WHO AND WORLD BANK JOIN FORCES FOR BETTER GLOBAL HEALTH INVESTMENTS

Delegates at the International AIDS Conference of the World Health Organization and the World Bank address the pressing global debate around health systems and initiatives in specific aspects of health, nutrition and population. Critics claim that disease-specific iniatives are eroding already weak health systems, while others assert that weak health systems are holding back progress in disease-specific initiatives. In an effort to gather evidence and provide technical guidance in this area, WHO and the World Bank have agreed to join forces in collaboration with a wide range of interested stakeholders, including country officials, academic and research institutions, Global Health Initiatives and civil society organizations.

During the past decade, global health initiatives have become a prominent part of the international aid architecture, bringing new resources, partners, technical capacity and political commitment. Examples include The Global Fund to Fight AIDS, Tuberculosis and Malaria, the GAVI Alliance, and the US President’s Emergency Plan for AIDS Relief, known as PEPFAR. Now numbering more than 80, these initiatives have contributed to a dramatic increase in the level of resources for health in low- and middle-income countries.

Notwithstanding the gains that have been made in funding and access to health services, critics allege that Global Health Initiatives have also exposed weaknesses in health systems. These weaknesses in overstressed health systems in many low- and middle- income countries are thought to be Iimiting the effectiveness of Global Health Initiatives and may be undermining investments that are now being made. The new effort will examine the issues in the debate, separate reality from rhetoric, and provide governments with sound technical guidance to enhance health systems without diminishing the benefits of disease-specific initiatives.

It is not about choosing between health systems strengthening on the one hand and disease-specific programmes on the other.

It is about working together to generate added value. The time has come to move from observing the intentional and unintentional impacts of health investments to actively managing better outcomes that can be sustained.

The WHO-World Bank collaboration will examine and combine the strengths of different approaches around the world in order to get better results from investments and improve health outcomes for all. “This collaboration will be useful at the country and global levels. We will generate new knowledge, work with countries to improve their approaches and share lessons at the regional and global levels,” says Julian Schweitzer, Director of Health, Nutrition and Population at the World Bank.

WHO/26/2008

HEALTH CRISES HEIGHTEN HUMANITARIAN DESPAIR IN ETHIOPIA

Worsening malnutrition and the threat of disease outbreaks are compounding Ethiopia’s humanitarian crisis. The World Health Organization is working with the Government of Ethiopia and health partners to support the 4.6 million people again needing urgent emergency food relief nationwide.

The number of people needing food assistance is increasing markedly in Ethiopia, and health risks are being compounded by the global food security crisis, the impact of drought on agricultural production and the country’s weak health system. During the coming months, annual rains are expected to again cause large-scale flooding, increasing loss of crops and risk of disease.

“In humanitarian terms, the situation is unacceptable,” said Dr Eric Laroche, Assistant Director-General for WHO’s Health Action in Crises Cluster. “The health of millions of Ethiopians is worsening by the day, and the international community must act to support the country’s government to ease this terrible suffering.”

In three regions alone (Somali, SNNP and Eastern Oromiya), the number of government-run feeding centres has risen from 200 three months ago to 605 today. Some 75 000 children aged under 5 need therapeutic and supplemenlary nutrition support. WHO, UNICEF and nongovernmental organization partners are supporting these centres.

Additional major gaps affecting people’s health and livelihoods are lack of access to safe drinking water, shortages of drugs and medical supplies and insufficient human resources. The areas affected by shortages are also at significant risk of disease outbreaks: diarrhoeal diseases, measles and meningitis. Cases of acute watery diarrhoea have been reported in 16 districts, and outbreaks of cerebrospinal meningitis in 37 districts. More than 7000 cases of measles have been registered in 38 districts.

WHO works with federal and regional government partners, UN agencies and nongovernmental organizations to provide better health and nutrition services throughout Ethiopia, using emergency mobile teams; deploy drugs, medical and nutrition supplies and staff for emergency action in affected areas; plan the rolling out outpatient therapeutic programmes in the health extension programme which promotes the primary health care approach in Ethiopia; and strengthen disease and nutritional surveillance systems to enable rapid response.

Response efforts include:

• Strengthening disease and nutritional surveillance, particularly for severe acute malnutrition to enable critical response.

• Preventing measles via immunization activities, including vaccinations and vitamin A supplementation. The first phase of supplementary immunization activities had a more than 95% coverage rate.

• Training and support for health staff and strengthening systems to address health needs.

• Water treatment and hygiene and sanitation promotion interventions to stop the spread of acute watery diarrhoea and other communicable diseases.

• Provision of urgently needed drugs and medical supplies to support health services and therapeutic feeding programmes.

WHO/22/2008

The Treaty on the Non-Proliferation of Nuclear Weapons: Prospects for the 2010 Review Conference

The UN DPI/NGO meeting examined the Preparatory Committee (PrepCom) for the 2010 Review Conference of the Parties to the Treaty on the Non-Proliferation of Nuclear Weapons (NPT). The purpose of the PrepCom is to prepare for the Review Conference in terms of assessing the implementation of each article of the NPT and facilitating discussion among States with a view to making recommendations to the Review Conference. The guest speakers were Mr Sergio de Queiroz Duarte, High Representative for Disarmament Affairs and Mr John Burroughs, Executive Director, Lawyers’ Committee on Nuclear Policy.

A short film entitled “Genie in a Bottle: Unleashed” was screened. The film, produced by Stephen Trace Films, tells the story of the Manhattan Project (in memory of the 60th anniversary of the Hiroshima and Nagasaki Bombs in August 2005). The film reflects on the history and tragedy of nuclear weapons.

Mr Sergio de Queiroz Duarte noted that the Non-Proliferation Treaty was the only instrument committing the majority of countries to non-proliferation and disarmament. It was important for all UN Member States to abide by the Treaty. Mr Duarte stressed the important role the civil society played in raising awareness of nuclear weapons, the reason why he decided to share his knowledge with UN NGOs. Mr Duarte discussed the ways in which security perceptions have changed over the past four decades. He noted a misconception of several countries that believed non-proliferation would diminish their security, although he recognized that with time many have come to see the option as the opposite, as enhancing their security. Security was better served by signing the Treaty, which was a binding agreement. All countries, except three, have signed the agreement. The three non-parties have important security perceptions, which in their view justifies acquiring nuclear weapons. Mr Duarte noted that high marks of evolution for the Treaty took place between 1995 through 2000. Serious work must still be done. Terrorism added a difficult element to the equation. He noted that the 2005 Conference demonstrated how irreconcilable the positions had become, but in 2006 things seemed more positive. The Second PrepCom should avoid procedural pitfalls and concentrate on substance. Mr Duarte added that the Third PrepComm would be an important test, due to its mandate to make recommendations to the Review Conference. Mr Duarte concluded by saying that although our intelligence tells us to be pessimistic our will makes us optimistic. He said: “Let us use our will” and change into a nuclear-free world.

Mr. John Burroughs discussed possible problems for the 2010 Review Conference such as the dispute over Iran’s nuclear issue, the United States resistance to commitments made at the 1995 and 2000 conference, and Arab countries insisting on progress towards bringing Israel to sign the Treaty as a non-nuclear weapon state. Mr Burroughs noted possible solutions for these problems to be a resolution of the dispute over Iran’s nuclear issue, progress in resolving the Palestine-Israel conflict, and movement towards creation of a Middle East free of weapons of mass destruction. More than one billion dollars was spent to extend missile life to the year 2042. He added that there were 25,000 nuclear warheads and bombs in the world and there was no sign that countries were willing to cut those numbers. Problems of proliferation and terrorist acquisition must be addressed, but can only be solved when reduction and elimination of existing nuclear arsenals takes place. Mr Burroughs spoke about the priorities of his organization to be: verified reduction of nuclear forces, negotiation of a Fissile Material Cut-off Treaty, strengthening negative security assurances, regulation of nuclear fuel supply and production, and improved governance of the Treaty on Non-Proliferation of Nuclear Weapons; and explore the idea of having a weapons-of-mass-destruction free world and a new treaty to ban all nuclear weapons in the future. In 2006, 26 billion dollars was spent worldwide on nuclear forces, warhead maintenance, research, and delivery systems. If we had complete nuclear disarmament, the finances could be shifted to other areas such as poverty issues.

DPI/NGO Newsletter 4/2008