At WHA, Chan cites Zika, yellow fever policy failures

first_imgIn stern comments today on Zika virus and yellow fever epidemics before the World Health Assembly (WHA) in Geneva, Margaret Chan, MD, MPH, World Health Organization (WHO) director-general, said a massive policy failure allowed mosquito control to lapse in the 1970s, adding that the world has failed to take full advantage of an excellent tool to control yellow fever.Infectious diseases and reforms related to the WHO’s role in responding to epidemics are among the agenda items at this year’s WHA taking place through May 28. WHA is made up of health ministers from member states, who weigh in on major policy decisions, set the direction for the WHO’s work, and approve the WHO’s budget.At a press briefing last week ahead of the 69th WHA meeting, Chan said about 3,500 people from 194 member states are expected to attend and that 76 items are on the agenda, the most ever for a WHA meeting.Policy failures and ZikaChan said Zika took the world by surprise, and, like many health emergencies, it has revealed fault lines in the world’s collective preparedness. With no vaccines and no reliable and widely available diagnostic test, “All we can offer is advice. Avoid mosquito bites. Avoid pregnancy. Do not travel to areas with ongoing transmission.”The Zika outbreak also reveals an “extreme consequence” of the failure to provide universal access to sexual and family planning services, she said. “Latin America and the Caribbean have the highest proportion of unintended pregnancies anywhere in the world.”In addition, the spread of Zika, resurgence of dengue, and the emerging chikungunya threat are prices paid for “a massive policy failure that dropped the ball on mosquito control in the 1970s.”Unheeded yellow fever warningsLessons learned from the recent yellow fever outbreaks in Africa are especially brutal, Chan said. “The world failed to use an excellent preventive tool to its full strategic advantage.” She added that the world has had a safe, low-cost, and effective vaccine that affords lifelong protection since 1937. “That’s nearly 80 years.”Chan said the vaccine should be used more widely to protect people where the disease is endemic.”For more than a decade, WHO has been warning that changes in demography and land use patterns in Africa have created ideal conditions for explosive outbreaks of urban yellow fever,” she said. “Africa’s urbanization has been rapid and rampant, showing the fastest growth rates anywhere in the world.”In Angola, migrant workers from rural mining and construction sites can carry the disease into urban settings, where “powder-keg conditions” exist:  dense populations of nonimmune residents, heavy infestations with mosquitoes that are suited to urban life, and weak infrastructure that makes mosquito control almost impossible, Chan added.WHO reform on the agendaThe WHA agenda item with the most sweeping consequences is the reform of the WHO’s work in health emergencies, which includes a plan for its structure, oversight, implementation, and financing, she said, noting that the proposal combines technical expertise, response, and operational capacity.West Africa’s Ebola outbreak highlighted the WHO’s limited capacity to respond to such a large event, and many countries and groups have pressed the agency to take on a larger role as the world’s top health emergency responder. The WHO announced a set of reform proposals in January ahead of its executive board meeting, which sought to shore up expert staffing and partnerships and establish an emergency fund to speed work in the early phase of emergency response.”I urge you to give this item the serious consideration it deserves. Anything short of full political and financial support for the program will handicap the WHO response, right now and into the future,” Chan said.Other infectious disease topics at WHAAccording to the WHO’s background materials on the meeting, the group will also discuss a global action plan on antimicrobial resistance, polio, pandemic preparedness , destruction of variola (smallpox) virus stocks, and other communicable diseases such as HIV, viral hepatitis, and sexually transmitted diseases.See also:May 23 Margaret Chan WHA opening addressWHA Web portalWHA agendalast_img

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