WHO new directionssolid roots

1
WHO new directions-solid roots

• Derek Yach
• World Health Organisation
• Sydney October 2003

2
Continuity and change Gro Harlem Brundtland

• Built the case to invest in health and took it
  to global fora and heads of states
• Highlighted the issue of health systems
  performance
• Spotlighted mental health
• Had the Framework Convention on Tobacco Control
  adopted
• New partnerships for health from GAVI to MMI

3
Continuity and change Gro Harlem Brundtland

• Part of building the AIDS, malaria, TB priority
  trio among the donor community
• Placed NCDs at equivalent institutional level to
  CDs created first injuriesviolence dept
• Initiated country focus initiative
• Raised new extra-budgetary funds with less
  strings

4
Continuity and change JW Lee

• Greater focus and intensity for country action
• Targeted action related to HIV/AIDs, malaria, TB
  health systems and workforce issues paramount
• Eradicate polio on his watch
• Build on SARS experience global surveillance,
  alert and response revise IHR

5

• Today, WHO is declaring the failure to deliver
  AIDS medicines to those who need them a global
  health emergency. I am making this announcement,
  along with UNAIDS and the Global Fund, in New
  York, at a press conference and at a roundtable
  at the UN General Assembly meeting on HIV/AIDS.
• We have decided to take this rare measure after
  evaluating the global situation and finding that
  only 5 of those in the developing world who
  require antiretrovirals are getting them. Of 5-6
  million people in need, just 300,000 are on ARVs.
  In sub-Saharan Africa, for example, only 50,000
  people, of 4.1 million who require ARVs, actually
  have access.
• To address this global health emergency, WHO will
  take all necessary measures to achieve the "3 by
  5" target - putting three million people on
  antiretrovirals by the end of 2005.
  
  JW Lee, DG, WHO, September 2003

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Continuity and change JW Lee

• NCDs new WHO global strategy
• FCTC country implementation and ratification
  lessons?
• Injuriesviolence World Health Day 2004
• Enhanced country focus with resource transfers to
  support progress by 2006/7

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NCDs?

• Global strategy on diet, nutrition and physical
  activity
• Global cancer control alliance
• Better emphasis on chronic care

8
FCTC approach and other commodities that affect
public health

• Foodbeverages
• Alcohol
• Pharmaceuticals

9
FCTC getting there

• Long incubation period
• Public health rationale
• Partnerships evolving
• Selected political support few leaders
• WHO ready to lead with DG
• Negotiations

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Mobilization of Forces
Member States
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Express the truth
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Limit opposition as they mobilize against FCTC
Surrogates International Tobacco Growers
Association
Antonio Abrunhosa
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SUMMARY
Changed circumstances mean that we should look
seriously at the possibility of setting up a
global regulatory regime for the policing of the
declared aims of the tobacco industry. Such a
change in strategy might increase public
confidence in the regulatory process, and thereby
decrease political support for anti-tobacco
pressure groups. Further, it may lead to a more
reason-oriented arena for the consideration of
our critics case. The negotiations around the
establishment of such a regime would require the
accommodation of developing world interests.
Although such a strategic change of direction
would incur considerable risks, the potential
benefits are sufficient to warrant further
examination of the case for such a strategic
change.
Philip Morris / BAT/ JTL
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Negotiating with varying intent and ability
Those who have done. Those who want to
do.. Those who want to, but cannot do.. Those
who do not want to do..
Quote - Ambassador Luiz Felipe de Seixas Corrêa,
Chair INB.
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Resolution of Complex areas

• Public healths priority in international
  agreements
• Self-regulation versus binding laws
• Constitutional constraints
• Demand reduction and impact on supply
• Federated systems

16
New messages emerging

• Importance of process staff renewal
• Country health information systems
• Practical approaches to health systems
  development
• Strengthen poverty focus through work on maternal
  deaths childhood deaths

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Likely challenges

• Defining WHOs roles in health systems
  development-linkage to HIV/AIDs treatment plans
• Expansion of country work while maintaining
  global competence for norms development on a
  fixed regular budget
• Maintaining impetus on NCDs, FCTC, mental
  health...