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Follow-up on selected resolutions/decisions of the last three years: international migration of health personnel: a challenge for health systems in developing countries
( 2008-06-28 )
International migration of the health workforce is a challenge for countries as it impedes the momentum of strengthening health systems. In response to Regional Committee Resolution SEA/RC60/R9 and to sustain the health workforce in a health system, the Regional Office is developing tools to assess and explore the trend or pattern of migration and categories of health workforce that migrate from and to the South-East Asia (SEA) Region. It is also developing a database for health workforce in the SEA Region that will include the yearly output of health workforce, as well as the proportion that migrates and its categories. The database will contribute towards crafting of policies and strategies for health workforce retention and setting up forums for discussion and exploration to develop a regional code of practice for the ethical recruitment of health workers that will enable government-to-government exchange of the health workforce without incapacitating the health system in the country of origin and collaboration with Global Alliance for Health Workforce, World Trade Organization, Asia Pacific Action Alliance for HRH, International Organization for Migration, Organization for Economic Cooperation and Development for technical and policy dialogue. The views and recommendations of the Meeting of Advisory Committee (ACM) on this agenda item will be submitted to the Sixty-first Session of the Regional Committee for its consideration.
Public health approach to combating HIV/AIDS
( 2008-06-25 )
The HIV epidemic continues to take its toll in the SEA Region. Yet countries have demonstrated that implementing an effective response is feasible, both to halt and reverse epidemics and to provide services to those in need. To date, efforts to scale up HIV/AIDS programmes have involved a variety of different service delivery models, guidelines and tools for multiple HIV/AIDS interventions. Countries seeking to scale up HIV/AIDS health services to achieve universal access will benefit by adopting a service delivery model that brings together the best of these approaches and helps to compensate for the significant health systems challenges that many of them face. Accordingly, WHO promotes a public health approach to the delivery of health services for HIV/AIDS, drawing upon the successful experiences of other health programmes. A public health approach is one that is directed to address the health needs of a population, or the collective health status of the people, rather than just individuals. This paper discusses the four steps of the approach: • Define the problem and the risk factors; • Find out what works to control the disease; • Scale up effective interventions in a wide range of settings; and • Monitor/evaluate the impact and cost-effectiveness of these interventions. The key lessons for a public health approach to HIV include: • The health sector’s role is central in the overall national response to the epidemic; • A scaled-up integrated package of prevention, treatment, care and support services is necessary to halt and reverse the epidemic and mitigate its impact; • Implementing a scaled-up response to the HIV epidemic requires effective programme management, trained human resources and robust health systems. The points for discussion on how the public health approach to HIV can be strengthened further are proposed in this paper. The views and recommendations of the Meeting of the Advisory Committee (ACM) on this agenda item will be submitted to the Sixty-first Session of the Regional Committee for its consideration.
Follow-up on selected resolutions/decisions of the last three years: challenges in polio eradication
( 2008-06-05 )
Despite major challenges, the polio eradication efforts in India successfully eliminated subtype-P1 polio cases from western Uttar Pradesh (UP) and also recorded the lowest number of P1 cases due to sustained efforts with the use of mop-ups in successive rounds of supplemental immunization in the two endemic states, i.e Bihar and UP. However, this strategy also led to lowering of population immunity in UP and Bihar against the type 3 polio virus that had led to a P3 outbreak in 2007. Fortunately, with the use of monovalent type 3 vaccine (mOPV3) in the last few months of 2007 and in early 2008, the outbreak seems to have been brought under control. Intensified efforts are under way to achieve the goal of sequential elimination of subtype P1 poliovirus in 2008, and P3 in 2009. However, appropriate rounds with sufficient size for mop-ups are essential to keep the pressure on the virus in India, particularly in UP and Bihar. In all countries, efforts to sustain high-level acute flaccid paralysis (AFP) surveillance are crucial to ensure timely detection of any case of polio and for appropriate response when a case, either indigenous or imported, is detected. Also, to sustain the gains of polio eradication, it is critical that countries achieve and sustain high routine coverage for all antigens, particularly against poliomyelitis. The views and recommendations of the Meeting of the Advisory Committee (ACM) on this agenda item will be submitted to the Sixty-first Session of the Regional Committee for its consideration.
Climate change and health
( 2008-06-18 )
The warming of the planet will be gradual but the frequency and severity of extreme weather events, such as intense storms, heat waves, droughts and floods could be abrupt - the consequences for health will be dramatic. Populations of Member countries in the South-East Asia (SEA)Region are disproportionately more vulnerable to the impacts of climate change. The Sixty-first World Health Assembly adopted a resolution requesting WHO and Member States to take urgent action on climate change. The SEA Region has developed a regional action plan to protect human health from the effects of climate change. The goal of the regional action plan is to build capacity and strengthen health systems. Mitigating the effects of climate change can have direct and immediate health benefits. Adaptation is needed: failure to respond will be costly in terms of disease, health-care expenditure and lost productivity. The views and recommendations of the ACM on this agenda item will be submitted to the Twenty-sixth Meeting of Ministers of Health for its consideration.
Follow-up on selected resolutions/decisions of the last three years: South-East Asia regional health emergency fund
( 2008-06-09 )
The South-East Asia Regional Health Emergency Fund (SEARHEF) has been established to provide immediate financial assistance to Member countries for meeting their health requirements following an emergency. As a first step, a contribution of US$ 100 000 was received for the Fund from the Royal Thai Government in October 2007. Additionally, US$ 1 000 000 (one million US dollars) were approved and allocated in January 2008 under the Regular Budget for the 2008-2009biennium. Efforts are on to mobilize resources through voluntary contributions from partner agencies to enhance the corpus of the Fund. For oversight and governance of SEARHEF, a Working Group represented by each of the Member countries of the WHO South-East Asia Region has been established, the first meeting is of the group scheduled to be held on 5 July 2008. With SEARHEF in operation, WHO successfully met the immediate financial needs of populations affected by the Cyclone Nargis in Myanmar (May 2008) and floods in Sri Lanka (June 2008). The views and recommendations of the Meeting of the Advisory Committee (ACM) on this agenda item will be submitted to the Sixty-first Session of the Regional Committee for its consideration.
Governing bodies: review of the decisions and resolutions of the sixty-first World Health Assembly and the 122nd and 123rd sessions of the Executive Board.
( 2008-06-19 )
The attached working paper highlights the most significant and relevant decisions and resolutions emanating from the Sixty-first World Health Assembly (held from 19-24 May 2008) as well as the 122nd and 123rd Sessions of the Executive Board (held from 21-26 January 2008 and on 26-27 May 2008 respectively). These decisions and resolutions are particularly relevant to the Member States of the WHO South-East Asia (SEA) Region, have obvious and immediate implications for them, and would merit follow-up action by both Member countries as well as WHO at the Regional Office and Country Office levels. During the Sixty-first World Health Assembly, Member countries of the SEA Region made consolidated statements on behalf of the Region on seven agenda items, which they themselves identified after considerable discussion among themselves. This was the first time that such an exercise had been undertaken. The background of the selected decisions/ resolutions, highlights from the main operative paragraphs of these selected decisions/ resolutions, as well as the regional implications of each decision and/or resolution, as applicable, and actions proposed for Member States and WHO have been presented. The working paper is submitted for consideration by the Meeting of the Advisory Committee (ACM) to review technical matters to be discussed at Sixty-first Session of the Regional Committee in 2008, with particular reference to the regional implications and actions proposed to be taken towards implementation of the recommendations contained in the selected decisions/ resolutions. The ACM may wish to consider the decisions/ resolutions as relevant (details of these decisions/ resolutions are provided in the Annex to this paper). The views and recommendations of the ACM will be submitted to the Sixty-first Session of the Regional Committee in New Delhi for review and noting, as appropriate.
Millennium development goals
( 2008-06-16 )
The Fifty-fifth World Health Assembly in 2002 reaffirmed its commitment to the UN Millennium Declaration and the related Millennium Development Goals (MDGs)through Resolution WHA 55.19. In 2002, the Fifty-fifth Session of WHO Regional Committee for South-East Asia discussed the MDGs and the commitment of the Member countries to these development goals. The Twenty-second Meeting of Ministers of Health of countries of the South-East Asia Region in September 2004 reviewed the progress made towards achieving MDGs in the Region and recommended that Member States should identify specific challenges and develop appropriate intervention programmes, with the support of all partners in health, that focus on the health needs of the underprivileged and poorest segments of the population. A High-Level Forum on the MDGs in Asia and the Pacific met in Tokyo in June 2005 and reviewed the progress made and challenges faced by countries in Asia and the Pacific and highlighted actions that can be initiated at the country level. The Fiftyeighth World Health Assembly in May 2005 requested Member States to reaffirm the MDGs as critical for health development, and to develop nationally relevant “roadmaps” that incorporate the actions as a guide to accelerating progress towards achieving health-related MDGs. The work of WHO on MDGs has not only formed an integral part of its activities but has also contributed to the collective efforts of the UN. Ten out of the 11 SEA Region Member countries have submitted at least one country report on the progress in achieving MDGs to the UN Secretary-General. The Inter-Agency and Expert Group on MDGs revised the monitoring framework of MDGs and some of their targets and indicators in November 2007 to facilitate better monitoring of progress in achieving MDGs (Annexure 1). Agenda Item 11.2 of the WHA 61 was on monitoring of the achievements of the health-related Millennium Development Goals. Observing the slow progress in achieving health-related MDGs, the resolution on “monitoring of the achievements of the health-related Millennium Goals” was passed (Annexure 2). The views and recommendations of the ACM on this agenda item will be submitted to the Twenty-sixth Meeting of Ministers of Health for its consideration.
Tobacco control: progress and plans for implementing the framework convention on tobacco control (FCTC)
( 2008-06-09 )
The tobacco epidemic is one of the major global public health problems today, which is being fuelled by a variety of complex factors. The tobacco epidemic killed 100 million people worldwide in the twentieth century and it could kill one billion people during this century if effective control measures are not taken. Out of 5.4 million global deaths from tobacco every year, 1.2 million occur in the Region. However, it is the single most preventable cause of death in the world today. Tobacco use is fast increasing in developing countries due to weak tobacco control measures.Member countries of WHO’s South-East Asia Region are not only major tobacco producers; also a majority of males in these countries are users of some form of tobacco. In order to respond to this epidemic, Member States had developed, negotiated and adopted unanimously the WHO Framework Convention on Tobacco Control (FCTC) at the Fifty-sixth World Health Assembly in May 2003 (WHA56.1). At present 168 Member countries are signatory to the Convention and 154 are party to it. Ten out of eleven Member countries of the SEA Region are parties to the Convention. In order to implement the WHO FCTC effectively, five Member countries in the Region have comprehensive tobacco control legislation, while others are in the process of formulating the same. This brief paper focuses on the progress of implementation of the concrete measures for tobacco control in the Region based on the provisions of the Convention. The views and recommendations of the Meeting of the Advisory Committee (ACM) on this agenda item will be submitted to the Sixty-first Session of the Regional Committee for its consideration.
Responding to emerging and re-emerging vector-borne diseases
( 2008-06-25 )
The paper outlines the growing burden of emerging and re-emerging vector-borne diseases in the South East Asia Region. To prevent the emergence of new vector-borne diseases and re-emergence of those already under control, it is essential to strengthen national vector control programmes. Regional guidelines and activities are in place to bring together to combat vector control against malaria, lymphatic filariasis, leishmaniasis, dengue, Japanese encephalitis and chikungunya etc. Most Member countries of the SEA Region have in place appropriate surveillance system for the vector borne diseases which includes monitoring of drug resistance in the case of malaria and kala-azar. The WHO regional integrated vector control strategy has been developed. Global climate changes, emerging drug resistance and development of pediatric dengue vaccine etc. are the main challenges of the future. The WHO is playing a pivotal role in capacity building, advocacy, partnerships and operational research. The views and recommendations of the Meeting of the Advisory Committee (ACM) on this agenda item will be submitted to the Sixty-first Session of the Regional Committee for its consideration.
Regional Initiative on Environment and Health
( 2008-06-04 )
WHO’s global Strategy for Health and Environment was formulated in 1993 as a response to the mandate given by the Global Commission for Sustainable Development for WHO to be the task master for coordinating the implementation of Chapter 6 of Agenda 21, on human health. A regional strategy followed soon after and countries in the South-East Asia (SEA) Region embarked on preparing their National Health and Environment Action Plans (NEHAPs) to delineate national-level operational actions. Since then, nine countries have prepared their NEHAPs and carried these through various stages of implementation. With partnerships for health development becoming ever important, it is timely that Member countries in the Region review the progress in implementing their NEHAPs and chart new ground by including newly formulated global developmental and environmental compacts such as the Millennium Development Goals (MDGs), and various other framework conventions that reflect new partnerships in environmental management and coordination. New opportunities for collaboration between and among regions of WHO and with other UN partners are also opening up, as exemplified by the Regional Ministers’ Environment and Health Initiative unveiled in Bangkok last year. These need to be expanded and pursued vigorously in order to address the impending health challenges from climate change and to achieve the MDGs. The WHO collaborative programmes reflect the continuity of this mandate and would need the concerted support of Member countries to reach the achievable targets. The views and recommendations of the Meeting of the Advisory Committee (ACM) on this agenda item will be submitted to the Sixty-first Session of the Regional Committee for its consideration.