WHO celebrates 75th anniversary and calls for health equity in face of unprecedented threats
On 7 April 2023, the World Health Organization (WHO) will mark its 75th anniversary, along with its 194 Member States and other partners, by calling for a renewed drive for health equity.
Seventy-five years ago, in the aftermath of the deadliest and most destructive war in human history, the Constitution of the World Health Organization came into force: a treaty between the nations of the world, who recognized that health was not only a fundamental human right, but also fundamental to peace and security.
Over the past seven and a half decades, there has been extraordinary progress in protecting people from diseases and destruction, including smallpox eradication, reducing the incidence of polio by 99%, saving millions of lives through childhood immunization, declines in maternal mortality and improving health and well-being for millions more.
“The history of WHO demonstrates what is possible when nations come together for a common purpose,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We have much to be proud of, but much work to do to realize our founding vision of the highest attainable standard of health for all people. We continue to face vast inequities in access to health services, major gaps in the world’s defences against health emergencies, and threats from health harming products and the climate crisis. We can only meet these global challenges with global cooperation.”
To meet these challenges, WHO is urging countries to take urgent action to protect, support and expand the health workforce as a strategic priority. Investments in education, skills and decent jobs for health need to be prioritized to meet the rapidly growing demand for health and avert a projected shortage of 10 million health workers by 2030; primarily in low- and middle-income countries.
A global education programme on basic emergency care targeting 25% of nurses and midwives from 25 low- and middle-income countries by the end of 2025 was also recently announced by WHO. This 25x25x25 emergency care programme will provide nurses and midwives with the skills and competencies to make a major difference in saving lives and reducing disabilities.
Looking forward to the next 75 years and close to the turn of the next century, a renewed commitment to health equity will be the key to addressing future health challenges. In the shadow of the COVID-19 pandemic, WHO’s roadmap to recovery includes an urgent paradigm shift towards promoting health and well-being and preventing disease by addressing its root causes and creating the conditions for health to thrive. WHO is urging countries to provide health by prioritizing primary health care as the foundation of universal health coverage.
The COVID-19 pandemic has shown that protecting health is fundamental to our economies, societies, security and stability. Learning from the worst pandemic in recent history, WHO stands ready to support the countries of the world as they negotiate a pandemic accord, the revision of the International Health Regulations and other financial, governance and operational initiatives to prepare the world for future pandemics.
Over the past five years, WHO has invested in science and digital health, creating a Science Division led by the Organization’s first Chief Scientist. This has come at a time when science is under sustained attack every day. Countries must protect the public from misinformation and disinformation. The future of health depends on how well we power health through science, research, innovation, data, digital technologies, and partnerships.
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WHO convenes the Fifth Global Forum on Human Resources for Health
WHO is organizing the Fifth Global Forum on Human Resources for Health from 3 to 5 April 2023 in Geneva, Switzerland. The Forum, the largest gathering of the health workforce professionals, health policymakers and multisectoral partners is focusing on the theme of Protecting, safeguarding, and investing in the health and care workforce.
As the halfway point to the Sustainable Development Goals approaches, and three years since the COVID-19 pandemic began, population health outcomes and life expectancy are in reverse.
Health systems are dependent on health worker availability, accessibility and quality. Yet chronic shortages of health workers, underinvestment in their education and training, as well as low salaries and mismatch between education and employment strategies are leading to major challenges. The pandemic placed a heavy toll: the latest figures show that an estimated 50% of health and care workers, who already felt overworked and undervalued before COVID-19, experienced burnout from the huge additional burdens placed upon them.
“The world must take urgent action to protect and invest in health workers in all countries. Health workers need decent pay and working conditions,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “WHO calls for all countries to increase investment in health workforce education and jobs to meet their population needs and health system demands. This requires political leadership across all sectors, not just health”.
Marking more than five years since the adoption of the Global Strategy on Human Resources for Health: Workforce 2030, the Forum will share evidence and experiences on workforce development, as well as opportunities for a post COVID-19 era. It will examine the required policy solutions, investments, and multi-sectoral partnerships to address health and care workforce challenges and advance the implementation of the Working for Health 2022-2030 Action Plan.
WHO is recommending that all countries increase graduation of health personnel to reach 8-12% of the active workforce per annum. For instance, a country with a total of 5000 physicians would need to graduate between 400-600 physicians per annum to maintain and improve capacity in relation to population needs and health system demand.
“National responses to COVID-19 showed that the health and care workforce is capable of hugely positive change”, said Jim Campbell, Director of the Health Workforce Department. “If we want equity and universal health coverage, if we want global health security, we must protect health workers. We must invest in them, and we must take action together”.
The Forum will dedicate particular attention to health workforce investment and financing in all countries: to secure the resources for the scale-up of education and jobs. It will feature work led by the WHO African Regional Office together with Member States and regional partners in the development of the African Health Workforce Investment Charter, which aims to align and stimulate investments to halve inequities in access to health workers; especially in those African countries identified as having the greatest shortages.
The Forum is being attended by over 2000 delegates with most joining online and close to 200 participating in person. It provides a pivotal moment to focus on the topic that lies at the heart of global health agenda, taking place during the World Health Worker Week campaign, and just ahead of World Health Day, which this year marks WHO’s 75th birthday on 7 April 2023.
The outcomes of the Forum will inform the United Nations General Assembly’s High-Level Meetings on Universal Health Coverage and Pandemic Prevention, Preparedness and Response scheduled in September 2023.
Note to the editorAt the Seventy-fifth World Health Assembly in May 2022, Member States encouraged utilization of the Global health and care worker compact that consolidates relevant international legal instruments to provide succinct guidance on how to protect health and care workers, to safeguard their rights, and to promote and ensure decent work, free from racial and all other forms of discrimination and a safe and enabling practice environment. The WHO Global Code of Practice on the International Recruitment of Health Personnel is a key instrument in this area. The Code, adopted by the World Health Assembly in 2010, establishes and promotes voluntary practices for the ethical international recruitment of health personnel. It requires countries to implement effective health workforce planning, education, training and retention strategies to sustain a health workforce that is appropriate for the specific conditions of each country. In March 2023, WHO released the WHO health workforce support and safeguards list (2023).
WHO and the Inter-Parliamentary Union launch a new handbook on Universal Health Coverage
The World Health Organization (WHO) recently participated in a number of joint activities at the 146th Inter-Parliamentary Union (IPU) Assembly which took place from 11-15 March 2023 in Manama, Bahrein.
This collaborative work included the launch of the IPU-WHO Handbook on Universal Health Coverage (UHC), which follows up on the 2019 IPU resolution on UHC. The handbook aims to introduce parliamentarians to the concept and importance of UHC and describe the key roles Members of Parliaments (MPs) can play to make progress by offering practical and actionable recommendations.
On the launch of the handbook, WHO’s Director-General, Dr Tedros, said: “It therefore gives me great pleasure to launch the new UHC handbook, a joint project of WHO and the IPU, which can help to guide you along the path towards universal health coverage, in accordance with the landmark 2019 IPU resolution.”
Gaudenz Silberschmidt, Head of WHO delegation, also addressed the plenary during the General Debate on “Promoting peaceful coexistence and inclusive societies: Fighting intolerance”, where he highlighted that the longstanding collaboration between WHO and IPU to improve parliamentary engagement on health has never been more critical.
During the Assembly there was also a side event on ‘UHC and Health Taxes’ to raise awareness on the need to further leverage the role of parliamentarians to progress towards UHC and how they can strengthen their roles at the country level.
The WHO also presented a plan of work with the IPU during the meeting of the IPU Advisory Group on Health. The new workplan confirms the three priority areas of the collaboration: UHC, global health security and promoting health, especially on vulnerable groups, including women, children and adolescents health. It also includes two new areas: the role of parliamentarians in supporting Sustainable Financing for WHO and the Pandemic Accord. Furthermore, WHO and IPU co-organised a workshop on Sexual and Reproductive Health, with a focus on Comprehensive Sexuality Education (CSE). This workshop brought together parliamentarians to share perspectives on CSE from their national contexts.
More information about WHO’s participation at the 146th IPU Assembly can be found here
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Quadripartite call to action for One Health for a safer world
Recent international health emergencies such as COVID-19 pandemic, mpox, Ebola outbreaks, and continued threats of other zoonotic diseases, food safety, antimicrobial resistance (AMR) challenges, as well as ecosystem degradation and climate change clearly demonstrate the need for resilient health systems and accelerated global action. One Health is seen as the main approach for tackling these pressing and complex challenges facing our society.
At their first annual face-to-face meeting today, the heads of the Quadripartite organizations working on One Health issued an unprecedented call for enhanced global action.
The Quadripartite aims to achieve together what no one sector can achieve alone, and it consists of four main agencies: the Food and Agriculture Organization of the United Nations (FAO), United Nations Environment Programme (UNEP), World Health Organization (WHO) and World Organisation for Animal Health (WOAH).
Call to actionStressing the need for enhanced collaboration and commitment to translate the One Health approach into policy action in all countries, the Quadripartite leaders urge all countries and key stakeholders to promote and undertake the following priority actions:
- Prioritize One Health in the international political agenda, increase understanding and advocate for the adoption and promotion of the enhanced intersectoral health governance. The One Health approach should notably serve as a guiding principle in global mechanisms; including in the new pandemic instrument and the pandemic fund to strengthen pandemic prevention, preparedness and response;
- Strengthen national One Health policies, strategies and plans, costed and prioritized in line with the Quadripartite One Health Joint Plan of Action (OH JPA), to foster wider implementation across relevant sectors and at all levels;
- Accelerate the implementation of One Health plans, including supporting of national One Health governance and multisectoral coordination mechanisms, development of situation analyses, stakeholder mapping, priority setting, and metrics for One Health monitoring and evaluation frameworks;
- Build intersectoral One Health workforces that have the skills, capacities and capabilities to prevent, detect, control, and respond to health threats in a timely and effective way, by strengthening joint pre-service and continuing education for human, animal, and environmental health workforces;
- Strengthen and sustain prevention of pandemics and health threats at source, targeting activities and places that increase the risk of zoonotic spillover between animals to humans;
- Encourage and strengthen One Health scientific knowledge and evidence creation and exchange, research and development, technology transfer and sharing and integrating of information and data and facilitate access to new tools and technologies; and
- Increase investment and financing of One Health strategies and plans ensuring scaled up implementation at all levels, including funding for prevention of health threats at source.
To build one healthier planet we need urgent action to galvanize vital political commitments, greater investment and multisectoral collaboration at every level.
The Quadripartite has been playing a central role in promoting and coordinating a global One Health approach, in line with the OH JPA[1] which was launched in October 2022. To further support countries and governments putting the One Health approach into practice, the Quadripartite partners are developing an OH JPA implementation guide to be released in 2023.
QU Dongyu, Director-General, FAO
Inger Andersen, Executive Director, UNEP
Tedros Adhanom Ghebreyesus, Director-General, WHO
Monique Eloit, Director-General, WOAH
[1] https://www.who.int/publications/i/item/9789240059139
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The cholera emergency is avoidable
The world is facing an upsurge in cholera, even touching countries that have not had the disease in decades. Years of progress against this age-old disease have disappeared. While the situation is unprecedented, the lesson to draw is not a new one: safe drinking water, sanitation and hygiene are the only long-term and sustainable solutions to ending this cholera emergency and preventing future ones.
The global cholera situation is concerning, but as we mark World Water Day today, and the historic United Nations Water Conference begins in New York, the Global Task Force for Cholera Control (GTFCC) is appealing to countries and the international community to channel that concern towards concrete action.
First, to prevent future outbreaks, countries need strong public health surveillance systems to quickly identify and confirm cholera cases, allowing for immediate action. Countries with ongoing widespread outbreaks need immediate support to track and tackle the current crisis. We can’t solve a problem we can’t see.
Second, stop the cycle that takes us from emergency to emergency by investing in water, sanitation, and hygiene (WASH). When there is a cholera outbreak, responders rush in soap and chlorine tablets, bring in safe water in trucks, and build temporary latrines to prevent the outbreak from spreading. While these actions are undoubtedly life-saving, longer-term investments in WASH infrastructure can prevent outbreaks in the first place. Wherever in the world cholera has been eliminated, it has been thanks to improvements in basic water, sanitation and hygiene – access to these is an internationally recognized human right.
Moving from an emergency response to long-term improvements is more effective, because although cholera is a health issue, first and foremost, it is a development issue.
Third, focus efforts on cholera hotspots. Fighting cholera requires a targeted approach centred on hotspots–health zones or districts–where cholera cases are concentrated. Focusing on cholera hotpots more than doubles the return on investments in safe water, sanitation and hygiene: from US$4.30 to US$10 for every US$1 invested.
Fourth, support the development and implementation of national cholera plans, including the budget allocated for WASH. These national plans lay out multisectoral actions needed for sustained cholera prevention and control, including the use of oral cholera vaccines, putting communities at the center.
Poverty, conflict, and disasters continue to fuel cholera, now turbo-charged by climate change. The future presents multiple challenges, but at least for cholera, we have the answer: access to safe water, sanitation and hygiene in cholera hotspots. Urgent, targeted investments will get us there.
Note to editors
In the past months, the world has seen a resurgence of cholera. Last year, as many as 30 countries experienced outbreaks, and we continue to see a worrying geographic spread into 2023. Countries like Lebanon, South Africa and Syria are seeing their first outbreaks in decades. It is not just the number and spread of outbreaks which is concerning, but the severity with which they are striking. The average case fatality rate of the current outbreaks is double the target threshold of less than 1%.
Many of these outbreaks have clear links with extreme climate events, which bring at times too much and at times too little water, both potent fuel for cholera as access to water supplies are disrupted, and people may be forced to move from their homes to more temporary—and at times crowded—settlements. Looking ahead, we can expect more frequent floods, droughts, storms and displacement. Other than climate change, modelling exercises show that population growth and urbanization alone could lead to a doubling of cholera cases over the next 20 years if we do not act now.
For more information on the full multisector approach to cholera control and elimination, please see the GTFCC Steering Committee statement on the current cholera situation.
Signed by the Steering Committee of the Global Task Force for Cholera Control (GTFCC)
His Excellency Mr Hakainde Hichilema, President of the Republic of Zambia and Global Cholera Control Champion
Dr Frew Benson, Chair, GTFCC Steering Committee
Dr Christopher J. Elias, President, Global Development, Bill & Melinda Gates Foundation
Dr Howard Zucker, Deputy Director for Global Health, Centers for Disease Control and Prevention (CDC)
Dr Seth Berkley, CEO, Gavi, the Vaccine Alliance
Dr Tahmeed Ahmed, Executive Director, icddr,b
Jagan Chapagain, Secretary General, International Federation of Red Cross and Red Crescent Societies (IFRC)
Dr Christos Christou, International President, Médecins Sans Frontières
Catherine Russell, Executive Director, UNICEF
Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization
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WHO steps up the Director-General’s flagship initiative to combat tuberculosis
On the occasion on World TB Day, the World Health Organization (WHO) is announcing the expanded scope of the WHO Director-General’s (DG) Flagship Initiative on tuberculosis over the period from 2023 to 2027 to support fast-tracking progress towards ending TB and achieving Universal Health Coverage (UHC) by 2030.
Tuberculosis remains one of the world’s top infectious killers, causing 1.6 million deaths each year and affecting millions more, with enormous impacts on families and communities. The COVID-19 pandemic coupled with ongoing crises such as armed conflict, food insecurity, climate change, political and economic instability, has reversed years of progress made in the fight against TB. Last year, for the first time in nearly two decades, WHO reported an increase in the number of people falling ill with TB and drug resistant TB, alongside an increase in deaths.
“TB is preventable, treatable and curable, and yet this ancient scourge that has afflicted humanity for millennia continues to cause suffering and death for millions every year,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “WHO is committed to supporting countries to step up their response, by expanding access to services to prevent, detect and treat TB as part of their journey towards universal health coverage, and to strengthen their defences against epidemics and pandemics.”
The WHO DG flagship initiative on TB builds on the progress achieved and lessons learned from 2018-2022. It aims to scale up the delivery of quality care to people living with TB through equitable access to WHO-recommended rapid diagnostics, shorter all-oral treatment for infection and disease, increasing their access to social protection and other innovations including digital tools for health.
The initiative highlights the pressing need to increase both domestic and international investments in TB services, research, and innovation, particularly in new vaccine development. It calls for TB services and programmes, particularly in countries with a high TB burden, to be recognized as an essential component of health systems, bolstering primary healthcare and pandemic preparedness and response.
The DG’s flagship initiative aims to drive multisectoral action and accountability to tackle the key drivers of the TB epidemic - poverty, undernourishment, diabetes, HIV, tobacco and alcohol use, poor living and working conditions, among others. And its enhanced scope is much needed and timely as the international partners prepare for the upcoming UN High-Level Meeting on TB.
World Tuberculosis Day this year is being commemorated under the theme 'Yes! We can end TB!' with the goal of promoting optimism and fostering high-level leadership, increased investments, rapid adoption of new WHO recommendations, and strengthened multisectoral partnerships to combat the TB epidemic.
As part of the DG Flagship initiative, a special call to action is being issued by WHO and partners urging Member States to accelerate the rollout of new WHO-recommended shorter all-oral treatment regimens for drug-resistant TB.
Drug-resistant TB continues to be a pressing public health concern, taking a significant toll on individuals affected by TB, communities, and healthcare systems worldwide. In 2021, nearly half a million people fell ill with multidrug- or rifampicin-resistant TB (MDR/RR-TB), only one in three accessed treatment.
New WHO guidelines on drug-resistant TB treatment recommend rapid roll-out of the novel BPaLM/BPaL regimen that has the potential to significantly increase cure rates due to its high effectiveness, offer more extensive access because of its lower cost, and improve patients' quality of life, as it is an all-oral treatment that is considerably shorter than traditional regimens.
“2023 is our chance to push forward the agenda towards ending TB, ” said Dr Tereza Kasaeva, Director of WHO’s Global Tuberculosis Programme. “On World TB Day, WHO is pressing for firm political commitment at the highest level, strong multisectoral collaboration including beyond health, and an effective accountability system. We need everyone--individuals, communities, societies, donors and governments--to do their part to end TB. Together, yes, we can end TB.”
In September 2023, the UN General Assembly will convene three High-Level Meetings focusing on UHC, pandemic preparedness and response and ending TB. There are clear linkages between these agendas and the Heads of State will deliberate to accelerate action, including on the goal to end TB.