On Monday 21 May, the 71st World Health Assembly (WHA) will commence in Geneva. Member State delegates will have a full agenda of topics to consider and reach decisions on. While antibiotic resistance is not specifically on the agenda this year, the general work programme for the WHO covers antimicrobial resistance and other relevant topics related to access to medicines will be discussed. Moreover, several side events on, or related to, antibiotic resistance will be held in conjunction with the WHA. ReAct will be speaking at three of these side-events.
WHA71 main agenda
This year, the WHA agenda has a focus on strategic priority matters such as:
- The WHO’s general programme of work 2019-2023.
- Addressing the global shortage and access to medicines and vaccines.
- The global strategy and plan of action on public health, innovation and intellectual property.
- Tuberculosis (TB) is prominently featured on the agenda in preparation for the high-level meeting of the UN General Assembly (UNGA) on ending TB, including a draft multisectoral accountability framework to accelerate progress to end TB.
WHO’s general programme of work 2019-2023
The WHA will be presented with the draft WHO’s general programme of work 2019-2023. In this, antimicrobial resistance is spelled out to continue to be a high priority for WHO by being one of five so called Platforms. The draft gives a broad outline that WHO will provide strategic support for scaling up sustainable actions on antimicrobial resistance, but does not specify actions to be taken.
While the specific implementation plan will be developed in a framework for how to translate the strategy into action, it is worth noting that the future work of the WHO on AMR may also be influenced by the report from UN Inter-Agency Coordination Group on AMR that will go the UN General Assembly next year with recommendations for global coordination and governance of AMR.
Global shortage and access to medicines and vaccines
The agenda point on Global shortages and access to medicines and vaccines is becoming almost a standing point on the WHA agenda. This year several side events on the role of monopolies as a barrier to access and on the WHO’s roadmap for access to medicines will accompany the discussions.
These discussions are of course highly relevant for the field of antibiotic resistance where lack of access to antibiotics still causes more deaths per year than resistance. Approximately half of the 900,000 children under 5 that die from pneumonia every year could be saved by providing access to correct antibiotics. In addition, immunization is an important factor in preventing infections which will lead to decreasing the use of antibiotics. Universal coverage by a pneumococcal conjugate vaccine (PCV) could potentially avert 11.4 million days of antibiotic use per year in children younger than five, roughly a 47% reduction in the amount of antibiotics used for pneumonia cases caused by S. pneumoniae. However, global coverage of PCV is estimated to be 42% with many middle-income countries claiming they are not able to afford the introduction and scale up due to the high price charged for the vaccines.
Increasingly the unsustainable production and supply of old antibiotics is also recognised as a serious global problem that further limits the treatment options for common bacterial infections and is adding to the worldwide crisis of antimicrobial resistance.
New report on global shortage and access to medicines and vaccines
The WHA will be presented with a report outlining a list of priority options for actions on addressing the global shortage of, and access to, medicines and vaccines. It partly builds on the recommendations from the UN high-level panel on Access to medicines report from 2016, and specify the progress and continued need for action on all those recommendations. The WHA will be asked to take a decision whether to request the development of a roadmap on WHO’s work on access to medicines and vaccines in 2019-2023. The process to develop such a roadmap should avoid working in silos from other ongoing initiatives on access, stewardship and Innovation, in particular the WHO’s Global Framework for Development and Stewardship to combat antimicrobial resistance.
Public health, innovation and intellectual property
In 2008, the WHA adopted a global strategy and plan of action on public health, innovation and intellectual property (GSPA-PHI), to foster innovation and improve access for people in developing countries. Today, 10 years later we are still facing the same challenges. Namely, in aligning the policies on innovation and intellectual property to ensure affordable and equitable access to medicines, vaccines and diagnostics.
The WHA will be presented with an overall programme review of the GSPA-PHI done by an external expert panel. Actions recommended by the expert panel on the way forward are set out in the report. The report suggests to request WHO to develop an updated implementation plan, and to incorporate the suggested actions by the expert panel.
The full report of the programme review mentions that antimicrobial resistance was not at all addressed in the GSPA-PHI and identified the need for more emphasis on it. However, in the recommendations by the expert panel, antimicrobial resistance is not at all referred to. Thus there is a risk that an updated strategy and implementation plan will not sufficiently address AMR.
Side events on AMR and access to medicines
A number of official side events and other technical briefings and civil society meetings will take place before and during the WHA. Antibiotic resistance and access to medicines will be featured in at least ten events and ReAct will speak at three of these.
Highlights from the side event programmes:
Mirfin Mpundu from ReAct will speak at the civil society meeting Antimicrobial Resistance (AMR): Are We Off Track? Organizers: World Alliance Against Antibiotic Resistance (WAAAR).
When and where? Saturday 19 May, 14:00-17:00 hrs. Ecumenical Centre.
Global Challenges in Antimicrobial Resistance. Organizer: Global Antibiotic Research and Development Partnership (GARDP)
When and where? Tuesday 22 May, 15:30-17:00 hrs. Graduate Institute, Maison de la Paix.
Diagnostics and the Fight Against Superbugs. Organizers: MedTech Europe, Global Diagnostics Alliance, Global Medical Technology Alliance, and AdVaMedDX.
When and where? Tuesday 22 May, 17:30-19:30 hrs. Maison de la Paix.
Medicines We Can Trust: A Call to Safeguard Quality. Organizers: USP, Access to Medicine Foundation, Asia Pacific Leaders Malaria Alliance, Brazzaville Foundation, Concept Foundation, Mexican Federal Commission for Protection from Sanitary Risks (COFEPRIS), Ecumenical Pharmaceutical Network, Harvard Global Health Institute, Infectious Diseases Data Observatory, Mahidol Oxford Tropical Medicine Research Unit, PATH.
When and where? Wednesday 23 May, 8:00-10:00 hrs. Restaurant Vieux-Bois.
Thomas Tängdén from ReAct will speak at the International Global Health & Antimicrobial Resistance Workshop 2018: Establishing antibiotic efficacy as a global public good. Organizer: World Federation of Public Health Association (WFPHA).
When and where? Wednesday 23 May, 9:00-18:00 hrs. Institute of Global Health, Campus Biotech.
Panel discussion on: WHO’s Roadmap on Access to Medicines and Vaccines. Organizers: Knowledge Ecology International and Stichting Health Action International (HAI).
When and where? Wednesday 23 May, 12:30-14:30 hrs, Musée international de la Croix Rouge Espace Henry Dunant, Avenue de la Paix 17.
Seizing the opportunity: catalyzing quality UHC and tackling AMR through water, sanitation and hygiene and infection prevention and control. Organizers: WHO, WaterAid, IntraHealth and the Frontline Health Worker Coalition.
When and where? Thursday 24 May, 7:30-9:00 hrs, Restaurant Vieux-Bois.
Addressing Antimicrobial Resistance: A Threat to Global Health and the Achievement of Universal Health Coverage. Organizers: delegations of Republic of Korea, Sweden, Canada, Chile, Fiji, Italy, the Netherlands, Philippines and Vietnam.
When and where? Thursday 24 May, 18:00-19:30 hrs. Palais des Nations, Room VII.
The path to Universal Health coverage: Access to Affordable Treatments. Organizer: Medicines Patent Pool.
When and where? Thursday 24 May, 18:00-19:30 hrs. Red cross Humanitarium, Henry Dunant Room.
Incentivizing Investments in Access to Quality Medicines. Organizer: United States Pharmacopeial Convention (USP)
When and where? Friday 25 May, 9:00-11:00 hrs. Intercontinental Hotel, Paris Room.
Access to Medicines: Overcoming Obstacles created by monopolies – Essential to UHC and the 2030 Agenda. Organizers: Morocco, India and Senegal, Brazil and Thailand.
When and where? Friday 25 May, 12:30-14:00 hrs. Palais des Nations, Room VIII.