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More ways to save more lives for less money, by WHO

By Chukwuma Muanya
01 June 2023   |   3:06 am
The World Health Organisation (WHO) has expanded the list of ‘Non-Communicable Diseases (NCD) best buys’. The updated list was approved, this week, at the 76th World Health Assembly, a move that will support governments to select lifesaving interventions and policies for the world’s biggest killers, NCDs.

World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus (Photo by Fabrice COFFRINI / AFP)

•WHA adopts more Best Buys to tackle non-communicable diseases, first-ever global strategy on infection prevention, control

The World Health Organisation (WHO) has expanded the list of ‘Non-Communicable Diseases (NCD) best buys’. The updated list was approved, this week, at the 76th World Health Assembly, a move that will support governments to select lifesaving interventions and policies for the world’s biggest killers, NCDs. This gives countries of every income level support to improve the health of their citizens.

Interventions offered include taxes and bans on advertising for tobacco and alcohol, reformulation policies for healthier food and drinks and the promotion and support of optimal breastfeeding practices.

The new list also includes secondary prevention for rheumatic fever, acute and long-term management of asthma and chronic obstructive pulmonary disease, as well as several cancer control interventions related to cervical, breast, colorectal, liver and childhood cancer, and the comprehensive treatment of cancer for those living with Human Immuno-deficiency Virus (HIV).

The updated best buys come with policy options and cost-effective interventions that will help governments prioritise investments according to their specific country context.  Investing in evidence-based policies is an investment in a healthy future.

The latest revision was updated to reflect WHO’s recommendations and guidance and the latest scientific evidence on impact. The report is part of the NCDs Global Action Plan 2023-2030 and is an update from 2017 and core to the Implementation Roadmap on NCDs. Each revision is based on new WHO normative and standard-setting products, new evidence and data to expand and update the interventions.

The updated list continues to support that NCD prevention and control is a remarkable bargain that can save millions of lives and add millions of healthy life-years.

These interventions can help support countries to achieve the Sustainable Development Goal of reducing by one third, premature mortality from non-communicable diseases through prevention and treatment and the promotion mental health and well-being worldwide by 2030.

They also provide an opportunity to accelerate national action to prevent and control NCDs to reduce suffering and prevent deaths and pave the way for political commitment at the fourth High-level Meeting of the United Nations General Assembly on the Prevention and Control of NCDs in 2025.

Meanwhile, the World Health Assembly, a, agreed on the first-ever global strategy on infection prevention and control (IPC), which builds on almost two decades of efforts led by WHO and partners. The strategy provides Member States with strategic directions to substantially reduce the ongoing risk of healthcare-associated infections (HAIs), including those that exhibit antimicrobial resistance.

HAIs are among the most frequent adverse events occurring in the context of health service delivery. The COVID-19 pandemic and recent major disease outbreaks such as Ebola virus disease, the Middle East respiratory syndrome and the Sudan virus disease have clearly exposed the existing gaps in IPC programmes in all countries.

The strategy sets a clear vision: by 2030, everyone accessing or providing health care is safe from associated infections. Its three key objectives are: to prevent infection in health care; act to ensure IPC programmes are in place and implemented; and coordinate IPC activities with other areas and sectors.

The strategy is focused on any setting where health care is delivered, across the health system; it is based on the principle of clean and safe care as a fundamental component of the right to health, which is equity driven, and which should ensure accountability and sustainability.

The global IPC strategy will be complemented by, and used in conjunction with, an associated global action plan and monitoring framework, that will be developed in 2023–2024.

The resolution lists a range of actions to be taken by the WHO Secretariat such as: publishing a baseline report by the end of 2026 with information on the capacity of Member States to respond to rehabilitation needs; developing targets and indicators for effective coverage of rehabilitation services by 2030; ensuring appropriate resources are allocated at WHO to support Member States in implementing technical guidance and resources; and supporting Member States to integrate rehabilitation and assistive technology in their emergency preparedness and response plan.

The WHO Secretariat will report on progress in the implementation of this resolution to the Health Assembly in 2026, 2028 and 2030.

Also, delegates at the 76th WHA adopted the resolution on accelerating efforts to prevent micronutrient deficiencies through safe and effective food fortification. The resolution urges Member States to make decisions on food fortification with micronutrients and/or supplementation and to consider ways of strengthening financing and monitoring mechanisms.

Deficiencies in vitamin and mineral status, particularly of folate, iron, vitamin A, and zinc, affect 50 per cent of all preschool aged children and 67 per cent of all women of reproductive age (WRA) worldwide. Micronutrient deficiencies can have serious consequences, including spina bifida and other neural tube defects. These preventable deficiencies are also associated with a higher risk of blindness, fragile immune systems, diminished exercise and physical capacity. Mothers with low micronutrient can have babies prematurely or with low birth weight. Iodine deficiency, still prevalent in many countries, impairs brain development in children, undermining their ability to learn and their eventual productivity.

Large-scale food fortification (LSFF) is part of the solution. By adding essential vitamins and minerals to staple foods and condiments, such as wheat and maize flours, rice, cooking oil, and salt in accordance with national consumption patterns and deficiencies, countries can correct and further prevent a demonstrated micronutrient deficiency.

Fortification is an evidence-informed intervention that contributes to the prevention, reduction and control of micronutrient deficiencies. It can be used to correct a demonstrated micronutrient deficiency in the general population (mass or large-scale fortification) or in specific population groups (targeted fortification) such as children, pregnant women and the beneficiaries of social protection programmes.

He has been working in food fortification for decades and collaborates with different networks for fortification at the regional, country and community levels. WHO recommends large scale food fortification as a powerful evidence-informed and cost-effective intervention to fight the consequences of vitamin and mineral deficiencies, including iodine deficiency disorders, anaemia and iron deficiency, and neural tube defects among others.

The resolution was put forward by Australia, Brazil, Canada, Chile, Colombia, Ecuador, European Union and its 27 Member States, Israel, Malaysia and Paraguay.

The resolution received a wide support from the civil society, with over 50 organisations calling on WHO to accelerate efforts on micronutrient fortification of food through a jointly signed letter. The organizations underlined in their letter that micronutrient deficiency is a crisis that affects all communities globally, low-income or high-income, and that there is still a large unfinished agenda on food fortification, calling on WHO to double the efforts to improve the reach and quality of food fortification programmes, which have big potential to combat these preventable deficiencies and protect health.

The resolution was adopted under the umbrella of the United Nations Decade of Action on Nutrition (2016-2025) report. The Nutrition Decade aims to accelerate the implementation of the Second International Conference on Nutrition (ICN2) commitments, achieve the global nutrition and diet-related noncommunicable disease (NCD) targets by 2025, and contribute to the realization of the Sustainable Development Goals by 2030. Reflection on global progress and challenges encountered and on a way forward after the ending of the UN Decade of Action on Nutrition (2016 – 2025) is encouraged.