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Highlights from the 66th World Health Assembly and the pharmaceutical industry?s role in addressing noncommunicable diseases, mental and neurological disorders, R&D for diseases of the developing world, counterfeit medicines, the global vaccine action plan, and neglected tropical diseases.
The 66th World Health Assembly (WHA), the decision-making body of the World Health Organization (WHO), was held last month in Geneva, Switzerland and concluded with agreement on a range of new public health measures. In all, 24 resolutions and five decisions were adopted by the nearly 2000 delegates representing WHO member states. The pharmaceutical industry was part of the discussions. The International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), which represents research-based pharmaceutical companies and associations, weighed in on the discussions and provided input on various topics, including noncommunicable diseases (NCDs), mental and neurological disorders (MNDs), R&D for diseases of the developing world, counterfeit medicines, the global vaccine action plan, and neglected tropical diseases (NTDs).
The WHA addressed NCDs through a global action plan for the prevention and control of NCDs (including heart disease, stroke, diabetes, cancer, and chronic lung diseases) by seeking to achieve nine globally agreed targets for NCDs, including a reduction in premature mortality from NCDs by 25% in 2025. The action plan also contains a monitoring framework, including 25 indicators to track mortality and morbidity, as well as ways to assess progress in addressing risk factors and evaluate the implementation of national strategies and plans. WHO was requested to develop draft terms of reference for a global coordination mechanism through a consultative process culminating in a formal meeting of WHO member states in November 2013. WHO also was tasked with providing technical support to member states and developing a limited set of action plan indicators to chart progress made with the implementation of the action plan in 2016, 2018, and 2021.
IFPMA supports these efforts. “The Global Action Plan is a focused and pragmatic document, which recognizes the size of the challenge, identifies barriers that must be overcome, and proposes sounds approaches,” said IFPMA in a May 28, 2013 press release. “To achieve significant impact on NCDs, multistakeholder strategies are required at the global, regional, and national levels. These should be fully integrated into healthcare systems and extend beyond the traditional health sector.”
Mental and neurological health
A resolution on WHO’s mental health action plan 2013–2020 set four major objectives: strengthen effective leadership and governance for mental health; provide comprehensive, integrated, and responsive mental-health and social-care services in community-based settings; implement strategies for promotion and prevention in mental health; and strengthen information systems, evidence, and research for mental health. According to WHO, the plan sets important new directions for mental health, including a central role for provision of community-based care and a greater emphasis on human rights. It also emphasizes the empowerment of people with mental disabilities and the need to develop strong civil society and health promotion and prevention activities. The document proposes indicators and targets, such as a 20% increase in service coverage for severe mental disorders and a 10% reduction of the suicide rate in countries by 2020, which can be used to evaluate levels of implementation, progress, and impact.
IFPMA supports the Mental Health Global Action Plan discussed at the WHA. “With annual mental and neurological disorders cases estimated at 700 million and accounting for 30% of the global NCD burden, MNDs are more than just a health issue; they should be a societal priority involving decision makers from education, employment, science, government, and other spheres,” said IFPMA in its release. To facilitate those efforts, IFPMA launched You Mind?, an interactive website where people can explore how different stakeholders—policymakers, researchers, patients, or relatives of someone with an MND—can play a part in addressing these disorders.
Global Vaccine Action Plan
At the WHA, WHO member states reiterated their support to the Global Vaccine Action Plan (GVAP) to prevent millions of deaths by 2020 through more equitable access to vaccines and for the proposed Framework for Monitoring, Evaluation and Accountability, which is linked to the Commission on Information and Accountability for Women’s and Children’s Health, according to WHO. Delegates also supported the independent review process to assess and report progress. Speakers highlighted the following: the need to mobilize greater resources to support low- and middle-income countries to implement the GVAP and monitor impact; ensure that support to countries to implement the GVAP includes a strong focus on strengthening routine immunization; and to facilitate vaccine technology transfer.
IFPMA emphasized the need to develop a holistic approach. “Looking ahead, the success of the GVAP requires a holistic approach to vaccine access that balances considerations of availability and continuity of supply, efficient management of the total cost of immunization in countries, development of adapted and safe products, and maintenance of R&D incentives to foster innovation of new vaccines that satisfy unmet medical needs from developing countries,” said IFPMA. “Greater recognition by policymakers and communities of the broader socioeconomic value of vaccination, beyond vaccine affordability and individual antigen disease burden, would be also an important step towards investing in immunization.”
WHA delegates supported the decision to establish an open-ended working group to identify the actions, activities and behaviors that result substandard/spurious / falsely labeled/ falsified/counterfeit medical products (SSFFC) medical products. Participants highlighted the need for increased cooperation and collaboration among national and regional regulatory authorities, including the exchange of best practices and knowledge. IFPMA acknowledged its support for the working group of member states on SSFFC medical products
Neglected tropical diseases
At the WHA, a resolution on NTDs urged member states to ensure country ownership of prevention, control, elimination, and eradication program and calls on international partners to provide sufficient and predictable funding. It encourages greater harmonization of support to countries and the development of new technologies to support vector control and infection prevention. The resolution also calls on WHO to do the following: sustain its leadership in the fight against NTDs; to develop and update evidence-based norms, standards, policies, guidelines and strategies; monitor progress; and support member states in strengthening human resource capacity for the prevention, diagnosis, including vector control and veterinary public health. Many member states highlighted the particular importance of intensifying efforts to tackle dengue, according to WHO.
IFPMA noted the pharmaceutical industry’s efforts in addressing NTDs. In 2012, the industry announced a major commitment to donate 14 billion treatments this decade to control or eliminate nine major NTDs responsible for the 90% of the global burden and currently leads 132 R&D projects for NTDs, 85% of which are carried out in product development partnerships. IFPMA also said it welcomed a a systematic and standardized global review of both unmet needs for Type II (HIV, malaria, tuberculosis) and III (NTDs) diseases and supports identifying how current efforts can be leveraged to achieve progress on diseases disproportionately affecting the developing world, R&D flows, and research capacity. “This task will help develop a clear picture of needs, gaps and priorities and should be performed by talking, among others, to those with experience in planning and conducting R&D and those who provide significant funding,” said IFPMA.”In a time of scarce financial resources and high fragmentation, we believe that understanding key research gaps is a precondition to addressing them.”