Geneva World Health Assembly Update – Part 5 (By Robert Doble)

The WHA is in the process of finishing up - things should get finalized by tomorrow so this will likely be last update unless anything else major comes up.

1. NCDs

Bryan attended the NCDs discussion on Saturday morning where the resolution was passed, draft final text is available at (http://apps.who.int/gb/ebwha/pdf_files/WHA64/A64_61P-en.pdf) - just needs to be approved in final plenary. Final resolution will get posted here: http://apps.who.int/gb/e/e_wha64.html#Resolutions.

It includes and endorses the text of the Moscow Declaration, which includes access references but the language on access to treatment could be much stronger. A useful document highlighting the edits from the closed working group on NCDs, where most of discussion on issue has taken place this week, is available at http://apps.who.int/gb/ebwha/pdf_files/WHA64/A64_21-en.pdf.

Apparently the discussion on Saturday morning was fairly lively and lengthy with around 50 country interventions and 16 NGO interventions. UAEM tried to submit an intervention but there was a process issue, which meant the Chair didn't allow it. Quite a few member state interventions mentioned access, particularly the statement given by Uruguay on behalf of the Union of South American Nations (UNASUR). So this is promising in terms of having some countries to potentially work with for High-Level Meeting on NCDs in Sept 2011 in NY.

2. Counterfeits

Member states then considered the report from WHO Working Group of Member States on Substandard/Spurious/Falsely-Labelled/Falsified/Counterfeit Medical Products, which was established by decision at WHA2010 and met 28th February - 2nd March 2011 (see http://apps.who.int/gb/ebwha/pdf_files/WHA64/A64_16-en.pdf).

The main outcome was that member states agreed for WG for carry-on its work through to 65th WHA.

 3. HIV/AIDS strategy 2011-15

This morning the WHA approved the HIV/AIDS strategy (see http://apps.who.int/gb/ebwha/pdf_files/WHA64/A64_15-en.pdf). I was unable to follow this item much but the major issues raised seem to have been over terminology used, the goals and indicators, the reporting burden on countries, and resources. 

On the Medicines Patent Pool which I'm sure many of you will be interested in, it includes a reference to the MPP as "a means to enhance availability and facilitate the development of new fixed-dose combinations and adapted formulations, such as pediatric formulations, through voluntary license agreements".

The Global Network of People Living with HIV/AIDS (GNP+) gave a statement where they commended the consultative process for development of the strategy and called for more support to engage PLHIV in policy decisions. They called for extra effort to remove barriers to accessing HIV prevention, treatment and care - including calling on WHO to review the recent evidence on providing ARVs to HIV negative persons as a means of reducing transmission and calling for greater efforts to reduce stigma and marginalization.

Full GNP+ statement is here: http://www.gnpplus.net/en/news-and-events/1713-gnp-addresses-the-world-health-assemby

And link to BBC story on trial results of role of ARVs in helping reduce transmission: http://www.bbc.co.uk/news/health-13381292

On Friday, MSF delivered an intervention on the item, see: http://www.msfaccess.org/main/hiv-aids/wha-64-msf-intervention-on-who-draft-hivaids-strategy-2011-2015/. And today they have released a statement highlighting the inconsistency between the EU's position in relation to UN High Level Summit next month and WHO strategy - in particular on the setting of a 2015 target for the number of people with HIV who are to be provided with antiretroviral treatment. Can't find it online yet so copied below:

*Statement by Médecins Sans Frontières – EU position on AIDS response for UN summit at odds with support for WHO strategy*

“Today at the World Health Assembly, European countries, along with all World Health Organisation Member States, endorsed the WHO strategy for HIV/AIDS for the next five years, which sets ambitious goals and strategies to guide the health sector’s response to HIV/AIDS.

This strategy will only be effective if it is matched by a political commitment from countries to deliver. One of the key indications of that commitment will be the outcomes of the UN High Level Meeting on HIV/AIDS in New York next month, where governments - including EU countries - will be committing to the blueprint for the next decade of the global AIDS response.

But the support given by European Union member states at WHO contrasts starkly with the position the EU bloc is adopting ahead of the UN summit, where it is seeking to remove any substance from a global target on the number of people living with HIV that will be provided with life-saving treatment.  UN Secretary General Ban Ki-Moon called for 13 million people in need of HIV treatment to be on life-saving antiretroviral therapy by 2015. However, Medecins Sans Frontieres has learned the EU has removed any reference to a target, instead proposing vague language to *"significantly increase the numbers of people living with HIV who are provided with access to HIV antiretroviral treatment”.*

While EU countries including France, Germany, and United Kingdom are major contributors to the fight against HIV/AIDS, these countries must set an ambitious target, supported by policies that ensure access to affordable medicines. An ambitious treatment target is important if a credible global response is to be mounted to break the back of the epidemic and realize long-term commitment to achieving WHO strategies.”

*Dr Tido von Schoen-Angerer, Director of Médecins Sans Frontières’ Campaign for Access to Essential Medicines.*

Hope these updates have been useful. The WHA is a strange old beast, both inspiring and frustrating at the same time - and it doesn't feel like definitively things have changed much as a result but incrementally I'm sure they have, I guess it is just how things get built on and how as UAEM we can take forward these challenges. I hope these updates have helped shed light on the processes involved in getting decisions on global health issues here anyway. I have enjoyed sharing events with you via these updates as has helped it feel like the UAEM delegation was bigger than it was.