WHO Executive Board to tackle key global health issues

The Executive Board of the World Health Organization (WHO) opened its twice-yearly session on Monday with a speech from the new Director-General, Dr Margaret Chan, highlighting recent public health successes and setting out some of the threats to global health. The 34-member Board will discuss a range of issues including measles, malaria, polio, the prevention and control of chronic diseases, avian and pandemic influenza, and implementation of the International Health Regulations.

In her opening speech, Dr Chan told the Board members, "We begin our discussions in what I believe are optimistic times for health." She outlined what she called the "spectacular success story" of measles. WHO announced last week that global deaths from measles have been reduced by 60 per cent since 2000, exceeding the already ambitious target of a 50% cut.

Dr Chan set out the wider health gains linked to measles immunisation. "The news gets even better. Increasingly, this initiative is delivering a bundle of life-saving and health-promoting interventions: bed nets for malaria, vitamin A to boost the immune system, de-worming tablets that help keep children in school, polio vaccine, and tetanus vaccine for pregnant women."

"I view this initiative as a model of what can be achieved through integrated service delivery," she said. "This is a value-added approach that amplifies the power of public health."

Dr Chan then returned to one of her key themes: the work of the World Health Organization should be judged by the impact it has on the health of women and of people in Africa. "Much of what we are already doing has an impact on women and the African people. This is not surprising. The threats to these two groups are numerous. Many of these threats are receiving high-level attention as we strive to meet the Millennium Development Goals, to which I am fully committed."

Dr Chan addressed another potentially huge gain for children around the world: the eradication of polio. She reported the conclusion of the advisory committee on polio eradication that "it is technically feasible to interrupt polio transmission worldwide." However, she said the world now faces a key question: "Are we now in a position to overcome the operational and financial obstacles? I believe we need to assess the country-level operations very carefully to ensure that we can indeed interrupt transmission globally."

She told the Board that she will convene an "urgent high-level consultation" from 27 to 28 February: "The expected outcome is a set of milestones that must be met if transmission is to be interrupted in the four remaining endemic countries. The consultation will also consider the funding required to meet these milestones."

Dr Chan also re-emphasized her focus on evidence. "As I have said, what gets measured gets done ... If we want to set out a compelling health agenda, we must look not only at the needs we are addressing, but also at the results of our efforts. We must keep track to stay on track."

She went on to address avian influenza and the threat of an influenza pandemic. "The message is straightforward: we must not let down our guard," she said. "The whole world has lived under the imminent threat of an influenza pandemic for more than three years. These years of experience have taught us just how tenacious this H5N1 virus is in birds."

The Board also heard a report from Dr Anders Nordström, acting WHO Director-General until January 3, on the work of the Organization since May. Dr Nordström told the Board that since the death in May of the previous Director-General, Dr LEE Jong-wook, WHO has been "continually focusing on improving the health of people across the world."

Dr Nordström outlined key areas in which progress has been made since May, including collaboration with other UN agencies and with the World Bank, direct engagement in the G8 summit in July, engaging in and providing leadership in health partnerships, advancing work on chronic, non-communicable diseases and on communicable diseases, including the neglected tropical diseases. Dr Nordström also outlined important developments in the areas of health systems development and the management of WHO. A report to the Executive Board on implementation of the global strategy for the prevention and control of chronic diseases concludes that much has been done but more progress is still needed. The global epidemic of chronic diseases continues. Last year, 35 million people died as a result of chronic diseases, equivalent to 60% of all deaths globally. These deaths are projected to increase by a further 17% over the next decade.

Other issues on the Board's agenda include: tuberculosis; gender, women and health; oral health; health systems; and the rational use of medicines, including better medicines for children. 10.5 million children under the age of five years die every year. Most of these deaths are from treatable conditions. Treatments exist, but some are not available in dosages that are suitable for children; of those that do exist in appropriate dosages, many are not available in low- and middle-income countries.

Also on the agenda at next week's Board meeting are: health promotion; progress reports on public health, innovation and intellectual property; cancer prevention and control; public health problems caused by the harmful use of alcohol and the Commission on Social Determinants of Health.

The Executive Board is comprised of representatives from 34 WHO Member States. The individuals are designated by Member States elected to do so by the World Health Assembly. The main functions of the Executive Board are to give effect to the decisions and policies of the Assembly, to advise it and generally facilitate its work. This session of the Board is scheduled to last from 22-30 January.