VAC met on 11-12 May 2023 to review the genetic and antigenic evolution of SARS-CoV-2, the performance of currently approved vaccines against circulating SARS-CoV-2 variants and the implications for COVID-19 vaccine antigen composition.
As previously stated by the TAG-CO-VAC, the objective of an update to COVID-19 vaccine antigen composition is to enhance vaccine-induced immune responses to circulating SARS-CoV-2 variants. This statement and the recommendation for change is intended for all vaccine manufacturers and is intended to inform future formulations of COVID-19 vaccines.
The TAG-CO-VAC recognizes and reiterates that currently approved COVID-19 vaccines, including those based on the index virus, continue to provide substantial protection against severe disease and death, which is the primary objective for COVID-19 vaccination. Currently approved COVID-19 vaccines should continue to be used in accordance with the current WHO SAGE Roadmap, published in April 2023. Notwithstanding the protection against severe disease, protection against symptomatic disease is limited and less durable. New formulations of COVID-19 vaccines are needed to improve protection against symptomatic disease.
The published and unpublished evidence reviewed by the TAG-CO-VAC included: (1) SARS-CoV-2 evolution, including genetic and antigenic characteristics of earlier and current SARS-CoV-2 variants, including XBB.1 descendent lineages, and its impact on cross-neutralization and cross-protection following vaccination and/or infection; (2) Vaccine effectiveness (VE) of currently approved vaccines during periods of XBB.1 descendant lineage circulation; (3) Antigenic cartography analyzing antigenic relationships of SARS-CoV-2 variants using naïve animal sera and human sera following vaccination and/or infection; (4) Preliminary preclinical data on immune responses in animal models, following infection with XBB.1 descendent lineages; (5) Preliminary preclinical immunogenicity data on the performance of candidate vaccines with updated antigens (data not shown); and (6) B cell memory responses following vaccination and/or infection.
Further details on the publicly available data reviewed by the TAG-CO-VAC can be found in the accompanying data annex. Unpublished and/or confidential data are not shown.
The TAG-CO-VAC acknowledges the limitations of the available data:
- While the trajectory of further SARS-CoV-2 evolution indicates that XBB will likely be the progenitor of SARS-CoV-2 variants in the near term, the timing, specific mutations and antigenic characteristics, and the potential public health risks of future variants remain unknown;
- Data on cross-reactivity (breadth) of immune responses elicited by currently circulating SARS-CoV-2 variants are limited. The majority of the available clinical and preclinical data are on the recent variants XBB.1 or XBB.1.5, but there is minimal information on other current variants of interest or variants under monitoring;
- Data on immune responses over time following infection with currently circulating SARS-CoV-2 variants are limited;
- Though neutralizing antibodies titers have been shown to be important in protection from SARS-CoV-2 infection and in estimates of vaccine effectiveness, there are multiple layers of immune protection elicited by infection and/or vaccination. Data on the immune response specific for XBB.1 descendent lineages are largely restricted to neutralizing antibodies and are limited for other aspects of the immune response, including cellular immunity;
- Data on the protection conferred by hybrid immunity (i.e. combination of infection- and vaccination-induced immunity) are largely derived from populations that predominantly received an mRNA booster dose;
- Data on VE of current COVID-19 vaccines, including index-virus based and bivalent mRNA vaccines, against XBB descendent lineages are limited and estimates during periods of XBB.1 descendant lineage circulation are only available for mRNA vaccines;
- Data on candidate vaccines that include an XBB.1 descendent lineage are limited to animal models.
A summary of available evidence and the recommendations that follow were discussed by the TAG-CO-VAC and provided to WHO.
Summary of available evidence
- In the fourth year of the pandemic, there is high seroprevalence in the global population as a result of vaccination and/or infection, and immunological profiles against SARS-CoV-2 are highly heterogeneous (i.e. individuals have been infected with different variants and/or vaccinated using a variety of vaccine platforms).
- There continues to be substantial genetic and antigenic evolution of the spike protein of SARS-CoV-2, and the evolutionary trajectory continues to diverge from the index virus. Despite increasing gaps in genomic surveillance globally, the available sequencing data indicates that the index virus and other early variants (e.g., Alpha, Beta, Gamma and Delta) are no longer detected in humans.
- As of May 2023, the XBB.1 descendent lineages currently predominate globally (i.e., XBB.1.5, XBB.1.16, XBB.1.9).
- As described in the WHO Technical Advisory Group on SARS-CoV-2 Virus Evolution XBB.1.5 Updated Risk Assessment and the XBB.1.16 Initial Risk Assessment, XBB descendent lineages, including XBB.1.5 and XBB.1.16, are highly immune evasive, with XBB.1.5 being one of the SARS-CoV-2 variants with the greatest magnitude of immune escape from neutralizing antibodies to date.
- Estimates of VE against currently circulating SARS-CoV-2 variants, including XBB.1 descendent lineages, are very limited in terms of the number of studies, vaccine products evaluated, and populations assessed; some studies show similar VE against BA.5 descendent and XBB.1 descendent lineages, while others suggest reduced VE during periods of predominance of XBB.1 descendent lineages.
- Sera from individuals who have received two, three or four doses of index virus-based vaccines, or a booster dose of a bivalent (BA.1- or BA.4/5- containing) mRNA vaccine show substantially lower neutralizing antibody titers against XBB.1 descendent lineages, as compared to titers specific for the antigens included in the vaccine. Individuals with hybrid immunity due to any SARS-CoV-2 infection show higher neutralizing antibody titers against XBB.1 descendent lineages as compared to responses from vaccinated individuals who had no evidence of infection.
- There is in vitro evidence that immune imprinting, which is a phenomenon in which B cell memory recall responses towards previously encountered antigen reduce the response to new antigens, may be occurring. However, based on observational epidemiological studies to date, the clinical impact remains unclear.
- Preclinical data shared confidentially with the TAG-CO-VAC by vaccine manufacturers show that vaccination with XBB.1 descendent lineage-containing candidate vaccines (including XBB.1.5) elicits higher neutralizing antibody responses to currently circulating SARS-CoV-2 variants, compared to responses elicited by currently approved vaccines.
Recommendations for updates to COVID-19 vaccine antigen composition
There is ongoing and considerable genetic and antigenic evolution of SARS-CoV-2, high seroprevalence and heterogeneous population immunity to SARS-CoV-2. As current WHO SAGE policy specifies, vaccination programmes should continue to complete the primary series and booster dose(s) for high priority and medium priority groups. Furthermore, the WHO Global COVID-19 Vaccination Strategy, published in July 2022, also calls for vaccines with improved durability and breadth of protection.
Updates to vaccine antigen composition may enhance vaccine-induced immune responses to circulating SARS-CoV-2 variants, consistent with the previous statement by the TAG-CO-VAC published in June 2022.
As of May 2023, XBB.1 descendent lineages predominate SARS-CoV-2 circulation globally. In order to improve protection, in particular against symptomatic disease, new formulations of COVID-19 vaccines should aim to induce antibody responses that neutralize XBB descendent lineages. One approach recommended by TAG-CO-VAC is the use of a monovalent XBB.1 descendent lineage, such as XBB.1.5 (e.g., hCoV-19/USA/RI-CDC-2-6647173/2022, GenBank: OQ054680.1, GISAID: EPI_ISL_16134259 or WHO Biohub: 2023-WHO-LS-01, GenBank: OQ983940, GISAID EPI_ISL_16760602) as the vaccine antigen. Given the small genetic and antigenic differences from XBB.1.5, XBB.1.16 (e.g., hCoV-19/USA/MI-CDC-LC1038976/2023, GenBank: OQ931660 GISAID: EPI_ISL_17619088) may be an alternative. The spike antigens of both of these lineages are genetically and antigenically very closely related, with only two amino acid differences between XBB.1.5 and XBB.1.16 (E180V and T478R). Other formulations and/or platforms that achieve robust neutralizing antibody responses against XBB descendent lineages can be considered.
While currently approved COVID-19 vaccines, including those based on the index virus, continue to provide protection against severe disease, the TAG-CO-VAC advises moving away from the inclusion of the index virus in future formulations of COVID-19 vaccines. This is based on the following reasons: the index virus and antigenically closely related variants no longer circulate in humans; the index virus antigen elicits undetectable or very low levels of neutralizing antibodies against currently circulating SARS-CoV-2 variants, including XBB descendent lineages; inclusion of the index virus in bi- or multivalent vaccines reduces the concentration of the new target antigen(s) as compared to monovalent vaccines, which may decrease the magnitude of the humoral immune response; and immune imprinting due to repeated exposure to the index virus may reduce immune responses to new target antigen(s).
Further data requirements and considerations
Given the limitations of the evidence upon which the recommendations above are derived and that the evolution of the virus is expected to continue, the TAG-CO-VAC strongly encourages the generation of data on immune responses and clinical endpoints in humans who receive a COVID-19 vaccine with an updated composition, across different vaccine platforms, as well as further data on the performance of current COVID-19 vaccines against circulating SARS-CoV-2 variants. Additionally, the TAG-CO-VAC continues to encourage the further development of vaccines that enhance mucosal immunity because they may improve protection against infection and reduce transmission of SARS-CoV-2, in alignment with the WHO Global COVID-19 Vaccination Strategy, published in July 2022. Finally, it is imperative for multilateral organizations, governments and manufacturers to continue collaborating towards access to currently approved COVID-19 vaccines and to ensure equitable global access for vaccine(s) with an updated antigen composition as they become available.