WHA Roundup & the intrigue of poisoned chocolate boxes
Two episodes: Philippines Health System overview & a public health scandal
Dear Friend of Global Health Conversations,
How has your fortnight been? 🙂
Having just finished Reinhardt’s ‘Priced Out: The Economic and Ethical Costs of American Healthcare,’ (excellent, albeit dry) I was looking for something new and light.
Thus, I spent my Friday night absorbed in a good, guilty pleasure, crime novel. Anthony Berkley’s ‘The Poisoned Chocolates Case’. (Very mild spoilers below so feel free to skip to the Fortnight in Resources) I really do love a good crime novel. The poisoned box of chocolates is a trope used in many mystery novels of that era. This particular story involves everything you’d hope for in a story of its kind: financial motives, shifting blame, realistic descriptions of chemical poisons and methods. As well as, perhaps inadvertently, an exploration of toxicology and dosing: The therapeutic index - minimum effective dose, the lethal dose and toxic dose. You see, two people consume the poisoned chocolates and due to circumstance, only one dies.
One of these factors was that one had access to quick and competent healthcare and the other did not. I do wonder how my mind works sometimes. Because this concept reminded me of a recent article I had read about what the Philippines is doing to combat NCDs in their country. And also, the Diabetes-Obesity-Hypertension nexus. So I recorded a health system overview on the topic.
It was the nebulous idea of how much chocolate is too much - appropriate dosing and the therapeutic index. I was reminded of the recent ‘Real Water’ Scandal, in which a company selling alkaline, bottled water inadvertently poisoned consumers across the Las Vegas area through inappropriate controls and negligence in their processes. And it motivated me to finally record the BONUS episode. During which I found even more lawsuits have been filed just this year. A story, not unlike my current fiction read, full of financial motives. Listen here.
All in all, I had a great time getting my mind off the stresses of the world. It gave me an opportunity to focus on the particular stresses that I most enjoy researching and writing about. Today’s letter was a little long: 77th WHA breakdown is below. And perhaps next fortnight, I’ll share some of my thoughts on my newest piece of health tech. The Oura Ring.
Warm wishes,
Christiana
Key outcomes highlighted - 77th World Health Assembly
Read the Director General’s consolidated report here.
1. Palestine, East Jerusalem and related
The 77th World Health Assembly (WHA) in 2024 addressed humanitarian crises. The WHA emphasized:
The need for humanitarian access to Gaza, the provision of life-saving medical care, essential supplies, and protection of health workers and facilities.
Mental health support, particularly for children and adolescents affected by the conflict.
Co-operation across UN agencies to assess and address psychiatric morbidity and other mental health challenges.
The importance of a comprehensive approach to humanitarian assistance, recognizing the interconnectedness of health with water, sanitation, and nutrition.
Support for the rehabilitation and development of the Palestinian health system and sustainable procurement of vaccines and medical supplies to enhance health outcomes.
Human rights and international law were central to the discussions, with the WHA condemning the use of health facilities by armed groups.
The WHA highlighted concerns over access to healthcare for detainees and reporting on deaths in custody. It called for immediate access to medical and humanitarian needs for all hostages and detainees.
A significant development was the decision to align Palestine's participation in the WHO with its status in the United Nations. This includes rights such as being seated among Member States, making statements, submitting proposals, and co-sponsoring amendments, albeit without voting rights.
(Relevant documents here)
2. Strengthening health emergency preparedness and response in cities and urban settings
Recognizing the unique vulnerabilities of urban areas to health emergencies, the Assembly emphasized the need for comprehensive and coordinated efforts to enhance preparedness. The Resolution on Strengthening health emergency preparedness and response in cities and urban settings was highlighted, urging Member States to maintain political commitment and adopt multisectoral approaches.
Member States were called upon to develop and implement health emergency plans that include regular simulation exercises and thorough after-action reviews. This approach ensures a holistic and coordinated response to health emergencies, integrating various sectors and levels of government. The Assembly underscored the importance of local authorities and communities in emergency preparedness, acknowledging their crucial role in preventing and responding to health crises.
WHO was requested to provide technical support to Member States to build their capacities in urban health emergency preparedness. This support includes the implementation of the WHO Framework for Strengthening Health Emergency Preparedness in Cities and Urban Settings, developed with contributions from global experts and institutions.
(Read the Agenda item and report here & here)
3. International Health Regulations
Mentioned last fortight. The amendments are noted in bold - read the document here: Amendments to International Health Regulations (2005) agreed at Seventy-seventh World Health Assembly.
4. Agreement for Global health leaders convene a Strategic Roundtable on climate change and health
Global health leaders and experts convened a Strategic Roundtable to tackle the pressing intersection of climate change and health. The roundtable was aligned with WHO's strategic objectives, highlighting both achievements and future challenges in global health.
The event underscored the landmark resolution on health and climate change approved earlier that week and aimed to build momentum for the upcoming COP 29.
Keynote speakers emphasized the urgency of addressing climate-related health impacts. Richard Horton, Editor in Chief of The Lancet, opened the meeting, stressing the critical nature of the climate crisis. WHO Director-General Dr. Tedros Adhanom Ghebreyesus highlighted WHO’s shift towards climate health action. Former U.S. Vice President Al Gore (sidetone: do you remember watching ‘An Inconvenient Truth?) and Dr. Teymur Musayev, Minister of Healthcare of Azerbaijan, provided some insights for COP 29. Hon. Dr. Atonio Lalabalavu from Fiji discussed climate justice for small island developing states, and Adnan Z. Amin, CEO of COP 28, reflected on historical health outcomes. Participants, including H.E. Dr. Filomena Gonçalves from Cabo Verde and Professor Celeste Saulo from the World Meteorological Organization, called for climate justice, equity, and enhanced public health outcomes through climate services.
(Read more here)
Listen to this fortnight’s Episodes
Behind the scenes:
I’m always happy when the sun comes out. Currently enjoying the start of Swiss summer. In gorgeous Lausanne, Geneva and spending some time in Zurich where I celebrated a dear friend’s belated birthday. We had a lovely time around the town and in the very quaint, Swiss dining room of the Kronenhalle where we ate were two genuine Chagall’s and a Picasso.
It has been good to take time to have coffees with friends and network before we all inevitably disperse for intermittent periods through July and August. I also had the pleasure of receiving a beautiful postcard from a fellow art loving friend. I always deeply cherish postcards when I receive them (mail that isn’t a bill.) Some of these delights mentioned are in the digital postcard below, but not all. Finally, last week was Volunteer’s week in the UK and my alma mater wrote this little ‘alumni story’ article about me and my volunteer work. Always an honour to be recognised by a place and people so close to my heart.
Episodes Relevant to this edition’s themes: In case you missed them! 💃🏾
BONUS: The Case of a Clinical Trial Catastrophe - the TGN1412 ‘Elephant Men’ Clinical trial
In March of 2006, a clinical trial for the drug TGN1412 gathered eight young and healthy men as volunteers. Within a mere 16 hours, all six were urgently transferred to Northwick Park Hospital's intensive care unit due to severe and life-threatening reactions. This ‘true crime’ style bonus episode is cosy-creepy.
Episode 6: Addressing Life Expectancy through Nudges, Financial incentives & Disincentives (ft. Maria Kasimati)
In this episode of Global Health Conversations, I spoke to Maria Myrto Kasimati. We talked about nudges, financial incentives, financial discincentives and using these health economics and policy approaches in addressing the causes affecting reduced life expectancy. It was an interesting talk - an unofficial Part 2 to Episode 3 structured as a discussion.
Episode 19: Drug Licensing and the Pandemic Accord
In this episode, we look at Colombia's recent move in issuing its first compulsory license. The country challenged ViiV Healthcare's monopoly on their patented drug, dolutegravir, an HIV therapeutic, in an attempt to open doors for affordable generic versions and thus improve accessibility & affordability.
Episode 7: Managing a Private Hospital in Nigeria, forming partnerships & addressing health disparities through the private sector (ft Dr Miriambeth Asika)
Dr. Asika Miriam is the Hospital Manager at Zenith Medical and Kidney Center. We discussed Managing a Private Hospital in Nigeria, forming partnerships & addressing health disparities and the intricate interworking as well as the role of the private sector in a largely private payer system.
Episode 8: Cancer in Africa: The Dual Burden of Disease
The dual-burden of disease concept deals with the phenomenon of more and more emerging economies dealing with a combination of infectious diseases such as tuberculosis and malaria alongside the rising incidence of non-communicable diseases (NCDs) like cancers, cardiovascular diseases, and diabetes.