“An effective health service needs to be able to prevent and manage infections” thus starts a very excellent draft WHO discussion paper: “Tackling AMR while making progress towards UHC”
By Garance F Upham
Vice-President, World Alliance Against Antibiotic Resistance (WAAAR)
Editor in Chief AMR CONTROL
Ex-Member Steering Committee, Patients for Patient Safety, WHO Patient Safety Program (2004-2014)
WHO Places Emphasis on IPC, AMR and UHC
This week and last, three news confirmed our hunch: the WHO is beefing up its commitment to infection prevention and control (IPC).
– Dr. Hanan Balkhy, was named Assistant Director-General (ADG) Antimicrobial Resistance, which places greater emphasis on AMR, as well as raising up on the agenda the urgency of IPC, since Dr Balkhy is a world renown cheffe in implementation of IPC, having lead the Saudi Arabia’s struggle against the MERS-CoV spread.
Previously, AMR had a low profile in the leadership group, since it fell under a very general heading of Strategic Initiative with the Italian ADG, Dr. Ranieri Guerra, now leading WHO’s preparations for the UN high-level meeting on Universal Health Coverage at the UN General Assembly in NYC this fall. Of note, Italy is today leading in an effort to bring drug pricing under control. Will Dr. Guerra follow his own government’s radical turn, or his own sentiment, whatever it may be?
If, as the Interagency Coordination Group-IACG reports tend to indicate as well as the general background rumors, AMR was to acquire dominance in global health to the point of demanding much greater visibility and funding, Hanan will have the awesome task of preventing a replay of what happened with HIV/AIDS: the creation of the GFATM, UNAIDS and UNITAID which all in all contributed to weakening of the WHO since 1996 and of the national ministries of health in their responsibility and funding to face deadly disease problems, even if the three, of course, did contribute to the necessary action. Perhaps the wisest comment came from Peter Sands (just as he was to assume his role as director of the Global Fund) when he said that to combat HIV, TB, Malaria, people should think of first dealing with the millions of cases of ordinary infectious diseases, because to do that would, indeed, affect our global capacities to roll back and treat the “HIV-TB-Malaria”.
In AMR, it seems to us important that WHO claims and retains global leadership, and be the funnel to funding.
The other news from the WHO reorganization pointing in the same direction are:
– Dr Mike Ryan was moved to become the Director the Health Emergency Department; as indicated in my previous blog article, his understanding of IPC as the only way to stop Ebola outbreaks, and his comments on WHO Director-General Dr Tedros having witnessed this in the Democratic Republic of Congo (DRC), indicates a commitment to IPC at the highest level of the WHO.
– Dr Alessandro Cassini (lead author of the report in The Lancet ID on the majority of AMR infections being acquired nosocomially, i.e. in health centers contaminations) is moving from the European Centers for Disease Control-ECDC to the WHO, this week, to beef up an IPC department which has had little staff and power over the past years.
Now, as I wrote earlier : “Dr Ryan could be the harbinger of a massive change in the WHO leadership on the need for IPC, which could come back to the forefront as a specialized department under the Emergency Health Department.
However, for that Member States would have to understand and fund that initiative.”
Or to put it otherwise: Member States could /should fund the WHO core, and the WHO stay on track to prioritize the 3 billion initiative. Dr Tedros and his team are said to hope for “emerging countries” to come forward.
“An effective health service needs to be able to prevent and manage infections” thus starts a very excellent draft WHO discussion paper: “Tackling AMR while making progress towards UHC”.
Sources and references
For the WHO listing of the new leadership:
For the new hot discussions on prices and access to medicines in general and cancer in particular:
Entitled: “Improving the transparency of markets for drugs, vaccines and other health-related technologies,” the resolution, to be discussed at the 72nd session of the WHA, asks national governments to demand greater price transparency as part of regulatory processes and also gives WHO a clear global mandate to track and compare drug prices nationally and worldwide.
The Italian lead initiative comes on the heels of the very hot discussions in and around the Executive Board meeting at WHO HQ this winter on the Cancer resolution (EB144/18 Cancer medicines,), and analysis of the high profitability of cancer drugs (14 USD profits for each dollar invested, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2720075)
See pre-EB preparatory discussions on: https://agenparl.eu/who-opens-discussions-on-roadmap-for-improving-access-to-medicines/