WHO Executive Board Special Session: PSI calls for Health before Wealth

The World Health Organization held a special session of its Executive Board on 5 – 6 October. This was the fifth time such a special session would be held in WHO’s history. The meeting was summoned to discuss on implementation of the 73rd World Health Assembly’s Covid-19 response resolution in May

It was also the first governing body meeting of WHO since its framework for engagement with non-state actors (FENSA) was adopted in 2016 where written statements of civil society organisations’ statements “may not be included in the official records.” This is a development which, as PSI argues in its statement; “impairs transparency, inclusiveness, and concerted efforts” needed for the Covid-19 global response.

The main report to the meeting was an update presented by Dr Tedros Ghebreyesus, the WHO Director General. In this interim report, he informed that WHO has continued to work closely with the United Nations Secretary General and relevant multilateral organizations on a comprehensive and coordinated response to support governments across the world in their responses to the pandemic.

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This is done through the United Nations Crisis Management Team chaired by WHO, which was activated in February. At its regional level, WHO has established technical and operational bodies to facilitate coordination between United Nations entities “and other partners across various sectors”.

WHO has also strengthened its capacities at all levels to better fulfil its mandate as stipulated in the International Health Regulations (2005). This has been facilitated with the WHO transformation agenda which has bolstered its Health Emergencies Programme at all levels of the organization since January. With this, the WHO Secretariat has been able to assist governments, at their request, in complying with the International Health Regulations.

The Director General also reported that WHO has taken steps to scale up procurement and delivery of personal protective equipment (PPE), testing and diagnostics supplies, and biomedical equipment such as ventilators and oxygen concentrators. This has been facilitated through the United Nations Covid-19 Supply Chain System coordinated by WHO.

Rosa Pavanelli, the PSI General Secretary had described the global shortage of PPE as a global emergency within the global health emergency in a letter to the WHO Director General in March, and called for urgent action to be taken to address this. We thus appreciate the scale up of PPE supply. But availability of supply is still inadequate. This has contributed to the high level of health worker infection such that 15% of all Covid-19 cases worldwide are health workers.

PSI also called for due appreciation of the mounting body of evidence that airborne transmission of Covid-19 is significant. Presently, only health workers performing aerosol generating medical procedures on Covid-19 patients are expected to be protected with the use of respirators and not all health workers caring for suspected or confirmed Covid-19 cases.

Members of PSI affiliates on the frontline are strongly of the view that this does not adequately ensure their respiratory protection. They are fighting for infection prevention and control measures which demonstrably prioritise health worker safety in all facets, within their countries. And since the beginning of the pandemic, they have been calling for guideline based on the precautionary principle from WHO, to strengthen their campaigns for provision of appropriate PPE, including respirators.

It is also important to stress the need for safe and effective staffing for health. The public health system is grossly understaffed in most countries. This, which itself is largely a fallout of years of underfunding and privatisation, contributed to the severity of the pandemic and its impact. Most governments have failed to live up to commitments they made to address the shortfall of eighteen million healthcare workers by 2030.

Recommendations of the United Nations High-Level Commission on Health Employment and Economic Growth (UNComHEEG) in 2016, which were reinforced with the World Health Assembly’s resolution for the implementation of a Working for Health: Five-Year Action Plan for Health Employment and Inclusive Economic Growth (2017-2021) have literally been abandoned.

Now more than ever, recommendations of the UNCommHEEG must be fully implemented. It is not enough to applaud health workers. Governments need to improve employment and working conditions in the health services with a keen sense of urgency.

We further pointed out the danger which “vaccine nationalism” and for-profit interests of pharmaceutical corporations present to the “equitable global allocation framework for vaccines”, which WHO has established in consultation with Member States. We thus called for an international commitment to make Covid-19 vaccination and therapeutics available to all, in all countries and free of charge.

This will be effective as part of a full turn to universal public healthcare. The pandemic once again shows limitations of privatisation and corporatization of health services. Crises present opportunity for change along with challenges.

The Covid-19 response must herald fundamental changes in how the world is run. Well-resourced and adequately staffed public health systems will help avoid such catastrophic extent of a pandemic in future, whilst shortening the world’s walk through the valley of the shadow of the current public health emergency. The global supply chain, resource mobilisation and science and technology must be geared to protecting the lives and wellbeing of people and the planet, putting health before wealth.