GMWHO 2023

Topic

Universal Health Coverage : Reorienting health systems to primary health care

About the committee

The COVID-19 pandemic has highlighted the importance of accelerating progress towards achieving universal health coverage (UHC) for all. Toward this end focusing on Primary Health Care is the best and most cost-effective way to reorient health systems. Inclusion of the topic in the Global Model WHO is a good opportunity to call for world leaders to support these efforts in advance of the United Nations high-level meeting on UHC in September 2023. Primary Health Care (PHC) assumes that everyone has the right to health care throughout their lives. Moreover, it aims to meet the health needs of an individual in all its aspects - whether physical, mental or social well-being - through community engagement and collaboration between government, civil society and the private sector. Community participation is an important principle of PHC and a critical element in improving health outcomes. Community engagement helps build trust which is needed to get the public to follow the directives of health care professional when responding to a health emergency. And by engaging multiple sectors, stakeholders in the health system can pool resources, share knowledge and expertise as they work toward the shared goal of producing better health outcomes. A third important element to ensure that PHC is prepared to respond to a pandemic is a surveillance system that can track and monitor outbreaks. All three elements, community engagement, a multisectoral approach and a surveillance mechanism are needed to ensure that PHC generates positive health outcomes in crisis situations. It is the best way to strengthen the responses of communities and countries whose health systems are mostly overwhelmed so that they are able to deliver sufficient care and quality services to all. These are some of the lessons learned in the case of the COVID-19 pandemic. Those countries that had the strongest PHC systems in place were among the best prepared to meet the demand for primary care services, and reduce the pressure on overburdened emergency services, help the most vulnerable people and directly assist in fighting and containing the virus globally.

Countries

Topic

Public health emergencies : preparedness and response

About the committee

Since 2011, there have been more than 1200 outbreaks of epidemic-prone diseases in 188 countries around the world. Large-scale epidemics cause widespread death and suffering, disproportionately affect the poorest and most vulnerable populations, and lead to social, economic and political disruption. Approximately 70-80% of high-risk pathogens spread between animals and humans (they are zoonotic). Some of these are known but many are unknown and are currently circulating among animal species around the world. The rapid detection, verification, assessment and communication of potential health threats is essential to save lives and reduce the negative impact of health emergencies. Countries, communities and organizations must be able to respond immediately and effectively to potential health threats and emergencies caused by any hazard. For this, readiness is essential.

Countries

Topic

WHO global action plan on promoting the health of refugees and migrants, 2019–2023

About the committee

Many refugees and migrants lack access to health care services, including mental health services, disease prevention, treatment and care, as well as financial protection. Nationality should never be a basis for determining access to health care; legal status often determines the level of access within national insurance schemes and health systems, without revoking the principle of universal health coverage as set in international agreements. Refugees and migrants may, in some circumstances, fear detection, detention or deportation and may be subject to trafficking or slavery. Unaccompanied children are particularly vulnerable and need specific provisions. Barriers to accessing health care services differ from country to country. They may include language and cultural differences, high costs, discrimination, administrative hurdles, adverse living conditions, and lack of information about health entitlements. All these conditions make seeking care difficult. Additionally, these experiences can precipitate negative mental health outcomes. Refugees and migrants may come from areas where communicable diseases are endemic. This does not, however, necessarily imply that they are an infectious risk to host and transit populations. On the other hand, they may be the ones to be at risk of contracting communicable diseases, including foodborne and waterborne diseases, as a result of the perils of travelling and factors in the host country associated with poor living and working conditions, together with lack of access to essential health care services. Access to vaccination and continuity of care is more difficult for people on the move. Poor access to medicines and poor management of treatment may facilitate the development of antimicrobial resistance. Specific vulnerabilities to HIV infection and tuberculosis require specific integrated health care services for refugees and migrants. In addition, if they have existing chronic conditions and hereditary diseases, they may experience interruption in their care, and may lack the medicines they need or health records documenting their treatment when they move to a different country. The goal of this proposed global action plan is to assert health as an essential component of refugee assistance and good migration governance. The aim of the plan is to improve global health by addressing the health and well-being of refugees and migrants in an inclusive, comprehensive manner.

Countries

Topic

Substandard and falsified medical products

About the committee

In 2012, the World Health Assembly established the Member State Mechanism to address the issue of tackling substandard and falsified medical products in a a transparent and inclusive way, from a public health perspective. The WHA65.19 resolution recognized the need to enhance support to national and regional regulatory authorities to protect public health and promote access to affordable, safe efficacious and quality medical products, to promote the prevention, detection, and response of substandard and falsified medical products. The main objective of the Member State Mechanism is to identify major needs and challenges and make policy recommendations to strengthen national and regulatory capacities. The growing phenomenon of the falsification of medical products threatens the right to life, as enshrined in different international human rights instruments. In its resolution 20/6, the Commission on Crime Prevention and Criminal Justice urged Member States to prevent trafficking in fraudulent medicines by introducing legislation, as appropriate, covering, in particular, all offences related to fraudulent medicines, such as money-laundering, corruption and smuggling, a well as the confiscation and disposal of criminal assets, extradition and mutual legal assistance, to ensure that no stage in the supply chain of fraudulent medicines was overlooked. According to the limited number of studies on the magnitude of the problem, organized criminal groups engage in falsified medical product-related crime using the same routes and techniques employed in the trafficking in other illicit commodities. In so doing, they exploit gaps and discrepancies in national legislation and criminal justice systems. In many countries, criminal groups use new technologies and platforms such as darknet sites to traffic in falsified medical products and avoid detection by law enforcement authorities. The WHO focuses on safeguarding public health and promoting access to affordable, safe, efficacious and quality medical products, WHO does not focus on criminal investigations. Despite the growing nature of the problem, legal and regulatory systems around the world are facing numerous challenges in effectively combating these types of products. Such challenges include weak or inconsistent legal frameworks and ineffective criminal laws that often fail to criminalize attempt, participation by accessories and the possession and sale of illegally obtained medical products. Online and distance selling of medical products are also growing concerns but are often still inadequately addressed. Many medical product sector-specific laws are inadequate and not harmonized with other laws and international standards. Some laws lack definitions, provide for insufficient penalties and fail to designate offences as predicate offences in anti-money-laundering legislation. The World Health Organization (WHO) recognizes that substandard and falsified medical products are most likely to be found where access to affordable, quality, safe and effective medical products is constrained, standards of governance are low or the tools and technical capacity to ensure good practices in manufacturing, quality control and distribution are limited. While the deleterious impacts of substandard and falsified medical products are difficult to quantify, there is no doubt that such products have a multidimensional impact that includes health, economic and socioeconomic consequences. They endanger health, prolong illness, kill, promote antimicrobial resistance and the spread of drug-resistant infections, undermine confidence in health professionals and health systems, create distrust about the effectiveness of medical products, waste resources, cut into the limited budgets of families and health systems and provide income for criminal networks.

Countries

Topic

The highest attainable standard of health for persons with disabilities

About the committee

Disability is a global public health issue – approximately 1.3 billion people have significant disability, which is one in six people worldwide. This number is growing because of the rise and ageing of the population, and also the increased number of people with noncommunicable diseases, who are living longer and ageing with limitations in functioning. Disability is also a human rights issue – people with disabilities are among the world’s most discriminated people, often experiencing violence, prejudice and denial of autonomy as well as facing barriers when accessing health and health-related services. Disability is a development issue – nearly 80% of all people with disabilities live in low- and middle-income countries and disability and poverty mutually reinforce each other. Persons with disabilities die earlier, have poorer health, and experience more limitations in everyday functioning than the rest of the population. For example, compared to persons without disabilities, many persons with disabilities: - Die up to 20 years earlier; - Have more than a double risk of developing comorbid conditions such as depression, asthma, diabetes, stroke, obesity or poor oral health; - Experience more limitations in functioning. For example, persons with disabilities find inaccessible health facilities up to 6 times more hindering; and are up to 15 times more limited by inaccessible and unaffordable transportation. - These differences often arise due to unjust and avoidable factors and conditions faced by persons with disabilities. These factors can be: Structural: Persons with disabilities experience stigma and discrimination in all facets of life, which affects their physical and mental health and often laws and policies may be discriminatory. Social determinants of health: Poverty, exclusion from education and employment, and poor living conditions all add to the risk of poor health and unmet health care needs among persons with disabilities. Risk factors: Persons with disabilities are more likely to have risk such as smoking, poor diet, alcohol consumption and a lack of physical activity. A key reason for this is that they are often left out of public health interventions. Health system: Persons with disabilities face barriers in all aspects of the health system. For example, a lack of knowledge, negative attitudes and discriminatory practices among healthcare workers; inaccessible health facilities and information; and lack of information or data collection and analysis on disability, all contribute to health inequities faced by this group. Disability inclusion is critical to achieving the Sustainable Development Goals and global health priorities to achieve health for all. WHO estimates that there could be almost an US$ 10 return for every US$ 1 spent on implementing disability inclusive prevention and care for noncommunicable diseases. Appropriate health services and support contribute to the full and meaningful participation of people with disabilities in society as anyone else. Article 25 of the UN Convention on the Rights of Persons with Disabilities (CRPD) reinforces the right of persons with disability to attain the highest standard of health, without discrimination. However, the reality is that few countries provide adequate quality services for people with disability.

Countries

Topic

Universal Health Coverage : Reorienting health systems to primary health care

About the committee

The COVID-19 pandemic has highlighted the importance of accelerating progress towards achieving universal health coverage (UHC) for all. Toward this end focusing on Primary Health Care is the best and most cost-effective way to reorient health systems. Inclusion of the topic in the Global Model WHO is a good opportunity to call for world leaders to support these efforts in advance of the United Nations high-level meeting on UHC in September 2023. Primary Health Care (PHC) assumes that everyone has the right to health care throughout their lives. Moreover, it aims to meet the health needs of an individual in all its aspects - whether physical, mental or social well-being - through community engagement and collaboration between government, civil society and the private sector. Community participation is an important principle of PHC and a critical element in improving health outcomes. Community engagement helps build trust which is needed to get the public to follow the directives of health care professional when responding to a health emergency. And by engaging multiple sectors, stakeholders in the health system can pool resources, share knowledge and expertise as they work toward the shared goal of producing better health outcomes. A third important element to ensure that PHC is prepared to respond to a pandemic is a surveillance system that can track and monitor outbreaks. All three elements, community engagement, a multisectoral approach and a surveillance mechanism are needed to ensure that PHC generates positive health outcomes in crisis situations. It is the best way to strengthen the responses of communities and countries whose health systems are mostly overwhelmed so that they are able to deliver sufficient care and quality services to all. These are some of the lessons learned in the case of the COVID-19 pandemic. Those countries that had the strongest PHC systems in place were among the best prepared to meet the demand for primary care services, and reduce the pressure on overburdened emergency services, help the most vulnerable people and directly assist in fighting and containing the virus globally.

Countries

Topic

Global agenda on health, environment and climate change

About the committee

Climate change is the single biggest health threat facing humanity, and health professionals worldwide are already responding to the health harms caused by this unfolding crisis. The Intergovernmental Panel on Climate Change (IPCC) has concluded that to avert catastrophic health impacts and prevent millions of climate change-related deaths, the world must limit temperature rise to 1.5°C. Global heating of even 1.5°C is not considered safe, however; every additional tenth of a degree of warming will take a serious toll on people’s lives and health. While no one is safe from these risks, the people whose health is being harmed first and worst by the climate crisis are the people who contribute least to its causes, and who are least able to protect themselves and their families against it - people in low-income and disadvantaged countries and communities. Climate change is already impacting health in a myriad of ways, including by leading to death and illness from increasingly frequent extreme weather events, such as heatwaves, storms and floods, the disruption of food systems, increases in zoonoses and food-, water- and vector-borne diseases, and mental health issues. Furthermore, climate change is undermining many of the social determinants for good health, such as livelihoods, equality and access to health care and social support structures. These climate-sensitive health risks are disproportionately felt by the most vulnerable and disadvantaged, including women, children, ethnic minorities, poor communities, migrants or displaced persons, older populations, and those with underlying health conditions. The climate crisis threatens to undo the last fifty years of progress in development, global health, and poverty reduction, and to further widen existing health inequalities between and within populations.

Countries

Topic

Strengthening Infodemic Management

About the committee

While the Covid-19 pandemic continues to claim lives and livelihoods around the world, a silent infodemic is proving to be as dangerous. The infodemic, defined by the World Health Assembly as the overabundance of information including false or misleading ones, has significant implications for public health management. Specifically, the creation and dissemination of inaccurate information hinder individual access to reliable sources and guidance, leading to the rejection of health interventions, disregard for epidemiological guidelines, and the proliferation of conspiracy-motivated beliefs and behaviour. For example, the association of vaccines with microchips and magnets has fuelled anti-vaccine sentiments, with data from across 23 countries in January 2021 showing that only 63% of respondents will accept a vaccine, well below the threshold of 75% minimum to attain herd immunity in a post-pandemic world. Against this backdrop, it is important to improve existing information management mechanisms and generate new ones to ensure effective responses to health emergencies, including the COVID-19 pandemic. Specifically, applying evidence and risk-based interventions that drive positive health-seeking behaviour is key to building social resilience, promoting a sound understanding of public health, and providing citizens with the toolkit to protect themselves and their communities. Ultimately, governments, organisations, and other stakeholders must strengthen infodemic management, regulate the information landscape, and create credible, constructive public health narratives. It is only with such collective efforts can the pandemic be truly and effectively be addressed.

Countries