Four Days at the World Health Assembly (WHA) - Eric's Journal

Le Palais des Nations

I'm in Geneva for the next 3-4 days on behalf of Save the Children and CORE Group. I'll be speaking briefly at a PMNCH, CORE, CLAC (Citizen Led Accountability Coalition), and Save event on "The Role of Government in Welcoming the Voice of the People." I'll also be covering as many of the HSS, PHC, community health, and UHC-related sessions as I can.

I'm going to use this blog to journal and report along the way...

• Monday, May 20, 2019 -- Geneva, First day at the WHA

Starting the way with the Save the Children pow-wow, colleagues from Advocacy and Humanitarian Response, from the UK, Germany, Australia, and of course Switzerland (kindly hosting us) so far...

Keywords: UHC - ACCOUNTABILITY & CIVIC SPACE

Very timely - our SCUK have just released a UHC AND ACCOUNTABILITY INDEX. This short document presents data for dozens of countries on prioritization of PHC, financing of UHC, and interestingly on general health financing accountability and civic engagement.

Interesting reminders: links between availability of skilled health workers, and government financial committment with  U5 mortality, and interesting observation (see the last figure) that "countries with higher U5 mortality rates are often countries with less civil space."

-> Read the blog: "is civic space the cornerstone of UHC?"
-> Download The Universal Health Coverage and Accountability Index

stay tuned...


The WHA is a whirlwind of official sessions, business sessions, technical updates, and side sessions. Here are a few that I caught...

• Still Monday, May 20, 2019 -- PHC session (aka Primary Health Care towards Universal Health Coverage and Sustainable Development Goals, official side event)

Keywords: PHC - UHC - SDGs ... and CHWs!

This official side event was sponsored by China, Denmark, Ethiopia, Iran, etc. I got there five minutes early - that was insufficient to have a seat among those arranged along the wall, around the central space of tables for official delegations. Apart from standing, the downside of that was absence of access to an earpiece for translations. So, I may have missed some of the wisdom of the Chinese and Russian presentations.

The dominant style at the WHA, I quickly figured out, is the reading of written speeches. It makes sense, in a context where everything is recorded, and where speakers represent their nation-state (when they have one) that written text would dominate. But it was very different from my usual conference experience.

The opening of that session and speeches I could understand restated loudly essential principles:
- no UHC without PHC
- health systems as a foundation of PHC and UHC
- the historical trajectory from Alma Ata to Astana
- the emergence of the PHC operational framework, the SDG accelerator (largely among global public private partnerships - more on that later), and still the need to build the evidence base.

One speaker ended his speech with "in the name of PHC and UHC"; I felt compelled to say 'Amen', but I resisted. I'll take all the signs of commitment and buy-in for PHC that I can take.

The Minister of Health of Ethiopia re-explained the Ethiopian model for PHC and community health that most of us are familiar with now. Of note, he explained how a bridge was needed between CHWs and the households themselves, how women were the bridge, and how this had led to the Health Development Army, renamed Women Development Army for the occasion. Given that our 'Beyond the Building Blocks' paper is finally under press, and that it articulates that very need for what we sometimes describe as a 'dual model' (CHWs becoming professionals, CHVs grounded in community life, with rational task distribution), I was naturally elated by this reference.

Other speeches were made -- it was interesting to hear how PHC could be described as a key concern in countries as different as Singapore, Ethiopia, and Denmark! Key message here: PHC is not an LMIC strategy, it's a fundamental Public Health strategy.

Quote from my notes (I think from the Singapore representative): "The definition of PHC will vary country to country depending on epidemiology, ..."
.
-> Spoiler alert: over the next few days, WHA72 endorsed a number of statements and resolutions, notably on Community Health Workers for the delivery of PHC. This built on the work of many people, WHO's official guidelines, support from governments including the USG as a co-sponsor of the resolution, advocates, implementers from civil society to countries in the last 50 years.
This historical resolution is available here.

• Monday, May 20, 2019 -- Second Plenary Session

Keywords: everything - non-state actor

The General Assembly Hall (from the Edge of my Seat)

I found my place as a non-state actor in the impressive plenary hall of the 'Palais des Nations', and I will not try to summarize it for you. There is a lot of process and protocol happening. OK, since you insist I'll give you key words: 'health of all humanity', '75 agenda items', 'responsive health systems providing quality care', 'no one left behind' (the theme), 'affordable, essential, quality health', a 'normative assembly', 'commitment', 're-commitment', 'walk the talk', 'health, environment, climate change', 'Astana', 'second chance', 'domestic resource mobilization', 'responsiveness to the most vulnerable populations'...

Dr Tedros

I'll skip over the debate about whether Taiwan should get its observer status back, which was rejected (China and Pakistan opposed, in spite of the Marshall Islands and St Vincent and the Grenadines strong plea), and whether there should be a side session on the health conditions in the occupied Palestinian Territories, East Jerusalem, and the Golan Heights, which took place a few days later (in spite of forceful objections by Israel and the United States of America).

Finally, we got to the speech by Dr Tedros. That was my primary target...
Unfortunately Dr Tedros explained that he had already made his speech during a morning plenary and wouldn't repeat himself. I haven't seen the text online yet, but

-> You can watch Dr Tedros' speech here.

And, no, I don't have a summary. Sorry.


I'll add more notes in the coming days, starting with a very interesting session by our friends from World Vision on CHWs, and "Committee A" sessions, where my Save the Children advocacy colleagues made key contributions, as well as FHWC, Impact Coalition, Intrahealth, and too many others to name...

Sorry to leave you on a cliffhanger. Stay tuned...