World Health Assembly appeals for more aid to health strategies of developing countries.

World Health Assembly appeals for more aid to health strategies of developing countries

The World Health Assembly at its thirty-ninth session (Geneva, 5-16 May) called for action to improve health strategies of developing countries and to combat drug abuse, tobacco use and the acquired immune deficiency syndrome (AIDS) eqidemic.

Delegates representing most of the 166 member States of the World Health Organization (WHO) expressed support for the WHO "Global Strategy for Health for All by the Year 2000' and appealed to developed countries and international organizations and agencies to assist developing countries with their national

health strategies.

The appeal, contained in a resolution adopted on 15 May, was made in view of the "widespread economic crisis which had resulted in a fall in living standards in many countries and provoked serious unemployment and formidable austerity policies', which in some countries resulted in substantial cuts in health care. The crisis, particularly in developing countries, had been aggravated by the persistent rise in the foreign debt and deterioration of the balances of trade', and endangered the possibility of reaching the goal of health for all by the year 2000.

Among the other resolutions adopted at the two-week session was one urging continued collaboration by WHO members to control AIDS. WHO was asked to co-operate with countries to study the problem and set up national and collective programmes to prevent and control of the disease.

Tobacco smoking and tobacco use in all forms was incompatible with the attainment of health for all by the year 2000, and Assembly declared, calling for a global public health approach and action to combat the tobacco pandemic. Other United Nations organizations were asked to support WHO in all ways possible within their fields of competence to help stem the spread of tobacco-induced diseases by protecting the health of non-smokers on their premises. The Director-General of WHO, Dr. Halfdan Mahler, was asked to ensure that WHO played an effective global advocacy role with regard to tobacco and health issues.

In response to the dramatic increase of serious health and social problems related to the abuse of narcotic and psychotropic substances, the Assembly urged member States to further develop national prevention and treatment programmes. WHO was asked to formulate a plan of action aimed at controlling health problems related to drug abuse, and it was suggested that the United Nations increase financial support in that area.

The Assembly endorsed the "Forward-looking Strategies for the Advancement of Women', adopted in 1985 in Nairobi, stating they provided a comprehensive policy framework for advancing the status of women to the year 2000', and deciding that WHO should take all appropriate measures with other United Nations organizations to implement the Strategies.

The Assembly noted that, though many member States had made substantial efforts to implement the 1981 World Health Assembly's International Code on the Marketing of Breast-Milk Substitutes, concerted efforts would continue to be needed to achieve full implementation. Member States were urged to implement the code if they had not done so.

The Assembly said that peace and security were important for preserving and improving the health of all people and that co-operation among nations on vital health issues could contribute significantly to peace.

The WHO Director-General was asked to set up an expert working group to examine the scientific and health effects of alcohol as an ingredient of some medicines and the implications of its possible reduction or elimination.

WHO was asked to continue to provide countries which were targets of destabilization by South Africa with technical co-operation in the health field, to rehabilitate their damaged health infrastructures.

The WHO Director-General was asked to help Palestinians promote primary health care inside and outside the occupied Palestinian territories, by developing adequate health and social services and training additional health personnel.

Considering the continuing health problems of refugees and displaced persons in Cyprus, the Assembly called on the Director-General to continue and intensify health assistance to them. The Director-General was also asked to continue and expand substantially WHO's programme of health, medical and relief assistance to Lebanon.

Drug strategy: The Assembly approved a strategy designed to make the use of drugs more rational throughout the world, based on recommendations made at the WHO Conference of Experts on the Rational Use of Drugs (Nairobi, November 1985).

The strategy requires WHO to secure the co-operation of a number of "concerned parties' in fulfilling the responsibilities laid down at the Nairobi Conference. Those parties are Governments; the pharmaceutical industry; health personnel involved in prescription dispensing, supply and distribution; universities and other teaching institutions; professional nongovernmental organizations; the public; patients' and consumer groups; and the mass media.

Through its Action Programme on Essential Drugs and Vaccines, WHO will give increased support to Governments for introduction of national drug policies and essential drug programmes. As part of the organization's activities related to drug standards and regulations, a group of WHO experts is to be asked to review and update the ethical criteria for drug promotion approved by WHO in 1968. The strategy also envisages measures to promote collaborative research and the education and training of health personnel in the rational use of drugs.

Combating health inequities: The Assembly accepted the recommendations that emerged from technical discussions, held concurrently with its session, on "the role of intersectoral co-operation in national strategies for health for all'.

The discussions, attended by 500 participants, included many senior government officials from sectors other than health. Four working groups were formed to focus debate on equity and health; agriculture, food and nutrition; education/culture, information and life patterns; and environment/water, sanitation, habitat and industry. Each working group produced its own set of recommendations.

Combating inequities in health must be "an overriding concern' in national strategies for attaining health for all by the year 2000, since vulnerable groups among the population were often by-passed in the general process of social and economic development, the group on that subject declared.

The agriculture group called for efforts to improve access to land, to ensure food security by promoting the production and use of traditional crops, and to pursue equitable farm price policies.

The education group emphasized that education was a decisive factor in health development and recommended that the training of health professionals should include an adequate knowledge of the social and economic determinants of health, so that they could identify and promote intersectoral actions for health.

The environment group recommended that policies and projects for developing natural resources should be linked to a sustained "watch' on areas where health and environment overlapped; thus, new initiatives to improve health would be appraised and the health impact of programmes with potentially high health risks would be monitored.

Nuclear accidents: A number of delegates had expressed concern regarding the international health consequences of large-scale accidents such as the recent nuclear accident at the Chernobyl power station. Dr. Mahler said he had already set in motion action "to meet the legitimate expectations of member States in this area'. WHO had reacted speedily to the Chernobyl reactor accident by convening an expert group that had already reported to the organization. WHO's European office would continue to follow the situation closely until it was stabilized, he said.

WHO would also intensify action to co-ordinate the collection, analysis and speedy dissemination of information on the health effects of accidents resulting from the peaceful use of atomic energy, Dr. Halfdan Mahler told the Assembly. "Should any serious accident occur in the peaceful use of atomic energy, the network of collaborating centres would go into non-stop action and WHO would issue consolidated reports on health effects as frequently as necessary and as rapidly as possible', Dr. Mahler indicated.

A multidisciplinary group of experts would advise him on how WHO could further expand its role concerning the health effects of nuclear power accidents, including how to gain immediate access to all relevant information. He assured delegates that WHO would co-ordinate its activities with other United Nations agencies and international non-governmental organizations with a mandate in that area.

Photo: Dr. Mahler WHO Director-General