Implementing WHO’s global strategy in the Eastern Mediterranean Region: what next?

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Editorial

Ahmed Al-Mandhari¹

¹Regional Director, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt

Citation: Al-Mandhari A. Implementing WHO’s global strategy in the Eastern Mediterranean Region: what next? East Mediterr Health J. 2018;24(8):703–704. https://doi.org/10.26719/2018.24.8.703

Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

In May 2018, the Seventy-first World Health Assembly, bringing together 194 Member States of the World Health Organization (WHO), unanimously adopted the Organization’s thirteenth General Programme of Work 2019–2023 (GPW 13) (1). GPW 13 will guide WHO’s work for at least the next five years. It is closely linked to the 2030 Agenda for Sustainable Development (2): essentially, it specifies strategic priorities and goals that need to be achieved globally by 2023 to keep on track with achievement of the health-related Sustainable Development Goals by 2030 (3).

GPW 13 was developed through extensive consultation and there is strong commitment to it among WHO’s Member States. Now, however, comes the challenge of translating the global priorities and goals in the GPW document into detailed plans at country and regional level. That will entail extensive collaboration between WHO and its Member States, including both one-to-one dialogues and collective deliberations.

The process is well underway in the Eastern Mediterranean Region. WHO’s Eastern Mediterranean Regional Office (EMRO) is undertaking a comprehensive review of its functions in each country with the aim of identifying national priority issues in the light of GPW 13 and determining how WHO might best support governments and other partners to address them. Meanwhile, Region-wide strategy is being systematically revised. In September 2018, policy-makers and technical experts from across the Region gathered at EMRO’s base in Cairo for an intensive five-day workshop to develop strategic plans covering major priority areas of work. Those draft plans will be shared with Member States and, taking into account their feedback, the detailed road map that guides WHO’s work will be updated (4).

The 65th session of the Regional Committee for the Eastern Mediterranean, to be held in Khartoum, Sudan, on 15-18 October 2018, will be another crucial stage in implementing GPW 13. Regional Committee is the main formal governance mechanism for WHO in the Eastern Mediterranean, and a wide range of business will be considered at the session, but the agenda focuses heavily on GPW 13. Four out of five of the technical papers prepared by the WHO Secretariat for discussion by Member States explore the implications of GPW 13 for the Region.

One paper is devoted to each of the three strategic priorities established in the new programme of work – also known as the “triple billion”. GPW 13 commits WHO and its Member States to ensure that 1 billion more people benefit from universal health coverage by 2023. What does that mean for the Eastern Mediterranean Region? The first technical paper (5) provides an analysis based on two conceptual tools: the framework for action to advance UHC in the Eastern Mediterranean Region and the UHC service coverage index (6,7). It presents a bleak picture of the current situation. Little more than half the Region’s people have access to the basic health services they need – 53% compared with a world population-weighted coverage of 64%. However, projections suggest that a concerted effort by WHO and Member States to implement recommended measures would see coverage increase to 60% within five years, meeting the Region’s share of the 1 billion goal.

A second paper explores the goal of 1 billion people better protected from the impact of health emergencies (8). As might be expected, this also poses many challenges in the Eastern Mediterranean – the world region worst affected by emergencies. Work is ongoing globally to quantify how different world regions and countries can contribute to the 1 billion target, and the paper does not seek to pre-empt that work, but it does identify significant potential to improve one key aspect of emergency preparedness and response: implementation of the public health capacities required under the International Health Regulations (IHR 2005).

The third strategic priority set by GPW 13 is promoting health and well-being. As the related technical paper makes clear, this poses challenges for all WHO Member States in the Region (9). Communicable diseases are a concern in many countries, while the highest-income countries can make major improvements to public health by tackling communicable diseases. The paper does not attempt to calculate the number of people in the Region who might reasonably be expected to benefit from improved health promotion measures, but instead recommends four new frameworks for action – covering obesity prevention, tobacco control, health and the environment, and preconception care – which should help to improve outcomes across the Region.

A fourth technical paper introduces the country functional review process mentioned above, which aims to ensure that each of WHO’s country offices in the Eastern Mediterranean has the optimum operating model and staffing, in terms of both numbers and skills (10). The review will also examine relationships with other United Nations agencies working in the field of health.

Implementing GPW 13 is a work in progress, and the technical papers being presented to the Regional Committee are not detailed prescriptions. Member State input will be crucial in setting country priorities, agreeing actions and implementing them. WHO will collaborate closely with its Member States every step of the way.

References

1. Draft thirteenth general programme of work, 2019–2023. Report by the Director-General to the Seventy-first World Health Assembly, 5 April 3018, (A71/4) (http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_4-en.pdf, accessed 23 September 2018).
2. United Nations. The Sustainable Development Agenda. New York: United Nations; 2016 (http://www.un.org/sustainabledevelopment/development-agenda/, accessed 23 September 2018).
3. Mahjour J, Mirza Z, Rashidian A, Atta H, Hajjeh R, Thieren M, et al. “Promote health, keep the world safe, serve the vulnerable” in the Eastern Mediterranean Region. East Mediterr Health J. 2018;24(4):323–324. https://doi.org/10.26719/2018.24.4.323.
4. WHO Regional Office for the Eastern Mediterranean (EMRO). Roadmap of WHO’s work for the Eastern Mediterranean Region 2017–2021. Cairo: EMRO; 2017 (http://applications.emro.who.int/docs/EMROPUB_2017_19695_EN.pdf, accessed 23 September 2018).
5. Advancing universal health coverage (EM/RC65/4). Technical paper presented at the 65th session of the WHO Regional Committee for the Eastern Mediterranean, 2018 (WHO internal publication).
6. Framework for action on advancing universal health coverage (UHC) in the Eastern Mediterranean Region. Cairo: WHO Regional Office for the Eastern Mediterranean, 2016 (http://applications.emro.who.int/docs/Technical_Notes_EN_16287.pdf, accessed 23 September 2018).
7. Hogan D, Hosseinpoor AR, Boerma T. Technical note: developing an index for the coverage of essential health services. Geneva: World Health Organization, 2016 (http://www.who.int/healthinfo/universal_health_coverage/UHC_WHS2016_TechnicalNote_May2016.pdf?ua=1, accessed 23 September 2018).
8. Protecting people from the impact of health emergencies (EM/RC65/5). Technical paper presented at the 65th session of the WHO Regional Committee for the Eastern Mediterranean, 2018 (EM RC 65) (WHO internal publication).
9. Promoting health and well-being (EM/RC65/6). Technical paper presented at the 65th session of the WHO Regional Committee for the Eastern Mediterranean, 2018 (EM RC 65) (WHO internal publication).
10. Optimizing WHO’s performance: countries at the centre (EM/RC65/7). Technical paper presented at the 65th session of the WHO Regional Committee for the Eastern Mediterranean, 2018 (EM RC 65) (WHO internal publication).