Charting a course towards a healthier future for the Eastern Mediterranean Region

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Editorial

Hanan Balkhy¹

¹Regional Director, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt.

Citation: Balkhy H. Charting a course towards a healthier future for the Eastern Mediterranean Region. East Mediterr Health J. 2024;30(10):657–659. https://doi.org/10.26719/2024.30.10.657.

Copyright: © Authors 2024; Licensee: World Health Organization. EMHJ is an open access journal. All papers published in EMHJ are available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

Governments across the Eastern Mediterranean Region (EMR) have agreed ambitious new plans to enhance measurable positive impact on public health in every country of the region. At the 71st Session of the WHO Regional Committee for the Eastern Mediterranean, held from 14 to 17 October 2024 in Doha, Qatar, Member States endorsed a collection of related strategic initiatives that will guide WHO’s work in the region for the next 4 years.

The regional committee is WHO’s main governing body at the regional level and its annual sessions bring together ministers of health, senior health advisers, staff of WHO and other United Nations agencies, partner organizations, and civil society groups. The Committee is a critical part of the governance mechanisms that ensure accountability between WHO and Member States, to whom WHO belongs. The resolutions adopted by Member States through the regional committee serve as a direct mandate for key technical programmes and strategies. Alongside the formal decision-making function, the regional committee sessions provide opportunities for stakeholders to network and share ideas, experiences and concerns.

This year’s committee meeting was particularly consequential. In May, the 77th World Health Assembly adopted a new high-level roadmap, the Fourteenth General Programme of Work (GPW14), which will guide WHO’s work in support of Member States and partners for 2025 to 2028 (1,2). While the GPW 14 charts a global course for WHO, further work is needed to guide its implementation within the context of each region. Developing a regional plan to implement GPW14 has been my focus since I assumed office in February 2024, and this plan was presented and discussed in detail during the 71st Session of the Regional Committee.

The new regional strategic plan will provide critical guidance on the approach to be adopted by the WHO Regional Office for the Eastern Mediterranean (WHO/EMRO) over the next 4 years. The plan highlights 6 strategic priorities for the region: promoting health; ensuring access to good-quality healthcare; expanding country capacities to tackle health emergencies; achieving and sustaining polio eradication; improving knowledge sharing, evidence-based policymaking and digital health; and optimizing WHO’s performance (3).

Crucially, the plan also specifies the high-level interventions needed to meet each priority and identifies

results that should be achieved if both WHO and Member States implement the interventions. Mutual accountability is built into the plan, which will be measured ultimately through the outcomes using the indicators and targets in the accompanying results framework (4).

The high-level interventions for implementing the regional priorities will be complemented by flagship initiatives in 3 key strategic areas: expanding equitable access to essential medicines, vaccines and medical products (5); investing to improve the production, employment and retention of skilled health workforce (6); and stepping up public health action to prevent substance abuse and reduce the massive harm that substance abuse causes to individuals, families and communities (7). These initiatives will function as accelerators for the regional strategic plan and are fundamental to the achievement of durable public health gains in the region. Progress on each of the initiatives is not only a desirable end in itself, but also a prerequisite for meeting many other targets in the plan. Evidence suggests that action on each initiative should generate significant economic and social benefits, and should help governments in mobilizing the resources needed to implement the initiatives (4).

The regional strategic operational plan and flagship initiatives were developed through participatory consultations with Member States and partners, a process which culminated in a full and rich discussion during the regional committee session. This was evidenced by the level of attention and commitment given by ministers of health and other senior stakeholders during the discussions – a commitment reflected and formalized by the Committee’s endorsement of the new plan (8).

During the committee meeting, Member States also endorsed a range of other proposals to accelerate action on some health issues of major concern in the region. Inevitably, these proposals included actions to improve preparedness for, and response to, the large-scale, complex and often protracted emergencies which unfortunately have become a defining feature of the EMR in recent years. Building on the pioneering Regional Trauma Initiative (9), a new regional operational framework was presented that offers the opportunity to save thousands of lives through the systematic application of basic systems and techniques to address physical trauma promptly and effectively in humanitarian settings (10). A complementary regional action plan for mental health and psychosocial support in emergencies will help strengthen efforts to deal with the huge psychological toll due to these emergencies (11). Momentum from the recent and upcoming global meetings on antimicrobial resistance (AMR) was reflected in a resolution to enhance the response to AMR in the region (12); EMR has the highest and most rapidly increasing levels of antibiotic consumption among all the WHO regions. Member States also introduced a new strategy to support the digitalization of health information systems (13) – the latest in a series of policies to harness the power of digital technology for health in the region (14).

The ongoing conflicts and crises in the EMR pose a grave threat to the health and wellbeing of millions of its people, and no one attending the regional committee underestimated the challenges that face the region. Indeed, participants repeatedly voiced their support for the delegations that could not attend the committee meetings because conflict had made travel too risky for them, and Member States paid formal tribute to all the courageous health workers struggling to provide essential health services in conflict situations (15).

Although the mood of the 71st Session was appropriately serious, it was not pessimistic. All the delegates expressed their belief that dramatic improvements in public health are possible across the region, and they have committed to achieving those improvements with the support of WHO and partners. We now have a plan, based on the best available evidence, to guide our work in the next 4 years, but now comes the hard and vital work of delivering on our shared commitment.

References

1. World Health Organization. Seventy-seventh World Health Assembly, Provisional agenda item 17, 3 May 2024: Draft Fourteenth General Programme of Work, 2025–2028: Report by the Director-General. Geneva: World Health Organization, 2024. https://apps.who.int/gb/ebwha/pdf_files/WHA77/A77_16-en.pdf.
2. World Health Organization. Seventy-seventh World Health Assembly: Geneva, 1 June 2024: Resolution WHA77.1: Fourteenth General Programme of Work, 2025–2028. Geneva: World Health Organization, 2024. https://apps.who.int/gb/ebwha/pdf_files/WHA77/A77_R1-en.pdf.
3. World Health Organization. Regional Committee for the Eastern Mediterranean, 71st Session, Doha, 14–17 October 2024, Provisional Agenda item 2(e): Strategic operational plan for the Eastern Mediterranean Region, 2025–2028. Cairo: WHO Regional Office for the Eastern Mediterranean, 2024. https://applications.emro.who.int/docs/Strategic-operational-plan-eng.pdf?ua=1.
4. Balkhy H. Introduction of the annual report and the Regional Director’s vision. Speech by the WHO Regional Director for the Eastern Mediterranean to the 71st session of the WHO Regional Committee for the Eastern Mediterranean, Doha, Qatar, 15 October 2024 (https://www.emro.who.int/media/news/introduction-of-the-annual-report-and-the-regional-directors-vision.html).
5. World Health Organization. Regional Committee for the Eastern Mediterranean, 71st Session, Doha, 14–17 October 2024, Provisional Agenda item 2(b): Regional flagship initiative 1: Expanding equitable access to medical products. Cairo: WHO Regional Office for the Eastern Mediterranean, 2024. https://applications.emro.who.int/docs/Flagship-Initiative-Expanding-Access-Medical-Products-eng.pdf?ua=1.
6. World Health Organization. Regional Committee for the Eastern Mediterranean, 71st Session, Doha, 14–17 October 2024, Provisional Agenda item 2(c): Regional flagship initiative 2: Investing in a resilient health workforce. Cairo: WHO Regional Office for the Eastern Mediterranean, 2024. https://applications.emro.who.int/docs/Flagship-Initiative-health-Workforce-eng.pdf?ua=1.
7. World Health Organization. Regional Committee for the Eastern Mediterranean, 71st Session, Doha, 14–17 October 2024, Provisional Agenda item 2(d): Regional flagship initiative 3: Accelerating public health action on substance use. Cairo: WHO Regional Office for the Eastern Mediterranean, 2024. https://applications.emro.who.int/docs/Flagship-initiative-substance-use-eng.pdf?ua=1.
8. World Health Organization. Regional Committee for the Eastern Mediterranean, 71st Session, Doha, 14–17 October 2024: Resolution EM/RC71/R.1: Regional Strategic Operational Plan including the flagship initiatives. Cairo: WHO Regional Office for the Eastern Mediterranean, 2024. https://applications.emro.who.int/docs/RC71-R1-D-RSOP-flagships-eng.pdf?ua=1.
9. World Health Organization. Regional Committee for the Eastern Mediterranean, 70th Session, Cairo, 9–12 October 2023: Minimizing morbidity and mortality due to trauma in humanitarian settings. Cairo: WHO Regional Office for the Eastern Mediterranean, 2023. https://applications.emro.who.int/docs/Tech-session-Trauma-eng.pdf.
10. World Health Organization. Regional Committee for the Eastern Mediterranean, 71st Session, Doha, 14–17 October 2024: Resolution EM/RC71/R.3: Addressing the increasing burden of trauma in humanitarian settings in the Eastern Mediterranean Region. Cairo: WHO Regional Office for the Eastern Mediterranean, 2024. https://applications.emro.who.int/docs/RC71-R3-D-trauma-eng.pdf?ua=1.
11. World Health Organization. Regional Committee for the Eastern Mediterranean, 71st Session, Doha, 14–17 October 2024: Resolution EM/RC71/R.5: Regional action plan for mental health and psychosocial support in emergencies, 2024–2030. Cairo: WHO Regional Office for the Eastern Mediterranean; 2024 (https://applications.emro.who.int/docs/RC71-R5-D-MHPSS-eng.pdf?ua=1).
12. World Health Organization. Regional Committee for the Eastern Mediterranean, 71st Session, Doha, 14–17 October 2024: Resolution EM/RC71/R.4: Promoting collaborative action to accelerate the response to antimicrobial resistance in the Eastern Mediterranean Region. Cairo: WHO Regional Office for the Eastern Mediterranean, 2024. https://applications.emro.who.int/docs/RC71-R4-D-AMR-eng.pdf?ua=1.
13. World Health Organization. Regional Committee for the Eastern Mediterranean, 71st Session, Doha, 14–17 October 2024: Resolution EM/RC71/R.6: Enhancement and digitalization of health information systems in the countries of the Eastern Mediterranean Region: a regional strategy, 2024–2028. Cairo: WHO Regional Office for the Eastern Mediterranean, 2024. https://applications.emro.who.int/docs/RC71-R6-D-HIS-eng.pdf?ua=1.
14. World Health Organization. Regional Committee for the Eastern Mediterranean, 69th session, Cairo, Egypt, 10–13 October 2024, Provisional Agenda item 3(e): Regional strategy for fostering digital health in the Eastern Mediterranean Region (2023–2027). Cairo: WHO Regional Office for the Eastern Mediterranean, 2022. https://applications.emro.who.int/docs/Digital-Health-EMR-2023-2027-eng.pdf?ua=1.
15. World Health Organization. Regional Committee for the Eastern Mediterranean, 71st session, Doha, 14–17 October 2024: Resolution EM/RC71/R.2: Annual report of the Regional Director for 2023. Cairo: WHO Regional Office for the Eastern Mediterranean, 2024. https://applications.emro.who.int/docs/RC71-R2-D-annual-report-eng.pdf?ua=1.