​ WONCA delegation at the 69th World Health Assembly

Photo: Garth Manning, Luisa Pettigrew, Michael Kidd and Amanda Howe at the Assembly

Every year the United Nations’ Palais des Nations in Geneva fills with 193 member states and almost 200 non-governmental organisations from across the world to participate in the World Health Assembly (WHA), the World Health Organization’s (WHO) decision-making body . WONCA was represented at the 69th World Health Assembly by Michael Kidd (WONCA President), Amanda Howe (WONCA President-Elect), Garth Manning (WONCA CEO) and Luisa Pettigrew (WONCA-WHO Liaison).

During the WHA this year new resolutions were adopted on a host of topics from the Sustainable Development Goals to Mycetoma. Margaret Chan, Director General, during her speech highlighted approval of the new programme for health emergencies. She welcomed the 2030 agenda for sustainable development and member states’ commitment to universal health coverage. The Zika outbreak featured frequently in discussions.

During the WHA, WONCA’s delegation held meetings with 12 WHO departments and other NGOs to discuss current and future joint activities in areas including international classifications systems, mental health, occupational health and radiation safety. WONCA submitted statements to the WHA on the following agenda items; Report of the Commission on Ending Childhood Obesity; Draft global plan of action on violence; Prevention and control of non-communicable diseases; Health in the 2030 Agenda for Sustainable Development- Health in the 2030 Agenda for Sustainable Development; Multisectoral action for a life course approach to healthy ageing- draft global strategy and plan of action on ageing and health; Promoting the health of migrants; and Health workforce and services. These statements alongside all other NGO statement can be found here.

Michael Kidd delivered in person the statement on the agenda item ‘Health in the 2030 Agenda for Sustainable Development’ (see below). WONCA contributed to a side-event on ‘Global and local: public health and primary care in action!’ in collaboration with The Network: Towards Unity for Health, International Alliance of Patients’ Organization, International Federation of Medical Students Associations, and World Federation of Public Health Associations.

WHA Resolutions and Family Medicine

Two important resolutions adopted by the 69th World Health Assembly should be highlighted for their potential contribution to the global development of Family Medicine. The first resolution adopted the ‘Global Strategy on Human Resources for Health: workforce 2030’ (Resolution 69.19). This global strategy sets out a vision to accelerate progress towards universal health coverage and the UN Sustainable Development Goals by ensuring equitable access to health workers within strengthened health systems. The principles of delivering equitable, holistic, person-centred care outlined in the strategy mirror those of primary care and family medicine. The strategy makes explicit and recurrent reference to the need to strengthen the primary care workforce. It states; “Appropriate planning and education strategies and incentives, adequate investment in the health-care workforce, including general practice and family medicine, are required to provide community-based, person-centred, continuous, equitable and integrated care”.

The second resolution of particular significance for primary care and family medicine worldwide adopted related to the WHO’s ‘Framework on integrated, people-centred health services’ (Resolution 69.24). The resolution urges member states and requests the WHO’s Director-General to pay special attention to strengthening primary health services as part of health system strengthening. The Framework reads; “Strong primary care services are essential for reaching the entire population and guaranteeing universal access to services. Building such services involves ensuring adequate funding, appropriate training, and connections to other services and sectors. This approach promotes coordination and continuous care over time for people with complex health problems, facilitating intersectoral action in health. It calls for interprofessional teams to ensure the provision of comprehensive services for all. It prioritizes community and family-oriented models of care as a mainstay of practice with a focus on disease prevention and health promotion.”

The Framework recommends policy options and interventions which will deliver:
• “primary care services with a family and community-based approach
• multidisciplinary primary care teams
• family medicine
• gatekeeping to access other specialized services
• greater proportion of health expenditure allocated to primary care”

WONCA has played a key role in WHO consultations, in providing evidence, and in working with the WHO to develop both the ‘Global Strategy on Human Resources for Health: workforce 2030’ and ‘Framework on integrated, people-centred health services’. The next stage will require countries to implement the recommendations made in these policy documents. This will require engagement and support by all stakeholders including WONCA. We encourage all WONCA members to bring these resolutions to the attention of policy makers in their countries and work with them to ensure their implementation.

New WHO web platform

Linked to the ‘Framework on integrated people-centred health services’, the IntegratedCare4People web platform was launched during the WHA. The website is hosted by the Andalusian School of Public Health and is led by a team which includes international leaders in primary care and family medicine. It aims to bring together knowledge, information and a global network of people and organisations working towards the goal of integrated people-centred health services for all. You are invited to join in building this global knowledge platform which is set up as a collaborative platform to be enriched by the sharing of knowledge and experience. You can contribute information and knowledge by publishing relevant Resources, sharing your Practices and participating in the various Communities emerging.

WONCA Statement to the 69th World Health Assembly on Sustainable Development, read by Professor Michael Kidd (WONCA President)

“Thank you Mr Chair. The World Organization of Family Doctors, WONCA, represents over 500,000 family doctors in over 150 countries and territories across the world. WONCA’s mission is to improve the quality of life of the people of the world through high standards of care in family medicine and general practice.
Primary care teams worldwide provide examples, from their daily practice, that illustrate their contribution across the Sustainable Development Goals. This includes helping to improve people’s life chances and reduce health inequities; advocating for healthy lifestyles and environments; and promoting health in communities. When integrated into a nation’s health system, family doctors are trained to care for all aspects of peoples’ health including health promotion, disease prevention, acute, chronic, rehabilitative and palliative care. Family doctors provide this care to people over the life-course, within the community they serve, and in collaboration with other health professionals.

National governments, and other stakeholders, need to be ambitious in measuring and monitoring progress towards strengthening primary health care to meet the SDGs. This monitoring includes the use of indicators that capture the principles of equity, community participation, prevention, use of appropriate technology, and inter-sectoral collaboration. Evidence is clear that this monitoring needs to measure the elements that make primary care services successful: first contact care, continuity, comprehensiveness, coordination, and care that is person-centred with family and community orientation.

Health financing indicators need to track government expenditure in primary care, and provide information on the economic accessibility of primary care services. Indicators on the make-up and distribution of the primary care workforce are crucial.

Primary health care integrates many of the SDGs. However in order to realise the full potential of the contribution of primary health care to sustainable development, and indeed universal health coverage, a strong interdisciplinary primary health care workforce, including family doctors, is needed in all countries. Thank you.”

Luisa Pettigrew