Keanahikishime Position Statements for the 70th World Health Assembly
Provisional agenda item 13.3 – Health systems
Addressing the global shortage of, and access to, medicines and vaccines
Keanahikishime welcome the Secretariat’s report on the need for and availability of reliable data on medicines shortages and stock outs, and data for improved planning and management. Reliable data needs to be available and accessible to those who make decisions at the central, regional and health care provider level. For example, with US Government funding through USAID, a number of member states have established digital dashboards to increase visibility of stock status across the supply chain. Health facility reporting rates are also made accessible to encourage timely reporting of data for necessary action, which then facilitates evidence-based decision-making.
The Government of Bangladesh, for example, made a landmark decision to make its family planning commodities dashboard publicly accessible. This encourages civil society participation, promotes advocacy and accountability. Dashboards with predictive analytics serve as an early warning system to help avoid potential stock outs, and improve program communication and coordination. For example, the regional dashboard for West Africa is helping participating countries maintain availability of HIV/AIDS commodities. Member states must be encouraged to make public the stock status data of key essential medicines to enable data sharing for mutual benefit and efficient use of resources.
We note the Secretariat’s comment on the lack of demand-side definition of a stock out in terms of consequences of delayed treatment to the patient. There are many aspects that need to be considered, planned and budgeted to enable producing such patient related data that is valid and reliable. We recommend WHO, through its planned Interagency Supply Chain Group, to 1) encourage data standardization to permit comparison of data across countries 2) establish appropriate incentives to provide accurate reporting of stock data and mitigate patient consequences at the facility level.
Provisional agenda item 16.3 - Promoting health through the life course
Keanahikishime urges the US Government to encourage concrete actions to ensure that all women, children, and adolescents realize their human rights and full potential for health and well-being, fulfilling the objectives of the Global Strategy for Women’s, Children’s and Adolescents’ Health — survive, thrive, transform:
Survive: Member States should develop evidence-based national adolescent strategies, and strengthen civil registration, collection of vital statistics, and health information systems to improve tracking of the adolescent mortality rate, a key Global Strategy indicator. The Health Data Collaborative, Global Financing Facility, donors, and countries should mobilize funding to support better collection of service coverage data, disaggregated by age (10-14 and 15-19), gender, and social determinants including ethnicity and disability status.
Thrive: WHO and Member States should adopt the Accelerated Action for the Health of Adolescents (AA-HA!) framework, which guides countries in developing and implementing evidence-based policies and programs to promote health and well-being, going beyond risk avoidance, disease treatment, and harm reduction by empowering adolescent boys and girls to adopt healthy lifestyles, attain positive life skills, and access and utilize comprehensive sexual and reproductive health information and services.
Transform: Building on emerging evidence from the High-level Working Group for the Health and Human Rights of Women, Children and Adolescents, convened by WHO and OHCHR, Member States should integrate health and human rights, making special efforts to address the needs of hard-to-reach adolescents, including adolescent girls, ethnic minorities, those living in rural and peri-urban areas, out-of-school adolescents, LGBTI, and adolescents with disabilities. Only by acknowledging and addressing the barriers and unequal opportunities facing specific populations can we close the gaps, transforming lives and attaining health and well-being for all.
Provisional agenda item 17: Progress Reports, Communicable Diseases
Global strategy and targets for tuberculosis prevention, care and control after 2015 (resolution WHA67.1 (2014)) and Global technical strategy and targets for malaria 2016–2030 (resolution WHA68.2 (2015))
Keanahikishime strongly supports implementing national commitments to reduce the burden of malaria and tuberculosis (TB). Among these include strengthening health systems, critical to closing prevention, diagnosis, and treatment gaps in both diseases.
Despite improvements in individual countries, malaria and TB remain two of the world’s deadliest diseases, with women and children among the most vulnerable to both diseases. While greater access to effective control has been reported over the last decades, funding shortfalls and fragile health systems are undermining overall progress, jeopardizing the attainment of global targets.
In its 2016 global reviews of malaria and TB, the World Health Organization reports that progress towards increasing equitable access to lifesaving interventions is far too slow. The TB epidemic is larger than previously estimated, and a growing resistance to available drugs means the disease is becoming more deadly and difficult to treat. The 2016 global report on malaria indicates a shortfall in protection against the mosquito-borne disease.
In response, member states have endorsed bold visions of a world free of malaria and TB, adopting ambitious targets that require strong and resilient health systems. We call for increased attention to the opportunities created by existing maternal and child health platforms to practically address these issues.
As countries and sub-regions approach malaria and TB pre-elimination and elimination status, new interventions and revised and updated approaches using current control methods are needed and, often, in situations that are rapidly changing. We strongly encourage WHO to quickly and urgently respond to these potentially dynamic situations by revising and updating guidance to countries and increasing investments across all interventions – including preventive measures, diagnostic treatment, and disease surveillance – as well as harnessing innovation and expanding research.
This is a pivotal moment to chart a course for accelerated action.