This is a guest blog by Dr. Inon Schenker, a former staff member of the World Health Organization (WHO), founding chair of the Jerusalem AIDS Project and current senior HIV/AIDS prevention specialist and global health consultant who is assisting in technology transfer and health leadership in Africa. Dr. Schenker is a member of the Global Health Council delegation to the 2010 World Health Assembly from Jerusalem, Israel.
GENEVA, Switzerland – World Health Organization Director-General Dr. Margaret Chan, dressed in pink, joined the head table after Dr. Carla Abou-Zahr, WHO’s coordinator for monitoring and analysis, concluded her presentation with a clear message: There are striking improvements in achieving the Millennium Development Goals (MDGs) related to child health, maternal mortality, malaria and HIV/AIDS, but the results mask inequalities between countries and between regions.
For example, the percentage of underweight children worldwide declined from an estimated 25% in 1990 to 16% in 2010. Between 2001 and 2008, HIV infections fell by 16% and the percentage of the world’s population with access to safe drinking water had increased from 77% to 87%. Yet, compared with other regions, Africa had the least progress on water and sanitation with the percentage of the population using toilets or latrines only increasing from 30 in 1990 to 34 in 2008. She also reported that 40% of deaths in children under five are estimated to occur in the first month of life, most in the first week.
It was a briefing session, many of which are convened as “lunch” or “side” events during the World Health Assembly. These are opportunities for governments, U.N. bodies and civil society to dialogue around global issues of interest. The format is inclusive, less formal than the discussions in the plenary and the committee halls. It’s free seating, no need to register early and if eligible to enter the Palais de Nations, you can participate in the discussion as an individual or representative of an NGO or a delegate of a Ministry of Health on equal terms.
There were several of us from the GHC delegation that found this briefing to be of special interest. We were also impressed with the structure of the session: Panelists at the head table, moderated by a distinguished scientist, who addressed hundreds of listeners who, in turn, posed questions or comments. You raise your hand, it catches the eyes of the moderator and you are on live! Nothing unusual, except the fact that seated next to you could be the minister of health from Thailand or the permanent secretary of health from Fiji and next to them senior managers of WHO, with whom it make take weeks for you to get an appointment.
On the podium we notice experts from WHO; the ministers of health of Tanzania, Bangladesh and Chile, and the executive director of the Global Fund to Fight AIDS TB and Malaria. There was a focus on the health MDGs least likely to be met — reducing maternal mortality—as well discussion on improving child survival and combating HIV/AIDS, malaria and tuberculosis.
Speakers recounted how progress, though uneven, was made possible by a combination of national policies, leadership, resources and provision of accessible community level health services. Removing barriers to services such as reimbursement of transportation costs and providing motorcycle ambulances were raised as potential solutions. Common challenges emerged from the discussions: health systems need strengthening, interventions are too compartmentalized, inadequate resources and a need for better systems to record births and deaths.
Other key issues raised included improving political commitment, community mobilization and ownership, working in partnership and addressing the effects of disasters. The link between the education of girls and empowerment of women to achieving MDGs 4 and 5 was repeated in the discussions.
Dr. Chan noted that whereas there is no lack of innovation, the main challenges are scaling up programs from the local to the national and global levels and ensuring their sustainability.
Knowing that 2015 is only five years away, I wondered why no one in the room was asking for an extension.