World Health Assembly Resolution Research Articles

A WHO remit to improve global standards for medical products of human origin.

In recent decades, considerable advances have been made in assuring the safety of blood transfusion and organ transplantation. However, with the increasing movement of medical products of human origin across international boundaries, there is a need to enhance global norms and governance. These products, which include blood, organs, tissues, cells, human milk and faecal microbiota, are today crucial for health care but they also pose unique risks due to their human origin, such as disease transmission and graft failure. Moreover, the demand for medical products of human origin often exceeds supply, leading to dependence on international supply chains, and emerging technologies like cell and gene therapy present further challenges because of their unproven efficacy and long-term risks. Current regulatory mechanisms, especially in low- and middle-income countries, are insufficient. The World Health Organization (WHO) has both the mandate and experience to lead the development of international quality and safety standards, consistent product nomenclature, and robust traceability and biovigilance systems. An international, multistakeholder approach is critical for addressing the complexities of how medical products of human origin are used globally and for ensuring their safety. This approach will require promoting uniform product descriptions, enhancing digital communication systems and leveraging existing resources to support countries in establishing regulations for these products. As illustrated by World Health Assembly resolution WHA77.4 on transplantation in 2024, WHO's ongoing efforts to ensure the safe, efficient and ethical use of medical products of human origin worldwide provide the opportunity to galvanize international cooperation on establishing norms.

WHO-listed authorities (WLA) framework: transparent evidence-based approach for promoting regulatory reliance towards increased access to quality-assured medical products.

Increased global access to safe, effective and quality-assured medical products remains a primary goal for the full realization of the World Health Assembly Resolution WHA 67.20 on regulatory systems strengthening for medical products as well as target 3.8 of the Sustainable Development Goals (SDG). To promote the development of efficient regulatory systems, the WHO introduced the Global Benchmarking Tool (GBT) in 2016, upon which the WHO-Listed Authority (WLA) framework was later established. This study aimed to appraise the development of the WLA framework across various phases while highlighting its achievements, challenges, and areas for improvement. An exploratory study design using a qualitative approach was used to gather information from relevant documents as well as views and experiences from purposefully selected participants from diverse backgrounds. Data was collected using a combination of desk reviews and In-depth one-to-one or small group interviews employing semi-structured interview guides with open-ended questions. Data was analysed using an inductive thematic analysis approach. The leading role of the WHO was noted in developing and implementing essential documents and mediating consultative processes among stakeholders. The framework was revealed to bring an evidence-based, inclusive, and transparent approach to recognizing regulatory authorities (RAs) operating at the highest standards of performance. The framework was anticipated to promote regulatory reliance among all RAs, the WHO's prequalification programme, and procurement agencies. Furthermore, remarkable progress towards WLA listing was noted among transitional WLAs including the Stringent Regulatory Authorities (SRAs). Challenges related to the availability of resources, resistance to change, and complexity were associated with the framework. The study provides a well-rounded view with regard to the roles of the WHO, Member States and other stakeholders in establishing and operationalizing the WLA framework. Furthermore, evaluating the performance and possible WLA designation of RAs operating at international regulatory standards underscores its high relevance in contributing to public health globally. Maintenance along with timely addressing of highlighted next steps to improve the framework particularly in creating better understanding, more communication, and coordination are highly encouraged.

World Health Assembly resolution: A global path forward in transplantation

World Health Assembly resolution: A global path forward in transplantation

The 77th World Health Assembly resolution calling for newborn screening, diagnosis, and management of birth defects: moving towards action in low-income and middle-income countries

The 77th World Health Assembly resolution calling for newborn screening, diagnosis, and management of birth defects: moving towards action in low-income and middle-income countries

A framework for identifying opportunities for multisectoral action for drowning prevention in health and sustainable development agendas: a multimethod approach

IntroductionThe 2023 World Health Assembly resolution 76.18 committed the World Health Organization to the coordination of drowning prevention efforts, including those of United Nations (UN) agencies. Here, we aim to...

World health assembly resolution for preventing micronutrient deficiencies and associated neural tube defects-A case study of global partnerships for a successful resolution adoption.

On May 29, 2023, the 76th World Health Assembly (WHA) unanimously adopted the resolution entitled, "Accelerating efforts for preventing micronutrient deficiencies and their consequences, including spina bifida and other neural tube defects, through safe and effective food fortification."The Society for Birth Defects Research and Prevention published their resolution in 2015 supporting mandatory fortification of staple foods with folic acid and recommendations aiming to achieve global total prevention of folate-sensitive spina bifida and anencephaly, setting a goal to achieve by the year 2024.The WHA resolution provides another global push for the cause, with recommendations to member nations for food fortification to be achieved by the year 2030. This short communication documents the steps, from inception up to the passage, of the 76th WHA resolution on food fortification, with a narrative on the nature of strategic advocacy efforts by multiple governmental and nongovernmental organizations. WHA resolutions can take many years to be introduced and passed by the assembly; however, this is a case study of the swiftness of the process enabled by powerful global partnership. The documentation of this process serves as an example for developing and processing future WHA resolutions aiming to improve global maternal and child health.

Developing a Dynamic Conceptual Model of a Home-Based Palliative Care Plan Using the Comprehensive Primary Health Care (PHC) Approach

Background: Palliative Care (PC) was a core component of Primary Health Care services during the World Health Assembly Resolution, 2014. The study aims to develop a Comprehensive Palliative Care Model (CPCM) for patients with life-threatening conditions compliant with the local context and unmet needs. Materials and Methods: A mixed-methods approach will be adopted for the three-phased study in two districts of Telangana. Phase I, a literature review, will be performed to explore globally available PC models, followed by an on-ground observational study. Phase II will address the gaps in existing models while identifying the unmet needs of the patients and caregivers. The outcome of the above phases will help develop a CPCM in Phase III. The developed model will be validated using the Delphi technique. Results: The expected outcomes of the study are a) Phase-I: Details of the PC models available globally and locally, b) Phase-II: Availability of essential resources in the Health and Wellness Centers (HWCs), Knowledge and Attitude of the PC team, Barriers to provide PC, Unmet needs, and c) Phase-III: CPCM model Conclusion: The study attempts to provide a holistic PC model, considering the health system, patients, and caregivers and offering policy suggestions to the state.

Building Research Capacity in Low- and Middle-Income Countries and Pandemic Preparedness: Lessons Learned and Future Directions.

Research capacity is a critical component of pandemic preparedness, as highlighted by the challenges faced during the Ebola outbreak in West Africa. Recent global initiatives, such as the Research & Development Task Force of the Global Health Security Agenda and the World Health Assembly's resolution on strengthening clinical trials, emphasize the need for robust research capabilities. This Perspective discusses the experiences of leaders in infectious disease research and capacity building in low- and middle-income countries, focusing on Colombia, Jamaica, and Pakistan. These case studies underscore the importance of collaborative efforts, interdisciplinary training, and global partnerships in pandemic response. The experiences highlight the necessity for rapid pathogen identification, capacity for genomic sequencing, and proactive engagement with policymakers. Challenges faced, including the shortage of trained staff and reliance on imported reagents, emphasize the ongoing need for building research capacity.

Redesigning Prehospital Care: Fiji's Response to the COVID-19 Pandemic.

The benefits of emergency care systems in low- and middle-income countries are well-described. Passed in the wake of the coronavirus disease 2019 (COVID-19) pandemic, the World Health Assembly (WHA) Resolution 76.2 emphasizes the importance of communication, transportation and referral mechanisms, and the linkages between communities, primary care, and hospital care. Literature describing prehospital care and ambulance system development is scarce, with little data on the effectiveness and cost effectiveness of different options. Prehospital care systems in Pacific Island countries are under-developed. In Fiji, out-of-hospital care is fragmented with an uncoordinated patchwork of ambulance providers. There is no scope of practice or training requirement for providers and no patient care records. There are no data relating to demand, access, and utilization of ambulance services.In response to a surge of COVID-19 cases in 2021, the Fiji government created a Prehospital Emergency Care Coordination Center (PHECCC) in the capital Suva, which was operational from July-October 2021. Access was via a toll-free number, whereby the public could receive a medical consultation followed by phone advice or dispatch of an ambulance for a home assessment, followed by transportation to hospital, if required. The PHECCC also provided coordination of inter-facility transport and retrieval of the critically ill.The system that was created met many of the prehospital care standards set by emergency care leaders in the region and created the first dataset relating to ambulance demand and utilization. This is the first article to document prehospital system development in the Pacific region.

Harnessing the law to advance equitable cancer care in South Africa: exploring the feasibility, desirability and added value of a dedicated national cancer act.

The 2017 World Health Assembly resolution on integrated cancer prevention and control provided clear guidance on creating an enabling environment for cancer care. Through a variety of mechanisms, including civil society advocacy, some countries have secured overarching legislation in the form of national cancer acts to promote equitable access and outcomes for cancer patients. In South Africa, cancer incidence is set to double by 2030; and, while existing legislative and policy frameworks do address cancer prevention and control, these are fragmented, poorly implemented and have had limited success. This study assessed the feasibility and potential impact of promulgating a dedicated national cancer act in South Africa through exploratory in-depth interviews with 25 purposively selected key informants from various stakeholder groups, including cancer survivors; legal scholars; human rights advocates; health care providers; public health specialists and academicians. Following thematic analysis, three key themes were identified: the content of a dedicated national cancer act, the socio-political leveragability of an act and accountability mechanisms that would support such an act. While most respondents had not considered the possibility of a dedicated national cancer act, they were open to the concept for South Africa. Concerns about widening inequities, duplication, funding and accountability would need to be addressed against the current backdrop of health inequities and limited human rights leveraging for health.

Trailing World Health Assembly Resolution 73.1: Pathway to Quick and Accurate Determination of the Source of Outbreak of COVID-19 in Wuhan, China.

For more than four years now, the objective of determining the source of the outbreak of COVID-19 in Wuhan, China and the route of transmission of the infection to the human population has not been achieved despite existing capacity in molecular epidemiology and World Health Assembly Resolution mandating that objective. This study seeks to ascertain the reasons for failure to achieve that objective and to propose feasible alternative strategies to attain that objective quickly and accurately. Exploratory research was adopted, applying the tools of input-output device, data extraction, management by objective, rational decision approach and the deductive model. Fitting the objective of determining the source of the outbreak of COVID-19 as expected output, the actions of key players in the pandemic response (fitted as processors) were evaluated for consistence or otherwise in transforming data/inputs to achieve the output/objective. The study found that the World Health Assembly (WHA) Resolution 73.1 (9 (6)) mandating the World Health Organization (WHO) to pursue the objective of determining the source of the outbreak of COVID-19 was not diligently and committedly implemented; that the WHO and China have deliberately evaded that objective; that previous and ongoing studies focusing on the circulation of SARS-CoV-2 in other countries and similar themes are diversionary and unnecessary workload that depart from the core objective; and that adopting a five-point alternative strategy will ensure the attainment of the core objective within 14 days, including: (i) re-phrasing of the WHA mandate for specificity; (ii) subjecting all possible pathways of transmission to scrutiny; (iii) adopting “confirmed” genetic sequences of SARS-CoV-2 for subsequent use in molecular epidemiology; (iv) establishing a ‘red circle’ of 2 km radius from the Huanan wet market for top-priority epidemiologic investigation; (v) review of Resolution WHA73.1(9 (6)) at upcoming WHA to expressly prescribe unfettered right of access to the international study team and sanction for non-compliance. The study concludes that determining the source of the outbreak of COVI-19 in Wuhan, China is an important objective that should be accomplished within 14 days considering existing capacity in molecular epidemiology, if avoidable impediments are removed.

Developing and sustaining high-quality care for children with cancer: the WHO Global Initiative for Childhood Cancer.

Cancer is a major public health concern, impacting nearly 20 million people each year, and it is responsible for 1 in 6 deaths worldwide. The burden of cancer is increasing rapidly, straining health systems that are unable to prevent and manage the disease. Childhood cancer constitutes a significant and relevant public health challenge; it was the ninth leading cause of childhood disease globally, according to findings by the Global Burden of Disease 2017 study. Almost 80% of all children diagnosed with cancer live in low- and middle-income countries where treatment is often unavailable or unaffordable. As a result, only about 15-45% of these children survive compared with more than 80% in high-income countries. This represents a great health inequity. Delivering on the mandate provided by World Health Assembly resolution 70.12, WHO together with St. Jude Children's Research Hospital and other global partners launched the Global Initiative for Childhood Cancer at the United Nations General Assembly during the third High-level Meeting on the prevention and control of noncommunicable diseases in September 2018. The Initiative aims to increase global survival for children with cancer to at least 60% by 2030, while reducing suffering for all children with cancer. Five years after launching the Initiative, more than 70 countries across the World Health Organization's 6 regions have advanced to different phases of action through implementation of the Initiative's CureAll framework for action. Many successful approaches to implementing the CureAll pillars and enablers have demonstrated that improving care for children with cancer in low- and middle-income countries is possible as long as there is strong political will, multisectoral commitments and strategic investment.

A world health assembly resolution on diagnostics: implications for the ESCMID community

A world health assembly resolution on diagnostics: implications for the ESCMID community

Advancing the World Health Assembly's landmark Resolution on Strengthening Rehabilitation in Health Systems: unlocking the Future of Rehabilitation.

In May 2023, the historic Resolution on Strengthening Rehabilitation in Health Systems was adopted unanimously by the 194 Member States of the World Health Assembly (WHA), the highest health policy-setting body. The resolution aims to scale up and integrate rehabilitation into health systems as part of Universal Health Coverage (UHC) to address the growing rehabilitation needs due to the global ageing population, the increasing prevalence of non-communicable diseases, and the emergence of new infectious diseases such as COVID-19. Globally, data extracted from the Global Burden of Disease Study in 2019 showed that one out of three people could benefit from rehabilitation, while more than half of the population in many countries is not receiving essential rehabilitation services. This special article highlights the global challenges in meeting rehabilitation needs and emphasizes the importance of affordable, accessible, and quality rehabilitation services for vulnerable populations. The resolution's path, which started in 2017 with the "Rehabilitation 2030: a Call for Action" initiative by the World Health Organization (WHO), is outlined. We summarize the key aspects of the WHA resolution, including its requests for Member States, international organizations, and the WHO Director-General. Finally, we discuss the way forward towards implementation, involving advocacy and concrete actions by all stakeholders, with the support of the newly established World Rehabilitation Alliance. The goal is to integrate rehabilitation into health systems worldwide, thus improving the well-being and socio-economic participation of those in need.

How and why snakebite became a global health priority: a policy analysis

BackgroundSnakebite was added to the WHO neglected tropical disease (NTD) list in 2017, followed by a World Health Assembly resolution in 2018, and an explicit global target being set to...

Characterizing Therapeutic Pluralism Policies in Latin America: A Qualitative Content Analysis.

Introduction: The 1978 Alma Ata Declaration initiated international recognition of non-biomedical healing systems and their relevance for primary health. World Health Assembly (WHA) resolutions have called for the study and inclusion of traditional and complementary medicine (T&CM) into national health systems through policy development. The increased public, political, and scholarly attention given to T&CM has focused on clinical efficacy, cost-effectiveness, mechanisms of action, consumer demand, and supply-side regulation. Although >50% of WHO member states have T&CM policies, scant research has focused on these policies and their public health implications. This paper defines a novel term "therapeutic pluralism," and it aims at characterizing related policies in Latin America. Methods: A qualitative content analysis of Latin American therapeutic pluralism policies was performed. Policies' characteristics and the reported social, political, and economic forces that have made possible their development were assessed. Pre-defined policy features were categorized on an MS-Excel; in-depth text analyses were conducted in NVivo. Analyses followed the steps described by Bengtsson: decontextualization, recontextualization, categorization, and compilation. Results: Seventy-four (74) policy documents from 16 of the 20 sovereign Latin American countries were included. Mechanisms for policy enactment included: Constitution, National Law, National Policy, National Healthcare Model, National Program Guideline, Specific Regulatory Norms, and Supporting Legislation, Policies, and Norms. We propose a four-category typology of policy approaches in Latin America: Health Services-centered, Model of Care-based, Participatory, and Indigenous People-focused. Common themes countries used when justifying developing these policies included: benefits to the health system, legal and political mandates, supply and demand, and culture and identity. Social forces these policies referenced as influencing their development included: pluralism, self-determination and autonomy, anticapitalism and decolonization, safeguarding cultural identity, bridging cultural barriers, and sustainability. Conclusion: Policy approaches to therapeutic pluralism in Latin America go beyond integrating non-biomedical interventions into health services; they offer perspectives for transforming health systems. Characterizing these approaches has implications for policy development, implementation, evaluation, international collaboration, the development of technical cooperation tools and frameworks, and research.

Lymphatic Filariasis Elimination in Kerala: A Success Story

National Filaria Control Programme has been running in the country since the year 1955 with the strategy of parasite detection, treatment and vector control mainly in urban areas. In the year 1997, the fiftieth World Health Assembly Resolution listed Lymphatic Filariasis (LF) for elimination by 2020 which now has been aligned with Sustainable Development Goal to be achieved by 2030. India also started its campaign to eliminate LF in 2004. The main strategy of the elimination programme is the Annual Mass Drug Administration (MDA) to progressively reduce and ultimately interrupt LF transmission. The other pillar of the strategy is morbidity management and disability prevention. Kerala state also started its LF elimination campaign in 11 endemic districts out of a total of 14 districts. The average population coverage during MDA in Kerala was reported to be more than 90% from 2004 to 2013, however, drug compliance during independent assessment was reported to be 40%-60% which improved in subsequent years due to a multipronged approach. The main reason of low consumption was the fear of side effects and the same was resolved through massive IEC activities highlighting its benefits compared to side effects, which are mostly self-limiting. The innovative strategic approach of extending the MDA period from 3 days to 3 weeks was undertaken to ensure that all the target population was covered. The results have been encouraging as compliance improved to above 65% and many districts have been validated for having achieved the elimination threshold through successfully clearing transmission assessment survey (TAS).

Assistive technology: The current perspective in India.

The world, today, recognizes the increasing importance of assistive technology (AT) that can reduce the functional limitations of persons with disabilities, individuals with chronic debilitating diseases, and elders. This indicates that at some point, everyone, either temporary or permanent, will require AT to improve their physical and functional abilities, thus contributing to independent living, social inclusion, and education. Besides this, the need for AT will be growing with a majority from low-middle-income countries. The same is true for India though we are not sure how many people have met a need, and unmet need for AT to date, but the requirement will continue to increase. There is a significant gap between needs and access to AT. Recently, the WHO has led many initiatives related to AT services after the 71st World Health Assembly's resolution in 2018, to improve access to AT for its member states. The UN Sustainable Development Goals (SDGs) have pledged that no one should be left behind irrespective of personal characteristics. India, a ratified member state, needs to align with various initiatives undertaken by the WHO and the UN. Despite many challenges, India needs to formulate evidence-based AT policy, planning within the purview of the healthcare delivery system in collaboration with various government and nongovernment sectors, including industries. This article explores the need, access, and potential challenges associated with AT services in India. Finally, we discussed various initiatives on AT in the country and possible recommendations to improve AT services across.

Emergent patterns in global health diplomacy: a network analysis of the resolutions adopted by the World Health Assembly from 1948 to 2022

From a complexity perspective on governance, multilateral diplomacy is based on interactions between people, ideas, norms, policies and institutions. This article uses a computer-assisted methodology to better understand governance systems...

Marketing of commercial milk formula during COVID-19 in Indonesia.

Baby food marketing poses a substantial barrier to breastfeeding, which adversely affects mothers' and children's health. Over the last decade, the baby food industry has utilised various marketing tactics in Indonesia, including direct marketing to mothers and promoting products in public spaces and within the healthcare system. This study examined the marketing of commercial milk formula (CMF) and other breast-milk substitute products during the COVID-19 pandemic in Indonesia. Using a local, community-based reporting platform, information on publicly reported violations of the International Code of Marketing of Breast-milk Substitutes and subsequent World Health Assembly resolutions (the Code) was collected. It was found that a total of 889 reported cases of unethical marketing of such products were recorded primarily through social media from May 20 through December 31, 2021. Our results suggest that the COVID-19 pandemic has provided more opportunities for the baby food industry in Indonesia to attempt to circumvent the Code aggressively through online marketing strategies. These aggressive marketing activities include online advertisements, maternal child health and nutrition webinars, Instagram sessions with experts, and heavy engagement of health professionals and social media influencers. Moreover, product donations and assistance with COVID-19 vaccination services were commonly used to create a positive image of the baby food industry in violation of the Code. Therefore, there is an urgent need to regulate the online marketing of milk formula and all food and beverage products for children under the age of 3.