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WHO @75: Keeping the world healthy
Health
The World Health Organization, WHO, has always been the last hope for every country of the world, especially during a global, continental, regional or national health challenge and the body has proved its integrity. Thus, it is fully in place for the WHO to mark its 75th anniversary in a different, but reassuring manner.
By Kennedy Nnamani
FOLLOWING the meeting of diplomats from the United Nations, UN in San Francisco in California in 1945, the representatives of Brazil and China proposed that an international health organisation be established. This proposal was accepted and a conference to frame its constitution was therefore convened.
Consequently, on February 15, 1946, the Economic and Social Council of the UN instructed the Secretary-General to summon a conference which birthed a group known as the Technical Preparatory Committee, which met in Paris from March 18 to April 5, 1946 and drew up proposals for the Constitution, which was presented to the International Health Conference in New York City between June 19 and July 22, 1946. The adopted Constitution of the World Health Organization, was therefore signed on July 22, 1946 by the representatives of 51 members of the UN and of 10 other nations.
The constitution came into force on April 7, 1948 and this date henceforth is celebrated every year as the World Health Day.
Since the foundation of the WHO in 1948, the world has experienced public health challenges that have required the organisation to come together with science, solutions and solidarity to brainstorm and tackle each challenge as it faces the world.
Every year, WHO has always adopted a theme and topical issues to mark its anniversary. This year, the organisation chose to examine some of the most memorable successes it has recorded and how these have contributed to improved health across the world.
In a statement published on its website, the WHO noted that “These milestone achievements also provide inspiration for us to face the health challenges of the future.”
Tracing its achievements after 1945 and 1946, its year of inception and approval of its constitution, respectively and to 1948, when the constitution came into force and the World Health Day enacted, it stated that in 1947, it established the first ever global disease-tracking service, with information transmitted via telex.
In 1950, the organisation said that it recorded the discovery of antibiotics and advised countries on their responsible use of the drugs for public health.
In addition, in 1952, Jonas Salk, a US physician developed an inactivated poliovirus vaccine (given by injection) for a crippling and life-threatening disease known as polio. This discovery paved the way for mass global campaigns facilitated by countries, WHO and other partners that have led to the near-eradication of polio, while in 1961, Albert Sabin developed the attenuated live-virus vaccine (given orally).
The WHO established the first International Health Regulations in 1969. This regulation represents an agreement between WHO Member States to work together to prevent and respond to acute public health risks that have the potential to cross borders and threaten world health.
In 1972, the WHO introduced a special programme on world sexual reproduction through the Special Programme of Research, Development and Research Training in Human Reproduction, HRP.
It is pertinent to note that the WHO is the sole body within the UN system with a global mandate to carry out research into sexual and reproductive health and rights. Thus, in achieving this, the organisation has been working assiduously to meet this mandate. For example, on Tuesday, April 4, 2023, the Organisation stated in its new report that Large numbers of people are affected by infertility in their lifetime. “Around 17.5% of the adult population – roughly 1 in 6 worldwide – experience infertility, showing the urgent need to increase access to affordable, high-quality fertility care for those in need,” it noted.
Building on the already running momentum, in 1974, WHO launched the Expanded Programme on Immunization, EPI, aimed at smallpox eradication to ensure that all children in all countries benefited from life-saving vaccines.
“Today every country in the world has a national immunization programme and vaccines are viewed as one of the safest, most cost-effective, and successful public health interventions to prevent deaths and improve lives,” the WHO stated in its report.
A year later, the WHO established and began hosting the Special Programme for Research and Training in Tropical Diseases, TDR, which is co-sponsored by UNICEF, UNDP and the World Bank. TDR provides tools to tackle neglected diseases and to increase the capacity for research in disease-endemic countries. The organisation noted that this intervention has made a significant contribution to elimination efforts for river blindness and leishmaniasis.
It disclosed that “by 2016, five of the eight diseases that the programme created to support research on are close to elimination.”
And 1977 saw the first publication of the Essential Medicines List. This list outlines the medicines that basic health system need. Each medicine is selected based on evidence for its safety, effectiveness and value for money.
In 1978, the WHO recorded two huge milestones with the introduction of Primary Health Care, PHC, programme and the launching of the global diarrhoeal disease programme.
The WHO believes that all people, everywhere, have the right to achieve the highest attainable level of health, thus its introduction of the “Health for All” programme, which laid the groundwork for WHO’s call for universal health coverage. The global diarrhoeal diseases programme focused on Oral rehydration salts, ORS.
Resultantly, by 2019, the 4·6 million annual deaths from diarrhoea in children younger than 5 years estimated in 1980 had fallen to just under 365 000 deaths, despite a 70% increase in the world’s population.
In its report, the organisation remarked that “although several factors contributed to this reduction. As of 2007, it was estimated that oral rehydration therapy (ORT) alone had prevented 54 million diarrheal deaths.
“In addition, ORT helped reduce the nutritional impact of diarrhea.”
It decried that as of 2022, ORT remained underused in some critically-affected countries, including high-income countries.
Furthermore, in 1980, following an ambitious 12-year global vaccination campaign led by the WHO, smallpox became the first human disease to be eradicated. However, recently, in some tropical countries of Africa, there were reports of resurrection of the disease.
The WHO, in 1981, launched the International Code of Marketing Breast milk substitutes in recognition that breastfeeding is one of the most effective ways to improve child health and survival.
Happily, by 2022, 75% of countries had adopted legal measures to implement at least some of the provisions in the Code. Since the Code was adopted, the percentage of babies who are exclusively breastfed has gone up by 50%.
The Human Immunodeficiency Virus, HIV, which causes AIDS, was discovered in 1983. Consequently, four years later, the first antiretroviral medication to control HIV infection and prevent it from progressing to AIDS is licensed, prompting a shift in WHOs priorities.
1988 and 1994 saw the development of the momentum on polio eradication and reproductive healthcare, respectively, with the introduction of the Global Polio Eradication Initiative and Comprehensive definition of reproductive health, respectively.
Countries of the world came together to collectively call for the eradication of polio at the World Health Assembly at a time when the disease was paralysing more than 350 000 children every year in more than 125 endemic countries and at the International Conference on Population and Development, ICPD, held in Cairo, Egypt, countries agree to the adoption of a comprehensive definition of reproductive health and a recognition of reproductive rights.
Other achievements of the World Health Organization include:
The launching of the Integrated Management of Childhood Illness, IMCI, strategy in 1995, in collaboration with UNICEF to promote health and provide preventive and curative services for children under five in countries with more than 40 deaths per 1000 live births.
Playing a pioneering role (in 1998) in emergency contraception by confirming the effectiveness of levonorgestrel, which resulted in changes in regulations in countries of differing income levels and its inclusion in the list of essential medicines.
In 1999, WHO recorded double achievements; the establishment of the Global Alliance for Vaccines and Immunization (now Gavi, the Vaccine Alliance), consisting of major players in global immunization, including WHO, other key UN agencies, leaders of the vaccine industry, government representatives and major foundations with the role to overcome barriers preventing millions of children from receiving vaccines and the launching of the first global strategy for the prevention and control of Non communicable Diseases, NCDs.
The following year, 2000, witnessed the adoption of the Millennium Development Goals, MDGs, during which the UN committed world leaders to combat poverty, hunger, disease, illiteracy, environmental degradation, and discrimination against women. Within this year, the WHO Global Outbreak Alert and Response Network, GOARN, was established to detect and combat the international spread of outbreaks, while in 2001, during the 26th special session of the United Nations General Assembly there was the UN Declaration of Commitment on HIV/AIDS, as a matter of urgency to address the HIV/AIDS crisis worldwide as well as to secure a global commitment to enhancing coordination and intensification of national, regional and international efforts to combat it in a comprehensive manner.
Also in 2001, the WHO launched the Global Fund to fight AIDS, Tuberculosis and Malaria, a new partnership and funding mechanism initially hosted by WHO, in collaboration with other UN agencies and major donors.
2003 saw the birth of the “3 by 5” initiative which was launched to bring treatment to 3 million people living with HIV by 2005 and laid the groundwork for reaching 13 million people infected with HIV with antiretroviral treatment by 2013. In the same year, the World Health Assembly unanimously adopted WHO’s first global public health treaty on the WHO Framework Convention on Tobacco Control with the aim to reduce tobacco-related deaths and disease worldwide.
A year later, there was the establishment of the UN Road Safety Collaboration where the WHO and the World Bank launched the first ever world report on road traffic injury prevention and the New Strategic operations Centre for emergency response through the WHO’s Strategic Health Operations Centre, used for the first time to coordinate emergency response support following the Indian Ocean tsunami. The Centre is the nerve centre of global alert and response for health emergencies.
In 2005, the International Health Regulations were revised, giving countries clear and tested guidelines for reporting disease outbreaks and other public health emergencies to WHO, and triggering response systems to isolate and contain threats.
In 2006, the WHO recorded a great achievement concerning child mortality rate as well as launching the WHO Child Growth Standards to check malnutrition in children. It noted that “the number of children who die before their fifth birthday declines below 10 million for the first time in recent history.”
In 2008, there was a paradigmatic shift in the attention of the world health agency from infectious diseases to “world’s number one killers” non communicable diseases namely heart disease and stroke.
The following year, in collaboration with centres and pharmaceutical industries, following the emergence of the new H1N1 influenza virus, the first influenza pandemic since 1968, the WHO developed the influenza vaccines in record to brace itself to combat the pandemic.
In 2010, WHO issued a menu of options for raising sufficient resources and removing financial barriers so that all people, especially those with limited resources to spend on healthcare, have access to essential health services and developed the first rapid molecular test for the detection of TB for more accurate identification of the disease after decades of using only sputum-smear microscopy.
2012 birthed the adoption of the Pandemic Influenza Preparedness Framework which paved the way for equitable access to counter measures during pandemics.
Through the collective efforts of member states in 2012, the WHO, for the first time, set global targets to prevent and control heart disease, diabetes, cancer, chronic lung disease and other diseases. Also in the same year, the World Health Assembly adopted WHO’s implementation plan on maternal, infant, and young child nutrition.
2013 birthed the endorsement of the first global Comprehensive Mental Health Action Plan while 2014 saw the approval of Every Newborn Action Plan to prevent newborn deaths and stillbirths.
Between 2014 and 2016, the efforts of the WHO was put on the spotlight with the outbreak of the Ebola virus in West Africa. The WHO Secretariat activated an unprecedented response to the outbreak: deploying thousands of technical experts and support staff and medical equipment; mobilizing foreign medical teams; and coordinating the creation of mobile laboratories and treatment centres.
Meanwhile, while battling the deadly Ebola virus disease, the Organisation did not deem its light on other challenging issues. As a matter of fact, there seemed to be more projects which the WHO was carrying out concurrently with the fight against the virus.
For example, in 2015 alone, HIV treatment coverage expanded rapidly with well over 17 million people living with HIV on antiretroviral therapy by the end of 2015, elimination of mother-to-child transmission of HIV and syphilis with Cuba becoming the first country in the world to receive validation from WHO, interruption of indigenous malaria transmission with WHO European Region becoming the first Region in the world to achieve this, introduction of the first ever water-dispersible tablets for child-friendly formulations of anti-TB medicines as well as checking the achievement of the organisation on the SDGs.
Realnews recalled that the SDG 3 focuses on “Good Health and Well-Being.” Thus the WHO calls on countries to ensure healthy lives and promote well-being for all at all ages.
In 2016, the WHO recorded the following:
UN General Assembly adoption of a political declaration on Antimicrobial Resistance, AMR, and calls for the establishment of an ad-hoc inter-agency coordination group on antimicrobial resistance to provide practical guidance to ensure global action against AMR.
Progress towards polio-free certification in the African region, with Nigerian which was long considered the global epicentre of poliovirus reporting its last wild poliovirus, paving the way for certifying the African Region free of such strains.
Treatment of neglected tropical diseases. With this the goal of at least one billion people treated for at least one neglected tropical disease in a single year was met for the first time.
The Global Strategy for Women’s, Children’s and Adolescents’ Health was launched to run through 2016 to 2030.
Before the end of 2016, WHO announced zero cases of Ebola in West Africa, but warned that flare-ups of the disease are likely to continue and that countries in the region need to remain vigilant and prepared.
While displaying its responsiveness to world health related issues, the WHO in March 2015 had reported a large outbreak of rash illness in Brazil, which it soon identified as Zika virus infection found to be associated with Guillain-Barré syndrome. In 2016, WHO declared that the association of Zika infection with clusters of microcephaly and other neurological disorders constituted a Public Health Emergency of International Concern. It further reported that a total of 86 countries and territories have reported evidence of mosquito-transmitted Zika infection
According to WHO, no vaccine is yet available for the prevention or treatment of Zika virus infection, however development of a vaccine remains an active area of research.
In 2017, WHO published its first ever list of antibiotic-resistant “priority pathogens” – a catalogue of 12 families of bacteria that pose the greatest threat to human health and launched the Partnership for Healthy Cities which include 70 cities of over 300 million inhabitants in total. The Partnership aims to put in place policies and programmes to prevent road traffic injuries and diseases like cancer, heart disease, diabetes and lung disease.
2019 saw the World leaders adopt a high-level United Nations Political Declaration on universal health coverage, the most comprehensive set of health commitments ever adopted at this level.
In the year 2020, the WHO also proved its integrity and strength at the outbreak of the novel COVID-19 originating from Wuhan city in China, by declaring a Public Health Emergency of International Concern, PHEIC.
It is pertinent to note that in the International Health Regulations (2005), a PHEIC is defined as, “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response”.
Today, the world health challenge has so far been tamed and vaccines are still being produced to help eradicate the deadly virus from the globe.
While assiduously fighting the COVID-19 disease and observing the global lockdown which it caused, the WHO was still engaged in its responsibilities of maintaining a sustainable health for nations. In the same year, 2020, through the data provided by WHO’s Global Antimicrobial Resistance and Use Surveillance System, the UN Statistical Commission approves a new SDG indicator on blood stream infections due to selected antimicrobial-resistant organisms. It also established the first 2-3 times shorter, fully oral regimen , more effective treatments for the treatment of multidrug-resistant tuberculosis (MDR-TB) to replace the administration of painful injectable agents. In addition, in collaboration with the European Commission, Emmanuel Macron, the President of France, the Bill & Melinda Gates Foundation, Tedros Adhanom Ghebreyesus, WHO Director-General, launched the Access to COVID-19 Tools Accelerator (ACT-Accelerator) partnership by the.
Between 2021 to 2022, the WHO has also added the following achievements:
In 2021, not less than 75 percent of all people living with HIV were accessing antiretroviral therapy.
Also in 2021, the long-awaited malaria vaccine came into the world’s health atmosphere. This vaccine is a breakthrough for science, child health and malaria control. WHO recognised it as “the first vaccine against a parasite and could save tens of thousands of young lives each year.”
In the same year, the Organisation recorded that more than 74 million lives had been saved through tuberculosis prevention, diagnosis and treatment since 2000.
In 2022, the WHO led a ground-breaking agreement with four international agencies, namely the Food and Agriculture Organization, FAO, the World Organisation for Animal Health, WOAH, the UN Environment Programme, UNEP to strengthen cooperation to sustainably balance and optimize the health of humans, animals, plants, the environment and the ecosystem. This agreement could perhaps check the outbreak of animal to man diseases.
While looking at global health, the WHO also concerned itself with the population of the world as it appears to be a key and important factor while checking global health. Thus, before the end of the year 2022, with co-authors USAID and Johns Hopkins University, WHO releases the 4th edition of “Family Planning: A Global Handbook for Providers”. The Handbook provides clinic-based health professionals with the latest guidance on providing contraceptive methods.
With all these milestones achieved by the body saddled with the responsibility of maintaining a healthy world, it is therefore not out of place for it to mark this year’s World Health Day with a retrospection and quick look at its achievements over 7 decades.
The Organisation underlined therefore that “it is also an opportunity to motivate action to tackle the health challenges of today ̶ and tomorrow.”
KN
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