by Martin Khor
Monday 29 May
WHO reviews world’s health problems
Last week’s annual
meeting of Health Ministers at the World Health Assembly of the WHO
started with the shocking news of the sudden death of its Director General,
and went on to review global health problems, including avian flu, the
effects of patents on health care, and the drain of doctors from poorer
to rich countries.
A range of heath
issues came under scrutiny when Ministers of Health and their senior
officials met last week at the World Health Assembly in Geneva.
The assembly is
the governing body of the World Health Organisation and it meets every
It started in solemn
mood on 22 May morning with the shocking news that the WHO’s Director
General Dr. Lee Jong Wook had passed away just two hours earlier, following
surgery two days earlier to remove a blood clot on his brain.
Dr. Lee, a Korean,
had been the WHO Director-General since July 2003 and he had been working
at the WHO for 23 years, including in its tuberculosis programme.
"It is very sad news," said the Spanish health minister when
the Assembly opened. “Dr Lee was an exceptional person and an exceptional
The process to elect
a new Director General will start soon, and already names are being
floated as to who should take over the world’s top health job.
As the Assembly
started, there was news that a case of human-to-human transmission of
avian flu could have taken place when six family members died in Indonesia.
The WHO officials were cautious, saying a human-to-human transmission
could not be confirmed, but also that it could not be ruled out.
Experts are worried
that a flu pandemic can emerge when the flu virus evolves a strain that
can be passed on among people. So far victims get the disease from
contact with poultry.
on avian flu included the degree of preparedness by countries to deal
with a pandemic, the lack of availability of vaccines, whether the need
for stockpiling of drugs has been exaggerated and whether the recommended
medicine to treat the virus really works.
A major concern
running through the Assembly was the effect of patents on the cost of
medicines. In particular, many governments expressed opposition to
provisions in bilateral trade agreements that remove their ability to
make cheaper generic drugs available through compulsory licensing and
through the use of safety data provided by the companies producing branded
The Assembly’s biggest
decision was to set up a WHO working group to draw up a global strategy
and plan of action to follow up on the recommendations made by a WHO
commission on intellectual property and health, whose report was recently
The resolution establishing
the working group noted that the patent system did not meet the need
to develop new medicines to fight diseases that especially affect developing
countries. The group will propose how to ensure resources and the basis
for research and development relevant to diseases that affect developing
Today, most of the
research is on medicines that sell in developed countries, while little
funds go towards developing new vaccines, diagnostic tools and medicines
for diseases such as AIDS, malaria and tuberculosis that kill millions
in the developing world.
The new working
group is tasked with proposing an action plan to correct this situation,
including by suggesting how to handle the problem of the effects of
patents on the prices and availability of health products.
Another big issue
was what to do with the remaining stocks of smallpox virus which now
reside in two centers in the United States and Russia under WHO supervision.
Years ago, when
smallpox was eliminated, the World Health Assembly authorized the two
centers to maintain stocks of the dangerous virus with the aim of destroying
them within a few years.
many deadlines for destruction of the stocks, they remain and recently
the US proposed to expand research using the virus, including genetic
engineering of the smallpox virus. This had raised safety concerns
among many governments.
At last week’s meeting,
many countries asked for a new deadline to destroy the stocks but this
was refused by the US and Russia. Proposals to limit and control the
research were also not acceptable to the US.
As a result, the
WHA could not reach agreement on how to deal with this subject, and
transferred it to the WHO’s board for further discussion.
especially from Africa, highlighted the medical brain drain, with their
doctors and nurses migrating to rich countries, after receiving expensive
This has depleted
the medical workforce in developing countries, placing heavier burdens
on the over-worked personnel who remain and stressing the whole health
Some countries asked
for compensation from the countries receiving the medical personnel,
and for ethical recruitment policies. In the end a mild resolution
was adopted, urging the rich countries to help fund medical education
in developing countries so that more doctors and nurses can be trained,
that could serve the needs of the home counties as well as supply personnel
for other countries.
This is seen by
many as an inadequate solution, for it might only increase the number
of doctors and nurses to be trained in poorer countries but who would
eventually migrate to rich countries.
But more direct
measures, such as disallowing out-migration of health personnel, or
asking for compensation to the “source countries” that have trained
the personnel at high cost, are considered too “sensitive.”
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