Report of the World Health Assembly, May 2020

WONCA-WHO Liaison  person, Dr Viviana Martinez-Bianchi reports on the recent World Health Assembly

The 73rd World Health Assembly (WHA73) was held virtually due to the COVID-19 pandemic on May 18 and 19, 2020, with a reduced agenda dedicated only to the Pandemic response.

During WHA73, delegates adopted a landmark resolution intending to bring the world together to fight the COVID 19 pandemic. They endorsed a call for the intensification of efforts to control the pandemic, and for equitable access to, and fair distribution of all products and essential health technologies to combat the virus. It also calls for an independent and comprehensive evaluation of the global response, including WHO’s performance.

WHO Director-General Dr Tedros Adhanom Ghebreyesus. Addressed the 73rd World Health Assembly on May 18th 2020. More here.

In his address, Dr Tedros highlighted the activities in which WHO has been involved to support countries during the pandemic and expressed grief for the lives lost. He exalted nations to come together to confront the ”defining health crisis of our time.” And alluded to difficult political relations, “The pandemic has brought out the best – and worst – of humanity: fortitude and fear; solidarity and suspicion; rapport and recrimination. This contagion exposes the fault lines, inequalities, injustices and contradictions of our modern world. It has highlighted our strengths, and our vulnerabilities. Science has been hailed and scorned. Nations have come together as never before, and geopolitical divisions have been thrown into sharp relief. We have seen what is possible with cooperation, and what we risk without it”.

Dr. Tedros highlighted inequities. “Even before COVID-19, the world was off track for achieving the Sustainable Development Goals. The pandemic threatens to set us back even further. It exploits and exacerbates existing gaps in gender equality, poverty, hunger and more”. “COVID-19 is not just a global health emergency; it is a vivid demonstration of the fact that there is no health security without resilient health systems, or without addressing the social, economic, commercial and environmental determinants of health. More than ever, the pandemic illustrates why investing in health must be at the centre of development.

We’re learning the hard way that health is not a luxury; it’s a necessity. It is a necessity. Health is not a reward for development; it is a prerequisite. Health is not a cost; it’s an investment. Health is a pathway to security, prosperity and peace...”

Non State actors like WONCA were invited to attend the virtual assembly and to submit statements related to the agenda of the WHA to the website of the World Health Assembly.

WONCA submitted the following statement:

WONCA represents 550,000 family doctors in 150 countries working at the frontline of primary health care (PHC). “First in, Last out” Family Doctors have a strong and continuous role in the fight against novel coronavirus.

Family doctors are often the first contacts of patients in the fight against outbreaks and manage people’s chronic conditions, mental health and preventive measures with attention to the whole family and the community. A key problem is that many countries put all the emphasis on hospital-centered models, often relegating PHC to the margins, when PHC should have been at the forefront of a pandemic response.

WONCA recommends
1. Appropriate funding for PHC, and an increase in the numbers of family doctors and other members of the healthcare team trained so that every country is prepared to manage the pandemic.
2. Ensure access to care, drugs & diagnostics availability for COVID-19 and non COVID-19 care
3. Family doctors and other PHC professionals are central to health emergency risk management, preparedness and communication locally & nationally. To ensure their protection, PPE must be provided to all.
4. Rural migrants, inner city dwellers, people living in multigenerational family unities, refugees and other vulnerable populations are often worst affected during a crisis; adequate consideration should be given to their socioeconomic & health needs.
5. More widespread testing to better understand the true prevalence of disease in the community
6. Breaking silos and providing innovation in data and technology with data integration, allowing much improved health information exchange between hospitals, PHC, labs, practices, and health departments.
7. PHC needs to be included in Humanitarian Aid and Global Health planning and budgeting. Without PHC the outcomes of this and future pandemics and disasters will be worse.

Success will come from investing in the frontline with well-resourced PHC teams working at the community level. 

I listened to country representatives speak about the characteristics of their COVID response and their requests of WHO. My biggest concern is that PHC is clearly not in the agenda of most countries with the importance it should have for an appropriate emergency response and recovery plan. It will take much work to strengthen the understanding of the importance of a well resourced primary health care. I urge our Family Doctor Organizations around the world to engage with regional WHO representatives and consult and how best to organize the pandemic response at the community level.

On May 26, 2020 the World health Organization published a “Manifesto for a healthy recovery from COVID-19” proposing that societies need to recover to a new normal, that protects the earth and nature, a #healthyrecovery

The Manifesto prescribes:
1. Protect and preserve the source of human health: Nature.
2. Invest in essential services, from water and sanitation to clean energy in healthcare facilities.
3. Ensure a quick healthy energy transition.
4. Promote healthy, sustainable food systems.
5. Build healthy, liveable cities.
6. Stop using taxpayers money to fund pollution.

A letter by 350 health organizations representing over 40 million health professionals, including WONCA written to the G20 leaders called for a #HealthyRecovery from COVID19 in a way that protects the environment – and thereby the health of the populations that they serve.

On May 27, the UHC2030 International Health partnership published a discussion paper, “Living with COVID-19: Time to get our act together on health emergencies and UHC”.

The paper highlights the need to strengthen basic public health capacity, the protection of essential health services alongside the pandemic response, ensuring equity in access to care with removal of financial barriers, the creation of strong health systems based on primary health care as the foundation of an effective response; and the critical importance of Health and care workers.