Thoughts From the Second Day of the World Health Assembly

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Today our group attended the Committee A meeting on the prevention and control of NCDs, the first annual progress meeting on HIV, and an evening event put on by the Tobacco Free Initiative. Various speakers at the Committee A meeting rallied for an increased emphasis on non-communicable diseases (NCDs), as infectious diseases pose a decreasing threat throughout the world, opening the door for chronic diseases such as Alzheimer’s and cancer to affect an aging population. NCDs, many argued, should be at the forefront of the health agenda as they place a disproportionate and increasing burden on developing countries. This phenomena, however, is not widely understood by the greater community as NCDs have until recently been thought of as a “rich country” problem. This mentality contributes to a significant financial burden for organizations representing NCDs as donors throw their money into communicable diseases like HIV and malaria and are reluctant to consider NCDs in their gifting. The economic pinch has forced organizations such as the NCD Alliance to accept, to the dismay of many, financial contributions from the private sector. While many are concerned private sector donations will influence the values and agenda of the NCD Alliance, they and other organizations like them respond that the private sector has money and far reaching influence that can be of great service to their organization without affecting internal policy and decision making. In light of these tensions, I was not surprised to hear delegates repeatedly assert that partnerships between UN agencies, member states and the private sector should be forged “with due consideration where conflicts of interest arise.”
From Committee A, we meandered our way over to the First Annual Progress Meeting on HIV. Delegates rattled off the latest data on HIV status, developments, and recommendations from their respective countries as they endeavor to follow the Global Plan, which sets targets and 40 countries, 30 private sector, 15 national regional bodies to achieve the ultimate goal of eliminating new HIV infections among children via vertical transmission and keeping their mothers alive (the interim goal being the reduction of new infections among children by 90% by 2015). I was interested to hear a delegate emphasize the need for an increased emphasis on changing the cultural climate of HIV-affected communities. Many HIV-positive women are stigmatized for having HIV and will be thrown out of the home by her spouse or in-laws because of it.  So they hide it.  And hiding their condition means being less compliant with medication and follow up visits. So this session, for me at least, was an important reminder to consider the cultural and societal context in which the individual is embedded when tackling any health issue. The most revolutionary pharmaceutical breakthroughs for HIV will be completely obsolete if they aren’t taken.
WHO DG Margaret Chan and panelists at the Tobacco Free Initiative event.
The real treat of the day was attending the evening event put on by the Tobacco Free Initiative. Panel speakers and delegates brought their passion to the meeting as Uruguay, Norway, Australia, Namibia are each being subject to attack by the tobacco industry for introducing anti-tobacco legislation. WHO Director General Margaret Chan described the tobacco industry’s offensive strategies as belonging to “a theater of the absurd,” as tobacco representatives, in the death throws of a desperate industry, use political influence, marketing strategies, and other scare tactics to intimidate these countries. Douglas Bettcher, Director of the Tobacco Free Initiative for WHO, likened the tobacco industry to a malaria-ridden mosquito vector, mutating and becoming more despicable and difficult to manage with time. With a clear enemy in mind, the room was filled with a furious enthusiasm as delegates, panelists, NGO representatives and concerned individuals from all corners of the world felt their ideals and principles coalesce in solidarity. “Can we take this lying down!?” exclaimed an animated Chan. “No…” the audience murmured. “Say it again.” “No,” the audience replied, only slightly more audibly. “Louder!” she retorted, “why are you guys so quiet today?” And finally there was a resounding “NO!”
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