“We might be tired of COVID-19, but it is not tired of us.” With those words punctuating his opening remarks, World Health Organization (WHO) Director-General Dr. Tedros Adhanom Ghebreyesus reminded World Health Assembly (WHA) participants that the ongoing pandemic continues to dominate both our lives and the agenda in multilateral fora. This year’s virtual assembly tried to continue to galvanize the global community around a coordinated response to the pandemic and reassert the importance of other key global health priorities.
While this virtual assembly did not provide the same opportunities as years past to engage with stakeholders, GHTC tracked the proceedings and worked with partners to weigh in on key agenda items. Here are our top takeaways from this year’s forum:
WHO and member states remain focused on pandemic response, health emergencies governance
With the ongoing pandemic continuing to dominate the attention of the world, global coordination to address COVID-19 was a clear priority for WHO during the assembly. Delegates debated the challenges and gaps in the ongoing response efforts, as well as preparedness and response mechanisms for future health emergencies. The assembly also approved a resolution to bolster WHO’s work and strengthen countries’ preparedness capacities; while the resolution primarily focuses on health system strengthening, the International Health Regulations, and governance, it does include a provision that calls on member states “to facilitate investment in strong national research agendas and adequate infrastructures for research and development in support of new measures to counteract the impact of health emergencies, including non-pharmaceutical interventions.”
The debate between member states over the resolution felt like a precursor for the more far-reaching reform proposals that may be in the offing next year, following the completion of multiple reviews over pandemic response that are now underway. Those reviews are looking at countries’ and WHO’s pandemic performance, WHO’s health emergencies program, and the International Health Regulations system itself.
There appeared to be a slowly emerging political consensus shaping up around initiatives being advanced by both Germany and France to significantly strengthen the hand of WHO in terms of its emergencies powers to obtain data from member states and take action. Unfortunately, the proposals currently don’t formally integrate research and development (R&D) into their frameworks.
WHO develops Immunization Agenda 2030
Member states expressed broad support during the assembly for the Immunization Agenda 2030, which outlines research and innovation as one of its seven strategic priorities, highlighting the need for “continued research into new and improved vaccines, technologies and vaccine manufacturing platforms, as well as innovations in immunization service delivery and program management.”
Germany noted that the current strategy does not factor in the impact of COVID-19 on current immunization priorities and programs and that an additional evaluation to integrate pandemic response efforts will be necessary to adequately reflect the shifting landscape.
WHO TB research and innovation strategy moves forward
This year, WHO unveiled their new Global Strategy for Tuberculosis Research and Innovation, drawing on consultation with scientists, national tuberculosis (TB) program managers, and other officials from within and beyond ministries of health, including ministries of science and technology, representatives of civil society and affected communities, research funding institutions, and other TB research and innovation stakeholders. A resolution on this new strategy was passed by member states via silence procedure in the summer and formally adopted during the assembly.
The strategy outlines four major areas for action: 1) creating an enabling environment for TB research and innovation; 2) increasing financial investments in TB research and innovation; 3) promoting and improving approaches to data sharing; and 4) promoting equitable access to the benefits of research and innovation.
“This global strategy will guide member states and other relevant stakeholders in translating political commitments on TB research and innovation into concrete action backed by investment, as an integral part of efforts to end TB,” said Dr. Tereza Kasaeva, director of WHO’s Global TB Program.
The WHO strategy also promotes the sharing of data arising from publicly funded research, with the ultimate goal of ensuring that the public benefits from public investments in science. The resolution also calls for WHO to provide technical and strategic assistance to member states, urges countries to strengthen efforts for TB research and innovation as a complement to broader cooperation to tackle antimicrobial resistance at all levels, and pushes for increased coordination across United Nations agencies and greater collaboration with the private sector.
While the strategy is a welcome development, further investment for TB research must follow from member states. Global leaders must close the US$1.3 billion funding gap for TB R&D annually if the 2030 targets are to be achieved.
WHA adopts new road map for neglected tropical diseases
While member states did not spend much time debating the topic, they did adopt a new road map on tackling neglected tropical diseases (NTDs) at the assembly. The NTD road map sets global targets and milestones to prevent, control, eliminate, and eradicate 20 NTD groups.
One of the key components of the road map is a shift away from single-disease vertical programs to integrated approaches, which promote improved coordination and collaboration. Another distinct feature is to drive greater ownership by national and local governments, including communities. The overarching 2030 global targets include a 90 percent reduction in the number of people requiring treatment for NTDs and a call to eradicate dracunculiasis—also known as Guinea-worm disease—and the chronic skin disease yaws, which affects mainly children under 15 years old.
Research and innovation will be a critical component to ensure that these targets are met, and several member states called for greater investment for new tools to combat these diseases.
Civil society engagement with WHO remains limited
Civil society engagement with WHO continues to be a challenging process, and after several disappointing meetings this year, this month’s assembly was no different. The often hectic and oblique communication, or lack thereof, on how civil society organizations (CSOs) could meaningfully participate in these meetings heading into the assembly was yet another sign that the trend line on productive collaboration between WHO and CSOs is heading in the wrong direction.
CSOs were also prohibited from delivering statements on certain agenda items, and like member states, they were forced to consolidate a number of agenda items into a single statement as WHO pulled together several topics into one session, creating a disjointed dialogue in which not all issues received adequate airtime.
Moving forward, WHO needs to provide new avenues for CSO input around these fora, whether through separate listening sessions, online consultations, or other mechanisms that allow civil society to bring its expertise to bear and provide technical feedback to various processes.
This year’s assembly felt largely more ceremonial than substantive at times, given the lack of debate on many agenda items and WHO speeding through the list of topics. The pandemic will continue to be a major focus in 2021 for WHO and member states, but other health areas that have been neglected through underinvestment on the WHA73 agenda must also re-emerge as key priorities.