The world health organization and international

The world health organization and international

ВОЗ выпустила новые рекомендации по лечению Эболы и призвала повысить доступность препаратов ‎

Оспа обезьян: эксперты присвоили новые наименования вариантам вируса

ВОЗ призывает принять меры для удовлетворения срочных потребностей в области здравоохранения в регионе Большого Африканского Рога

Создан новый глобальный альянс для искоренения СПИДа среди детей к 2030 г.

Что такое оспа обезьян?

Здоровье подростков и молодежи

Коронавирус Ближневосточного респираторного синдрома (БВРС-КоВ)

Гонорея с множественной лекарственной устойчивостью

В центре внимания

Загрязнение воздуха и здоровье

Загрязнение воздуха имеет тяжелые последствия для здоровья — одна треть случаев смерти от инсульта, рака легких и сердечных заболеваний обусловлена загрязнением воздуха.

Серия публикаций «Все о вакцинах»

Серия публикаций «Все о вакцинах» содержит иллюстрированные статьи о создании и распределении вакцин против COVID-19. Узнайте о том, какие этапы проходят вакцины с самых первых этапов их разработки до внедрения в странах.

Вопросы и ответы

Радиация и здоровье

Радиация – это перенос энергии в виде электромагнитных волн или субатомных частиц. Каждый день человек вдыхает или потребляет с воздухом, водой и продуктами питания некоторое количество радиоактивных веществ.

Новости о вспышках болезней

Самые последние новости о вспышках болезней

Поддержим медицинских работников

Материалы кампании для поддержки и отстаивания интересов медико-санитарных и социальных работников

Европейское региональное бюро

Лабораторное тестирование на вирус оспы обезьян: Временные рекомендации 23 мая 2022 г.

Новая специальная инициатива ВОЗ: повышение налогов на алкоголь позволит ежегодно спасать 130 000 жизней

В выводах нового исследования ВОЗ содержится призыв к прекращению агрессивного маркетинга молочных смесей

Генеральный директор ВОЗ

Д-р Тедрос Адханом Гебрейесус

«Вместе — за здоровый мир».

Заявления Генерального директора

Вступительное слово Генерального директора ВОЗ на пресс-брифинге по COVID-19 – 17 августа 2022 г.

Заявление Генерального директора на пресс-конференции по завершении совещания Комитета Международных медико-санитарных правил (2005 г.) по чрезвычайной ситуации в связи со вспышкой оспы обезьян в нескольких странах. 23 июля 2022 г.

Вступительное слово Генерального директора на втором совещании Комитета ММСП по чрезвычайной ситуации в связи со вспышкой оспы обезьян в нескольких странах – 21 июля 2022 г.

Contact us

General enquiries

Please visit our frequently asked questions if you have a query about WHO or use the list below to contact the relevant service.

WHO Headquarters in Geneva

Avenue Appia 20
1211 Geneva
Switzerland

Telephone: +41 22 791 21 11

Information disclosure policy

Employment questions

Visit our Careers pages.

Publications

Please visit our publications pages to search for or to order WHO publications.

Media enquiries

Visit our newsroom to access our media products and contact a communication officer.

Permissions, copyright and licensing

Please visit the permissions and licensing page if you need information on copyright and licensing.

General information

Follow WHO on social media

WHO regional offices

Regional Office for Africa

Cité du Djoué, P.O.Box 06 Brazzaville
Republic of Congo

Regional Office for Americas

525 23rd Street NW
Washington, DC 20037

Telephone: +1 202 974 3000
Fax: +1 202 974 3663
Website: https://www.paho.org/

Regional Office for South-East Asia

Permanent address:

World Health House
Indraprastha Estate
Mahatma Gandhi Marg
New Delhi 110 002, India

Temporary address:

Metropolitan Hotel Office Block
Bangla Sahib Road
Gole Market, Sector 4
New Delhi-110 001, India

Frequently asked questions

What is the World Health Organization?

Founded in 1948, the World Health Organization (WHO) is the United Nations agency dedicated to global health and safety. The Organization connects nations, partners and communities to promote health and serve the vulnerable. WHO works with its Member States to achieve the highest level of health for all people by pursuing universal health coverage.

WHO headquarters are located in Geneva, Switzerland. WHO is governed by 194 Member States grouped into 6 regions. Each region is represented by a regional office, which coordinates programming in country offices and field offices. The WHO regions are:

What does WHO do?

WHO works globally to promote health, expand universal health coverage and respond to emergencies. The Thirteenth General Programme of Work 2019–2023 aims to achieve the Triple Billion targets:

To achieve these targets, WHO focuses on primary health care in every country to improve access to quality essential services. This includes training the health work force, supporting policy development and working towards sustainable financing for health systems.

WHO also responds to emergencies including natural disasters, conflicts and displaced populations. Acting in a coordinating leadership role, WHO provides medical supplies and equipment, doctors and other medical professionals, and support for local governments.

How is WHO funded?

WHO receives funding through membership dues paid by Member States and voluntary contributions from Member States and other partners. Calculated as a percentage of each country’s gross domestic product, membership dues are assessed every 2 years at the World Health Assembly. Less than 20% of WHO’s total budget comes from membership dues, while the remainder comes from voluntary contributions, largely from Member States as well as from other United Nations organizations, intergovernmental organizations, philanthropic foundations, the private sector and other sources.

How can I support the work of WHO?

WHO’s work in public health relies on the contributions and collaboration of many groups and individuals around the world including governments, donors, scientists, experts, implementing partners and advocates.

Individuals and corporate partners can make financial contributions or in-kind donations or expertise to support our work through the independent WHO Foundation.

Individuals can also assist WHO by contributing expertise to our workforce through our careers section, participating in expert groups, as well as supporting our health guidance and messages in your health work and through discussions on social media.

Is WHO a religious organization?

WHO is not a religious organization and is not affiliated with any specific spiritual belief. The Organization celebrates the diversity of faiths around the world as reflected by its Member States.

Is WHO a non-governmental organization (NGO)?

WHO is an international organization composed of a group of Member States, and so it is not an NGO. Each Member State has a voice in determining the direction and targets of the Organization. WHO works with many local and international NGOs, as well as governments and other partners, to achieve its goals.

What is the WHO definition of health?

The preamble to WHO’s constitution provides a definition of health:

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

Where can I find career and internship opportunities at WHO?

The WHO careers section provides information about working at WHO, including types of recruitment contracts and internship opportunities. Current positions are posted to the job board, where you can create a personal profile and submit an application. Information on internships is also available in our careers section under the internship programme.

How do I sell my products or services to WHO?

Procurement of goods and services is a critical part of WHO’s mandate to direct and coordinate international health work. All procurement activities are subject to our guiding principles, which focus on fairness, integrity, transparency and equal treatment.

Can I link to the WHO website from my website? How do I request a link from the WHO website to my site?

Any external website may add a hyperlink to the WHO website without requesting permission. However, this use must not infringe WHO’s intellectual property rights, in particular relating to its name, emblem, copyright or authors’ rights. WHO does not normally provide links to external websites unless there is a clear association with WHO’s activities.

Where can I find WHO publications?

Visit our publications page for the latest WHO publications, journals, series and guidelines. WHO also maintains a repository of all official publications. A separate hub for publications specific to coronavirus disease (COVID-19) is also available.

Does WHO offer scholarships or grants?

While WHO does not have a scholarship or grant programme, certain WHO programmes and departments do fund research. In addition, some WHO regional offices offer fellowship and scholarship opportunities in cooperation with local ministries of health. WHO programmes may also provide funding for WHO collaborating centres.

How can I find information about a specific topic?

The WHO website features several hubs that can be used to find information by health topic, country, year or type. These are useful places to start researching an area of interest:

You may also want to find information by:

Why are countries referred to the way they are?

The official names of WHO Member States and their sequence in alphabetical lists produced by WHO are based on the names received from the Member States and the United Nations. Some Member States are referred to using a long-form name for official uses and a shorter version for more routine descriptions.

Why do some WHO maps have dotted borders?

Dotted lines on maps produced by WHO represent approximate border lines for which there may not yet be full agreement. The boundaries, names and designations used on maps do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area, of its authorities, or concerning the delimitation of its frontiers or boundaries.

I am travelling abroad soon. Where can I find information and advice on health risks?

The latest information on international travel, including current recommendations on travelling during the COVID-19 pandemic, is available on the travel advice page.

WHO has prepared an eBook on ways to stay healthy while travelling internationally. It includes guidance on the medical risks of travelling, vaccines, items to take with you and more.

WHO recommends consulting a travel medicine clinic or medical practitioner before travelling internationally. Travellers are also encouraged to review active travel advisories for your destination country, which are often available from the government of your home country.

Have I received a scam email?

Scam emails made to look like they are from or associated with the World Health Organization have been circulating on the internet. These emails may request information or money from individuals, businesses or non-profit organizations with the promise that they will receive funds or other benefits in return. These emails sometimes carry the WHO logo and come from or mention an email address made to look like a WHO or United Nations address.

These emails are not sent from WHO or associated with WHO projects or events.

More information is available on our cyber security page. If you have any doubts about the authenticity of an email, letter or phone call that suggests that it is from or connected with WHO, please report the misinformation online or contact us.

WHO global health days

Mark these days for health in your calendar

Global public health days offer great potential to raise awareness and understanding about health issues and mobilize support for action, from the local community to the international stage. There are many world days observed throughout the year related to specific health issues or conditions – from Alzheimer’s to zoonoses.

However, WHO focuses particular attention on the 9 days and 2 weeks that WHO Member States have mandated as «official» global public health days. These are:

Year of Health and Care Workers 2021

World Neglected Tropical Diseases Day

World Health Day

World Chagas Disease Day

World Malaria Day

World Immunization Week

World No Tobacco Day

World Blood Donor Day

World Hepatitis Day

World Patient Safety Day

World Antimicrobial Awareness Week

Join in for better health

Whether you are taking the kids to be vaccinated, talking to students on the devastating health effects of tobacco, organizing a mobile blood collection in your community, or contributing to the online conversation through social media, you can play a part in these worldwide efforts to create a healthier world.

Leading up to each day, this is where you will find background information, graphics, multi-media links, facts and figures that help highlight the issues and focus global attention on today’s major public health challenges.

If you have comments or questions, please write to: [email protected]

WHO Member States and officially certified partners supporting the campaigns can adapt these materials with their logos and disseminate to their networks. Some of the campaigns create unique logos that can be used by individuals who wish to promote the public health messages to their communities. Find out the terms of use of WHO campaign materials and logos here. For more questions, please write to [email protected]

The world health organization and international

When diplomats met to form the United Nations in 1945, one of the things they discussed was setting up a global health organization.

WHO’s Constitution came into force on 7 April 1948 – a date we now celebrate every year as World Health Day.

In April 1945, during the Conference to set up the United Nations (UN) held in San Francisco, representatives of Brazil and China proposed that an international health organization be established and a conference to frame its constitution convened. On 15 February 1946, the Economic and Social Council of the UN instructed the Secretary-General to convoke such a conference. A Technical Preparatory Committee met in Paris from 18 March to 5 April 1946 and drew up proposals for the Constitution which were presented to the International Health Conference in New York City between 19 June and 22 July 1946. On the basis of these proposals, the Conference drafted and adopted the Constitution of the World Health Organization, signed 22 July 1946 by representatives of 51 Members of the UN and of 10 other nations.

The Conference established also an Interim Commission to carry out certain activities of the existing health institutions until the entry into force of the Constitution of the World Health Organization. The preamble and Article 69 of the Constitution of WHO provide that WHO should be a specialized agency of the UN. Article 80 provides that the Constitution would come into force when 26 members of the United Nations had ratified it. The Constitution did not come into force until 7 April 1948, when the 26th of the 61 governments who had signed it ratified its signature. The first Health Assembly opened in Geneva on 24 June 1948 with delegations from 53 of the 55 Member States. It decided that the Interim Commission was to cease to exist at midnight on 31 August 1948, to be immediately succeeded by WHO.

Global Health Observatory

WHO’s data repository for health-related statistics for its 194 Member States, providing access to over 1000 indicators on priority health topics

Popular indicators

WHO releases regular reports on data trends and analysis related to global health.

A technical package of five essential interventions with key elements to strengthen country health data and information systems and enable governments to track progress towards the health-related SDGs and national and subnational priorities.

Data collection and analysis tools

A core component of WHO’s support to Member States is to strengthen their capacity to collect, compile, manage, analyze and use health data mainly derived from population-bases and institution-based sources.

Monitoring health inequalities

WHO supports Member states to strengthen their health information systems to collect, analyze, report and use inequality data.

Data standards

The WHO Family of International Classifications (FIC) is a set of integrated classifications that provide a common language for health information across the world.

GIS Centre for Health

Geospatial data and techniques are also an effective tool to monitor progress and provide a strong basis for policy making to achieve the SDGs and deliver the GPW 13 Triple Billion targets.

Careers at WHO

Together for a healthier world

WHO’s work is founded on the principle that all people, everywhere, should enjoy the highest standard of health. We seek talented professionals looking to contribute to this important mission as members of our international workforce. WHO offers a dynamic work environment, opportunities for professional development and a competitive pay and benefits package. We are committed to achieving a diverse, multicultural and gender balanced workforce with broad representation from our Member States.

Are you 1 in a billion? Can you imagine by 2023 one billion more people with access to health services, one billion more kept safer from outbreaks and emergencies, and another billion living healthier? WHO and our partners can. Join us on the drive to provide health for all.

The WHO environment

Our values, our DNA

Trusted to serve public health at all times

Professionals committed to excellence in health

Persons of integrity

Collaborative colleagues and partners

People caring about people

WHO provides a safe environment, cares deeply about employee wellbeing and is committed to providing a work environment that respects the inherent dignity of all persons. WHO has a responsibility to take all appropriate steps to prevent and respond to harassment, including sexual harassment, discrimination and abuse of authority in the workplace. Learn more about the WHO environment

WHO’s policies and hiring practices are grounded in diversity and inclusion. We continue to strive for gender balance throughout the organization. WHO encourages applications from underrepresented countries, people with disabilities, younger applicants and from women. Learn more about WHO workforce data

…it was pure fate that my application to WHO was successful. It was as though everything had been leading to this.

Tuan Nghia Ton
Technical Officer

I can contribute to this area of work, and in an organization like WHO it means I can have a lasting impact on the lives of so many people.

Maria Intan Josi
Health Research Assistant

. I believe that real wealth is measured by the health of our communities

Mahmoud Sabra
Logistics Assistant

. I am on an exciting journey, and exactly where I need to be today, supporting WHO’s mission and I will continue to grow wherever I go.

Moreblessing Moyo
Programme Management Officer

WHO job areas

WHO acknowledges the needs for a strong workforce to achieve the vision of improving the health and well-being of people everywhere. Each day, our teams meet the emerging challenges in all the areas of the Organization, from senior leaders to emergency administration staff, and from health specialists to data managers.

Public health

We are proud of our public health experts. They are results oriented and drive programmes in all areas of health and emergencies. They are agile and work at the country, regional and headquarters levels to achieve the highest standards of health through evidence based programmes and goals.

Management and leadership

WHO’s pillar of accountability is held by senior leadership roles. They are our driving force and our face to the public. They are committed to upholding WHO’s role in our changing world and inspiring the next generation of leaders. The stronger our leaders, the healthier our world will be.

Operations

Our administration is dedicated to business strategy and innovative practices. WHO recognizes the importance of a strong management administration structure, committed to enabling people to work to the best of their ability and to optimizing the resources available throughout the organization.

Emergency

At any one time, the WHO workforce is actively responding to dozens of infectious disease outbreaks and natural disasters around the world. WHO staff have an essential role to play in supporting Member States to prepare for, respond to and recover from emergencies with public health consequences.

WHO categories

The WHO workforce is our most important resource. WHO offers job opportunities under three kinds of staff categories as well as other contractual arrangements.

International Professional staff

Our internationally recruited staff serve in health technical, operational, managerial and leadership roles, across the world. They are committed to mobility and are employed to work according to their expertise and WHO’s programmatic needs.

National Professional Officer

Our National Professional Officers are professional level staff, often employed for their local knowledge and expertise in the country of their nationality. They work in diverse areas across the world and fulfill a wide range of responsibilities.

General Services staff

Our programmes and professional staff are supported by local residents or nationals, employed in the general service staff category. They are essential for our success, have a wide range of skills and are valued by our teams across the organization.

Consultants and other contractual arrangements

WHO contracts subject matter experts to provide time-limited, project-focused professional level support to attain specific programme deliverables. These are not employment contracts and remain outside the scope of the WHO Staff Rules and Regulations.

WHO staff can apply to fixed term or temporary appointments and successful candidates will receive an attractive salary and benefits package. Some staff are part of our agile workforce mobility programme and all staff are employed under WHO’s Rules and Regulations.

Depending on your duty station, you may benefit from different health and well-being programmes and services.

WHO has opportunities at different levels of responsibility and experience. We seek motivated individuals in all categories of work that meet our educational and work experience requirements.

WHO also advertises other contractual arrangements for specific programme needs and offers competitive rates.

WHO Talent Programmes

Help us reach our Triple Billion targets by joining us through one of our talent programmes.

Junior Professional Officer Programme

The Junior Professional Officer (JPO) Programme allows young professionals to gain practical experience in multi-lateral technical co-operation at an early stage in their career. Positions are available at our headquarters and at our regional and country offices.

Internship Programme

WHO’s Internship Programme offers a wide range of opportunities for students and recent graduates to gain insight into our technical programmes and administration; to acquire knowledge in specific areas and benefit from hands on work experience.

UN Volunteers Programme

WHO offers opportunities for UN Volunteers in many areas of expertise to strengthen capacity at the country and regional levels. UN Volunteers support WHO by contributing their skills to help reach our Triple Billion targets.

Young Professionals Programme

This WHO programme offers young professionals from a specific list of “Least Developed Countries” structured opportunities to engage in WHO’s work and build skills and competencies in key public health areas and incorporates exposure at country level.

International Health Regulations

While disease outbreaks and other acute public health risks are often unpredictable and require a range of responses, the International Health Regulations (2005) (IHR) provide an overarching legal framework that defines countries’ rights and obligations in handling public health events and emergencies that have the potential to cross borders.

The IHR are an instrument of international law that is legally-binding on 196 countries, including the 194 WHO Member States. The IHR grew out of the response to deadly epidemics that once overran Europe. They create rights and obligations for countries, including the requirement to report public health events. The Regulations also outline the criteria to determine whether or not a particular event constitutes a “public health emergency of international concern”.

At the same time, the IHR require countries to designate a National IHR Focal Point for communications with WHO, to establish and maintain core capacities for surveillance and response, including at designated points of entry. Additional provisions address the areas of international travel and transport such as the health documents required for international traffic.

Finally, the IHR introduce important safeguards to protect the rights of travellers and other persons in relation to the treatment of personal data, informed consent and non-discrimination in the application of health measures under the Regulations.

The responsibility for implementing the IHR rests upon all States Parties that are bound by the Regulations and on WHO. Governments are responsible, including all of their sectors, ministries, levels, officials and personnel for implementing IHR at the national level.

WHO plays the coordinating role in IHR implementation and, together with its partners, helps countries to build capacities.

The IHR require that all countries have the ability to do the following:

To support countries in strengthening and maintaining their capacities for ensuring rapid detection, verification and response to public health risks, WHO develops and provides tools, guidance and training.

WHO’s support focuses on the priority needs identified by the WHO Regional and Country Offices, in order to help each country meet its IHR commitment. This includes:

If a PHEIC is declared, WHO develops and recommends the critical health measures for implementation by Member States during such an emergency.

World Health Organization

The World Health Organization (WHO) is a specialized United Nations agency with a constitutional mandate as the “Directing and Coordinating authority on international health work”.

When diplomats met to form the United Nations in 1945, one of the things they discussed was setting up a global health organization. WHO’s Constitution came into force on 7 April 1948 – a date we now celebrate every year as World Health Day.

WHO adheres to the UN values of integrity, professionalism and respect for diversity. The values of the WHO workforce furthermore reflect the principles of human rights, universality and equity established in WHO’s Constitution as well as the ethical standards of the organization. These values are inspired by the WHO vision of a world in which all peoples attain the highest possible level of health, and our mission to promote health, keep the world safe and serve the vulnerable, with measurable impact for people at country level. We are individually and collectively committed to put these values into practice.The values of the WHO workforce reflect the principles of human rights, universality and equity established in WHO’s Constitution as well as the ethical standards of the organization.
These values are inspired by the WHO vision of a world in which all peoples attain the highest possible level of health, and its mission to promote health, keep the world safe and serve the vulnerable, with measurable impact for people at country level.

More than 7000 people from more than 150 countries work for the organization in 150 WHO offices in countries, territories and areas, six regional offices, at the Global Service Centre in Malaysia and at the headquarters in Geneva, Switzerland. In addition to medical doctors, public health specialists, scientists and epidemiologists, WHO staff include people trained to manage administrative, financial, and information systems, as well as experts in the fields of health statistics, economics and emergency relief.

Procurement is a critical function in support of the effective discharge of WHO mandate. In order to fulfill its mandate and achieve its vision WHO must procure a significant volume of goods and services. As a public organization entrusted with donor funds and committed to supporting developing economies, the objective of procurement activities within the WHO is the timely acquisition of goods and services while addressing the following guiding principles:

In order to promote transparency of the procurement process and accountability, WHO expects its providers to adhere to the principles, and meet the standards, set forth in the UN Supplier Code of Conduct.

What We Buy

On average, WHO buys approximately USD 700 million worth of goods and services every year to maintain operations in the field and to react to upcoming and recurring demands. While the needs vary, services account for approximately 75% of demand.

Commonly Procured Services:

Commonly Procured Goods:

How We Buy

WHO buys goods and services from various countries through WHO Headquarter, Regional Offices and different Country Offices in the following six regions;

In WHO responsibility for procurement is based on three tier system, which is at Global level, Regional Office level and at the Country Office level. The Major Offices will enter into contracts with vendors, which may be companies or individuals or organizations. The Contract Review Committee (CRC) ensures that procurement undertaken by the WHO Major Offices complies with relevant guidelines, and that procurement risks are properly assessed and mitigated and also finally best value for money and interest of organization is fully achieved.

As a public organization, WHO must strictly adhere to the organization financial rules and regulations, which mandate that contracts be awarded through a competitive process, obtaining bids through formal tenders or through pre-qualified suppliers for specialized items. To ensure consistency across all Major offices, WHO uses standard templates for bidding documents, available in English and French in some Regions.

WHO procure through recommended suppliers for most of their requirements for goods and services. WHO also procure some products under Pre-Qualification Programme (PQP), main objective of PQP is close cooperation with national regulatory agencies and partner organizations and aims to make quality priority medicines available for the benefit of those in need. This is achieved through its evaluation and inspection activities. Some of the WHO requirements are posted on the United Nations Global Marketplace and WHO procurement website under tender alerts.

Procurement Methods

A Request for Quotation (RFQ) is an informal invitation to submit a quotation, used for goods valued below USD 25,000. Depending on the complexity of the requirement, vendors will be given minimum 7 business days to respond to an RFQ. Prices, and other commercial terms and conditions are requested and award is usually made to the lowest priced and technically acceptable offer.

An Invitation to Bid (ITB) is used for two types of solicitation methods in WHO, one is procurement request with estimated value between USD 25,000 to USD 200,000, with this method of solicitation there is no public bid opening. Other is a formal invitation to submit quote for procurement over USD 200,000 with a requirement of public bid opening. ITB is usually associated with requirements that are clearly and concisely defined. Normally price is the sole determinant in making an award. Where all technical criteria are met, an award is made to the lowest evaluated and responsive bidder. Vendors will normally be given 15 business days or more to respond, depending on the complexity of the requirement.

A Request for Proposal (RFP) is a formal request to submit a proposal usually associated with requirements for services, which cannot be clearly or concisely defined. Price is only one of several factors comprising the evaluation criteria. Award is made to the qualified bidder whose bid substantially conforms to the requirement set forth on the solicitation documents and is evaluated to be the lowest cost and responsive to WHO. Vendors are normally given 15 business days or more to respond to an RFP.

Qualifications and Eligibility

Make sure vendors are qualified and eligible

WHO is a public organization and as such must diligently follow its financial regulations and rules. All WHO procurement is subject to the relevant policies set forth in the eManual. All WHO Suppliers must abide by the UN Supplier Code of Conduct. Under this framework, all vendors must be qualified, as well as eligible.

While qualification criteria may be further specified to meet the needs of a particular purchase, in general terms all qualified WHO vendors must meet the following commercial criteria:

Eligible vendors are qualified vendors that have not been temporarily suspended or debarred by WHO or another UN Agency. For more details regarding suspended vendors, WHO considers vendors included in the UN Security Council Sanction Lists (1267) http://www.un.org/sc/committees/consolidated_list.shtml to be ineligible for their contracts. If you are a consortium, holding or parent company, the entire group must meet these eligibility requirements.

Vendor Registration and Tender Alert Service

All WHO suppliers must abide by the UN Supplier Code of Conduct and comply with WHO General Terms & Conditions.

WHO issues tenders to their pre-qualified vendors for goods and services but occasionally publishes some of its procurement opportunities directly on UNGM and its Procurement website under tender alerts.

WHO also participates in the United Nations Global Marketplace, the common procurement portal of the United Nations. UNGM acts as a single window through which potential suppliers may register to access a global market of over USD 15 billion annually across UN organizations. It allows suppliers to keep current business information available to all UN Organizations as a tool for locating potential suppliers. It also provides online access to all tender opportunities and contract awards published by many UN agencies.

In WHO new suppliers can register their business through In Tend which is WHO electronic tendering portal. For registration you can visit following link to access (In- Tend) supplier portal where you can also find step by step supplier guide to the WHO Electronic Tendering Portal: https://ungm.in-tend.co.uk/who/aspx/Home

In case of any help or technical support is required, please follow this link: https://ungm.in-tend.co.uk/who/aspx/Help

Regional or local suppliers who wish to register can contact respective WHO Regional and Country Offices.

Registering with UNGM

To be listed as a potential supplier in the UNGM, please fill out the Supplier Registration Form. The Supplier Registration Form is the same form used by individual organizations to pre-qualify suppliers and incorporate them into their internal procurement rosters. Registering on UNGM is free of charge.

Области деятельности ВОЗ

Области деятельности ВОЗ

Системы здравоохранения

Сильные системы здравоохранения способствуют улучшению здравоохранения в различных странах и играют ключевую роль в обеспечении эффективности программ здравоохранения. ВОЗ осуществляет мониторинг региональной и глобальной ситуации и тенденций в области здравоохранения, сводя воедино все информационные системы о заболеваниях и состоянии здоровья. Надежные новейшие фактические данные и медико-санитарная информация чрезвычайно важны для принятия решений в области общественного здравоохранения, выделения необходимых ресурсов, мониторинга и оценки. ВОЗ выступает в роли глобального блюстителя надежности медико-санитарной информации и сотрудничает со странами в укреплении механизмов создания, обмена и использования высококачественных информационных ресурсов.

Неинфекционные заболевания

Укрепление здоровья на протяжении всей жизни

Содействие укреплению здоровья на протяжении всей жизни касается всей деятельности ВОЗ и учитывает необходимость привлечения внимания к экологическим факторам риска и социальным детерминантам здоровья, а также к гендерным аспектам, обеспечению справедливости и соблюдению прав человека. Работа в течение этого двухгодичного периода в основном сосредоточена на успешном завершении повестки дня в рамках Целей тысячелетия в области развития и на сокращении неравенств, существующих между странами, а также между наиболее бедными и наиболее богатыми слоями населения внутри отдельных стран.

Инфекционные болезни

ВОЗ работает со странами над расширением и обеспечением устойчивого доступа к средствам профилактики, лечения и медицинской помощи в случаях заболевания ВИЧ, туберкулезом, малярией и забытыми тропическими болезнями, а также над снижением заболеваемости болезнями, предотвратимыми с помощью вакцин. В достижении ЦТР 6 (Борьба с ВИЧ/СПИДом, малярией и другими болезнями) отмечается заметный прогресс, но еще предстоит большая работа в этом направлении.

Обеспечение готовности, эпиднадзор и ответные меры

В чрезвычайных ситуациях операционная роль ВОЗ включает руководство связанными со здравоохранением ответными мерами и их координацию в целях оказания содействия странам, проведение оценки рисков, определение приоритетов и разработку стратегий, предоставление важнейших технических руководств, обеспечение запасами и финансовыми ресурсами, а также мониторинг ситуации в области здравоохранения. Кроме того, ВОЗ оказывает поддержку странам в укреплении их национального потенциала управления рисками в области здравоохранения в случае чрезвычайных ситуаций в целях предупреждения таковых, реагирования на них и восстановления после чрезвычайных ситуаций, обусловленных каким-либо фактором, представляющим угрозу для обеспечения безопасности здоровья людей.

Корпоративные услуги

Корпоративные услуги включают вспомогательные функции, инструменты и ресурсы, благодаря которым возможно выполнение всей этой работы. Так, например, категория «корпоративные услуги» охватывает руководящие органы, организующие встречи государств-членов для разработки политики; консультации, предоставляемые юридическим отделом в ходе разработки международных договоров; помощь со стороны сотрудников по связям с общественностью в распространении информации, касающейся здравоохранения; работу отдела по работе с персоналом, который привлекает лучших в мире экспертов в области общественного здравоохранения, а также укрепляет службы, отвечающие за предоставление помещений и средств, необходимых для примерно 7 тысяч сотрудников, работающих в более чем 150 офисах ВОЗ.

Ageing

Every person – in every country in the world – should have the opportunity to live a long and healthy life. Yet, the environments in which we live can favour health or be harmful to it. Environments are highly influential on our behaviour and our exposure to health risks (for example, air pollution or violence), our access to services (for example, health and social care) and the opportunities that ageing brings.

The number and proportion of people aged 60 years and older in the population is increasing. In 2019, the number of people aged 60 years and older was 1 billion. This number will increase to 1.4 billion by 2030 and 2.1 billion by 2050. This increase is occurring at an unprecedented pace and will accelerate in coming decades, particularly in developing countries.

This historically significant change in the global population requires adaptations to the way societies are structured across all sectors. For example, health and social care, transportation, housing and urban planning. Working to make the world more age-friendly is an essential and urgent part of our changing demographics.

Ageing presents both challenges and opportunities. It will increase demand for primary health care and long-term care, require a larger and better trained workforce, intensify the need for physical and social environments to be made more age-friendly, and call for everyone in every sector to combat ageism. Yet, these investments can enable the many contributions of older people – whether it be within their family, to their local community (e.g., as volunteers or within the formal or informal workforce) or to society more broadly.

Societies that adapt to this changing demographic and invest in healthy ageing can enable individuals to live both longer and healthier lives and for societies to reap the dividends.

WHO works with Member States, UN agencies and diverse stakeholders from various sectors to foster healthy ageing in every country. Healthy ageing is defined as developing and maintaining the functional ability that enables well-being in older age. Functional ability is determined by the intrinsic capacity of an individual (i.e., an individual’s physical and mental capacities), the environment in which he or she lives (understood in the broadest sense and including physical, social and policy environments) and the interactions among them.

WHO does this work in line with the Global strategy and action plan on ageing and health 2016–2020 and the related UN Decade of Healthy Ageing (2021–2030) in the following four action areas:

The world health organization and international

WHO Headquarters Leadership Team

Deputy Director-General

Dr Zsuzsanna Jakab, Deputy Director-General

A native of Hungary, Dr Jakab was appointed as Deputy Director-General in 2019 after serving as WHO Regional Director for Europe since 2010. She has held a number of high-profile national and international public health policy positions in the last three decades, including as the founding Director of the European Centre for Disease Prevention and Control in Stockholm, Sweden.

Between 2005 and 2010, she built the centre into an internationally respected centre of excellence in the fight against infectious diseases.

Chef de Cabinet

Dr Catharina Boehme, Chef de Cabinet

Dr Catharina Boehme assumed the role of Chef de Cabinet at WHO in March 2021. She was the Chief Executive Officer of FIND, the international alliance for diagnostics, for eight years. Under her leadership, the organization improved access to diagnosis for more than 100 million people in low- and middle-income countries and tackled major emerging challenges such as AMR, infectious disease outbreaks and noncommunicable diseases. As co-convener of the Access to COVID-19 Tools Accelerator, she has been widely featured in the press, driving equitable access to testing.

Dr Boehme is a trained medical doctor with diplomas in public health and management (IMD) and received her academic training in Germany, France and the United States of America. Early in her career, she worked in Ghana and Tanzania, focusing on clinical research to eliminate tuberculosis. She has served in several WHO and global advisory bodies, participated in two Lancet Commissions and published several hundred peer-reviewed publications.

Executive Directors

Ms Jane Ellison, Executive Director for External Relations and Governance

As Public Health Minister, she was involved in the UK’s response to the 2014–2015 Ebola outbreak and represented the Government of the United Kingdom in World Health Assemblies. During her time in Parliament she played a pivotal role in advancing health issues including founding the first All-Party Parliamentary Group on Female Genital Mutilation in 2011 and taking forward the UK’s plain packaging of tobacco legislation. Prior to becoming a Member of Parliament she worked in the private sector for the John Lewis Partnership. Ms Ellison has a degree in Politics, Philosophy and Economics from Oxford University.

Dr Michael Ryan, Executive Director, WHO Health Emergencies Programme

Dr Mike Ryan has been at the forefront of managing acute risks to global health for nearly 25 years. He served as Assistant Director-General for Emergency Preparedness and Response in WHO’s Health Emergencies Programme from 2017 to 2019.

Dr Ryan first joined WHO in 1996, with the newly established unit to respond to emerging and epidemic disease threats. He has worked in conflict affected countries and led many responses to high impact epidemics. He is a founding member of the Global Outbreak Alert and Response Network (GOARN), which has aided the response to hundreds of disease outbreaks around the world. He served as Coordinator of Epidemic Response (2000-2003), Operational Coordinator of WHO’s response to the SARS outbreak (2003), and as WHO’s Director of Global Alert and Response (2005-2011),

He was a Senior Advisor on Polio Eradication for the Global Polio Eradication Initiative from 2013 to 2017, deploying to countries in the Middle East.

He completed medical training at the National University of Ireland, Galway, a Master’s in Public Health at University College Dublin, and specialist training in communicable disease control at the Health Protection Agency in London and the European Programme for Intervention Epidemiology Training.

Dr Soumya Swaminathan, Chief Scientist

Dr Soumya Swaminathan was appointed WHO’s first Chief Scientist in March 2019. A paediatrician from India and a globally recognized researcher on tuberculosis and HIV, she brings with her 30 years of experience in clinical care and research and has worked throughout her career to translate research into impactful programmes. Dr Swaminathan was Secretary to the Government of India for Health Research and Director General of the Indian Council of Medical Research from 2015 to 2017. In that position, she focused on bringing science and evidence into health policy making, building research capacity in Indian medical schools and forging south-south partnerships in health sciences. From 2009 to 2011, she also served as Coordinator of the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases in Geneva.

She received her academic training in India, the United Kingdom, and the United States of America, and has published more than 350 peer-reviewed publications and book chapters. She is an elected Foreign Fellow of the US National Academy of Medicine and a Fellow of all three science academies in India. The Science division’s role is to ensure that WHO stays ahead of the curve and leverages advances in science and technology for public health and clinical care, as well as ensuring that the norms, standards and guidelines produced by WHO are scientifically excellent, relevant and timely. Her vision is to ensure that WHO is at the cutting edge of science and is able to translate new knowledge into meaningful impact on population health worldwide.

Assistant Directors-General

Dr Samira Asma, Assistant Director-General, for Data, Analytics and Delivery

Dr Samira Asma, from the United States of America, is the Assistant Director-General for Data, Analytics and Delivery for Impact where she leads the organization’s efforts to establish the results framework for accountability and using timely, reliable and actionable data to drive progress towards the Triple Billion targets and health-related Sustainable Development Goals (SDGs). Dr Asma brings more than 25 years of experience in building country capacity and meaningful partnerships that lead public health programmes and policies to catalyze substantial and measurable long-term impact.

Dr Asma re-joined WHO in 2018 as the Director for Health Metrics and Measurement and led an organization-wide and multi-partner engagement to develop the 13 th General Programme of Work (GPW 13), the WHO results framework and the SDG Global Action Plan with UN partners.

The COVID-19 pandemic has underscored the urgency to strengthen country heath information systems. By aligning with countries and partners, Dr Asma is working to ensure every country has a robust data and health information system, to make health data accessible, and to use data to improve health. These efforts are essential to realizing Dr Tedros’ vision of transforming WHO into a modern, data-driven organization.

Prior to joining WHO, Dr Asma served in leadership positions at the U.S. Centers for Disease Control and Prevention for over two decades. By building successful collaborations, she established global programmes on tobacco control, noncommunicable diseases, environmental health, and injuries. Dr Asma is recognized for leading the establishment of a reliable, sustained surveillance system for tobacco control in 180 countries, using innovative technologies to monitor health, generating epidemiologic and economic evidence for policy interventions, and launching a global initiative to reduce heart attacks and strokes – all through global networks and partnerships. Dr Asma has contributed to more than 100 publications, books and policy papers on global health and public health surveillance and is internationally recognized as a scientific and policy expert on preventing leading risk factors that cause premature deaths and making a measurable impact in countries.

Professor Hanan H. Balkhy, Assistant Director-General, Antimicrobial resistance

Professor Balkhy graduated from King Abdulaziz University in Jeddah, Kingdom of Saudi Arabia in 1991. She completed her paediatric residency training at Massachusetts General Hospital in Boston USA 1993-1996; followed by a paediatric infectious diseases fellowship from 1996-1999 from the Cleveland Clinic Foundation and Case Western Reserve University, Cleveland, Ohio, USA.

Prior to her appointment with WHO, she was the Executive Director, Infection Prevention and Control (IPC) at the Ministry of National Guard for 10 years and prior to that, the hospital epidemiologist for 10 years. She also led the establishment of the infectious diseases research department at King Abdulla International Research Centre at King Saud bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia. Professor Balkhy runs the WHO Collaborating Centre for IPC and anti-microbial resistance (AMR) and the Gulf Cooperation Council center for infection control. She is the Editor-in-Chief of the Journal of Infection and Public Health and has over 200 publications in peer-reviewed journals.

Professor Balkhy is a member of the WHO Global unit for IPC,and in addition has served on many WHO committees including: the Advisory Group on Integrated Surveillance and Antimicrobial Resistance (AGISAR), the Strategic and Technical Advisory Group on Antimicrobial Resistance (STAG-AMR), the International Health Regulations review committee (IHR-RC) and the most recent Interagency Coordination Group committee for AMR.

With her broad spectrum of responsibilities, she has been able to develop the expertise in managing and leading both her teams of infection preventioninsts on one hand and research teams in the fields of AMR and MERS-CoV on the other. She has received two research awards from her institution acknowledging her leading role in her field. Most recently she has been given the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Fellows honorary title.

Professor Agnès Buzyn, Executive Director, WHO Academy

Agnès Buzyn is the Executive Director of the WHO Academy. Prior to that she was the Director-General’s Envoy for Multilateral Affairs. Professor Buzyn served as the French Minister of Solidarity and Health from 2017 to 2020 before joining WHO. In 2016, she was appointed Chairman of the French Authority for Health (HAS) in charge of notably Health Technology Assessment. Between 2011 and 2016, Professor Buzyn served as the Executive President of the French National Cancer Institute (INCa). During that mandate, she wrote and implemented the national cancer control plan 2014-2019. In the same period, she represented the French government at the governing council of the International Agency for Research on Cancer (IARC) and in 2015 was elected Vice-President of the IARC. From 2008 to 2013, Professor Buzyn chaired the Executive Board of the French Radioprotection and Nuclear Safety Institute (IRSN).

Agnès Buzyn was a Professor of Hematology at the University Pierre-and-Marie-Curie in Paris. She spent a large part of her career as an academic hematologist and clinician at the University Paris Descartes Necker Hospital, where she was in charge, between 1992 and 2011, of the adult hematology intensive care and bone marrow transplants unit. Before that, starting back in 1995, she carried out research at the National Institute of Health and Medical Research (INSERM) where she headed a team on tumor immunology. Professor Buzyn also served as faculty professor at that hospital. She received an M.D. from University Pierre-and-Marie-Curie in Paris and a Ph.D. in immunology from the University Paris Descartes.

Dr Ibrahima Socé Fall, Assistant Director-General, Emergency Response

Doctor Ibrahima Socé Fall is the Assistant Director-General for Emergencies Response. He was previously the Regional Emergencies Director for WHO in the African Region. Dr Fall has worked as the WHO Representative in Mali before being appointed by the UN Secretary General as Ebola Crisis Manager and Head of UN mission for Ebola Emergency Response in Mali in November 2014. He returned to WHO in March 2015 as Director of the Health Security and Emergencies Cluster in the Regional Office after a successful mission in leading partners’ support to interrupting Ebola virus disease transmission in Mali.. He largely contributed the reform of WHO’s work in emergencies from design to implementation following his contribution to ending Ebola in West Africa.

Dr Fall was WHO Representative in Mali in the midst of the political and humanitarian crisis when WHO needed strong leadership and expertise to deal with complex emergencies. Prior to this role, Dr Fall was Regional Advisor in the WHO Regional Office for Africa in charge of strategic planning for the malaria programme as well as chair of the Roll Back Malaria Partnership’s strategic planning workstream at global level. He also coordinated capacity building for countries to access financing of the Global Fund to fight AIDS, Tuberculosis and Malaria. Dr Fall joined WHO in November 2003 as coordinator of the malaria intercountry support teams in the African Region.

Dr Fall also served as a member of the experts group that led the introduction and implementation of the Roll Back Malaria Partnership, which was launched in 1998 by WHO, UNICEF, UNDP and the World Bank.

Before joining WHO, Dr Fall has occupied many positions in Senegal including head of epidemics and communicable diseases control, immunization at provincial level, Member of the National Malaria Control Program steering committee, and Lecturer in Public Health at the Dakar University.

Dr Fall was trained as a military physician and has over 25 years’ experience in medical practice and Public Health. He has earned a doctorate in medicine, a Master’s in Public Health from Dakar University (UCAD), and a doctorate in Public Health jointly from Tulane University, Payson Center for International Development in the USA and UCAD, a Master of Science in International Development from Tulane University and a post-graduate diploma in tropical medicine and epidemiology in France at Aix-Marseille University and the Institute of Tropical Medicine of the French Army. Dr Fall is also a fellow of the Faculty of Public Health of the Royal College of Physicians of the United Kingdom.

World Health Organization

World Health Organization منظمة الصحة العالمية 世界卫生组织 Organisation mondiale de la Santé Всемирная организация здравоохранения Organización Mundial de la Salud
Flag of the World Health Organization
Org type	Specialized agency of the United Nations
Acronyms	WHO
Head	Dr. Margaret Chan
Status	Active
Established	7 April 1948
Headquarters	Geneva, Switzerland
Website	www.who.int
Parent org	ECOSOC

The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health Organization, which was an agency of the League of Nations. [ 1 ] It is a member of the United Nations Development Group. [ 2 ]

Contents

Constitution and history

The WHO’s constitution states that its objective «is the attainment by all people of the highest possible level of health.» [ 3 ] The flag features the Rod of Asclepius as a symbol for healing.

The World Health Organization (WHO) is one of the original agencies of the United Nations, its constitution formally coming into force on the first World Health Day, (7 April 1948), when it was ratified by the 26th member state. Jawaharlal Nehru, a major freedom fighter of India had given an opinion to start WHO. [ 4 ] Prior to this its operations, as well as the remaining activities of the League of Nations Health Organization, were under the control of an Interim Commission following an International Health Conference in the summer of 1946. [ 5 ] The transfer was authorized by a Resolution of the General Assembly. [ 6 ] The epidemiological service of the French Office International d’Hygiène Publique was incorporated into the Interim Commission of the World Health Organization on 1 January 1947. [ 7 ]

Activities

Apart from coordinating international efforts to control outbreaks of infectious disease, such as SARS, malaria, tuberculosis, influenza, and HIV/AIDS, the WHO also sponsors programs to prevent and treat such diseases. The WHO supports the development and distribution of safe and effective vaccines, pharmaceutical diagnostics, and drugs, such as through the Expanded Program on Immunization. After over two decades of fighting smallpox, the WHO declared in 1980 that the disease had been eradicated – the first disease in history to be eliminated by human effort. [ 8 ] The WHO aims to eradicate polio within the next few years.

The organization develops and promotes the use of evidence-based tools, norms and standards to support Member States to inform health policy options. It oversees the implementation of the International Health Regulations, and publishes a series of medical classifications including the International Statistical Classification of Diseases (ICD), the International Classification of Functioning, Disability and Health (ICF), and the International Classification of Health Interventions (ICHI). [ 9 ] The WHO regularly publishes a World Health Report including an expert assessment of a specific global health topic. [ 10 ] The organization has published tools for monitoring the capacity of national health systems [ 11 ] and health workforces [ 12 ] to meet primary health care goals. The organization has endorsed the world’s first official HIV/AIDS Toolkit for Zimbabwe (from 3 October 2006), making it an international standard. [ citation needed ]

In addition, the WHO carries out various health-related campaigns – for example, to boost the consumption of fruits and vegetables worldwide [ 13 ] and to discourage tobacco use. [ 14 ] Each year, the organization marks World Health Day focusing on a specific health promotion topic.

WHO conducts or supports health research in areas of communicable diseases, reproductive health, [ 15 ] non-communicable conditions and injuries, neglected tropical diseases, [ 16 ] health policy and systems, [ 17 ] and other areas, as well as improving access to health research and literature in developing countries such as through the HINARI network. [ 18 ] The organization relies on the expertise and experience of many world-renowned scientists and professionals to inform its work, such as the WHO Expert Committee on Biological Standardization, the WHO Expert Committee on Leprosy, and the WHO Study Group on Interprofessional Education & Collaborative Practice.

The World Health Organization’s suite of health studies is working to provide the needed health and well-being evidence through a variety of data collection platforms, including the World Health Survey [ 19 ] covering 308,000 respondents aged 18+ years and 81,000 aged 50+ years from 70 countries, and the Study on Global Ageing and Adult Health (SAGE) [ 20 ] covering over 50,000 persons aged 50+ across almost 23 countries. The WHO Assessment Instrument for Mental Health Systems (WHO-AIMS), [ 21 ] the WHO Quality of Life Instrument (WHOQOL), [ 22 ] and the Service Availability Mapping (SAM) tool [ 23 ] provide guidance for data collection in other health and health-related areas. Collaborative efforts between WHO and other agencies, such as through the Health Metrics Network, serve the normative functions of setting high research standards.

WHO has also worked on global initiatives in surgery such as the Global Initiative for Emergency and Essential Surgical Care [ 24 ] and the Guidelines for Essential Trauma Care [ 25 ] focused on access and quality. Safe Surgery Saves Lives [ 26 ] addresses the patient safety in surgical care. The WHO Surgical Safety Checklist is in current use worldwide in the effort to improve safety in surgical patients.

COMPASS
Manual for Human Rights Education with Young people

Health

The World Health Organisation (WHO) has defined health as «a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.» 2
Humanity has made considerable progress in improving the state of health in the world. We have learned how to treat and control diseases that used to kill millions. We have improved access to water and sanitation as well as created complex health-care systems. Our knowledge and expertise in health is growing rapidly and we have more resources available for health than ever before.
However, progresses in health have been extremely unequal. A child born today in Sweden can expect to live more than 80 years, but fewer than 72 years if she is born in Brazil, fewer than 63 years if she is born in India, and fewer than 50 years if born in Lesotho. In Ireland, the risk of a woman dying during pregnancy or childbirth is 1 in 47 600; in Afghanistan it is 1 in 8. Our life expectancy and health can dramatically differ depending on where we live and grow; however, magnificent inequalities in health exist not only between countries, but also within countries. A child born in the Calton, a district in the Scottish city of Glasgow, can expect a life 28 years shorter than another child living in Lenzie, a Scottish village only 13 kilometres away. In Bolivia, babies born to women with no education have a 10% chance of dying before age 1, while one born to a woman with at least secondary education has a 0.4% chance. In the United Kingdom the adult mortality rates in poor neighbourhoods are 2.5 times higher than in the least deprived neighbourhoods. 3

«Among the most important freedom we can have is freedom from avoidable ill-health and from escapable mortality.» 1
Amartya Sen

Dramatic inequalities in health as revealed by statistics cannot be explained by biology. The health differences between and within countries are a result of social and economic policies that determine the environment where people are born, grow, live and work. 5 Health inequalities are unfair and can be avoided. In most of the cases it is not even a question of economic growth. While economic growth is important for development, without equal distribution of resources, national economic growth can even deepen health inequalities. The WHO points out that some developing countries such as Cuba, Costa Rica, or Sri Lanka have managed to achieve good levels of health despite a relatively low national economic growth. 6 Fighting health inequalities is a matter of social justice and human rights.

Global commitment to health for all is manifested in the Millennium Development Goals. Our governments have promised to achieve eight poverty reduction goals by 2015. However, this global effort will not be possible without the active involvement of civil society. People have to know their rights and the obligations of their governments; it has to be demanded that social and economic policies that are being created or reformed by governments do not deepen health inequalities. Health is not only an aspiration for well-being; it is a human right.

The right to health

The right to health is recognised in numerous international and regional instruments, starting with the Universal Declaration of Human Rights (Article 25) and including the International Covenant of Social Economic Rights (Article 12), the Convention on the Rights of the Child (Article 6, 24), the Convention on the Elimination of All Forms of Discrimination against Women (Article 10, 11, 12, 14), and the European Social Charter.
The right to health is not to be understood as the right to be healthy: it is impossible to provide protection against every possible cause of human ill-health. It is the right for everyone without discrimination to the enjoyment of different services, facilities and goods as well as appropriate living conditions that are necessary for staying as healthy as possible. The right to health includes not only health-care services but also conditions that determine our health, including: access to safe drinking water, adequate sanitation and housing, adequate food, healthy working and environmental conditions, and access to health-related education and information. 7

Question: Should everyone be entitled to medical treatment regardless of their status and economic possibilities?

The right for everyone without discrimination to the enjoyment of differ-ent services, facilities and goods as well as appropriate living conditions that are necessary for staying as healthy as possible.

According to international human rights instruments, health services and facilities have to be available, accessible, acceptable and of good quality for everyone without discrimination.

In September 2010 the UN Human Rights Council adopted a resolution recognising access to water and sanitation as a human right.

Availability means that public health-care facilities, goods and services, as well as programmes, have to be available in sufficient quantity within the country.

Accessibility means that health facilities, goods and services have to be physically and economically accessible to everyone without discrimination and there has to be a possibility to seek, receive and impart information concerning health issues. For example, health facilities for young people have to be close to where young people live (including rural areas and small towns), and there has to be public transportation that allows people to reach the health facility easily. The opening times have to be convenient for young people. Health facilities should be free or very cheap, so that young people can afford them. Health-related information, including sexual and reproductive health information, should be easily accessible for young people without discrimination.

Acceptability means that goods and services must be culturally appropriate and respectful of medical ethics. For example, doctors and nurses have to be trained in how to talk to young people and children. The atmosphere in the health centre should be supportive and non-judgemental to young people.

«. health will finally be seen not as a blessing to be wished for, but as a human right to be fought for.»
Kofi Annan

Question: Do asylum seekers and undocumented people have access to health care where you live?

Participation

A further important aspect of the right to health is active and informed participation of the population, including young people, in health-related decision making at the community, national and international level. 9 The UN Committee on Economic, Social and Cultural Rights explains that «State parties should provide a safe and supportive environment for adolescents that ensures the opportunity to participate in decisions affecting their health, to build life skills, to acquire appropriate information, to receive counselling, and to negotiate the health-behaviour choices they make.» 10

Young people can and should be strategic partners in activities or programmes that deal with health problems. There are a number of international organisations and networks that work in partnership with young people on different health-related topics, including: the International Federation of Red Cross and Red Crescent Societies, the European Network of Health Promoting Schools, the Youth Peer Education Network, the International Federation of Medical Students Associations, and others.

The European Youth Forum also highlights the role of youth organisations as key stakeholder in developing health policy relevant to young people. In their 2008 policy paper on the health and well-being of young people they write, «They [youth organisations] are a good space to organise consultations among young people and they are the most representative bodies to voice the concerns of a wide range of youth. Many youth organisations have certain competences in the field of health and are therefore adequate partners for these consultations.» 11

Question: How can you participate in health-related decision making in your community or country?

Accountability

Human rights require governments to be accountable for their actions: to show, explain and justify how the state has fulfilled its obligations regarding the right to health.
NGOs and activists around the world have used different methods to demand accountability for the right to health, including media campaigns, submitting shadow reports to international treaty bodies, submitting complaints to national, regional and international courts, advocating for health rights before national and regional elections, and actively participating in monitoring initiatives.

How can you hold your government accountable for the right to health?

The right to health and
the European Social Charter

In Europe, the right to health is upheld in the European Social Charter. The main article that focuses on the right to health is Article 11, which obliges European states to take measures to promote health and to provide health care in case of sickness.

European Social Charter – Article 11 – The Right to Protection of Health

With a view to ensuring the effective exercise of the right to protection of health, the Contracting Parties undertake, either directly or in co-operation with public or private organisations, to take appropriate measures designed inter alia:
1. to remove as far as possible the causes of ill-health
2. to provide advisory and educational facilities for the promotion of health and the encouragement of individual responsibility in matters of health
3. to prevent as far as possible epidemic, endemic and other diseases.

The Charter is monitored by the European Committee of Social Rights. Each year the Committee examines the reports submitted by the state parties and decides whether or not the situation in the country regarding the right to health and other social and economic rights are in conformity with the European Social Charter. In addition to this, some European organisations and national NGOs can submit a collective complaint against the State to the Committee.

The Council of Europe and health

No poor health for poor people
Council of Europe, Health policy website

In addition to the continued work on monitoring and implementing the European Social Charter, the Council of Europe assists member states in implementing a «health and human rights for all» approach by taking account of minorities and vulnerable groups with the Committee of Experts on Good Governance in Health care. The European Directorate for the Quality of Medicines and Health Care contributes to the human right of access to good quality medicines through the harmonisation and co-ordination of standardisation, regulation and quality control of medicines, blood transfusion, organ transplantation, pharmaceuticals and pharmaceutical care.

In the constantly changing field of bioethics, the Council of Europe aims to find a balance between freedom of research and protection of individuals. The European Conference of National Ethics Committees promotes co-operation between national ethics bodies in the member states and plays a role in promoting debate in issues raised by developments in biomedical and health sciences. The 1997 Oviedo Convention on human rights and biomedicine established the basic principles of biomedical ethics. There have since been three additional protocols dealing with the prohibition of cloning human beings, organ transplantation and biomedical research.

Young people and health

«If we, as health workers, or teachers, or students, or civil servants, do not feel that we, and the groups and organisations we belong to, have some power to alter policy that affects our lives, or the lives of those around us, why get up in the morning?»
Gill Walt 4

Having a healthy lifestyle will mean something different for everyone. Generally it can be agreed that a healthy lifestyle is one which enables a person to live life in a way that promotes physical and mental well-being. For young people, there are various risk factors they are exposed to throughout childhood and adolescence that can often lead to poor nutrition, lack of physical activity and/or addictions – all of which have consequences that can continue for the rest of their lives.
For young people who start working very early in life there are occupational health risks which can also lead to sometimes life-long consequences. Across Europe, young people are at least 50% more likely to be hurt at work than older people and are also more likely to suffer from an occupational illness. 12
The Council of Europe youth policy also acknowledges the well-being of young people as an important aim of youth policy within the framework of Agenda 2020 on the youth policy of the Council of Europe. This follows the fact that in recent years, a worrying trend in many European countries has been the rise in the consumption of alcohol, drugs and tobacco by young people combined with the worsening of prospects for social and economic autonomy.

Question: Should tobacco be made illegal?

Alcohol: According to WHO, alcohol consumption in Europe is double the world average. Alcohol is the second largest risk factor for death and disability among adults, and the largest risk factor for young people. In Europe, alcohol accounts for 618,000 deaths every year. Excessive drinking contributes not only to ill-health but also to loss of productivity in the educational setting and workplace, criminal damage and violence. 14

ACTIVE – Sobriety, Friendship and Peace – is a European organisation gathering young people who have decided to live sober and share a vision of a ‘’democratic, diverse and peaceful world free from alcohol and other drugs where any individual can live up to her full potential».
www.activeeurope.org

Drugs: According to the United Nations Office on Drugs and Crime, between 155 and 250 million people worldwide, or 3.5-5.7% of the population aged 15-64, had used illicit drugs at least once in 2009. Cannabis users make up the largest number of illicit drug users; however, in terms of harm, opiates are ranked at the top. 15

Question: Do you know what are the consequences for young people who drink excessive alcohol and use illicit drugs?

Obesity: According to WHO, 30-80% of adults in Europe and around 20% of children and adolescents are overweight, and 7% are obese. 16 Obesity creates risks for cardiovascular diseases, diabetes, orthopaedic problems and mental disorders. Reports indicate that discrimination, bullying and teasing can be both causes and effects of weight gain. 17

It is too easy to say that individuals are totally responsible for their health and hence if they start smoking, eating unhealthy food, or using drugs, it is their choice. Victim blaming is a popular approach to «solving» unhealthy behaviour and unfortunately it is being implemented in health policies and programmes in a number of European countries. Public health specialists argue that if a health policy is ignoring existing inequalities and focuses only on health education and information campaigns, a huge number of people will not be able to enjoy their right to health. For example, a WHO report on obesity in Europe shows that children from families with lower socio-economic status and lower level of education are choosing less healthy food than children from families with more education and a higher socio-economic status. 18

Question: Why do you think relatively better-off groups in society are less likely to eat unhealthy foods or suffer from a drug addiction?

Another element that may lead to unhealthy behaviour is values and life goals that are being appreciated in society and promoted by mass media. Western industrialised societies increasingly embrace life goals such as financial success, popularity, power, prestige, social status and consumption. Advertisement campaigns often target young people to think that they are not good enough if they do not have a certain new gadget, or fashionable clothes, do not drink a certain new type of drink, or do not have perfect hair or a perfect body as seen on television. The enormous pressure to look good and to have new things affects young people’s mental and physical health adversely. The WHO identified bullying, low self-esteem, social pressures, difficulties in coping with stress and glamorisation of thinness in mass media as risk factors in the development of eating disorders such as anorexia and bulimia. 19

Size Zero Model Ban

In 2006, Madrid Fashion Week banned underweight models, with Milan taking the same action directly afterwards. Health organisations and civil society groups have been campaigning for other cities to follow suit with limited success. The Spanish ban started as a result of two young models in South America dying from starvation and anorexia. 20

Sexual and reproductive health

Sexual and reproductive health often involve sensitive and controversial issues for young people, their families and health professionals. Adolescents and young people face many challenges related to their sexual and reproductive health. Because of puberty and the rapid psychological development young people go through, they are vulnerable to the pressures of society and their peers in adopting risky health behaviour which often includes risky sexual behaviour. In many societies adolescents’ sexuality is a very controversial issue and people question whether young people should receive sexual education outside the family, or whether young people under the age of 18 should receive anonymous counselling or treatment without permission of their parents. Sexual and reproductive health also affects women and men differently.

Question: What views exist in your country that may negatively affect the sexual and reproductive health of young people?

Sexual and reproductive health in numbers

Every minute in the world, at least one woman dies while giving birth, or from complications related to pregnancy; that means 529,000 women a year. 21
According to UNFPA, at least 200 million women worldwide want to use, but do not have access to safe and effective family planning methods.
More than a quarter of women who become pregnant each year have abortions; most of these abortions are done in secrecy and performed under unsafe conditions. 22
According to an assessment conducted in 2008, 33.4 million people were living with HIV/AIDS, the vast majority in low- and middle-income countries. 23 Young people (15-24 years old) accounted for an estimated 40% of all new HIV infections worldwide.

Ill-health becomes a human right violation when it occurs because of the failure of a state to respect, protect or fulfill human rights obligations. 24 Our states have a duty to do everything that is possible to protect us from ill-health, including such measures as sexual and reproductive health education, appropriate counselling, accessible and good quality health-care services, as well as programmes that fight stigma, discrimination and dangerous cultural practices.

K.L. v. Peru and freedom from cruel and inhumane treatment

K.L., a 17-year-old girl was pregnant with an anencephalic foetus (a foetus with partial or total absence of a brain that would not survive a birth or would die within a few hours or days after the birth). Although Peruvian abortion law allows abortion in a case when the life or health of the mother is in danger, K.L. was denied an abortion and had to deliver the baby and breastfeed her for the four days she survived.
In 2005, the United Nations Human Rights Committee ruled that Peru had violated K.L.’s right to be free from cruel, inhumane, and degrading treatment (Article 7 of ICCPR) and the right to privacy (Article 17). The Committee held that the State should have provided during and after her pregnancy «the medical and psychological support necessary in the specific circumstances of her case». 25

Mental health

The World Health Organisation (WHO) defines mental health as «a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.» 26
According to the WHO, one in four people worldwide will be affected by mental or neurological disorders at some point in their lives. 27 Young people are especially at risk of developing mental health disorders as they transition from dependence to independent or adult life. New pressures and changes such as puberty, new relationships, leaving the parental home for the first time, financial instabilities, employment or education-related anxiety can cause high levels of stress, which can lead to mental disorders. Several disorders, such as depression, schizophrenia, eating disorders and substance abuse, are identified as having their onset at a young age. 28 In addition to this, suicide is the second leading cause of death among children and young people aged 10-24 worldwide.

«The unnecessary disease and suffering of the disadvantaged, whether in poor or rich countries, is a result of the way we organise our affairs in society.»
Michael Marmot 30

It is estimated that only 10-15% of young people with mental health issues receive help from professionals. 29 Therefore, it is essential not only to have accessible mental health services, but also to educate the general public about existing professional help as well as to fight stigmatisation and stereotypes that prevent young people from seeking help.

Question: Do you know where a young person can receive youth-friendly mental health care where you live?

Poverty and access to medicines

Public health spending in high and low income countries mostly benefits the rich rather than the poor. More than 90% of the global production of pharmaceuticals is consumed only by 15% of the world’s population. For example, between 1975 and 2004, 1,556 new drugs were approved for the global market. However, only 21 of these were specifically developed for tropical diseases and tuberculosis, even though these diseases account for 11.4% of the global disease burden. 31 Tropical diseases such as malaria, leprosy, Chagas disease and others are called neglected diseases, because even though they affect over one billion people worldwide, they are often forgotten because they affect the poorest and the most marginalised communities. 32 It is also estimated that in developing countries patients have to pay 50-90% of essential medicines from their own pocket.

Every year over 100 million people fall into poverty because they need to pay for their health-care bills. 33

Almost two billion people worldwide do not have access to essential medicines. The high cost of medicines is one of the major reasons why people in need cannot get the available medicines they need. The United Nations Special Rapporteur on the right to health argues that improving access to existing medicines could save 10 million lives each year. 34

Generic drugs

One of the best ways to lower prices and increase access to medicaments is by allowing and promoting generic drugs. A generic drug is a copy of a branded pharmaceutical product. Generics are as effective as their branded counterparts; the biggest difference is the price. It is cheaper to produce a generic drug because manufacturers do not have to cover expenses of drug invention and extensive safety and efficacy clinical trials. Because of the low price, generic drugs are often the only medicines that the people living in poverty can access.
Pharmaceutical companies argue that generic drugs decrease their profits and subsequently affect their ability to invest in researching and developing new drugs. In order to help pharmaceutical companies that discover new drugs to recover the money they spent on drug creation and to allow them to profit from the invention, they are granted a patent. A patent or intellectual property right is a set of exclusive rights granted by a state to an inventor to make, use, sell, and offer to sell or import the invention. The patent usually lasts for twenty years and during this period other companies cannot produce, sell, offer to sell or import the patented drug.

Question: Do pharmaceutical companies have human rights responsibilities?

Intellectual property issues created a huge tension between the global North and South. Developed countries argued for the pharmaceutical industries’ right to patent their drugs. Developing countries argued that global intellectual property standards would obstruct their development because they were not well prepared or equipped to benefit from such standards. The international agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) came into force in 1995 and is administrated by the World Trade Organisation (WTO). The legislation was to have a huge impact on the production of generic drugs; therefore the developing countries were given a transition period and were allowed to continue developing generic drugs until 2000, and the least developed countries were granted a transition period until 2016 for pharmaceutical patents and undisclosed information. 35

The impact of intellectual property rights on the right to health

What are the main functions of the World Health Organization?

The World Health Organization (WHO) is the body of the United Nations (UN) responsible for directing and coordinating health. As such WHO has come to play a vital role as an actor in the field of international public health and international public health policy. Since its inception in 1947 WHO has been at the forefront of many breakthroughs in the field including, most notably, what has come to be described as one of the greatest humanitarian achievements of the 20 th century, the elimination of Smallpox in 1979. However WHO’s inability to control the spread of HIV/AIDS, particularly in Africa has cast doubt on its effectiveness. Though much of the media attention given to WHO concentrates on its role in controlling and ultimately eliminating infectious disease, WHO’s mandate is far broader. The details of WHO’s mandate will be examined in detail throughout this paper but put simply this mandate is to ensure the attainment of the highest possible level of all forms of health by all human beings. This paper will focus on the area of maternal health. Maternal health is an important indicator, alongside life expectancy, of development. This is reflected by the inclusion of maternal health in the Millennium Development Goals (MDGs) however the area of maternal health is often ignored by international relations (IR) scholars who tend to focus analysis of WHO on its role in dealing with infectious disease. This focus on infectious disease by IR scholars is understandable in light of globalization. Due to globalization and the related transport revolution of the 20 th century it is now possible for infectious diseases to spread around the globe in a matter of days. The threat of infectious disease brings with it a number of traditional, hard security issues that put bluntly other health issues do not. However in light of the development of the human security paradigm from the late 1990s onwards it is now becoming increasingly apparent that IR scholars will need to expand their examination of the ways in which WHO functions beyond the realm of infectious disease.

This paper will examine the ways in which WHO functions in relation to maternal health. It will do this by first examining the history, structure and functions of WHO and the role that the MDGs have come to play in influencing WHO’s operations. The paper will then focus on maternal health as a concept before detailing what role WHO plays in the field of maternal heath at an international, regional and national level. The final section of the paper will critique WHO’s functioning in the area of maternal health with a focus on WHO’s operations at the international level. The paper will conclude by asking if it is fair or even possible to pass judgement on the functioning of an organization as complex and multifaceted as WHO by focusing on only one, narrow section of its overall mandate.

The History, Functions and Structures of the World Health Organization

In order to understand how WHO functions when dealing with the area of maternal health it is first necessary to understand something of the history, functions and structures of WHO. These three areas are closely interrelated. It is important to examine all three in order to paint a complete picture of WHO’s functioning in relation to maternal Health.

The constitution of the World Health Organization entered into force on the 7 th April 1948; however the idea of an international (or at least transnational) approach to dealing with matters of health had existed since the middle of the 19 th century with efforts centred on combating infectious disease[1]. As the 20 th century progressed, the focus of international health policy broadened[2].

The constitution of WHO indicates that, by the middle of the 20 th century nations were willing to cooperate in a broad range of health-related policy matters. Chapter II, Article 2 of WHO’s constitution lists the twenty-two functions of WHO[3]. In addition to a continuing focus on infectious disease there are also functions that specifically deal with areas including research, assistance to government and addressing non-infectious disease that had previously been given little attention on the international health policy stage.

The constitution of the World Health Organization also addresses its structures. These structures are complex, with three levels of organization at an international level, the World Health Assembly (WHA), comprising representatives of every WHO member state[4], The Executive board, which comprises members elected by the WHA[5] and The Secretariat[6] comprised of WHO’s Director-General and technical and administrative staff[7]. The constitution also specifies provisions to create regional organizations[8] and “committees considered desirable to serve any purpose within the competence of the organization[9]”.

The focus of WHO’s work has shifted over time. This is not surprising, considering the broad scope of WHO’s mandate that the organization tends to focus its work around only some of its functions at any given time. The organization’s Eleventh General Programme of Work 2006-2015 details the six core functions it is focusing on between 2006 and 2015[10]. These functions are:

This set of functions, according to WHO are based on an analysis of WHO’s comparative advantage as an actor in the international system[12]. This advantage WHO believes, lies in the organization’s “neutral status and near universal membership, its impartiality and its strong convening power[13].” This set of functions and WHO’s claims about its comparative advantage will be examined in greater detail later in this paper.

Two points become apparent from reading WHO’s Eleventh General Programme of Work 2006-2015, the first is that WHO is acutely aware of the challenges it faces if it is to remain a relevant actor in international health[14] (a topic that will be returned to later in this paper) and second, the direction of WHO’s work for this period is geared towards meeting the health related Millennium Development Goals. Both these points indicate that WHO is aware of the fact that it cannot function as an independent actor in the international system. Any action WHO takes must be informed by the actions of other actors in the international system and likewise WHO’s actions impact upon the actions of other actors in the international system.

The Millennium Development Goals

Before examining WHO’s role in maternal health it is important to understand how the Millennium Development Goals (MDGs) have come to play such a prominent role in shaping WHO’s work. The MDGs came out of the United Nations Millennium Declaration which was endorsed by 189 countries in September 2000[15] and resolves to work towards combating poverty, ill health, discrimination and inequality, lack of education and environmental degradation[16].

The MDGs are eight specific goals that the 191 United Nations (UN) states have committed themselves to achieving by 2015. The MDGs are:

1. to eradicate extreme poverty and hunger;

2. to achieve universal primary education;

3. to promote gender equality and empower women;

4. to reduce child mortality;

5. to improve maternal health;

6. to combat HIV/AIDS, malaria and other diseases;

7. to ensure environmental sustainability; and

8. to develop a global partnership for development[17].

These goals are interdependent[18], progress or lack thereof in achieving one goal will have effects on progress towards achieving the others. Likewise it is acknowledged that in order to achieve the MDGs all sections of the UN system will be required to work together and, more importantly, that the UN alone cannot achieve the MDGs. Achieving the MDGs will require the cooperation and action of UN member states and of other international, regional and local governmental and non-governmental organizations. WHO in particular accepts this to be the case; WHO’s need to work closely with other UN bodies, states and other actors in the international system is a major theme of WHO’s Eleventh General Programme of Work 2006-2015.

The MDGs are unique in that they have broad support across the international system. The constituent bodies of the UN and all 191 UN member states are committed to achieving the MDGs. Regional organizations including the European Union[19] and the Association of Southeast Asian Nations[20] (ASEAN) frame, to varying extents, their policies in a variety of areas around the achievement of the MDGs. Many major international charities such as the Red Cross[21] and OXFAM[22] are focusing their work, again to varying degrees, on achieving the MDGs. There are also many civil society organizations, operating at local, national, regional and international levels that are engaged with the MDGs[23]. Considering this broad support it is little wonder that WHO have chosen to focus so heavily on the achievement of the MDGs in the Eleventh General Programme of Work 2006-2015.

WHO and Maternal Health

Following the preceding discussion of WHO’s functions and Millennium Development Goals it is now possible to examine how WHO functions in the area of maternal health. This discussion will be framed around WHO’s contribution to achieving MDG 5 which concerns improving maternal health. It will first examine exactly what maternal health is, before looking at how WHO functions in relation to maternal health at the international, regional and national levels.

Defining Maternal Health

The World Health Organization defines maternal health as referring to “the health of women during pregnancy, childbirth and the postpartum period[24].” Maternal health is complex. There are a broad range of conditions, complications and circumstances that can negatively impact upon maternal health. Some of these are specific to pregnancy, childbirth and the postpartum period[25] (the period immediately following pregnancy or childbirth, defined as being 42 days in length by the International Statistical Classification of Diseases and Related Health Problems (ICD)[26]). Others are either pre-existing conditions or conditions that are contracted during pregnancy, childbirth and the postpartum period that are exacerbated or complicated by pregnancy, childbirth or the postpartum period[27]. Some conditions and complications are acute in nature and others chronic[28]. Conditions and complications can affect physical health, mental health or both[29]. Many conditions and complications are universal, affecting women worldwide[30]. Others are common in the developing world and almost unheard of in the developed world[31]. Certain conditions and complications of pregnancy are strongly associated with cultural practices[32]. The one fact that links all these conditions, complications and circumstances is that they are, almost without exception, preventable and/or treatable[33].

WHO and Maternal Health: The International Picture

The goal of MDG 5 is to improve maternal health. This goal was translated into two targets to be achieved by 2015[34]. These two targets are:

1. to reduce by three quarters, between 1990 and 2015, the maternal mortality ratio; and

2. to achieve by 2010, universal access to reproductive health[35].

The second of these targets is the major goal of the International Conference on Population and Development and was incorporated into the MDGs in 2005[36]. The first is one of the original MDG targets. Progress towards these goals is measured by a number of indicators. The indicators related to the first target are:

a) the maternal mortality ratio; and

b) the proportion of births attended by skilled health personnel[37].

The indicators related to the second target are:

a) the contraceptive prevalence rate;

b) the adolescent birth rate;

c) antenatal care coverage; and

d) the unmet need for family planning[38].

It is clear from examining these goals that WHO must address a number of challenges if it is to succeed in meeting these goals by 2015. These challenges are multifaceted. They relate not only to health but to culture[39], economics[40] and gender[41] amongst other factors.

At an international level WHO coordinates much of its policy related to maternal health through the Department of Making Pregnancy Safer (MPS). MPS was formed in 2005[42] and works “to strengthen WHO’s role in providing technical, intellectual, and political leadership in the field of health and human rights[43].” The department aims to “strengthen WHO’s capacity to support countries in their endeavour to improve maternal and newborn health[44].” MPS evolved out of WHO’s Safe Motherhood Initiative[45] and focuses its work on 75 priority countries. These countries, located mostly in sub-Saharan Africa and south and central Asia[46] account for 97% of maternal mortality[47].

MPS primarily focuses on four key working areas:

1. strengthening national capacity by assessing the technical capacity of health systems and health policy within countries;

2. building partnerships with governments and other actors in order to build upon existing strategies for poverty reduction and cost-effective interventions;

3. monitoring progress towards achievement of the MDGs through global surveys and data analysis; and

4. advocacy, particularly mobilizing resources at national, regional and international levels in order to increase investment in maternal health, advocate continuum of care approaches in the area of maternal and newborn health and work towards achieving universal maternal health coverage and skilled care at all births[48].

The most recent MPS annual report published in 2008 continues with these themes detailing achievements such as the development and enhancement of partnerships with other UN organizations, academic and professional organizations[49], capacity building workshops[50] and the development of major advocacy projects[51].

MPS also publishes recommendations for preventing, managing and treating a variety of common conditions and complications of pregnancy[52] and on what care should be provided as standard to all women before, during and after pregnancy, childbirth and the postpartum period[53].

With the exception of the Pan-American Health Organization (PAHO) (which serves as WHO’s regional office for the Americas (AMRO)[54]) which includes maternal health in its general report on health in the region[55], each WHO regional office, the Regional Office for The Eastern Mediterranean (EMRO), the Regional Office for Africa (AFRO), the Regional Office for Europe (EURO), the Regional Office for South-East Asia (SEARO) and the Regional Office for the Western Pacific (WPRO) publishes reports dealing specifically with maternal health[56][57][58][59][60].

These reports all take on a similar form. All are focused on one or more of the MDG targets and all follow roughly the same structure. This structure looks at the current situation in each region, strategic directions for the region, and implementation frameworks. What becomes apparent from reading these reports is that all WHO regions face a number of similar difficulties in making progress in the area of maternal health. These difficulties mostly stem from deep and in many cases deepening inequalities within regions. Economic capacity of states and individuals, pre-exisiting health problems including infection and malnutrition, cultural values including gender discrimination and religion and political instability are some of the root causes of inequalities in the area of maternal health[61][62][63][64][65][66].

In addition to the common problems that all WHO regions face there are a number of issues that are specific to particular regions. These problems, like those which all WHO regions face are rooted in a complicated web of economic capacity, health, culture and politics. One well-known example of a maternal health issue that exists almost entirely at a regional level is obstetric fistula in Africa[67].

Each WHO regional office believes that if the maternal health situation is to improve they must work to overcome these difficulties at a regional level. For example EURO states that “a regional strategy for Making Pregnancy Safer (MPS) provides the opportunity to call attention to the maternal and perinatal ill-health situation in the region and creates a means to unite efforts to accelerate actions needed to improve maternal and perinatal health in the European region. This strategy was developed in response to requests from some of the 53 European Members States based on their needs[68].” Similarly AFRO states that its regional roadmap for improving maternal health “provides a framework for building strategic partnerships for increased investment in maternal and newborn health at institutional and programme levels. Consensus amongst the major stakeholders at African regional level to support countries over the next eleven years using this Road Map is a breakthrough in maternal and newborn mortality reduction efforts[69].”

It is clear to see that the regional level of WHO plays a significant role in improving maternal health and in achieving MDG 5 not only because WHO regional offices are equipped to deal with problems that are specific to particular regions but also because they play an important role in coordinating international policy. WHO regional offices are not merely concerned with issues that affect their own regions, they are also deeply involved with attempting to tailor regional solutions to global problems in the area of maternal health.

WHO and National Policy

WHO’s major contribution to the health policy of individual nations is normative in nature. One of WHO’s major functions, as discussed above, in the area of maternal health at an international level is to publish recommendations on how to care for women before during and after pregnancy, childbirth and the postpartum period and how to prevent, manage and treat many of the complications that can arise during this period.

WHO produces a range of literature designed to fulfil this normative function. Some of it is technical in nature, designed largely as a teaching aid to those working in the field. An example of this type of literature is Care in Normal Birth: a practical guide which is a detailed and systematic guide to care providing information on such matters as diagnosing when labour has started, how to monitor the progress of labour, how to prevent prolonged labour etc[70]. Other literature is directed at policymakers. An example of this form of literature is Standards for Maternal and Neonatal Care. This document discusses standards for maternal and newborn care. Each standard is presented in a uniform manner[71] and details the evidence and rationale used in developing the standard[72]. WHO states that the purpose of this document is to help policymakers develop and implement policy at national, sub-national and facility levels for providing effective maternal and newborn health services and improve to the uptake of these services by communities[73]. Other documents are a combination of technical and policy considerations.

WHO’s regional bodies also play a normative function in relation to national health policy. An example of this can be found in EURO’s Assessment Tool for the Quality of Hospital Care for Mothers and Newborn Babies which is an exhaustive survey assessing everything from drug availability to foetal monitoring[74].

How effective is WHO in the area of maternal health?

The role WHO plays as an actor in maternal health is a complex one. Now that some insight as to how WHO functions in relation to maternal health has been gained it is possible to assess how effective it has been.

Assessing the effectiveness of WHO in the area of maternal health is not as easy as it may first appear. This is the case for a number of reasons. First is the question of exactly how to measure the effectiveness of WHO. Should WHO’s effectiveness be measured against the MDGs, against the WHO constitution or against the functions outlined in Eleventh General Programme of Work 2006-2015? Second is the question of which level any assessment should focus on. Should assessment of WHO’s effectiveness be focused on the international, regional or national levels or should any accurate assessment of WHO’s functionality take in all three? Complicating the situation further is the fact that WHO itself admits that acquiring accurate data in relation to maternal morbidity and mortality is difficult[75], though the acquisition of data is improving[76] it is still the case that any judgment passed on WHO’s effectiveness as an actor has the potential to be grossly inaccurate.

This paper will assess WHO’s performance in relation to maternal health using two frameworks. These frameworks will both focus on WHO at an international level. The reason for this is simple, as a scholar of international relations the international level is the most relevant. One framework will focus on the MDGs and the other will focus on WHO’s Eleventh General Programme of Work 2006-2015 and the functions WHO has defined for itself in this report. These two approaches whilst by no means exhaustive serve to illustrate the difficulties in accurately assessing the performance of an organization as multidimensional as WHO.

WHO, Maternal Health and the Achievement of the MDGs

Assessing WHO’s performance using the achievement of the MDG 5 targets discussed above as a benchmark does not paint a pretty picture. Put bluntly WHO will fail to achieve these targets. Data published in 2005 indicates that few low and middle income countries will achieve the 75 percent reduction in the maternal mortality ratio that the first target of MDG 5 demands[77]. Worse still, the African region has gone backwards with the maternal mortality ratio widening from 870 deaths per 100,000 live births in 1990 to 1,000 deaths per 100,000 live births in 2001[78]. However there is still cause for cautious optimism. Though, at a regional level, none of the regions have achieved the yearly percentage decline in the maternal mortality ratio required to achieve the 75 percent target, some, most notably East Asia are close to doing so[79]. Moreover the global maternal mortality ratio is slowly declining[80]. Another point of progress is the increase in number of births attended by a skilled assistant with the percentage of births attended worldwide increasing by 14 percent in the 16 year period from 1990 to 2006.

Data related to the second MDG target of achieving universal reproductive health and its indicators is far more difficult to come by which in itself suggests that it is unlikely that this target will be met. The available data indicates that some progress has been made particularly in the area of access to and use of contraception however this progress is patchy at both the international level and within states[81]. Progress in this area, especially within states is tightly linked to socio-economic status and other markers of development[82].

As noted above it is difficult, if not impossible to assess progress towards the achievement of any one of the eight MDGs in isolation. Progress or lack thereof in achieving any one of the eight goals has effects on progression towards achieving the others. This is especially true of MDG 5. Perhaps more than any of the other goals the achievement of MDG 5 will require progress towards achieving at least some of the targets and indicators of almost every other MDG. This is because the improvement of maternal health is so closely interlinked with other aspects of development. The eradication of extreme poverty and hunger will mean that women’s bodies will be better able to tolerate the physiological stress that even uncomplicated pregnancy causes[83]. Improved education and gender equality will result in fewer pregnancies in the very young and fewer unwanted pregnancies among women of all ages[84]. Uncontrolled HIV/AIDS, Malaria and other infectious diseases are in large part responsible for the increasing maternity mortality ratios in Africa[85] as such it stands to reason that combating these diseases will result in a fall in the maternal mortality ratio in the region. It also stands to reason that the development of global partnerships for development will undoubtedly have positive consequences for maternal health.

WHO recognizes this. The World Health Report 2005 titled Making Every Child and Mother Count reflects this recognition. Several case studies featured in the report focus on the links between maternal health and other areas of development. One looks at the situation in Africa with a focus on Malawi[86], another links economic crisis and political instability in Mongolia to a cascading sequence of events that ultimately resulted in the death of a mother[87] and yet another examines the direct effects of HIV/AIDS on pregnant women[88]. However much of WHO’s policy regarding the achievement of MDG 5 is narrow in focus. Areas of focus include promoting evidence-based clinical and programmatic guidance, promoting skilled care at every birth and developing educational tools for health professionals[89]. In light of WHO’s recognition that improving maternal health is much more complicated than simply providing technical support to healthcare workers WHO’s narrow focus is disappointing especially considering that so many of the concurrent improvements required to improve maternal health, such as those related to HIV/AIDS and other infections are unambiguously part of WHO’s mandate.

Assessing WHO’s progress: an Alternative View

Assessing WHO’s performance against the MDG’s paints a bleak picture however if WHO’s achievements in the area of maternal health are measured against WHO’s functions as outlined in the Eleventh General Programme of Work 2006-2015 quite a different picture emerges. Looking at the functions of MPS outlined above and comparing these functions to the functions that WHO sets itself in its Eleventh General Programme of Work 2006-2015 also discussed above one can see that on this measure WHO is performing quite well.

In the Eleventh General Programme of Work 2006-2015 WHO defines itself largely as an agency for providing leadership in the area of international public health and international public health policy. This is exactly the function WHO performs through MPS in the area of maternal health. MPS’s functions are very much geared towards providing countries, regions and international bodies with the information and expertise required to improve maternal healthcare. It does this through a number of avenues including advocacy, norm setting and the dissemination of technical knowledge and expertise.

As argued above a large part of WHO’s work at the international, regional and national levels in the area of maternal health involves the setting of norms. WHO has been far more successful in this function than it has been in its attempts to achieve any of the MDG targets. Additionally it is entirely possible that positioning WHO as an international normative body geared towards the achievement of long-lasting changes in maternal health through the setting of new norms and standards is both a far more realistic and in the long-term far more positive use of WHO’s finite resources than channelling all of WHO’s resources into the unrealistic achievement of the MDGs.

Conclusion

This paper has looked at two questions. The first concerns the functioning of WHO and the second concerns how well WHO functions in relation to a specific area of its mandate. The specific area of WHO’s mandate this paper has addressed is the area of maternal health, an area often ignored by IR scholars in favour of areas of WHO’s functioning that present traditional, hard security threats, particularly infectious disease. The choice to focus on maternal health came out of an interest in the human security paradigm and the belief that because of the emergence of this paradigm IR scholars need to broaden their interest in WHO beyond the traditional interest in infectious disease.

The first section of this paper examined WHO’s functioning on a general level and discovered that WHO’s mandate is far broader than the control of infectious disease. Put succinctly WHO’s role in the international system is nothing short of ensuring the attainment of the highest level of all forms of health, physical, mental and emotional by all human beings.

The paper then turned its attention to maternal health, examining what maternal health is and what WHO’s role in ensuring the improvement of maternal health is. It was discovered that maternal health is an important indicator of overall development. More importantly however it was discovered that maternal health is an incredibly multifaceted idea, taking in physical, mental and emotional health and complicated by a great many issues linked into larger questions of development. It was also shown that WHO’s operations are complex. WHO functions not only at the international level but at regional and national levels as well.

The final section of the paper examined two alternative critiques of WHO’s functioning in relation to maternal health. One was focused on WHO’s functioning in relation to the MDGs. By this account WHO had made little progress in the area of maternal health and by some measures had gone backwards. This account is important because so much of WHO’s energy over the course of the last decade has been placed into achieving the MDGs. However the other account which focused on WHO’s functions as defined by the Eleventh General Programme of Work 2006-2015 presented a brighter prognosis. It argued that instead of focusing on the achievement of the MDGs WHO should place its energy into becoming a catalyst for long-term improvement in the field of maternal health by acting as a setter of norms for international health and international health policy.

One of the questions this paper set out to answer is whether or not it is possible to assess the functioning of an international body with a mandate as broad as the one WHO is required to fulfil by focusing on only a small area of its functioning. After only a brief assessment of WHO’s functioning in the relatively narrow area of maternal health the only conclusion that can be drawn is that it is not possible. In assessing WHO’s functioning in the area of maternal health this paper came to two entirely different conclusions regarding WHO’s effectiveness. Considering this it could be strongly argued that it is impossible to objectively and fairly assess the functioning of WHO as a whole. It may in fact be impossible to assess WHO’s functioning in individual policy areas in a manner that is objective, fair and just.

[1] Mark W. Zacher and Tania J. Keefe, The Politics of Global Health Governance: United by Contagion (New York: Palgrave McMillan, 2008) p. 26.

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Healthy diet

Key facts

Consuming a healthy diet throughout the life-course helps to prevent malnutrition in all its forms as well as a range of noncommunicable diseases (NCDs) and conditions. However, increased production of processed foods, rapid urbanization and changing lifestyles have led to a shift in dietary patterns. People are now consuming more foods high in energy, fats, free sugars and salt/sodium, and many people do not eat enough fruit, vegetables and other dietary fibre such as whole grains.

The exact make-up of a diversified, balanced and healthy diet will vary depending on individual characteristics (e.g. age, gender, lifestyle and degree of physical activity), cultural context, locally available foods and dietary customs. However, the basic principles of what constitutes a healthy diet remain the same.

For adults

A healthy diet includes the following:

For infants and young children

In the first 2 years of a child’s life, optimal nutrition fosters healthy growth and improves cognitive development. It also reduces the risk of becoming overweight or obese and developing NCDs later in life.

Advice on a healthy diet for infants and children is similar to that for adults, but the following elements are also important:

Practical advice on maintaining a healthy diet

Fruit and vegetables

Eating at least 400 g, or five portions, of fruit and vegetables per day reduces the risk of NCDs (2) and helps to ensure an adequate daily intake of dietary fibre.

Fruit and vegetable intake can be improved by:

Reducing the amount of total fat intake to less than 30% of total energy intake helps to prevent unhealthy weight gain in the adult population (1, 2, 3). Also, the risk of developing NCDs is lowered by:

Fat intake, especially saturated fat and industrially-produced trans-fat intake, can be reduced by:

Salt, sodium and potassium

Most people consume too much sodium through salt (corresponding to consuming an average of 9–12 g of salt per day) and not enough potassium (less than 3.5 g). High sodium intake and insufficient potassium intake contribute to high blood pressure, which in turn increases the risk of heart disease and stroke (8, 11).

Reducing salt intake to the recommended level of less than 5 g per day could prevent 1.7 million deaths each year (12).

People are often unaware of the amount of salt they consume. In many countries, most salt comes from processed foods (e.g. ready meals; processed meats such as bacon, ham and salami; cheese; and salty snacks) or from foods consumed frequently in large amounts (e.g. bread). Salt is also added to foods during cooking (e.g. bouillon, stock cubes, soy sauce and fish sauce) or at the point of consumption (e.g. table salt).

Salt intake can be reduced by:

Some food manufacturers are reformulating recipes to reduce the sodium content of their products, and people should be encouraged to check nutrition labels to see how much sodium is in a product before purchasing or consuming it.

Potassium can mitigate the negative effects of elevated sodium consumption on blood pressure. Intake of potassium can be increased by consuming fresh fruit and vegetables.

Sugars

In both adults and children, the intake of free sugars should be reduced to less than 10% of total energy intake (2, 7). A reduction to less than 5% of total energy intake would provide additional health benefits (7).

Consuming free sugars increases the risk of dental caries (tooth decay). Excess calories from foods and drinks high in free sugars also contribute to unhealthy weight gain, which can lead to overweight and obesity. Recent evidence also shows that free sugars influence blood pressure and serum lipids, and suggests that a reduction in free sugars intake reduces risk factors for cardiovascular diseases (13).

Sugars intake can be reduced by:

How to promote healthy diets

Diet evolves over time, being influenced by many social and economic factors that interact in a complex manner to shape individual dietary patterns. These factors include income, food prices (which will affect the availability and affordability of healthy foods), individual preferences and beliefs, cultural traditions, and geographical and environmental aspects (including climate change). Therefore, promoting a healthy food environment – including food systems that promote a diversified, balanced and healthy diet – requires the involvement of multiple sectors and stakeholders, including government, and the public and private sectors.

Governments have a central role in creating a healthy food environment that enables people to adopt and maintain healthy dietary practices. Effective actions by policy-makers to create a healthy food environment include the following:

WHO response

The “WHO Global Strategy on Diet, Physical Activity and Health” (14) was adopted in 2004 by the Health Assembly. The strategy called on governments, WHO, international partners, the private sector and civil society to take action at global, regional and local levels to support healthy diets and physical activity.

In 2010, the Health Assembly endorsed a set of recommendations on the marketing of foods and non-alcoholic beverages to children (15). These recommendations guide countries in designing new policies and improving existing ones to reduce the impact on children of the marketing of foods and non-alcoholic beverages to children. WHO has also developed region-specific tools (such as regional nutrient profile models) that countries can use to implement the marketing recommendations.

In 2012, the Health Assembly adopted a “Comprehensive Implementation Plan on Maternal, Infant and Young Child Nutrition” and six global nutrition targets to be achieved by 2025, including the reduction of stunting, wasting and overweight in children, the improvement of breastfeeding, and the reduction of anaemia and low birthweight (9).

In 2013, the Health Assembly agreed to nine global voluntary targets for the prevention and control of NCDs. These targets include a halt to the rise in diabetes and obesity, and a 30% relative reduction in the intake of salt by 2025. The “Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020” (10) provides guidance and policy options for Member States, WHO and other United Nations agencies to achieve the targets.

With many countries now seeing a rapid rise in obesity among infants and children, in May 2014 WHO set up the Commission on Ending Childhood Obesity. In 2016, the Commission proposed a set of recommendations to successfully tackle childhood and adolescent obesity in different contexts around the world (16).

In November 2014, WHO organized, jointly with the Food and Agriculture Organization of the United Nations (FAO), the Second International Conference on Nutrition (ICN2). ICN2 adopted the Rome Declaration on Nutrition (17), and the Framework for Action (18) which recommends a set of policy options and strategies to promote diversified, safe and healthy diets at all stages of life. WHO is helping countries to implement the commitments made at ICN2.

In May 2018, the Health Assembly approved the 13th General Programme of Work (GPW13), which will guide the work of WHO in 2019–2023 (19). Reduction of salt/sodium intake and elimination of industrially-produced trans-fats from the food supply are identified in GPW13 as part of WHO’s priority actions to achieve the aims of ensuring healthy lives and promote well-being for all at all ages. To support Member States in taking necessary actions to eliminate industrially-produced trans-fats, WHO has developed a roadmap for countries (the REPLACE action package) to help accelerate actions (6).

References

(1) Hooper L, Abdelhamid A, Bunn D, Brown T, Summerbell CD, Skeaff CM. Effects of total fat intake on body weight. Cochrane Database Syst Rev. 2015; (8):CD011834.

(2) Diet, nutrition and the prevention of chronic diseases: report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series, No. 916. Geneva: World Health Organization; 2003.

(3) Fats and fatty acids in human nutrition: report of an expert consultation. FAO Food and Nutrition Paper 91. Rome: Food and Agriculture Organization of the United Nations; 2010.

(4) Nishida C, Uauy R. WHO scientific update on health consequences of trans fatty acids: introduction. Eur J Clin Nutr. 2009; 63 Suppl 2:S1–4.

(5) Guidelines: Saturated fatty acid and trans-fatty acid intake for adults and children. Geneva: World Health Organization; 2018 (Draft issued for public consultation in May 2018).

(6) REPLACE: An action package to eliminate industrially-produced trans-fatty acids. WHO/NMH/NHD/18.4. Geneva: World Health Organization; 2018.

(7) Guideline: Sugars intake for adults and children. Geneva: World Health Organization; 2015.

(8) Guideline: Sodium intake for adults and children. Geneva: World Health Organization; 2012.

(9) Comprehensive implementation plan on maternal, infant and young child nutrition. Geneva: World Health Organization; 2014.

(10) Global action plan for the prevention and control of NCDs 2013–2020. Geneva: World Health Organization; 2013.

(11) Guideline: Potassium intake for adults and children. Geneva: World Health Organization; 2012.

(12) Mozaffarian D, Fahimi S, Singh GM, Micha R, Khatibzadeh S, Engell RE et al. Global sodium consumption and death from cardiovascular causes. N Engl J Med. 2014; 371(7):624–34.

(13) Te Morenga LA, Howatson A, Jones RM, Mann J. Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids. AJCN. 2014; 100(1): 65–79.

(14) Global strategy on diet, physical activity and health. Geneva: World Health Organization; 2004.

(15) Set of recommendations on the marketing of foods and non-alcoholic beverages to children. Geneva: World Health Organization; 2010.

(16) Report of the Commission on Ending Childhood Obesity. Geneva: World Health Organization; 2016.

(17) Rome Declaration on Nutrition. Second International Conference on Nutrition. Rome: Food and Agriculture Organization of the United Nations/World Health Organization; 2014.

(18) Framework for Action. Second International Conference on Nutrition. Rome: Food and Agriculture Organization of the United Nations/World Health Organization; 2014.

(19) Thirteenth general programme of work, 2019–2023. Geneva: World Health Organization; 2018.

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Сопредседатели Координационного совета Инициативы АСТ приветствуют финансовые и политические обязательства, принятые на втором Глобальном саммите по борьбе с COVID-19

Женева. Второй Глобальный саммит по борьбе с COVID-19 показал, что мир способен объединить усилия во имя глобального общественного блага — прекращения пандемии COVID-19 и создания солидарной системы для предупреждения будущих чрезвычайных ситуаций в области здравоохранения, обеспечения готовности к ним и принятия мер реагирования.

Сто дней войны создали тяжелейшую нагрузку на систему здравоохранения Украины

После ста дней войны система здравоохранения Украины испытывает тяжелейшую нагрузку, и для содействия удовлетворению растущих медико-санитарных потребностей Всемирная организация здравоохранения (ВОЗ) расширила свое присутствие как в Украине, так и в странах, размещающих перемещенных лиц из Украины.

Новое соглашение под эгидой C-TAP ‎повысит доступность технологий ‎тестирования на COVID-19 во всем ‎мире

Новое открытое и транспарентное сублицензионное соглашение, заключенное Патентным пулом лекарственных средств (ППЛС) от имени Пула доступных технологий для борьбы с COVID-19 (C-TAP) с южноафриканской фармацевтической компанией «Байотек Африка», ускорит организацию производства и сбыта тест-систем для серодиагностики антител к COVID-19 во всем мире.
Всемирная организация здравоохранения приветствует подписание первого в своем роде сублицензионного соглашения под эгидой осуществляемой ВОЗ инициативы С-TAP. Инициатива была начата в 2020 г. для содействия обеспечению своевременного, равноправного доступа к приемлемой по цене медицинской продукции, предназначенной для борьбы с COVID-19.
Новое соглашение стало возможным благодаря лицензионному договору с Национальным советом Испании по научным исследованиям (НСИ), о котором ВОЗ и ППЛС объявили в прошлом году. Неисключительная сублицензия позволяет компании «Байотек» выпускать серологические тесты НСИ на COVID-19 и выводить их на рынок во всем мире.
«Постоянное тестирование – самый действенный способ опередить и сдержать распространение COVID-19, – отметил Генеральный директор ВОЗ д-р Тедрос Адханом Гебрейесус. – Это новое соглашение позволяет нам задействовать незагруженные производственные мощности и повысить доступность недорогих средств диагностики для большего числа людей в большем числе стран».
Тест позволяет эффективно определять присутствие антител к SARS-CoV-2, вырабатываемых в ответ на заражение COVID-19 или вакцинацию. Соглашение охватывает все соответствующие патенты и биологические материалы, требующиеся для производства теста. НСИ предоставит «Байотек» все необходимые технологии и проведет обучение ее сотрудников. Лицензия бесплатна для стран с низким и средним уровнем дохода и будет действовать до даты истечения действия последнего патента.
«“Байотек Африка” гордится тем, что стала первой африканской биотехнологической компанией, отобранной в качестве партнера C-TAP для налаживания местного производства недорогих средств ведения эпиднадзора за COVID-19», – отметила директор по производству «Байотек Африка» Дженни Лесли.
«Мы получили этот статус благодаря нашему упорному стремлению войти в число глобальных игроков на рынке производства рекомбинантных белков высочайшего качества. Подписание данного соглашения отражает неизменную цель компании – содействовать решению актуальных задач в области диагностики во всем мире», – подчеркнула Лесли.
«Мы очень рады тому, что инициатива по созданию Пула доступных технологий для борьбы с COVID-19, цель которой состоит в обеспечении равноправного доступа самых уязвимых групп населения во всем мире к жизненно необходимой медицинской продукции, приносит свои плоды», – заявил исполнительный директор ППЛС Чарльз Гор.
Пул C-TAP, созданный в 2020 г. Генеральным директором ВОЗ и президентом Коста-Рики при содействии 44 государств-членов, призван содействовать обеспечению своевременного и равноправного доступа к приемлемой по стоимости медицинской продукции для борьбы с COVID-19 путем стимулирования ее производства и поставки на основе открытых неисключительных лицензионных соглашений.
C-TAP представляет собой единую глобальную платформу, при помощи которой разработчики терапевтических и диагностических средств, вакцин и других приоритетных медицинских технологий борьбы с COVID-19 могут обмениваться знаниями и данными и предоставлять принадлежащие им объекты интеллектуальной собственности в распоряжение других производителей путем выдачи им добровольных, неисключительных и прозрачных лицензий в интересах охраны здоровья населения.
Создание пула технологий позволяет разработчикам медицинской продукции для борьбы с COVID-19 наращивать производственные мощности во всех регионах и расширять доступ к жизненно необходимым изделиям.

ВОЗ: необходимо срочно изменить подход к психическому здоровью и оказанию психиатрической помощи

Сегодня Всемирная организация здравоохранения выпустила свой крупнейший с начала века обзор мировой проблематики психического здоровья. В подробном документе намечаются действия правительств, академических кругов, медицинских специалистов, гражданского общества и других сторон, призванные изменить подход к вопросам психического здоровья во всем мире.

Приложение SunSmart Global UV помогает защититься от опасных факторов солнечного излучения и сохранить здоровье людей

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Предварительное заявление по вопросу о составе имеющихся вакцин против COVID-19

Техническая консультативная группа по составу вакцин против COVID-19 (ТКГСВ) – группа независимых экспертов, которая на постоянной основе ведет работу по анализу и оценке теоретического влияния новых вызывающих обеспокоенность вариантов SARS-CoV-2 (ВВО) на эффективность вакцин против COVID-19. После того, как в ноябре 2021 г. Всемирная организация здравоохранения (ВОЗ) объявила «омикрон» вариантом, вызывающим обеспокоенность, ТКГСВ провела тщательный анализ его влияния на характеристики зарегистрированных в настоящее время вакцин против COVID-19 на предмет изучения целесообразности изменения состава вакцин против COVID-19.

Предварительное заявление об отдельных аспектах принятия решений относительно использования вакцин против COVID-19, обновленных с учетом отдельных вариантов вируса

Всемирная организация здравоохранения (ВОЗ) при поддержке Стратегической консультативной группы экспертов (СКГЭ) по иммунизации и ее рабочей группы по вакцинам против COVID-19 продолжает анализировать поступающие даные о вакцинах, модифицированных с учетом новых вариантов вируса. Настоящее заявление отражает состояние текущих знаний о вариантах, вызывающих обеспокоенность (ВВО), и вакцинах, модифицированных с учетом новых вариантов вируса, и подчеркивает пробелы в фактических данных и понимании теоретического влияния новых вариантов и модифицированных вакцин на стратегии в области вакцинации.

Совещание Комитета Международных медико-санитарных правил (2005 г.) по чрезвычайной ситуации в связи со вспышкой оспы обезьян
в нескольких странах

Генеральный директор ВОЗ согласен с рекомендациями Комитета ММСП по чрезвычайной ситуации в связи со вспышкой оспы обезьян в нескольких странах и в настоящее время не считает, что это событие представляет собой чрезвычайную ситуацию в области общественного здравоохранения, имеющую международное значение (ЧСЗМЗ).

Важная веха: новая политическая декларация о снижении вдвое к 2030 г. травматизма и смертности в результате дорожно-транспортных происшествий является

Всемирная организация здравоохранения (ВОЗ) приветствует политическую декларацию, которая должна быть принята государствами-членами на Совещании высокого уровня Генеральной Ассамблеи ООН по глобальной безопасности дорожного движения. В ней будет провозглашено обязательство сократить к 2030 г. травматизм и смертность в результате дорожно-транспортных происшествий на 50%, что является важной вехой в области обеспечения безопасности дорожного движения и устойчивой мобильности.

ВОЗ усиливает меры реагирования в связи с медико-санитарным кризисом, ‎разворачивающимся в регионе Африканского Рога на фоне ухудшения ‎продовольственной ситуации ‎

Примечания для редакторов
Четыре года подряд в регионе в период сезона дождей практически не выпадало осадков, что является беспрецедентным климатическим катаклизмом по меньшей мере за последние 40 лет. Согласно последним прогнозам, существует реальный риск того, что следующий сезон дождей также может не наступить (источник: ВМО).
Более 80 миллионов человек в Восточной Африке испытывают нехватку продовольствия (источник: ВПП) и вынуждены прибегать к отчаянным мерам, чтобы прокормить себя и свои семьи.
Особенно острая ситуация сложилась в пострадавших от засухи районах Эфиопии, Кении и Сомали, где из-за нехватки продовольствия от недостаточности питания страдает примерно 7 миллионов детей, среди которых у 1,7 миллиона отмечается острая форма недоедания (источник: ЮНИСЕФ). Острая недостаточность питания – жизнеугрожающее состояние, требующее неотложного лечения.
Страны затронуты проблемой в разной степени

World Health Organization

World Health Organization
Organisation mondiale de la santé
Organización Mundial de la Salud
世界卫生组织

منظمة الصحة العالمية

Всеми́рная организа́ция здравоохране́ния (ВОЗ, англ. World Health Organization, WHO ) — специализированное учреждение Организации Объединённых Наций (самостоятельные международные организации, связанные с Организацией Объединённых Наций специальным соглашением о сотрудничестве), состоящее из 194 государств-членов, основная функция которого лежит в решении международных проблем здравоохранения населения Земли.

Всемирная организация здравоохранения была основана в 1948 году с главной конторой (офисом) в Женеве, в Швейцарии. В специализированную группу ООН, кроме ВОЗ, входят ЮНЕСКО (Организация Объединённых Наций по вопросам образования, науки и культуры), Международная организация труда (МОТ), ЮНИСЕФ (Фонд помощи детям) и другие (см. Специализированные учреждения ООН).

Государство-член ООН становится членом ВОЗ, приняв Устав. Государство не член ООН принимается в члены ВОЗ простым большинством голосов Генеральной ассамблеи. Территории, не правомочные выступать субъектами международных отношений, могут быть приняты в ВОЗ в качестве ассоциативных членов на основании заявлений, сделанных от их имени членом ВОЗ или другим полномочным органом, ответственным за международные отношения этих территорий.

Содержание

Предыстория создания ВОЗ

Первым органом, занимавшимся межнациональным сотрудничеством в этом вопросе, был Константинопольский высший совет здравоохранения, образованный в 1839 году. Его основными задачами были контроль за иностранными судами в портах Османской империи и противоэпидемические мероприятия по предупреждению распространения чумы и холеры. Позднее подобные советы были созданы в Марокко (1840 год) и Египте (1846 год). В 1851 году в Париже прошла I Международная санитарная конференция ( всего их было 14 [en] ), в которой участвовали 12 государств, в том числе и Российская империя. Итогом работы этого форума предполагалось принятие Международной санитарной конвенции, которая определила порядок морского карантина в Средиземном море. Однако достигнуть этого результата удалось только в 1892 году в отношении холеры, а в 1897 — в отношении чумы.

История ВОЗ

Приводится согласно официальному сайту [6] :

Структура ВОЗ

Штаб-квартира ВОЗ

Штаб-квартира ВОЗ находится в Женеве, Швейцария.

Руководство ВОЗ

Генеральный директор ВОЗ

Генеральные директора ВОЗ

Задачи ВОЗ

Сферы деятельности ВОЗ

Региональные бюро ВОЗ

В соответствии со статьёй 44 Устава ВОЗ в период с 1949 по 1952 год открыты региональные бюро ВОЗ:

Региональный директор является главой ВОЗ для своего региона. Региональный директор управляет и/или контролирует работников здравоохранения и других специалистов в региональных отделениях и в специализированных центрах. Наряду с Генеральным директором ВОЗ и руководителями региональных бюро ВОЗ, известных как представители ВОЗ в регионе, региональный директор также обладает функциями прямого надзорного органа в регионе.

Другие бюро ВОЗ

Работа ВОЗ

Работа ВОЗ организована в виде Всемирных Ассамблей здравоохранения, на которых ежегодно представители государств-членов обсуждают важнейшие вопросы охраны здоровья. Между Ассамблеями основную функциональную роль несёт Исполнительный комитет, включающий представителей 30 государств (среди них — 5 постоянных членов: США, Россия, Великобритания, Франция и Китай). Для обсуждения и консультаций ВОЗ привлекает многочисленных известных специалистов, которые готовят технические, научные и информационные материалы, организуют заседания экспертных советов. Широко представлена издательская деятельность ВОЗ, включающая отчёты Генерального директора о деятельности, статистические материалы, документы комитетов и совещаний, в том числе отчёты Ассамблеи, исполнительных комитетов, сборники резолюций и решений и т. д. Кроме того, выпускаются журналы ВОЗ: «Бюллетень ВОЗ», «Хроника ВОЗ», «Международный форум здравоохранения», «Здоровье мира», «Ежегодник мировой санитарной статистики», серия монографий и технических докладов. Официальными языками являются английский и французский, рабочими (кроме указанных) — русский, испанский, арабский, китайский, немецкий.

Деятельность ВОЗ осуществляется в соответствии с общими программами на 5—7 лет, планирование ведётся на 2 года. В настоящее время приоритетными направлениями являются:

ВОЗ удаётся решать многие важные вопросы. По инициативе ВОЗ и при активной поддержке национальных систем здравоохранения (в том числе и СССР) была проведена кампания по ликвидации оспы в мире (последний случай зарегистрирован в 1981 г.); ощутимой является кампания по борьбе с малярией, распространённость которой сократилась почти в 2 раза, программа иммунизации против 6 инфекционных заболеваний, организация выявления и борьба с ВИЧ, создание справочно-информационных центров во многих государствах, формирование служб первичной медико-санитарной помощи, медицинских школ, учебных курсов и т. д. Основная роль ВОЗ в достижении поставленных целей — консультативная, экспертная и техническая помощь странам, а также предоставление необходимой информации, чтобы научить страны помогать самим себе в решении ключевых проблем охраны здоровья. На сегодня ВОЗ определила наиболее важные направления деятельности национальных систем здравоохранения как: ВИЧ/СПИД, туберкулёз, малярия, содействие безопасной беременности — здоровье матери и ребёнка, здоровье подростков, психическое здоровье, хронические заболевания.

Финансирование ВОЗ

Источники и объёмы финансирования ВОЗ публичны.

Всемирные дни ВОЗ, входящие в систему международных дней ООН

Всемирные дни, поддерживаемые ВОЗ

Эти всемирные дни не входят в систему международных дней ООН

Послы доброй воли

Не стоит путать послов доброй воли с волонтерами-добровольцами, стать которыми может практически любой человек, соответствующий неприхотливым требованиям: возраст от 25 лет, высшее образование и стаж работы, а также знание английского языка. Достаточно, чтобы он подал заявление на сайт волонтёров ООН.

Реформа ВОЗ

Приводится согласно официальному сайту [22] :

Критика

Cancer

Cancer is a large group of diseases that can start in almost any organ or tissue of the body when abnormal cells grow uncontrollably, go beyond their usual boundaries to invade adjoining parts of the body and/or spread to other organs. The latter process is called metastasizing and is a major cause of death from cancer. A neoplasm and malignant tumour are other common names for cancer.

Cancer is the second leading cause of death globally, accounting for an estimated 9.6 million deaths, or one in six deaths, in 2018. Lung, prostate, colorectal, stomach and liver cancer are the most common types of cancer in men, while breast, colorectal, lung, cervical and thyroid cancer are the most common among women.

The cancer burden continues to grow globally, exerting tremendous physical, emotional and financial strain on individuals, families, communities and health systems. Many health systems in low- and middle-income countries are least prepared to manage this burden, and large numbers of cancer patients globally do not have access to timely quality diagnosis and treatment. In countries where health systems are strong, survival rates of many types of cancers are improving thanks to accessible early detection, quality treatment and survivorship care.

Between 30% and 50% of cancer deaths could be prevented by modifying or avoiding key risk factors and implementing existing evidence-based prevention strategies. The cancer burden can also be reduced through early detection of cancer and management of patients who develop cancer. Prevention also offers the most cost-effective long-term strategy for the control of cancer.

Modifying or avoiding the following key risk factors can help prevent cancer:

Cancer is more likely to respond to effective treatment when identified early, resulting in a greater probability of surviving as well as less morbidity and less expensive treatment.

There are two distinct strategies that promote early detection:

Treatment options include surgery, cancer medicines and/or radiotherapy, administered alone or in combination. A multidisciplinary team of cancer professionals recommends the best possible treatment plan based on tumour type, cancer stage, clinical and other factors. The choice of treatment should be informed by patients’ preferences and consider the capacity of the health system.

Palliative care, which focuses on improving the quality of life of patients and their families, is an essential component of cancer care. Survivorship care includes a detailed plan for monitoring cancer recurrence and detection of new cancers, assessing and managing long-term effects associated with cancer and/or its treatment, and services to ensure that cancer survivor needs are met.

Journals and series

African Health Monitor

Bulletin of World Health Organization

Eastern Mediterranean Health Journal

Pan American Journal of Public Health

Public Health Panorama

Weekly Epidemiological Record

Western Pacific Surveillance and Response

WHO Drug Information

WHO South-East Asia Journal of Public Health

The world health organization and international

История Всемирной организации здравоохранения берет свое начало 7 апреля 1948 года. Сегодня более 7 тысяч человек являются сотрудниками 150 страновых бюро, 6 региональных бюро и штаб-квартиры ВОЗ в Женеве.

Деятельность ВОЗ

ВОЗ является органом, направляющим и координирующим международную работу в области здравоохранения в рамках системы ООН.

Основные направления деятельности ВОЗ: Неинфекционные заболевания, Инфекционные заболевания, Обеспечение готовности, эпиднадзор и ответные меры, Укрепление здоровья на протяжении всей жизни, Системы здравоохранения.

Где работает ВОЗ

Мы оказываем содействие странам в координации деятельности многочисленных правительственных ведомств и партнерских организаций (в том числе двусторонних и многосторонних организаций, фондов, организаций гражданского общества и представителей частного сектора) в интересах достижения поставленных ими целей в области здравоохранения и поддержки их национальной политики и стратегий здравоохранения.

Руководство ВОЗ

Всемирная ассамблея здравоохранения является высшим органом ВОЗ, принимающим решения.

Партнеры

Одна из ключевых функций ВОЗ — координирование международной работы по здравоохранению путем расширения сотрудничества и привлечения к работе различных партнерств.

Финансирование

Бюджет ВОЗ устанавливается на 2 года и финансируется через обязательные и добровольные взносы государств-членов.

Всемирная организация здравоохранения

World Health Organization
Organisation mondiale de la Santé
Organización Mundial de la Salud
世界卫生组织

منظمة الصحة العالمية

Всеми́рная организа́ция здравоохране́ния (ВОЗ, англ. World Health Organization, WHO ) — специальное учреждение Организации Объединённых Наций, состоящее из 194 государств-членов, основная функция которого лежит в решении международных проблем здравоохранения и охране здоровья населения мира. Она была основана в 1948 году со штаб-квартирой в Женеве в Швейцарии.

В специализированную группу ООН кроме ВОЗ входят ЮНЕСКО (Организация по вопросам образования, науки и культуры), МОТ (Международная организация труда), ЮНИСЕФ (фонд помощи детям).

Страна-член ООН становится членом ВОЗ, приняв Устав. Страна не член ООН, принимается в члены ВОЗ простым большинством голосов Генеральной ассамблеи здравоохранения. Территории, не правомочные выступать субъектами международных отношений, могут быть приняты в ВОЗ в качестве ассоциативных членов на основании заявлений, сделанных от их имени Членом ВОЗ или другим полномочным органом, ответственным за международные отношения этих территорий.

Содержание

История ВОЗ

Первым органом, занимавшимся межнациональным сотрудничеством в этом вопросе был Константинопольский высший совет здравоохранения, образованный в 1839 году. Его основными задачами был контроль за иностранными судами в турецких портах и противоэпидемические мероприятия по предупреждению распространения чумы и холеры. Позднее подобные советы были созданы в Марокко (1840 год) и Египте (1846 год). В 1851 году в Париже прошла I Международная санитарная конференция, в которой участвовали 12 государств, в том числе и Россия. Итогом работы этого форума предполагалось принятие Международной санитарной конвенции, которая определила порядок морского карантина в Средиземном море. Однако достигнуть этого результата удалось только в 1892 году в отношении холеры, а в 1897 — в отношении чумы.

Структура ВОЗ

Руководство ВОЗ

Генеральный директор ВОЗ

В соответствии с Уставом ВОЗ Генеральный директор назначается на сессии Всемирной ассамблеи здравоохранения по представлению Исполнительного комитета. Государства-члены ВОЗ направляют свои предложения с кандидатам по установленной форме в Исполнительный комитет. Исполнительный комитет осуществляет первоначальное рассмотрение предложений по кандидатурам, составляет краткий список кандидатов, проводит с ними собеседование, осуществляет оценку физического состояния кандидата. [1] Создана рабочая группа государств-членов по процессу и методам выборов Генерального директора Всемирной организации здравоохранения. [2]

Генеральные директора ВОЗ

См. Список Генеральных директоров ВОЗ

Задачи ВОЗ

Сферы деятельности ВОЗ

Региональные бюро ВОЗ

В соответствии со статьёй 44 Устава ВОЗ в период с 1949 по 1952 год открыты региональные бюро ВОЗ:

Региональный директор является главой ВОЗ для своего региона. Региональный директор управляет и/или контролирует работников здравоохранения и других специалистов в региональных отделениях и в специализированных центрах. Наряду с Генеральным директором ВОЗ и руководителями региональных бюро ВОЗ, известных как представители ВОЗ в регионе, региональный директор также обладает функциями прямого надзорного органа в регионе.

Другие бюро ВОЗ

Работа ВОЗ

Работа ВОЗ организована в виде Всемирных Ассамблей здравоохранения, на которых ежегодно представители государств-членов обсуждают важнейшие вопросы охраны здоровья. Между Ассамблеями основную функциональную роль несёт Исполнительный комитет, включающий представителей 30 государств (среди них — 5 постоянных членов: США, Россия, Великобритания, Франция и Китай). Для обсуждения и консультаций ВОЗ привлекает многочисленных известных специалистов, которые готовят технические, научные и информационные материалы, организуют заседания экспертных советов. Широко представлена издательская деятельность ВОЗ, включающая отчёты Генерального директора о деятельности, статистические материалы, документы комитетов и совещаний, в том числе отчёты Ассамблеи, исполнительных комитетов, сборники резолюций и решений и т. д. Кроме того, выпускаются журналы ВОЗ: «Бюллетень ВОЗ», «Хроника ВОЗ», «Международный форум здравоохранения», «Здоровье мира», «Ежегодник мировой санитарной статистики», серия монографий и технических докладов. Официальными языками являются английский и французский, рабочими (кроме указанных) — русский, испанский, арабский, китайский, немецкий.

Деятельность ВОЗ осуществляется в соответствии с общими программами на 5—7 лет, планирование ведётся на 2 года. В настоящее время приоритетными направлениями являются:

ВОЗ удаётся решать многие важные вопросы. По инициативе ВОЗ и при активной поддержке национальных систем здравоохранения (в том числе и СССР) была проведена кампания по ликвидации оспы в мире (последний случай зарегистрирован в 1981 г.); ощутимой является кампания по борьбе с малярией, распространённость которой сократилась почти в 2 раза, программа иммунизации против 6 инфекционных заболеваний, организация выявления и борьба с ВИЧ, создание справочно-информационных центров во многих государствах, формирование служб первичной медико-санитарной помощи, медицинских школ, учебных курсов и т. д. Основная роль ВОЗ в достижении поставленных целей — консультативная, экспертная и техническая помощь странам, а также предоставление необходимой информации, чтобы научить страны помогать самим себе в решении ключевых проблем охраны здоровья. На сегодня ВОЗ определила наиболее важные направления деятельности национальных систем здравоохранения как: ВИЧ/СПИД, туберкулёз, малярия, содействие безопасной беременности — здоровье матери и ребёнка, здоровье подростков, психическое здоровье, хронические заболевания.

Финансирование ВОЗ

Всемирные дни ВОЗ

Всемирные дни ВОЗ входят в систему международных дней ООН и провозглашаются на сессиях Всемирной ассамблеи здравоохранения, что оформляется резолюциями.

Послы доброй воли

Послы доброй воли – это известные люди из мира искусства, литературы, эстрады, спорта и других областей общественной жизни, которые в тесном сотрудничестве с ВОЗ вносят вклад в усилия ВОЗ в сфере здравоохранения посредством привлечения внимания. Назначаются Генеральным директором на двухлетний срок. [5]

World Health Organization

The World Health Organization (WHO) «directs and coordinates» international health within the United Nations. It was established on 7th April 1948, and is headquartered in Geneva, Switzerland. The WHO works with 194 member states across the world. [1]

The International Statistical Classification of Diseases and Related Health Problems ( ICD ) is the «the bedrock for health statistics» and is maintained by WHO. It aims to classify every possible injury or disease a person may experience, including causes of death. [2]

Contents

First recognition of ME/ CFS [ edit | edit source ]

Myalgic encephalomyelitis (ME) has been recognized by the World Health Organization as a neurological disease since 1969, when it published the ICD-8 classification of diseases using code 323 for myalgic encephalomyelitis. [3] [4] The ICD-8 listing for ME/CFS is:

The United States edition of the ICD-8 included both myalgic encephalomyelitis (ME) and what is now known as postviral fatigue syndrome (PVFS), classifying both with code 323: [5]

The ICD-8 did not include any alternative names for myalgic encephalomyelitis although postinfectious encephalomyelitis could be classified under the same code; fatigue-related alternative names were not added in any later revisions. [3] [6] The alternative name chronic fatigue syndrome (CFS) was not in use at this time; it was proposed in 1988 by the Centers for Disease Control, which adopted new diagnostic criteria at the same time. [ citation needed ]

The current version of the ICD is the ICD-10; the newer ICD-11 has been published but is expected to be in widespread use within the next few years.

ICD-9 classification of ME/CFS [ edit | edit source ]

In the ICD-9, which was published in 1989, the entry for myalglc encephalomyelitis is uses code 323.9: [7]

ICD-10 classification of ME/CFS [ edit | edit source ]

The ICD-10 lists myalgic encephalomyelitis, chronic fatigue syndrome, and postviral syndrome (PVFS) as the same neurological disease, within the neurological disorders section. [8]

Myalgic encephalomyelitis (ME) has been classified by the WHO as a neurological disease since 1969 [3] and has occurred in both epidemic and sporadic form since at least the 1930s, although is probably much older.

Malaise and fatigue [ edit | edit source ]

The World Health Organization has stated that ME and CFS can only be classed as a neurological disorder and cannot be classified under the following «malaise and fatigue» diagnosis (in the General signs, symptoms and abnormal findings), or as neurasthenia or Fatigue syndrome in the mental and behavioral disorders category:

R53.83 Malaise and fatigue categorizies «lethargy» and «tiredness» which are regarded as «Signs, symptoms and abnormal findings» rather than a specific disease.

This is classed as a neurotic (anxiety) disorder, within the mental disorders section of the ICD-10; it is describes this as «increased fatigue» which may be after mental effort, or emphasizing «feelings of bodily or physical weakness and exhaustion after only minimal effort», with an inability to relax and «a feeling of muscular aches and pains».

In the ICD-10 this excludes burn-out (Z73.0), malaise and fatigue (R53) and postviral fatigue syndrome (G93.3). [9] [8]

Chronic fatigue with no known cause which does not meet the criteria for chronic fatigue syndrome is referred to as either idiopathic chronic fatigue or a medically unexplained symptom in medical literature.

ICD-10 coding manual [ edit | edit source ]

The ICD-10-CM used in the United States is a coding manual used for insurance purposes, differs from other countries, and includes two different classifications, each with virtually identical symptoms:

ICD-11 [ edit | edit source ]

In the more recently released ICD-11, Postviral fatigue syndrome (PVFS) is the name used for benign myalgic encephalomyelitis and chronic fatigue syndrome, and remains a disorder of the nervous system. [11]

08 Diseases of the nervous system

Other disorders of the nervous system 8E49 Postviral fatigue syndrome Benign myalgic encephalomyelitis chronic fatigue syndrome [11]

ICD Diagnostic coding [ edit | edit source ]

ICD-10 is the 10th revision of the ICD and was first published in 1992. [13] The ICD-11 was published in July 2018, but is not implemented in most countries at present. [11]

Different countries’ government healthcare systems might use different codes depending on their interpretation of some diseases, illnesses, and syndromes but still working within the ICD code structure. When using ICD10Data.com, certain pages will display a country’s flag indicating the diagnostic coding used by that nation’s healthcare system. [14] Additionally, a country does not have to officially implement the latest ICD release; the United States delayed the implementation of ICD-10 for over 20 years before implementing it’s own WHO-approved adaption, the ICD-10-CM. [15] [16] [17]

Myalgic encephalomyelitis [ edit | edit source ]

ICD-10-CM [ edit | edit source ]

ICD-10-CM G93.3 is grouped within Diagnostic Related Group(s) (MS- DRG v35.0):

Convert G93.3 to ICD-9-CM

Code annotations containing back-references to G93.3:

Diagnosis Index entries containing back-references to G93.3:

ICD-11 (2018) [ edit | edit source ]

All ancestors up to top

The ICD-11 no longer has a fatigue syndrome of any kind in the «Mental and Behavioral Disorders» section. Neurasthenia is not mentioned in any section. In response to the Wessely school’s textbook which incorrectly stated that chronic fatigue syndrome (CFS) can be classed as a mental disorder, Audre L’Hours from WHO has stated that a disorder can only be classed under one rubic, and that all WHO countries must follow the WHO classification of CFS or ME as a neurological disorder only. [20]

Dr Tarun Dua proposed moving Myalgic Encephalomyelitis from the Neurological Disorders section to Symptoms, signs or clinical findings of the musculoskeletal system, which would have re-classified ME/CFS as medically unexplained physical symptoms rather than a specific, neurological disease: this proposal was rejected. [21]

Chronic fatigue syndrome [ edit | edit source ]

ICD-10-CM [ edit | edit source ]

R53.82 (ICD-10-CM) is grouped within Diagnostic Related Group(s) (MS-DRG v35.0):

ICD-11 (2019) [ edit | edit source ]

All ancestors up to top

DSM [ edit | edit source ]

History with Fibromyalgia [ edit | edit source ]

The WHO ICD-10 lists fibromyalgia as a «disease of the musculoskeletal system and connective tissue,» diagnostic code M79.7. [23]

ICD Diagnostic coding [ edit | edit source ]

ICD-10-CM [ edit | edit source ]

In 2015, the United States adopted the 1992 ICD-10 and fibromyalgia as a diagnosis. [25] [26]

ICD-11 (2019) [ edit | edit source ]

Fibromyalgia was renamed to Chronic Widespread Pain in the ICD-11 update, with fibromyalgia retained as an indexed term. The ICD-11 uses diagnostic code MG30.1 Chronic widespread pain for fibromyalgia. [27]

MG30.0 Chronic primary pain

«Chronic widespread pain (CWP) is diffuse pain in at least 4 of 5 body regions and is associated with significant emotional distress (anxiety, anger/frustration or depressed mood) or functional disability (interference in daily life activities and reduced participation in social roles). CWP is multifactorial: biological, psychological and social factors contribute to the pain syndrome. The diagnosis is appropriate when the pain is not directly attributable to a nociceptive process in these regions and there are features consistent with nociplastic pain and identified psychological and social contributors.» [27]

DSM [ edit | edit source ]

Fibromyalgia is not included in the American DSM-5 manual of mental and behavioral disorders because it is a physical rather than psychological illness. [22] Fibromyalgia is also classified within a chapter of physical health conditions, and not in the mental and behavioral chapter of the ICD diagnostic manual. [27]

Online presence [ edit | edit source ]

The WHO uses social media in many languages.

English language [ edit | edit source ]

See also [ edit | edit source ]

Learn more [ edit | edit source ]

References [ edit | edit source ]

NICE guidelines Clinical guidelines used in the UK.

The information provided at this site is not intended to diagnose or treat any illness.
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.

WHO Library and Digital Information Networks

The WHO Library is the world’s leading library on public health. It provides access to knowledge from WHO as well as to other sources of scientific literature produced around the world. WHO Library resources and expertise also provide scientific evidence and knowledge to low- and middle- income countries through a set of low-cost/high-use initiatives.

Networks and partnerships are an essential component in ensuring that our global initiatives reach a world-wide audience. Using a suite of collaborative tools, librarians and information specialists have a close understanding of country realities and needs. This helps keep focus on adequate and cost-effective information and knowledge sharing solutions.

The WHO Library holds and stores all the published information produced by WHO, including proceedings of the World Health Assembly and Executive Board, monographs, periodicals, unpublished technical documents, press releases, fact sheets and administrative documents of the governing bodies. With rare exceptions (in particular unpublished technical documents), outside visitors are able to consult on the spot, immediately after their creation, all the library collections published and issued, even in the case of documents less than 20 years old.

A reference librarian is available for all onsite enquiries and any research assistance. Only WHO staff may borrow certain documents.

WHO Academy

Transforming lifelong learning for health impact

The WHO Academy is the World Health Organization’s state-of-the-art lifelong learning centre, bringing the very latest innovations in adult learning to global health. Now under development with the support of France, the Academy will scale up learning for impact through online, in-person and blended learning programmes, reaching millions of health workers and others all over the world. Using the latest technologies, it will enable all learners to tailor their learning experiences to meet their own needs and award them digital credentials they can use to verify their competencies and advance their careers.

The WHO Academy will be a school for the future – with a vision of a healthier, safer, fairer world.

Why is it needed?

The quickening pace of scientific discovery and advancement of technology is making it more difficult — not less — for health workers, policymakers and other public health practitioners to keep up with evidence-based health practice and policy. As a result, it often takes more than a decade to put new evidence-based health guidance into practice.

This is a key reason why no countries are currently on track to achieve all of the Sustainable Development Goals (SDG) health targets. The COVID-19 pandemic has also disrupted lifelong learning systems, generating growing demand for digital learning.

While the COVID-19 response has shown how quickly medical science can respond to a pandemic, an equally important task is to get critical knowledge and guidance to health workers in every community. The WHO Academy will focus on accelerating and improving how health workers and others obtain the guidance, competencies and tools they need to treat patients and keep their communities healthy and safe.

The Academy solution

Advancements in the science of adult learning science offer new and efficient ways of getting critical guidance to health workers and others who need it. Using the latest technologies, the Academy will expand access to critical learning for health workers, managers, public health officials, educators, researchers and policymakers – as well as the WHO and UN workforce around the world. It will offer multilingual, personalized learning programmes in digital, in-person and blended formats, deploying the latest evidence-based health guidance and state-of-the-art learning technologies. The vast majority of its learners will use online means to access the Academy’s programmes, which will be made available via desktop and mobile devices and in low-bandwidth settings, thereby ensuring an equitable, global and diverse cohort of learners.

The WHO Academy campus

The WHO Academy campus in Lyon, France – to be completed in 2024 – will reflect WHO’s values and ambitions: it will be a smart, accessible, eco-friendly and interactive facility in the heart of Lyon’s bio-medical district

When it opens, the WHO Academy campus will have high-tech spaces for collaborative learning design, educational research and innovation. It will also host a world-class health emergencies simulation centre that will use the latest technologies to enable health workers to sharpen their competencies amid realistic scenarios including mass casualties and disease outbreaks.

The support of France

As a WHO Member State and a key actor in global health, France is the lead investor for the Academy’s development, having committed more than 120 million EUR to support its establishment and infrastructure. This achievement is possible thanks to the collective actions, commitment and financial support of the Auvergne-Rhone-Alpes region, the Lyon Metropole and the City of Lyon.

WHO Academy Groundbreaking Ceremony

_{27 September 2021 14:30 – 17:30 CET | Cité Internationale, Lyon, France}

On 27 September 2021, WHO Director-General Dr. Tedros Adhanom and French President Emmanuel Macron joined to commemorate the groundbreaking of the WHO Academy campus in Lyon, France. The building will be part of the city’s world-class bio-medical district.

Всемирная Организация Здравоохранения

История

Учреждение

В ходе Конференции ООН 1945 года, доктор Сцеминг Сзе, делегат от Китая, поставил перед своими норвежскими и бразильскими коллегами вопрос о создании международной организации по вопросам здравоохранения под патронажем ООН. Поскольку к единому мнению по данному вопросу прийти не удалось, Альгер Хисс, генеральный секретарь конференции, выступил с рекомендацией использовать декларацию для учреждения такой организации. Доктор Сзе и другие делегаты лоббировали данный проект, благодаря чему была принята декларация по созданию всемирной конференции по вопросам здравоохранения. Использование слова «всемирная», а не «международная», подчёркивает глобальность целей организации. 2) Конституция ВОЗ была подписана всеми странами-членами ООН (51 страна) и другими 10 странами, 22 июля 1946 года. ВОЗ стала первым специализированным агентством ООН, в которое вошли все члены ООН. Её конституция формально вступила в силу в первый Всемирный День Здоровья, 7 апреля 1948 года, когда она была ратифицирована 26м членом ООН. Первая встреча Всемирной Ассамблеи Здравоохранения завершилась 24 июля 1948 года, после чего был установлен бюджет в 5 миллионов долларов США (что на тот момент составляло 1,250,000 фунтов стерлингов) на 1949 год. Первым президентом Ассамблеи стал Андрийя Стэмпар, а генеральным директором ВОЗ был назначен Г. Брок Чишольм, который служил в качестве исполнительного секретаря во время планирования создания организации. Первостепенными задачами ВОЗ были контроль распространения малярии, туберкулёза и заболеваний, передающихся половым путём, а также улучшение материнского здоровья и здоровья детей, вопросы питания и гигиены окружающей среды. Первый законодательный акт ВОЗ касался составления точной статистики по распространению заболеваний. Логотипом ВОЗ стал посох Асклепия (змея, обвивающая палку). 3)

Работа

ВОЗ организовала эпидемиологический информационный сервис через телекс в 1947 году. К 1950 году осуществлялось массовая вакцинация от туберкулёза (с использованием вакцины БЦЖ). В 1955 году была запущена программа по борьбе с малярией. В 1965 году был выпущен первый отчёт о сахарном диабете и создано Международное Агентство по Изучению Рака. В 1966 году ВОЗ перебралась в здание своей штаб-квартиры. В 1974 году была запущена Расширенная Программа Вакцинации, а также контрольная программа по онхоцеркозу – важное сотрудничество между Всемирной Продовольственной Организацией, Программой развития ООН и Всемирным Банком. В следующем году также была запущена Специальная Программа Исследования и Тренинга по Тропическим Болезням. В 1976 году Всемирная Ассамблея Здравоохранения проголосовала за то, чтобы утвердить резолюцию по профилактике заболеваний и реабилитации, с фокусом на медицинской помощи, предоставляемой общинами. Первый список жизненно необходимых и важнейших лекарственных средств был утверждён в 1977 году, а годом позже был провозглашен амбициозный лозунг «здоровье для всех». В 1986 году ВОЗ запустила свою глобальную программу по растущей проблеме с ВИЧ/СПИДом, а через два года – сконцентрировала внимание на предотвращении дискриминации лиц, страдающих ВИЧ/СПИДом. В 1996 году была создана программа ЮНЭЙДС (Объединённая программа ООН по ВИЧ/СПИДу). Глобальная инициатива по ликвидации полиомелита была учреждена в 1988 году. 4) В 1958 году Виктор Жданов, заместитель министра здравоохранения СССР, обратился к Всемирной Ассамблее Здравоохранения с предложением ввести глобальную программу по борьбе с оспой, что привело к принятию Резолюции ВОЗ11.54. К тому моменту, оспа ежегодно уносила жизни 2 миллионов человек. В 1967 году Всемирная Организация Здравоохранения усилила программу по борьбе с оспой, увеличив ежегодные отчисления на программу на 2,4 миллиона долларов в год и введя новый метод эпидемиологического надзора. 5) Первоначальной проблемой, с которой столкнулась ВОЗ, была проблема, связанная с неадекватным сообщением о случаях оспы. ВОЗ учредила сеть консультантов, помогающих странам осуществлять эпидемиологический надзор и способствовать сдерживанию распространения болезни. ВОЗ также способствовала подавлению последней вспышки заболевания в Европе (Югославия, 1972 год). По прошествии двух десятилетий борьбы с оспой, в 1979 году ВОЗ объявила, что заболевание было успешно искоренено – это было первым заболеванием в истории, уничтоженным волей человека. 6) В 1998 году генеральный директор ВОЗ осветил результаты, которые добилась организация в вопросах детский выживаемости, снижении младенческой смертности, увеличении средней продолжительности жизни и снижении распространения опасных заболеваний, таких как оспа и полиомиелит, на пятнадцатой годовщине основания ВОЗ. Он отметил, однако, что многое предстоит сделать в вопросах, связанных со здоровьем матерей и что прогресс в этой области был достаточно медленным. Холера и малярия оставались неразрешенными проблемами с момента основания ВОЗ, однако наблюдалось значительное уменьшение их распространения за этот период. В 2000 году было основано Stop TB Partnership (движение против распространения туберкулёза) и были поставлены Цели развития тысячелетия ООН. В 2001 году была создана инициатива по борьбе с корью, благодаря которой общее количество смертей в результате заболевания уменьшилось на 68% к 2007 году. В 2002 году был основан Глобальный Фонд по борьбе со СПИДом, туберкулёзом и малярией. В 2006 году организация ввела первый в мире официальный сбор средств по борьбе с ВИЧ/СПИД в Зимбабве, благодаря чему была сформирована основа для глобального плана по предотвращению, лечению и поддержанию мер по борьбе с эпидемией СПИДа. 7)

Общие цели

Конституция ВОЗ гласит, что целью организации является «достижение максимально возможного уровня здоровья всеми людьми мира». 8) К этой цели ВОЗ идёт благодаря исполнению своих функций, также определённых Конституцией: (a) действуя в качестве организующего и координирующего органа по вопросам здравоохранения во всем мире; (b) устанавливая и поддерживая эффективное сотрудничество с ООН, специализированными агентствами, министерствами здравоохранения различных стран, профессиональными группами и другими организациями; © помогая правительствами разных стран, при необходимости, решать вопросы по улучшению системы здравоохранения; (d) осуществляя соответствующее техническое сопровождение и, в экстренных случаях, оказывая необходимую помощь по требованию или согласию государств; (e) осуществляя обеспечение системы здравоохранения или помогая в обеспечении, по требованию Объединённых Наций, оборудованием специальных групп, например, людей из подопечных территорий; (f) устанавливая и поддерживая деятельность административных и технических служб, включая эпидемиологические и статистические службы; (g) стимулируя и поощряя работу по искоренению эпидемических, эндемических и других заболеваний; (h) способствуя, в сотрудничестве с другими специализированными службами, предотвращению случайных повреждений; (i) способствуя, в сотрудничестве с другими специализированными службами, улучшению питания, жилищных условий, санитарных условий, условий отдыха, экономических и рабочих условий и других аспектов гигиены окружающей среды; (j) способствуя сотрудничеству между научными и профессиональными группами, занимающимися вопросами улучшения состояния здоровья населения; (k) предлагая конвенции, соглашения и регламенты, а также выпуская рекомендации по вопросам всемирного здравоохранения. В настоящее время ВОЗ определяет свою роль в системе общественного здравоохранения следующим образом: 9)

Инфекционные заболевания

В бюджете ВОЗ 2012–2013 годов указывается 13 областей, среди которых было поделено финансирование. 10) Две из этих 13 областей связаны с инфекционными заболеваниями: первая – с уменьшением «экономического, социального груза и ущерба здоровью», связанного с инфекционными заболеваниями в общем; а вторая – с борьбой с ВИЧ/СПИДом, малярией и туберкулёзом в частности. Что касается ВИЧ/СПИД, ВОЗ сотрудничает с сетью ЮНАЙДС (Объединенная программа ООН по ВИЧ/СПИДу), при этом ВОЗ считает важным согласовывать свою работу с целями и стратегиями ЮНАЙДС. ВОЗ также старается участвовать не только в сфере здравоохранения, а также и в других сферах жизни общества, воздействуя также и на экономические и социальные эффекты заболевания. В сотрудничестве с ЮНАЙДС, ВОЗ поставила временную задачу на 2009-2015 годы по снижению количества страдающих ВИЧ/СПИДом в возрасте 15–24 года, на 50%; снижению детского инфицирования ВИЧ на 90%; и по снижению смертности, связанной с ВИЧ, на 25%. 11) Несмотря на то, что ВОЗ отказалась от своего обязательства участвовать в глобальной кампании по искоренению малярии в 1970х, посчитав её «чересчур амбициозной», ВОЗ сохраняет своё обязательство по контролю малярии. Глобальная программа против малярии ВОЗ действует, отслеживая случаи малярии и будущие проблемы в схемах контроля малярии. К 2015 году ВОЗ обещает сообщить о создании жизнеспособной вакцины против малярии (RTS,S/AS01). В настоящее время для предотвращения распространения малярии применяются инсектициды и накомарники, а также противомалярийные препараты – в частности, для уязвимых групп населения, таких как беременные женщины и дети. В 1990-2010 годах, вклад ВОЗ в борьбу с туберкулёзом привел к 40% снижению количества смертей от туберкулёза. С 2005 года под патронажем ВОЗ было осуществлено лечение более 46 миллионов человек, и 7 миллионов человек было спасено. Деятельность ВОЗ в этой сфере включает сотрудничество с национальными правительствами и их финансирование, раннюю диагностику, стандартное лечение, мониторинг распространения и влияния туберкулёза и стабилизация поставок лекарств. ВОЗ также была первой, кто отметил подверженность туберкулёзу у жертв ВИЧ/СПИДа. 12) В цели ВОЗ входит искоренение полиомиелита. ВОЗ успешно способствовала снижению количества случаев полиомиелита на 99% с момента запуска Глобальной Инициативы по Искоренению Полиомиелита в 1988 году, при участии Ротари Интернешнл, Центров контроля и профилактики заболеваний (CDC) и Детского фонда ООН (UNICEF), и других более мелких организаций. ВОЗ занимается прививанием маленьких детей и предотвращением повторного развития случаев полиомиелита в странах, объявленных «свободными» от заболевания.

Неинфекционные заболевания

Ещё одной из тринадцати приоритетных областей ВОЗ является предотвращение и снижение распространения «заболеваемости, инвалидности и преждевременной смертности в результате хронических неинфекционных заболеваний, психических болезней, жестокости и травм, а также зрительных расстройств». 13)

Продолжительность и образ жизни

ВОЗ работает с целью «снижения заболеваемости и смертности и улучшения состояния здоровья населения во время ключевых периодов жизни, включая беременность, рождение ребёнка, неонатальный период, детство и подростковый возраст, а также улучшение сексуального и репродуктивного здоровья и продвижение активного и здорового старения для всех людей». 14) ВОЗ также старается предотвратить или снизить факторы риска «состояний здоровья, связанных с использованием табака, алкоголя, наркотиков и других психоактивных веществ, нездоровым питанием и отсутствием физической активности и небезопасным сексом». 15) ВОЗ работает с целью улучшения условий питания и продовольственной безопасности для обеспечения положительного воздействия на здоровье населения и устойчивого развития.

Хирургия и травмы

ВОЗ продвигает дорожную безопасность в качестве средства для уменьшения травм, связанных с дорожными происшествиями. ВОЗ также работает над глобальными инициативами в сфере хирургии, включая неотложную и жизненно важную хирургическую помощь, травматологическую помощь и безопасную хирургию. В настоящее время в качестве меры улучшения безопасности пациентов по всему миру используется карта контроля хирургической безопасности ВОЗ. 16)

Неотложная медицинская помощь

Первичной целью ВОЗ является обеспечение естественной экстренной помощи и координация деятельности с государствами-участниками для «снижения неизбежной смертности и бремени болезней и инвалидности». 5 мая 2014 года ВОЗ объявила, что распространение полиомиелита является бедствием мирового масштаба, требующим немедленного внимания – вспышки заболевания в Азии, Африке и на Среднем Востоке считаются «экстраординарными». 17) 8 августа 2014 года ВОЗ объявила, что распространение вируса Эбола является также бедствием мирового масштаба; вспышка, которая, как считается, началась в Гвинее, распространилась по другим близлежащим странам, таким как Либерия и Сьерра-Леоне. Ситуация в Западной Африке считается очень серьезной.

Политика в области здравоохранения

ВОЗ обращается к политике в области здравоохранения с двумя целями: во-первых, «для решения важных социальных и экономических вопросов в области здравоохранения путем принятия программ и осуществления политики, способствующей равноправию в сфере здоровья и интегрированию программ, поддерживающих малообеспеченные слои населения, учитывающих гендерную проблематику и обеспечивающих права человека», и, во-вторых, «продвижение более здоровой окружающей среды, интенсификация первичного предотвращения развития болезней и усиление активности во всех сферах общественной жизни для решения проблем, лежащих в основе экологических рисков для здоровья населения». Организация развивает и продвигает использование конструктивных инструментов, норм и стандартов для поддержки стран-членов в плане информирования о вариантах политики в области здравоохранения. ВОЗ осуществляет контроль над применением международных медико-санитарных правил и публикует ряд медицинских классификаций; три из них считаются «референтными классификациями»: Международная Статистическая Классификация Заболеваний (ICD), Международная классификация функционирования, инвалидности и здоровья (ICF) и Международная классификация лечебных процедур (ICHI). Другие стандарты международной политики, производимые ВОЗ, включают Международный свод правил маркетинга заменителей грудного молока (принятый в 1981 году), Конвенцию против курения табака (принятую в 2003 году) и Глобальный кодекс практики межнационального рекрутинга персонала в области здравоохранения (принятый в 2010 году). 18) Если говорить о медицинских службах, ВОЗ стремится улучшить «управление, финансирование, обеспечение персоналом и менеджмент», а также доступность и качество данных и исследований для отслеживания проводимой политики. Организация также стремится «улучшить доступ, качество и использование медицинских продуктов и технологий». ВОЗ, работая с благотворительными организациями и национальными правительствами, может улучшить использование и сбор исследовательских данных в этих странах.

Управление и поддержка

Двумя оставшимися из тринадцати идентифицированных областей политики ВОЗ являются области, связанные с ролью ВОЗ самой по себе:

Сотрудничество

ВОЗ, наряду со Всемирным Банком, образует команду, ответственную за управление Международным Сотрудничеством Здравоохранения (IHP+). IHP+ представляет собой группу партнёрских правительств, агентств по развитию предпринимательства, гражданских обществ и других предприятий, ответственных за улучшение здоровья граждан в развивающихся странах. Партнёры совместно работают с целью улучшения международных принципов для содействия взаимопомощи и развития сотрудничества в секторе здравоохранения. 19) Эта организация сотрудничает также с научными организациями, учёными и профессионалами для информирования о результатах своей работы, такими как Комитет экспертов ВОЗ по биологической стандартизации, Комитет экспертов по лепре и Исследовательская группа ВОЗ по межпрофессиональному обучению и практике сотрудничества. 20) ВОЗ управляет Сотрудничеством по политике в области здравоохранения и исследовательских систем, которое было создано для улучшения политики в области здравоохранения и систем здравоохранения. ВОЗ также работает для улучшения доступа к исследованиям в сфере здравоохранения и публикациям в развивающихся странах, например, через сеть HINARI (Инициатива ВОЗ по обеспечению межсистемного доступа к материалам научно-исследовательских работ).

Просвещение и действия в области здравоохранения

Каждый год Организация организует Международный День Здоровья и другие празднества по теме здравоохранения. Международный День Здоровья отмечается 7 апреля каждого года, в день основания ВОЗ. Последними темами праздника были трансмиссивные болезни (2014), здоровое старение (2012) и лекарственная резистентность (2011). 21) Другие официальные глобальны публичные кампании под эгидой ВОЗ – это Всемирный день борьбы против туберкулёза, Всемирная неделя иммунизации, Всемирный день борьбы против малярии, Всемирный день борьбы с курением, Всемирный день донора, Всемирный день борьбы против гепатита и Всемирный день борьбы со СПИДом. Являясь частью ООН, ВОЗ поддерживает работу по Целям Развития Тысячелетия. Среди восьми Целей Развития Тысячелетия, три – снижение детской смертности на две третьих, снижение материнской смертности на три четвёртых и приостановление и начало снижения распространения ВИЧ/СПИДа – непосредственно связаны с политикой ВОЗ; другие пять взаимосвязаны с и оказывают влияние на всемирную систему здравоохранения.

Работа с данными и публикации

Всемирная Организация Здравоохранения обеспечивает получение информации о здоровье и благополучии населения при помощи большого количества платформ, обрабатывающих информацию, включая Всемирную Службу Информации о Здоровье, содержащую данные о почти 400,000 респондентах из 70 стран мира, и Исследование по глобальному старению и здоровью пожилых (SAGE), содержащее данные о более чем 50,000 человек в возрасте от 50 лет в 23 странах мира. 22) Портал по здоровью населения в разных странах (CHIP) был создан для обеспечения доступа к информации о системе здравоохранения в разных странах мира. Информация с этого портала используется для расстановки приоритетов относительно будущих стратегий или планов, их применения, мониторинга и оценки. ВОЗ публикует различные инструменты для измерения и мониторинга работоспособности национальных систем здравоохранения и кадров, работающих в сфере здравоохранения. Глобальная Обсерватория Здоровья (GHO) является основным порталом ВОЗ, обеспечивающим доступ к данным и анализу ключевых тем здравоохранения путем мониторинга ситуации в области здравоохранения во всем мире. 23) Инструмент Оценки Систем по психическому здоровью ВОЗ (WHO-AIMS), Инструмент качества жизни ВОЗ (WHOQOL) и Оценка сервисной доступности и готовности обеспечивают руководство для сбора данных. Совместные усилия ВОЗ и других агентств, таких как Сеть показателей здравоохранения, также нацелены на предоставление высококачественной информации для помощи при принятии государственных решений. 24) ВОЗ продвигает развитие науки в государствах-членах ООН с целью использования и проведения исследований, направленных на национальные нужды населения, включая Полицейскую сеть сбора данных (EVIPNet). Панамериканская организация здравоохранения (PAHO/AMRO) стала первой организацией, занимающейся развитием и проведением политики по исследованию в области здравоохранения, одобренной в сентябре 2009 года. 25) 10 декабря 2013 года в онлайн вышла новая база данных ВОЗ, известная как MiNDbank. Эта база данных была запущена в День Прав Человека, и является частью инициативы ВОЗ по качеству прав, нацеленной на прекращение ограничений прав людей с психическими проблемами. Новая база данных представляет большое количество информации о психическом здоровье, злоупотреблении веществами, недееспособности, правам человека и о различных политических движениях, стратегиях, законах и стандартах обслуживания в различных странах. Она также содержит важные международные документы и информацию. База данных дает посетителям доступ к информации о здравоохранении в государствах-членах ВОЗ и других партнерах. Пользователи могут получить информацию о политике, законах и стратегиях, а также узнать о лучших практиках и историях успеха в сфере психического здоровья. 26) ВОЗ регулярно публикует Всемирный доклад о здоровье, свою основную публикацию, включающую экспертную оценку по специфической теме о глобальном здоровье. Другие публикации ВОЗ включают Бюллетень Всемирной Организации Здравоохранения, Журнал Здоровья Восточного района Средиземного моря (контролируемый EMRO), Кадровые ресурсы здравоохранения (публикуемые в сотрудничестве с BioMed Central) и Панамериканский журнал общественного здоровья (контролируемый PAHO/AMRO). 27)

Структура

ВОЗ является членом Группы развития ООН.

Членство

По состоянию на 2015 год, в ВОЗ входит 194 стран-членов: все страны-члены ООН принимают Лихтенштейн, а также острова Кука и о. Ниуэ 28) (страна становится полноценным членом ВОЗ, ратифицируя договор, известный как Конституция Всемирной Организации Здравоохранения). По состоянию на 2013 год, ВОЗ имеет также два младших члена, Пуэрто-Рико и острова Токелау. Некоторые другие элементы имеют статус обозревателя. Палестина является обозревателем в качестве «национального освободительное движения», признанного Лигой Арабских Государств под Резолюцией ООН 3118. Святой Престол, как и Мальтийский Орден, также являются обозревателями. В 2010 году Тайвань была приглашена в ВОЗ под названием «Китайский Тайбэй». 29) Страны-члены ООН назначают делегации для Всемирной Ассамблеи Здравоохранения, высшего органа, принимающего решения в ВОЗ. Все страны-члены ООН могут вступать в ВОЗ и, в соответствии с веб-сайтом ВОЗ, «другие страны могут быть приняты в члены, если их заявление будет одобрено путём простого голосования Всемирной Ассамблеи Здравоохранения». Более того, организации-наблюдатели ООН, Международный Красный Крест и Международная федерация обществ Красного Креста и Красного Полумесяца вступили в «официальные отношения» с ВОЗ и включены в качестве наблюдателей. Во Всемирной Ассамблее Здравоохранения они допускаются в качестве членов наряду с другими неправительственными организациями.

Ассамблея и Исполнительный Совет

Всемирная Ассамблея Здравоохранения является законодательным и высшим органом ВОЗ. Ассамблея основывается в Женеве и встречается ежегодно в мае. Каждые пять лет Ассамблея избирает генерального директора и голосует по вопросам политики и финансов ВОЗ, включая проект бюджета. Она также получает отчёты от Исполнительного Совета и решает, какие области работы требуют дальнейшего рассмотрения. Ассамблея избирает 34 члена, технически квалифицированных в сфере здравоохранения, в Исполнительный Совет на срок три года. Основные функции Совета – осуществлять решения и политику Ассамблеи, давать советы и облегчать её работу. 30)

Региональные офисы

Региональные подразделения ВОЗ были созданы в 1949-1952 годах, и основываются на статье 44 конституции ВОЗ, что позволяет ВОЗ «устанавливать [единую] региональную организацию для удовлетворения требований региональных организаций для того, чтобы удовлетворять нужды [каждой] конкретной области». Многие решения делаются на региональном уровне, включая важные споры по поводу бюджета ВОЗ и по поводу членов следующей ассамблеи, назначенных регионами. Каждый регион имеет Региональный Комитет, который встречается раз в год, обычно осенью. Представители присутствуют от каждого члена или ассоциированного члена в каждом регионе, включая те страны, которые не являются полностью признанными. Например, Палестина принимает участие во встречах Регионального бюро стран Восточного Средиземноморья. Каждый регион также имеет свой региональный офис. Каждый региональный офис возглавляется региональным директором, избираемым региональным комитетом. Совет должен одобрить такие назначения, однако по состоянию на 2004 год, он ни разу не отклонил решения регионального комитета. Точная роль Совета в этом процессе является предметом споров, однако практический эффект всегда был небольшим. С 1999 года региональные директора служат в течение пятилетнего срока. 31) Каждый региональный комитет ВОЗ состоит из всех глав департаментов здравоохранения, во всех правительствах стран, входящих в регион. Помимо избирания регионального директора, региональный комитет также отвечает за установление руководящих принципов для применения внутри региона политики в области здравоохранения и не только, принятой Всемирной Ассамблеей Здравоохранения. Региональный комитет также служит в качестве прогрессивного наблюдательного совета ВОЗ внутри региона. Региональный директор является главой ВОЗ в данном регионе. Он управляет или следит за персоналом медицинских учреждений и другими экспертами региональных офисов и специализированных центров. Региональный директор также делегирует полномочия – параллельно с генеральным директором ВОЗ – среди всех глав офисов ВОЗ в различных странах, известных как представители ВОЗ, внутри региона. В ВОЗ работает 8,500 человек в 147 странах мира. В поддержку принципа свободы от табака, ВОЗ не нанимает курильщиков. В 2003 году Организация инициировала создание Конвенции против курения табака. 32) ВОЗ также ведёт работу с «представителями доброй воли», людьми из мира искусства, спорта и других сфер общественной жизни, занимающихся привлечением внимания к инициативам и проектам ВОЗ. В настоящее время существует пять представителей доброй воли (Джет Ли, Нэнси Брикер, Пенг Лийян, Йохец Сасакава и Венский Филармонический Оркестр) и ещё один представитель, связанный с партнёрским проектом (Крейг Дэвид).

Офисы связи и офисы в странах

Всемирная Организация Здравоохранения работает в 147 странах мира во всех регионах. Она также работает в некоторых офисах связи, включая офисы связи с Евросоюзом, ООН и один офис Всемирного Банка и Международного Валютного Фонда. Она также работает с Международным агентством онкологических исследований в Лионе, Франция и с Центром ВОЗ по развитию здравоохранения в г. Кобе, Япония. Дополнительные офисы включают офисы в Приштине; на Западном берегу реки Иордан и в г. Газа; офис в Эль-Пасо на границе США и Мексики; офис Карибской программы координации в Барбадосе и офис в Северной Микронезии. Обычно имеется один офис ВОЗ в столице и дополнительные офисы в провинции. Национальное бюро ВОЗ возглавляется представителем ВОЗ. По состоянию на 2010 год, единственным представителем ВОЗ за пределами Европы была Ливийская Арабская Джамахирия («Ливия»); все остальные члены являются интернациональными. Национальные бюро обеих Америк называются представителями PAHO/ВОЗ. В Европе два представителя также служат в качестве глав Национального Бюро, и включают в себя страны за исключением Сербии; также имеется глава Национального Бюро в Албании, Российской Федерации, Таджикистане, Турции и Узбекистане. 33) Основными функциями Национального бюро ВОЗ являются совещательные функции по вопросам здравоохранения и фармацевтической политики.

Финансирование и партнёрство

ВОЗ финансируется путём взносов от стран-членов и внешних вкладчиков. По состоянию на 2012 год, наибольшим ежегодным вкладом от стран-членов был вклад от США (110 миллионов долларов), Японии (58 миллионов долларов), Германии (37 миллионов долларов), Великобритании (31 миллион долларов) и Франции (31 миллион долларов). Совместный бюджет 2012–2013 годов составляет 3,959 миллиона долларов, 944 миллиона долларов из которых (24%) поступит от установленных взносов. Это представляет значительное снижение издержек по сравнению с предыдущим бюджетом 2009–2010 годов. Обязательные взносы остались теми же. Добровольные взносы составят 3,015 миллионов долларов (76%), 800 миллионов долларов из которых считаются высоко или средне гибким финансированием, при этом остаток связан с определенной программой или целями. 34) За последние годы работа ВОЗ включала усиленное сотрудничество с внешними организациями. По состоянию на 2002 год, все 473 неправительственные организации (НПО) образовали некую форму сотрудничества с ВОЗ. Существует 189 партнёрств с международными НПО в формальных «официальных отношениях» – остальные считаются неформальными. Партнёры включают Фонд Билла и Мелинды Гейтс и Фонд Рокфеллера.

Споры

IAEA – Соглашение ВАЗ 12–40

В 1959 году, ВОЗ подписала Соглашение ВАЗ 12–40 с Международным агентством по атомной энергии (IAEA). В соглашении указывается, что ВОЗ признаёт, что IAEA имеет ответственность за мирную ядерную энергию без ущерба относительно ролей ВОЗ в продвижении здравоохранения. Однако, следующий параграф гласит: «если любая из организаций предлагает запустить программу или активность по теме, в которой другая организация имеет или может иметь значительный интерес, первая компания должна консультироваться с другой для рассмотрения дела по обоюдному соглашению». 35) Природа этого соглашения привела к тому, что некоторые влиятельные группировки и активисты (включая организацию Женщины в Европе за Общее Будущее) начали считать, что ВОЗ имеет ограниченные возможности в исследовании эффектов радиации на здоровье человека, вызванных использованием ядерной энергии и продолжительными эффектами ядерных катастроф в Чернобыле и Фукусиме. Они считают, что ВОЗ должна вновь стать «независимой».

Римская католическая церковь и СПИД

В 2003 году ВОЗ выступила с осуждением министерства здравоохранения Римской Курии, не принимающей использования презервативов, утверждая, что «неправильные заявления касательно презервативов и ВИЧ являются опасными перед лицом глобальных эпидемий, убивших более 20 миллионов человек, и в настоящее время воздействует на по меньшей мере 42 миллиона человек». 36) По состоянию на 2009 год, Католическая Церковь продолжает оставаться в оппозиции к увеличенному использованию презервативов для борьбы с ВИЧ/СПИД. В это время, президент Всемирной Ассамблеи Здравоохранения, министр здравоохранения Гайяны Лесли Рамсамми, осудила оппозицию Папы Бенедикта относительно контрацепции, утверждая, что он пытается «создать путаницу» и «препятствовать» принятым стратегиям в битве против заболевания. 37)

Периодическое профилактическое лечение

Агрессивная поддержка периодического профилактического лечения малярии от фонда Билла и Мелинды Гейтс повлияла на выступление бывшего главы ВОЗ по малярии Акира Кочи.

Диета и потребление сахара

Некоторые исследования, проведенные или поддержанные ВОЗ для определения того, каким образом стиль жизни и окружение людей влияет на их здоровье, могут быть спорными, что было проиллюстрировано совместным отчётом ВОЗ/ФАО 2003 года по питанию и предотвращению хронических неинфекционных заболеваний. В отчёте рекомендуется, что сахар должен составлять не более 10% здоровой диеты. Этот отчёт привёл к лоббированию со стороны сахарной индустрии против этой рекомендации, на что ВОЗ/ФАО ответил путём включения в отчёт следующего заявления «Экспертная комиссия считает, что утверждение о том, что свободное потребление сахара должно составлять менее 10% от общего количества калорий, является спорным», однако также придерживается мнения, основанного на их анализе научных исследований. В 2014 году ВОЗ снизила рекомендуемый уровень сахара вполовину, утверждая, что потребление сахара не должно превышать более 5% от здоровой диеты. 38)

Эпидемия свиного гриппа 2009 года

В 2007 году ВОЗ организовала работу по созданию вакцины от гриппа после проведения клинических испытаний в сотрудничестве со многими специалистами. Пандемия, включающая вирус гриппа H1N1, была объявлена генеральным директором Маргарет Чан в апреле 2009 года. Критики заявляли, что ВОЗ преувеличивала угрозу, распространяя «страх и замешательство», вместо того, чтобы предоставлять «немедленную информацию». Специалисты отрасли парировали, что пандемия 2009 года привела к «беспрецедентному сотрудничеству между мировым сообществом управляющих органов в области здравоохранения, учёными и производителями, что привело к наиболее всеобъемлющему ответу пандемии за всю историю, при котором уже через три месяца после объявления об эпидемии появилось некоторое количество вакцин. Этот ответ был возможен только благодаря экстенсивной подготовительной работе«. 39)

Вирус Эбола 2014 года

После информации о вирусе Эбола в 2014 году в Западной Африке, организация была раскритикована за бюрократию, недостаточное финансирование, региональную структуру и статус персонала.

База данных FCTC

ВОЗ имеет базу данных по Рамочной конвенции по табаку (FCTC) для усиления конформности с FCTC. Однако, сообщается о многочисленных противоречиях между ней и национальными отчётами об её применении. По сообщению исследователей Хоффмана и Ризви, «по состоянию на 4 июля 2012 года, 361 отзыва (32·7%) из 1104 стран были неправильно переданы: 33 (3·0%) – чистые ошибки (например, в базе данных указывается «да», а в отчёте – «нет»), 270 (24·5%) не были обнаружены, несмотря на то, что страны подтвердили свой ответ и 58 (5·3%) были неправильно интерпретированы персоналом ВОЗ ». 40)

Штаб-квартира

Штаб-квартира организации находится в Женеве, Швейцария. Она была открыта в 1966 году.

WHO Internship Programme

For future leaders in public health

A competent and dynamic health workforce at the heart of each health system is essential to advance global health goals. Countries need a pool of health professionals trained and exposed to the systems and processes in the health sector and who understand how stakeholders interact within the international health arena.

WHO, as the leader in global public health issues, is committed to building a diverse pool of future leaders in public health. WHO’s Internship Programme offers a wide range of opportunities for students and recent graduates to gain insight into the technical and administrative programmes of WHO and enrich their knowledge and experience in various areas, thereby contributing to the advancement of public health.

What are the objectives?

Who is eligible for an internship?

Age: You are at least twenty years of age on the date of application.

Education: You are enrolled in a course of study at a university or equivalent institution leading to a formal qualification (undergraduate, graduate, or postgraduate), in a public health, medical or social field related to the technical work of WHO, or in a management, administrative, communications, or external relations-related field. Applicants who have already completed a qualification may also qualify for consideration, if they apply to the internship within six months following the completion of the formal qualification. You have completed three years of full-time studies at a university or equivalent institution prior to starting (bachelor’s level or equivalent) the internship.

Languages: You are fluent at least in one of the working languages of the office of assignment.

Family relation: You are not related to a WHO staff member (e.g., son/daughter, brother/sister, or mother/father).

Nationality: You hold a valid passport of a WHO Member State.

Other: You have not previously participated in WHO’s Internship Programme.

How to apply?

We invite candidates from across the world to apply to the WHO Global Internship Programme.

All applications must be made through the internship position vacancy notices posted on the WHO Careers site using the WHO online recruitment system (Stellis). There is no possibility to apply for an internship at WHO outside Stellis. More information on the recruitment process can be found in the FAQs section.

Internship positions are available in various areas of work and in different organizational locations (regional offices, country offices or headquarters). As internship opportunities are posted on a continuous basis, with each containing different requirements and application deadlines, we encourage you to check the internship page regularly for new opportunities.

COVID-19: Important update on application process

The WHO Internship Programme remains suspended due to the COVID-19 pandemic.

Please continue to monitor the Internship Vacancies page for the latest information.

We thank students for their understanding and encourage everyone to stay safe, continue to practice social distancing and protection measures, and to remain vigilant for themselves and those around them.

Benefits of the WHO Internship Programme

WHO provides all interns with medical and accident insurance coverage during the duration of the internship period. Insurance coverage before the start date of the internship and after the end date of the internship, including travel to and from the duty station location, is the sole personal and financial responsibility of the individual intern.

As of January 2020, WHO provides living allowance to eligible selected interns who need financial support. All interns must complete a legal Declaration of Interests form. This form requires intern candidates to declare any relevant financial disclosures, including any financial support in the form of grants bursaries, scholarships, etc. Based on the information provided in this form, the intern candidates’ eligibility to receive financial support from WHO will be assessed.

Lunch vouchers may be provided at some duty stations.

Ryoko Takahashi

Candidate obligations BEFORE an internship offer is extended

Further information

Interns do not have the status of WHO staff members and shall not represent the Organization in any official capacity.

WHO interns are not eligible for appointment to any non-staff position within WHO for a period of three months following the end of their internship. However, no such restriction will apply to temporary or longer-term staff positions if the vacancy has been advertised and a competitive process completed. Any employment with WHO shall be subject to established recruitment and selection procedures. Interns and former interns are free to apply as external candidates to any vacant positions open to external candidates and for which they are qualified.

WHO does not sign any agreements, proposed or required by a sponsor, university or equivalent institution.

WHO only considers higher educational qualifications obtained from an institution accredited/recognized in the World Higher Education Database (WHED), a list updated by the International Association of Universities (IAU)/United Nations Educational, Scientific and Cultural Organization (UNESCO). The list can be accessed through the link: http://www.whed.net/. Some professional certificates may not appear in the WHED and will require individual review.

Please note that internships at WHO are very competitive and only a small number of applicants will be selected every year. Only successful candidates will be contacted. If not selected, you may apply again to other posted internship positions if you are still interested and if you meet the eligibility criteria.

For internships in Geneva, Switzerland

An important reminder: Although WHO is now providing a living allowance to eligible interns (please see the exact amount in the vacancy notices), be aware that living in Geneva is expensive and finding accommodation can be challenging.

Where we work

WHO organizational structure

A global presence that puts countries at the centre of our work

From our longstanding Geneva headquarters to our 6 regional offices, 150 country offices and other offices around the world, WHO plays an essential role improving local health systems and coordinating the global response to health threats. Discover how we work to support the efforts of governments and partners to ensure everyone, everywhere has an equal chance at a safe and healthy life.

Regional offices

WHO Member States are grouped into 6 regions. Each region has a regional office.

Regional websites

Country offices

WHO collaborates with our Member States to provide on-the-ground planning, implementing and monitoring of health programmes. Today, more than half of WHO staff work in country offices.

Headquarters

WHO’s global office is located in Geneva, Switzerland.

Geneva headquarters

Since our inception in 1948, WHO has been hosted by the Swiss Federation. Our main building was inaugurated in 1966. Today, the campus is home to 2400 employees. The headquarters is currently undergoing modernization, which will be completed in 2024. The building renovation aims to increase site efficiency and decrease the operational budget by investing in a long-term modern, high standard and energy-efficient building.

Здоровое питание

Основные факты

Здоровое питание на протяжении всей жизни способствует профилактике неправильного питания во всех его формах, а также целого ряда неинфекционных заболеваний (НИЗ) и нарушений здоровья. Вместе с тем, рост производства переработанных продуктов, быстрая урбанизация и изменяющийся образ жизни привели к сдвигу в моделях питания. В настоящее время люди потребляют больше продуктов с высоким содержанием калорий, жиров, свободных сахаров и соли/натрия, и многие люди не потребляют достаточно фруктов, овощей и других видов клетчатки, таких как цельные злаки.

Точный состав разнообразного, сбалансированного и здорового питания зависит от индивидуальных особенностей (таких как возраст, пол, образ жизни и степень физической активности), культурного контекста, имеющихся местных продуктов и обычаев в области питания. Однако основные принципы здорового питания остаются одинаковыми.

Для взрослых людей

Здоровое питание включает следующие компоненты:

Для детей грудного и раннего возраста

Оптимальное питание на протяжение первых двух лет жизни способствует здоровому росту ребенка и улучшает его когнитивное развитие. Оно также снижает риск набора избыточного веса и ожирения и развития НИЗ позднее в жизни.

Рекомендации по здоровому питанию для грудных детей и детей других возрастных групп схожи с рекомендациями для взрослых, но важны также следующие компоненты:

Практические рекомендации по поддержанию здорового питания

Фрукты и овощи

Ежедневное потребление, по меньшей мере, 400 г, или пяти порций, фруктов и овощей снижает риск развития НИЗ (2) и помогает обеспечить ежедневное поступление клетчатки.

Потребление фруктов и овощей можно улучшить. Для этого необходимо:

Снижение общего потребления жиров до менее 30% от общей потребляемой энергии помогает предотвратить нездоровую прибавку веса у взрослых людей(1, 2, 3). Кроме того, риск развития НИЗ можно снизить благодаря:

Потребление жиров, особенно насыщенных жиров и трансжиров промышленного производства, можно сократить следующими путями:

Соль, натрий и калий

Многие люди потребляют слишком много натрия, поступающего с солью (соответствует потреблению, в среднем, 9-12 г соли в день), и недостаточно калия (менее 3,5 г). Высокий уровень потребления натрия и недостаточное потребление калия способствуют повышению кровяного давления, что, в свою очередь, повышает риск развития болезней сердца и инсульта (8, 11).

Сокращение потребления соли до рекомендуемого уровня, то есть до менее 5 г в день, могло бы способствовать предотвращению 1,7 миллиона случаев смерти в год (12).

Люди зачастую не знают, какое количество соли они потребляют. Во многих странах основное количество соли поступает в организм человека из переработанных продуктов (готовых блюд; мясопродуктов, таких как бекон, ветчина и салями; сыра; и соленых закусок) или из пищевых продуктов, часто потребляемых в больших количествах (например, хлеб). Соль также добавляют в пищу во время ее приготовления (например, путем добавления бульона, бульонных кубиков, соевого соуса и рыбного соуса) или во время еды (путем добавления столовой соли).

Потребление соли можно сократить следующими путями:

Некоторые производители пищевых продуктов изменяют состав своей продукции для снижения содержания натрия, и перед приобретением или потреблением продуктов следует проверять маркировку на предмет содержания в них натрия.

Калий может смягчать негативное воздействие избыточного потребления натрия на кровяное давление. Поступление в организм калия можно увеличить путем потребления свежих фруктов и овощей.

Сахара

Потребление сахаров как среди взрослых людей, так и среди детей необходимо уменьшить до менее 10% от общей потребляемой энергии (2, 7). Сокращение потребления до менее 5% от общей потребляемой энергии обеспечит дополнительные преимущества для здоровья (7).

Потребление свободных сахаров повышает риск развития зубного кариеса. Избыточные калории, поступающие вместе с едой и напитками, содержащими свободные сахара, способствуют также нездоровой прибавке веса, что может приводить к избыточному весу и ожирению. Недавно получены фактические данные, свидетельствующие о том, что свободные сахара оказывают воздействие на кровяное давление и липиды сыворотки крови. Это позволяет предположить, что сокращение потребления свободных сахаров способствует снижению рисков развития сердечно-сосудистых болезней (13).

Потребление сахаров можно сократить следующими путями:

Как способствовать здоровому питанию?

Рацион питания меняется со временем под воздействием многих социальных и экономических факторов и из-за их сложного взаимодействия, способствующего формированию индивидуальных моделей питания. Эти факторы включают доход, цены на продукты питания (которые оказывают воздействие на наличие продуктов питания и их доступность по стоимости), индивидуальные предпочтения и убеждения, культурные традиции, а также географические и экологические аспекты (включая изменение климата). Поэтому к формированию здоровой продовольственной среды ― включая продовольственные системы, способствующие разнообразному, сбалансированному и здоровому питанию, ― необходимо привлекать многочисленные сектора и заинтересованные стороны, в том числе правительства и государственный и частный сектора.

Правительства играют главную роль в формировании здоровой продовольственной среды, позволяющей людям принимать и поддерживать практику здорового питания. Эффективные действия лиц, формирующих политику, по созданию здоровой продовольственной среды включают следующие:

Стимулирование потребительского спроса на здоровые пищевые продукты и блюда с помощью следующих мер:

Деятельность ВОЗ

В 2004 г. Ассамблея здравоохранения приняла «Глобальную стратегию ВОЗ по питанию, физической активности и здоровью» (14). Стратегия призвала правительства, ВОЗ, международных партнеров, частный сектор и гражданское общество к принятию мер на глобальном, региональном и местном уровнях для содействия здоровому питанию и физической активности.

В 2010 г. Ассамблея здравоохранения одобрила ряд рекомендаций в отношении ориентированного на детей маркетинга пищевых продуктов и безалкогольных напитков (15). С помощью этих рекомендаций страны разрабатывают новые и улучшают существующие стратегии по уменьшению воздействия маркетинга нездоровых пищевых продуктов на детей. ВОЗ также разработала инструменты для регионов (такие как региональные типовые перечни питательных веществ), которыми страны могут пользоваться при осуществлении рекомендаций по маркетингу.

В 2012 г. Ассамблея здравоохранения приняла «Всеобъемлющий план осуществления деятельности в области питания матерей и детей грудного и раннего возраста» и шесть глобальных целей в области питания, которые должны быть достигнуты к 2025 г., включая сокращение числа детей, страдающих от задержки роста, истощения и избыточного веса, улучшение грудного вскармливания и сокращение числа детей с анемией и низкой массой тела при рождении (9).

В 2013 г. Ассамблея здравоохранения согласовала девять глобальных добровольных целей по профилактике НИЗ и борьбе с ними. Эти цели включают прекращение увеличения числа случаев диабета и ожирения и относительное снижение на 30% потребления соли к 2025 году. «Глобальный план действий по профилактике неинфекционных заболеваний и борьбе с ними на 2013-2020 гг.» (10) содержит руководство и варианты политики для содействия государствам-членам, ВОЗ и другим учреждениям Организации Объединенных Наций в достижении этих целей.

В мае 2014 г., принимая во внимание быстрый рост числа детей грудного возраста и других возрастных групп с ожирением во многих странах, ВОЗ учредила Комиссию по ликвидации детского ожирения. В 2016 г. Комиссия предложила ряд рекомендаций для успешной борьбы с ожирением среди детей и подростков в условиях разных стран мира (16).

В ноябре 2014 г. ВОЗ вместе с Продовольственной и сельскохозяйственной организацией ООН (ФАО) организовала вторую Международную конференцию по вопросам питания (ICN2). ICN2 приняла Римскую декларацию по вопросам питания (17) и Рамочную программу действий (18), которые содержат рекомендации в отношении ряда вариантов политики и стратегий для содействия разнообразному, безопасному и здоровому питанию на всех этапах жизни. ВОЗ помогает странам в выполнении обязательств, принятых на ICN2.

В мае 2018 г. Ассамблея здравоохранения приняла тринадцатую Общую программу работы (ОПР13), которой ВОЗ будет руководствоваться в своей работе в 2019—2023 гг. (19). Сокращение потребления соли/натрия и исключение трансжиров промышленного производства из состава пищевой продукции определены в ОПР13 в качестве приоритетных действий ВОЗ для достижения целей по обеспечению здорового образа жизни и содействию благополучию для всех в любом возрасте. Для оказания содействия государствам-членам в принятии необходимых мер для исключения трансжиров промышленного производства из состава пищевой продукции ВОЗ разработала дорожную карту для стран (пакет мер REPLACE) в целях ускорения действий (6).

Источники

(1) Hooper L, Abdelhamid A, Bunn D, Brown T, Summerbell CD, Skeaff CM. Effects of total fat intake on body weight. Cochrane Database Syst Rev. 2015; (8):CD011834.

(2) Diet, nutrition and the prevention of chronic diseases: report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series, No. 916. Geneva: World Health Organization; 2003.

(3) Fats and fatty acids in human nutrition: report of an expert consultation. FAO Food and Nutrition Paper 91. Rome: Food and Agriculture Organization of the United Nations; 2010.

(4) Nishida C, Uauy R. WHO scientific update on health consequences of trans fatty acids: introduction. Eur J Clin Nutr. 2009; 63 Suppl 2:S1–4.

(5) Guidelines: Saturated fatty acid and trans-fatty acid intake for adults and children. Geneva: World Health Organization; 2018 (Draft issued for public consultation in May 2018).

(6) REPLACE: An action package to eliminate industrially-produced trans-fatty acids. WHO/NMH/NHD/18.4. Geneva: World Health Organization; 2018.

(7) Guideline: Sugars intake for adults and children. Geneva: World Health Organization; 2015.

(8) Guideline: Sodium intake for adults and children. Geneva: World Health Organization; 2012.

(9) Comprehensive implementation plan on maternal, infant and young child nutrition. Geneva: World Health Organization; 2014.

(10) Global action plan for the prevention and control of NCDs 2013–2020. Geneva: World Health Organization; 2013.

(11) Guideline: Potassium intake for adults and children. Geneva: World Health Organization; 2012.

(12) Mozaffarian D, Fahimi S, Singh GM, Micha R, Khatibzadeh S, Engell RE et al. Global sodium consumption and death from cardiovascular causes. N Engl J Med. 2014; 371(7):624–34.

(13) Te Morenga LA, Howatson A, Jones RM, Mann J. Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids. AJCN. 2014; 100(1): 65–79.

(14) Global strategy on diet, physical activity and health. Geneva: World Health Organization; 2004.

(15) Set of recommendations on the marketing of foods and non-alcoholic beverages to children. Geneva: World Health Organization; 2010.

(16) Report of the Commission on Ending Childhood Obesity. Geneva: World Health Organization; 2016.

(17) Rome Declaration on Nutrition. Second International Conference on Nutrition. Rome: Food and Agriculture Organization of the United Nations/World Health Organization; 2014.

(18) Framework for Action. Second International Conference on Nutrition. Rome: Food and Agriculture Organization of the United Nations/World Health Organization; 2014.

(19) Thirteenth general programme of work, 2019–2023. Geneva: World Health Organization; 2018.

The world health organization and international

Consign nuclear weapons to history, once and for all

From the steppes of Kazakhstan to the pristine waters of the Pacific Ocean and the deserts of Australia, nuclear testing has long poisoned our planet’s natural environment and the species and people who call it home. The International Day Against Nuclear Tests represents a global recognition of the catastrophic and lingering damage done in the name of the nuclear arms race. It is a way to remember those who suffered because of the folly of atomic brinkmanship. And it is an alarm bell for the world to finally put in place a legally binding prohibition on all nuclear tests.

Ukraine: UN atomic energy experts head to stricken nuclear power station

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Ukraine: More than one million tonnes of grain and food items exported under Black Sea deal

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UN chief disappointed nuclear treaty conference ends without consensus

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UN Sustainable Development Goals

17 Goals to transform our world

The Sustainable Development Goals are a call for action by all countries — poor, rich and middle-income — to promote prosperity while protecting the planet.

ActNow Campaign

The ActNow campaign aims to trigger individual action on the defining issue of our time. People around the world have joined to make a difference in all facets of their lives, from the food they eat to the clothes they wear.

SDG Book Club

Reading and learning are essential to children’s growth and development; stories can fuel their imagination and raise awareness of new possibilities. The SDG Book Club aims to encourage them to learn about the Goals in a fun, engaging way, empowering them to make a difference.

Student Resources on the SDGs

Learn more about the Sustainable Development Goals! On our student resources page you will find plenty of materials for young people and adults alike. Share with your family and friends to help achieve a better world for all.

Goal of the Month

Goal 8: Promote inclusive and sustainable economic growth, employment and decent work for all

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Front-line workers in the direst settings

Molok is a 30-year-old midwife in Yemen. Since losing her husband to the country’s grinding war, she raises her two sons alone and supports the family by working at a UNFPA mobile clinic.

Angela Merkel is awarded UNESCO Peace Prize

The Jury of the Félix Houphouët-Boigny-UNESCO Peace Prize awarded the 2022 Prize to Ms Angela Merkel, former Federal Chancellor of Germany, in recognition of her efforts to welcome refugees.

Reggae legend Jimmy Cliff releases ‘Refugees’

Jimmy Cliff shines a light on people forced to flee and partners with UNHCR to create a portal to help refugees. “Refugees” continues Cliff’s long tradition of penning thought-provoking anthems.

Sustainable living to counter climate change

Research shows that lifestyle changes could help the planet slash emissions by up to 70 per cent by 2050. UNEP explains what people and policymakers can do to to help secure a healthier planet.

What we do

Due to the powers vested in its Charter and its unique international character, the United Nations can take action on the issues confronting humanity in the 21st century, including:

Maintain International Peace and Security

The United Nations came into being in 1945, following the devastation of the Second World War, with one central mission: the maintenance of international peace and security. The UN does this by working to prevent conflict; helping parties in conflict make peace; peacekeeping; and creating the conditions to allow peace to hold and flourish. These activities often overlap and should reinforce one another, to be effective. The UN Security Council has the primary responsibility for international peace and security. The General Assembly and the Secretary-General play major, important, and complementary roles, along with other UN offices and bodies.

Protect Human Rights

The term “human rights” was mentioned seven times in the UN’s founding Charter, making the promotion and protection of human rights a key purpose and guiding principle of the Organization. In 1948, the Universal Declaration of Human Rights brought human rights into the realm of international law. Since then, the Organization has diligently protected human rights through legal instruments and on-the-ground activities.

Deliver Humanitarian Aid

One of the purposes of the United Nations, as stated in its Charter, is «to achieve international co-operation in solving international problems of an economic, social, cultural, or humanitarian character.» The UN first did this in the aftermath of the Second World War on the devastated continent of Europe, which it helped to rebuild. The Organization is now relied upon by the international community to coordinate humanitarian relief operations due to natural and man-made disasters in areas beyond the relief capacity of national authorities alone.

Promote Sustainable Development

Uphold International Law

Structure of the
United Nations

The main parts of the UN structure are the General Assembly, the
Security Council, the Economic and Social Council, the Trusteeship Council, the International Court of Justice, and the UN Secretariat. All were established in 1945 when the UN was founded.

General Assembly

The General Assembly is the main deliberative, policymaking and representative organ of the UN. All 193 Member States of the UN are represented in the General Assembly, making it the only UN body with universal representation.

Security Council

The Security Council has primary responsibility, under the UN Charter, for the maintenance of international peace and security. It has 15 Members (5 permanent and 10 non-permanent members). Each Member has one vote. Under the Charter, all Member States are obligated to comply with Council decisions.

Economic and Social Council

The Economic and Social Council is the principal body for coordination, policy review, policy dialogue and recommendations on economic, social and environmental issues, as well as implementation of internationally agreed development goals.

Trusteeship Council

The Trusteeship Council was established in 1945 by the UN Charter, under Chapter XIII, to provide international supervision for 11 Trust Territories that had been placed under the administration of seven Member States, and ensure that adequate steps were taken to prepare the Territories for self-government and independence.

International Court of Justice

The International Court of Justice is the principal judicial organ of the United Nations. Its seat is at the Peace Palace in the Hague (Netherlands). It is the only one of the six principal organs of the United Nations not located in New York (United States of America).

Secretariat

The Secretariat comprises the Secretary-General and tens of thousands of international UN staff members who carry out the day-to-day work of the UN as mandated by the General Assembly and the Organization’s other principal organs.

Learn more

Climate Change

Climate change is the defining issue of our time and now is the defining moment to do something about it. There is still time to tackle climate change, but it will require an unprecedented effort from all sectors of society.

Gender Equality

Women and girls represent half of the world’s population and, therefore, also half of its potential. Gender equality, besides being a fundamental human right, is essential to achieve peaceful societies, with full human potential and sustainable development.

Ending Poverty

While global poverty rates have been cut by more than half since 2000, one in ten people in developing regions still lives on less than US$1.90 a day — the internationally agreed poverty line, and millions of others live on slightly more than this daily amount.

UN75 | Our Common Agenda

The UN’s 75th anniversary in 2020 arrived at a time of great upheaval and peril. To secure a world where everyone can thrive in peace, dignity and equality on a healthy planet we need a multilateral system that is inclusive, networked and effective. «Our Common Agenda» builds on the 12 commitments contained in the UN75 Declaration.

Did you know?

As the world’s only truly universal global organization, the United Nations has become the foremost forum to address issues that transcend national boundaries and cannot be resolved by any one country acting alone.

France, Slovakia, and Ukraine get more than half of their electricity from nuclear power.

Find out more in

Global Issues:
Atomic Energy

The fallout from the COVID-19 pandemic threatens to push over 70 million people into extreme poverty.

Find out more in

Global Issues:
Ending Poverty

The advocacy of racial or religious hatred is prohibited by international law.

Find out more in

Global Issues:
Human Rights

Polio cases have decreased by more than 99 per cent since 1988, because of immunization against the disease worldwide.​

Find out more in

Global Issues
Health

Watch and Listen

Video and audio from across the United Nations and our world-wide family of agencies, funds, and programmes.

Responding to overlapping crises: conflicts, COVID-19, and climate change

Delivering better water access in India

In northern India, UNOPS is partnering with the government of Denmark and Jal Jeevan Mission to lay the foundations for healthier communities through improved access to clean water and sanitation facilities. Watch the video to discover more.

Get ready for Global Week to Act4SDGs 2022

The UN SDG Action Campaign and its partners call on people everywhere to take action on climate, justice and peace in face of global challenges – the pandemic, climate change, war and conflict. In 2022, the Global Week to Act4SDGs takes place on 16-25 September. Learn more by going to Act4SDGs.

UN Podcasts

Leading in Tragic Times

“I found it fascinating as a leader […] to be in an environment of collective fear […] people naturally go to a place of great horror […] yet you’re trying to buffer it yourself, because you’ve got to function […] The second point is the ego of leadership […] you’ve got to be very careful that you’re not letting the ego of ‘I can do everything’ [. ] isn’t driving you past the point of really solid judgement and solid reflection.”

Deborah Lyons knows how to keep a cool head in a crisis. In August 2021, when the Taliban seized power, Deborah, in her former role as Head of the United Nations Assistance Mission in Afghanistan (UNAMA), was responsible for ensuring the safety of staff across the country, among them many women.

Since returning to power, the Taliban have severely curtailed women’s rights. Millions of women and girls are now excluded from work and school, contrary to initial assurances from Afghanistan’s new leaders. In this episode, Deborah Lyons reflects on the tragedy facing Afghan women, the trauma of the Taliban takeover, and what it takes to lead in turbulent times.

“I don’t think anyone expected the chaos, the sadness, the carnage, the enormous shock”

The world health organization and international

Более 800 учреждений в 80 странах оказывают поддержку программам ВОЗ.

Сотрудничающими центрами ВОЗ являются учреждения, такие как научно-исследовательские институты, отделения университетов или академических учреждений, назначенные Генеральным директором для проведения деятельности в поддержку программ ВОЗ. В настоящее время более 700 сотрудничающих центров ВОЗ в более 80 странах работают вместе с ВОЗ в таких областях, как сестринское дело, профессиональная гигиена, инфекционные болезни, психическое здоровье, хронические заболевания и технологии здравоохранения.

Идея использования национальных учреждений для международных целей возникла еще во время Лиги Наций, когда национальные лаборатории были впервые назначены в качестве справочных центров по стандартизации биологических препаратов. ВОЗ сразу же после создания назначила больше справочных центров, начав в 1947 г. со Всемирного центра по гриппу в Лондоне для всемирного эпиднадзора за гриппом.

Уже в 1949 г. Вторая сессия Всемирной Ассамблеи здравоохранения сформировала политику (которая с тех пор последовательно выполняется) в отношении того, что Организации не следует рассматривать «создание под своей эгидой международных исследовательских учреждений» и что » прогресс исследований в области здравоохранения обеспечивается наилучшим образом посредством содействия, координации и использования результатов деятельности существующих учреждений».

Coronavirus disease (COVID-19)

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus.

Most people infected with the virus will experience mild to moderate respiratory illness and recover without requiring special treatment. However, some will become seriously ill and require medical attention. Older people and those with underlying medical conditions like cardiovascular disease, diabetes, chronic respiratory disease, or cancer are more likely to develop serious illness. Anyone can get sick with COVID-19 and become seriously ill or die at any age.

The best way to prevent and slow down transmission is to be well informed about the disease and how the virus spreads. Protect yourself and others from infection by staying at least 1 metre apart from others, wearing a properly fitted mask, and washing your hands or using an alcohol-based rub frequently. Get vaccinated when it’s your turn and follow local guidance.

The virus can spread from an infected person’s mouth or nose in small liquid particles when they cough, sneeze, speak, sing or breathe. These particles range from larger respiratory droplets to smaller aerosols. It is important to practice respiratory etiquette, for example by coughing into a flexed elbow, and to stay home and self-isolate until you recover if you feel unwell.

Центр СМИ

Новости

ВОЗ выпустила новые рекомендации по лечению Эболы и призвала повысить доступность препаратов ‎

Оспа обезьян: эксперты присвоили новые наименования вариантам вируса

ВОЗ призывает принять меры для удовлетворения срочных потребностей в области здравоохранения в регионе Большого Африканского Рога

Контактная информация для СМИ

Подписаться на сообщения для медиа

Репортажи

Что необходимо знать о вакцине против COVID-19 компании «Модерна» (мРНК 1273)

Комментарии

Совместное использование технологий и поддержка инноваций — это не только вопрос равноправия. Это еще и налучший способ остановить пандемии

Информационные бюллетени

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Коронавирус Ближневосточного респираторного синдрома (БВРС-КоВ)

Гонорея с множественной лекарственной устойчивостью

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10 фактов о ВИЧ/СПИДе

10 фактов о переливании крови

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Вспышки болезней

Самые последние новости о вспышках болезней

Глобальные кампании ВОЗ по охране здоровья

События

Всемирный день безопасности пациентов 2022 г.

17 сентября 2022 г.

Совещания региональных комитетов в 2022 г.

22 августа – 28 октября 2022 г.

Спрос на вакцинацию против COVID-19. Глобальное мероприятие, посвященное проблеме формирования доверия к вакцинам и повышения охвата вакцинацией среди групп высокого риска и уязвимых категорий населения

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Программа по обеспечению доступа к результатам научных исследований в области здравоохранения (HINARI) – это партнерство с крупнейшими издательствами для обеспечения бесплатного или почти бесплатного доступа к публикациям в периодических изданиях в сфере биомедицины и здравоохранения для местных и некоммерческих учреждений в развивающихся странах. Возможность доступа к этим публикациям является ценным ресурсом для работников здравоохранения и ученых и в конечном итоге способствует улучшению здоровья населения в мире.

Сети научных библиотек и информационных ресурсов

Пользование библиотечным фондом:

Для ознакомления выдаются все материалы библиотечного фонда; книги выдаются только персоналу ВОЗ.

Выполнение исторических исследований:

доступ к историческим материалам предоставляется по записи (для записи следует обратиться в архивную службу ВОЗ).

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Under the global «health for all» strategy, WHO and its member states have resolved to place special emphasis on the developing countries. Nevertheless, the benefits of WHO’s international health work are reaped by all countries, including the most developed. For example, all nations have benefited from their contributions to the WHO programs that led to the global eradication of smallpox and to better and cheaper ways of controlling tuberculosis.

Prevention is a key word in WHO. The organization believes that immunization, which prevents the six major communicable diseases of childhood—diphtheria, measles, poliomyelitis, tetanus, tuberculosis, and whooping cough—should be available to all children who need it. WHO is leading a worldwide campaign to provide effective immunization for all children in cooperation with UNICEF.

Provision of safe drinking water and adequate excreta disposal for all are the objectives of the International Drinking Water Supply and Sanitation Decade proclaimed by the UN General Assembly in 1980 and supported by WHO.

WHO is also active in international efforts to combat the diarrheal diseases, killers of infants and young children. The widespread introduction of oral rehydration salts, together with improved drinking water supply and sanitation, will, it is hoped, greatly reduce childhood mortality from diarrhea.

WHO’s program for primary health care comprises eight essential elements:

These eight elements were defined in the Declaration of Alma-Ata, which emerged from the International Conference on Primary Health Care, held in Alma-Ata, USSR, in 1978.

A. Disease Research, Control and Prevention

UNAIDS Programme

The Acquired Immune Deficiency Syndrome (AIDS) pandemic is an international health problem of extraordinary scope and urgency. The mission of UNAIDS is to mobilize an effective, equitable, and ethical response to the pandemic. It strives to raise awareness, stimulate solidarity, and unify worldwide action. UNAIDS works with countries to develop programs to prevent HIV transmission and reduce the suffering of people already affected. It provides technical and policy guidance to governments, other United Nations agencies, and non-governmental organizations. It also promotes and supports research to develop new technologies, interventions, and approaches to AIDS prevention and care. Its inception in 1988 was first as the Global Programme on AIDS. UNAIDS combines the efforts of six other UN system organizations, including UNDP, the World Bank, UNICEF, UNFPA, WHO, and UNESCO. Since January 1996, the joint and co-sponsored UN Programme on HIV/AIDS, or UNAIDS, has been operational to better coordinate fund raising and prevention efforts.

WHO estimated in 2002 that more than 42 million people were living with HIV/AIDS. It was also estimated that during 2002, 5 million people (including 800,000 children under the age of 15) became infected. It was estimated that in 2002, 3.1 million adults and children died because of HIV/AIDS. In 2002, approximately 610,000 of these deaths occurred among children and 1.2 million (50%) were among women. The total number of deaths worldwide due to HIV/AIDS since the beginning of the epidemic until the end of 2001 was 21.8 million. Of the 42 million people living with HIV/AIDS in 2002, 29.4 million (approximately 70%) lived in Sub-Saharan Africa, the region that has been hardest hit by AIDS/HIV.

The disease is caused by a virus which destroys the body’s innate capacity to withstand disease (the immune system). As the immune system is weakened, infected persons can no longer resist diseases which cause diarrhea, fatigue, severe weight loss, and skin lesions. Eventually, the AIDS-related illnesses cause death. Persons become infected with the HIV virus by contact with body fluids like semen (during sexual intercourse) or blood (if they receive contaminated blood during a transfusion). Intravenous drug users who share hypodermic needles have been shown to be at great risk for contracting HIV. HIV cannot be transmitted by air or simple touch. The insidious nature of the disease contributed to its silent explosion into the world population, since infected persons do not show signs of infection for as many as six to ten years.

AIDS was already an international epidemic (a «pandemic») by the time it was first recognized in 1981. In late 1983, WHO held the first international meeting on AIDS in Geneva. In February 1987, WHO established its Special Programme on AIDS in order to develop a global strategy for AIDS control, obtain financial resources, and begin implementation of the program. In 1988, the Executive Board renamed it the Global Programme on AIDS (GPA). Today it is known as UNAIDS Programme. The main objectives of the global strategy are:

The global strategy was updated in 1992 to place increased emphasis on:

A World Summit of Ministers of Health on Programmes for AIDS Prevention was held in London in January 1988. The summit proclaimed 1 December as Worlds AIDS Day. In 1989 the World Health Assembly resolved to make World AIDS Day the annual focus for worldwide efforts against AIDS. That same year, WHO established a Global Commission on AIDS to provide the Director General with broad policy and scientific guidance from eminent experts representing a wide variety of disciplines. By the end of 1991, AIDS programs had been established in every WHO member country.

On 12 December 2002, a new international alliance, the International HIV Treatment Access Coalition (ITAC), was launched in Geneva and Dakar. It aims to boost efforts to provide access to antiretroviral drugs to the growing number of people with HIV/AIDS in low and middle income countries.

Tuberculosis

In April 1993, WHO declared a tuberculosis (TB) global emergency. WHO said that 35 years of neglect by governments, and a linkage to the HIV/AIDS pandemic, had led to a resurgence of the bacillus that causes tuberculosis. In New York City, the incidence of TB rose 150% between 1980 and 1993, prompting WHO to declare a global TB epidemic. The link between HIV/AIDS and tuberculosis, which were fueling each other, was so pronounced that by 1994 WHO called the phenomenon a co-epidemic. The breakdown in health services, the spread of HIV/AIDS, and the emergence of strains of TB that are multidrug-resistant contributed to the worsening impact of the disease. As of 2002, the global epidemic was growing and becoming more dangerous: Tuberculosis was killing 2 million people a year. Health experts estimated that between 2000 and 2020, nearly one billion people would be newly infected, 200 million people would get sick, and 35 million would die from TB if the disease was not controlled.

Tuberculosis is an age-old killer, traces of which have been found in the lungs of 3,000-year-old Egyptian mummies. It is caused by a bacillus that infects the lungs, forming knobby lesions called «tubercles.» Up until the 20th century it was commonly called «consumption.» Today the bacillus responsible for TB is called Mycobacterium tuberculosis. The first diagnostic test was discovered in 1905 and the first vaccine was created in France in 1921. The first antibiotic effective against TB, streptomycin, was discovered in 1944 in the United States. By 1960, chemotherapy for TB was so effective, sanitoria in mountain areas which had been used for more than a century to care for TB patients were closed. TB was presumed dead, at least in the industrialized world: public health measures for TB control were dismantled, and funding for research fell to a trickle. However, multidrug-resistant (MDR) strains began to flourish as patients being treated with antibiotics neglected to completely finish a course of treatment. In New York City, MDR strains accounted for only 7% of all TB strains in the early 1980s. By 1992, more than one-third of the strains tested were resistant to one drug, and almost one-fifth were resistant to the two main drugs.

WHO contends that the rise of tuberculosis in the industrialized world is linked not only to HIV/AIDS, but also to inadequate funding of international programs to combat tuberculosis in the developing world. The organization has insisted that it will be impossible to control TB in the industrialized countries unless it is sharply reduced in Africa, Asia, and Latin America.

The WHO Tuberculosis Programme aimed to cut the annual death toll from TB from 3 million deaths in 1992 to 1.6 million by 2002, but that goal was not reached. WHO predicts that about US$ 100 million needs to be spent each year to provide medicines, microscopes, and a modest infrastructure enabling poor countries to undertake successful tuberculosis programs. WHO reports that in the developing world, a complete cure could cost as little as US$ 13 per patient. However, the treatment of a patient with a multidrug-resistant strain of TB in New York City could cost US$ 180,000 per patient.

As of 2002, WHO targets were to detect 70% of new infectious TB cases and to cure 85% of those detected. Six countries had achieved these targets by 1998. But WHO stated that governments, non-governmental organizations, and civil society must continue to act to improve TB control in order to reach these targets worldwide.

The Tropical Disease Research Programme

The UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) was set up in 1975 to target malaria, schistosomiasis (bilharzia or «snail fever»), leishmaniasis, African trypanosomiasis (sleeping sickness), American trypanosomiasis (Chagas disease), lymphatic filariasis (which leads to elephantiasis), onchocerciasis (river blindness), and leprosy. Almost 500 million people, nearly all of them in developing countries, suffer from these diseases, which can cause terrible anguish, deformity, and death. At the same time, they cause considerable economic losses and frequently interfere with development projects (particularly water projects such as dams and irrigation schemes, and planned and unplanned forestry).

The death toll from the diseases—particularly among children from malaria in Africa—is expected to double by 2010, possibly reaching four million lives a year, unless radical solutions are found. Population increase, the spread of parasite resistance, mass migrations, environmental disturbance, and disruption of control programs through economic devastation, civil unrest, and wars, all contribute to the tropical disease problem.

TDR has a mandate to:

In this work, TDR collaborates closely with WHO’s Division of Control of Tropical Diseases (CTD), and with many other WHO programs and outside bodies concerned with tropical disease research and control.

TDR acts to some extent like a research council, supporting investigator-initiated projects selected by peer-review, and to some extent as a pro-active agency commissioning the research required to reach its objectives. A quarter of TDR’s funds goes to research capability strengthening (RCS) in developing countries. This RCS work is being increasingly combined with the performance of needed research: «training by doing.»

Over the eighteen years of TDR’s existence, a large number of drugs, diagnostic techniques, vector control agents, and other products have been developed, and in conjunction with national and international control programs there has been considerable success in applying these to reduce (or potentially reduce) the burden of some of the tropical diseases—notably leprosy, onchocerciasis, and Chagas disease. The other diseases still pose major problems, either globally or regionally.

TDR’s research targets, and the appropriate management and decision-making structure to reach those targets was thoroughly reviewed in 1992–93. A new structure, initiated in 1994, gave the program greater focus on priority targets and more flexibility to identify and respond to the practical health and control needs of populations. The structure is divided into three functional areas: basic and strategic research (STR); product research and development (PRD); and research capability strengthening (RCS).

Basic and Strategic research. STR activities are divided into three areas, each of which is managed through a steering committee: pathogenesis and applied genomics; molecular entomology; and social, economic and behavioural research. The pathogenesis and applied genomics committe emphasizes using genome information and advances in functional genomics to understand the mechanisms leading to disease and to the survival of parasites and viruses. The molecular entomology committee focuses on malaria and dengue research, aiming to develop ways to replace natural mosquitoes in the wild with mosquitoes that are unable to support the development of malaria parasites or the dengue virus. The third committee supports research to investigate how social, behavioral, political, economic, and health factors affect disease patterns and control.

TDR’s particular strength is that, as part of the United Nations system, it enjoys a world view of the tropical disease scene and the standing conferred by a lack of partisan or profit-making motivation. These assets explain in large measure TDR’s rapid success in creating an international network of over 5000 scientists, which gives it access to a broad range of expertise and scientific disciplines.

Through its WHO connection, TDR has ready access to programs and units working in related fields and—most importantly, with its new focus on the field and on national control programs—to WHO’s 192 Member States. TDR can call on government support in endemic regions in order to engage populations and facilities in multi-center field trials rapidly and at very low cost.

Leprosy

Leprosy, also known as Hansen’s disease, has been a serious public health problem in the developing countries. But the widespread use of multidrug therapy (MDT) has reduced the disease burden dramatically. In the last 15 years of the 20th century, 10 million leprosy patients were cured, the prevalence rate dropped by 85%, and the number of countries where leprosy remained a public health problem dropped from 122 to 24. Once the prevalence rate at the global level is reduced to less than one case per 10,000 persons, health experts believe there will be a natural interruption of transmission over time and future generations will not contract the disease.

At the end of the 20th century, the prevalence rate at the global level was 1.4 cases per 10,000 people. At the beginning of 2002, the number of leprosy patients in the world was around 635,000, as reported by 106 countries. About 760,000 new cases were detected during 2001. It was estimated that about 2.5 million patients would be detected between 2000 and 2005.

In the late 1990s, leprosy remained a public health problem in 24 countries situated mainly in the inter-tropical belt of the world. Of the 24, it was estimated that 12 (Cameroon, Chad, Congo, Côte d’Ivoire, Ethiopia, Gabon, Gambia, Guinea-Bissau, Mali, Papua New Guinea, Paraguay, Sierra Leone) would meet the elimination goal in the year 2000 if strategies were intensified and accelerated. WHO reported that special efforts would be needed to eliminate leprosy in 12 other countries: Angola, Brazil, Central African Republic, Democratic Republic of the Congo, India, Indonesia, Guinea, Madagascar, Mozambique, Myanmar, Nepal, and Niger. Together these 12 countries represented 90% of the prevalence in the world in 1999. As of 2002, the countries most affected by leprosy were Angola, Brazil, India, Madagascar, Mozambique, Myanmar and Nepal.

Malaria

As of 2002, WHO reported that malaria was a public health problem in more than 90 countries, inhabited by a total of some2.4 billion people or roughly 40% of the world’s population. At the time, worldwide prevalence of the disease was estimated to be approximately 300 clinical cases a year, with more than 90% of the cases occurring in sub-Saharan Africa. Of those contracting the disease, an estimated one million die each year, with the majority of deaths occurring among young African children. WHO stated that other high-risk groups were pregnant women, and non-immune travelers, refugees and other displaced persons, and workers entering endemic areas.

Malaria has been a priority for WHO since its founding in 1948. Control activities are coordinated by WHO’s Programme on Communicable Diseases (CDS). The four basic technical elements of WHO’s global control strategy are: provision of early diagnosis and prompt treatment for the disease; planning and implementation of selective and sustainable preventive measures; early detection for the prevention or containment of epidemics; and, strengthening local research capacities to promote regular assessment of malaria situations, in particular the ecological, social and economic determinants of the disease.

In 1992, WHO convened a Ministerial Conference on Malaria in Amsterdam which was attended by health leaders from 102 countries and representatives of United Nations bodies and nongovernmental organizations. The conference endorsed a global malaria control strategy. WHO planned to implement control programs in 90% of the countries affected by the disease no later than 1997. The target was to reduce mortality by at least 20% between 1995 and 2000.

WHO has published many books in support of its fight against malaria, including: A Global Strategy for Malaria Control, Basic Malaria Microscopy, Parasitic Diseases in Water Resources Development, and books in many languages on the diagnosis and treatment of malaria.

Smallpox

The eradication of smallpox is among the finest achievements of WHO, which coordinated the international effort to combat this disease. It is the first time in history that a human malady has ever been totally eliminated. This became feasible because the virus causing the disease was transmitted only by direct human contagion; there were no animal reservoirs or human «carriers.» Victims of the disease were immune to further attacks, while successful vaccination at three-year intervals gave essentially complete protection.

Eradication was based on a twofold strategy of surveillance containment and vaccination. Rapid detection of cases, their immediate isolation, and the vaccination of anyone with whom the patient could have come in contact during the infective period, lasting about three weeks after the onset of rash, prevented further transmission. Implementation of these procedures, coupled with the basic immunity level attributable to routine immunization, resulted in the eradication of smallpox everywhere in the world.

Although a global program of eradication was initiated in 1959, it was not until 1967, when a special WHO budget with increased bilateral and multilateral support was prepared, that a definitive target date of 10 years was set for global eradication. By the end of 1977, this goal was achieved.

In 1967, 131,776 cases of smallpox were reported from 43 countries, 31 of which were classified as smallpox-endemic; however, the actual number of cases was estimated to have been between 10 million and 15 million, among whom possibly 1.5 to 2 million died. Since that time, WHO has convened many international commissions which certified smallpox eradication in 79 recently endemic countries. The global eradication of the disease was declared by the World Health Assembly in 1980. By 1985, all WHO member states had discontinued routine smallpox vaccination, and no country required smallpox vaccination certificates from international travelers.

By 1993, the complete nucleotide sequence of the genomes of several strains of the virus had been determined, fulfilling the requirements set in 1990 for the final destruction of the remaining stock of variola virus. On 9 September 1994, an expert committee agreed that the destruction of the remaining clinical specimens of variola virus should take place on 30 June 1995, after confirmation by the May 1995 meeting of the World Health Assembly. The committee also recommended that 500,000 doses of smallpox vaccine be kept by WHO in case of an emergency and that the vaccine seed virus be maintained in the WHO Collaborating Centre on Smallpox Vaccine in Bilthoven, Netherlands.

In the wake of the 11 September 2001 terrorist attacks on the United States, many countries began to take definitive steps toward preventing such attacks, including those that might come from biological weapons. Five people in the United States died as a result of anthrax sent throught the U.S. postal system in late 2001. Those events led to concern about the possibility of smallpox being used as a biological weapon. After UN Security Council Resolution 1441 was passed on 8 November 2002, calling on Iraq to immediately disarm itself of all weapons of mass destruction (nuclear, biological, and chemical), and to allow UN and IAEA weapons inspectors to enter the country, the United States announced a policy of smallpox vaccination. Smallpox vaccinations were given to select groups of Americans, including 500,000 military personnel and 500,000 civilian health care workers. The vaccine given to this population was the same as that used to eradicate smallpox as of 1980. Once a new vaccine was to be manufactured and licensed, estimated in 2004, it would be made available free to Americans who want it.

Cholera

Numerous field and laboratory studies showed that the control measures were not sufficiently effective. The anticholera vaccines in use, when tested in controlled field trials, were shown to protect at most about half the persons vaccinated and for less than six months. Some vaccines provided no protection at all.

In view of these findings, WHO intensified its research activities in improving treatment and vaccines; it also worked to reinforce the ability of governments to face the problem of cholera within the framework of control programs directed against diarrheal diseases in general.

A simple and inexpensive oral-rehydration treatment, proven effective in the 1970s for all acute diarrhea, has made cholera treatment substantially easier. As most of the cases of El Tor vibrio cholera cannot be differentiated from other diarrheal diseases on clinical grounds, WHO has developed a comprehensive and expanded program for the control of all diarrheal diseases, including cholera.

Other communicable diseases

WHO continues to monitor and sponsor research on influenza, viral hepatitis, arthropod-borne viruses, yellow fever, Japanese encephalitus, bubonic plague, meningitis, Legionellosis, and streptococcal infections.

Diseases Transmissible Between Animals and Man (Zoonoses) and Related Problems

Since its inception, WHO has been developing veterinary public health programs in cooperation with its member states. In the 1970s, WHO’s veterinary public health program was reoriented toward more direct collaboration with member states in the development of national and intercountry programs in which zoonoses and food-borne disease control receive the highest priority. This action was justified because these diseases have become increasingly prevalent in many countries mainly as a result of the following factors: the greatly expanded international and national trade in live animals, animal products, and animal feedstuffs, which facilitates the spread of infection; the growth of urbanization, coupled with the increased numbers of domestic and half-wild animals living in close association with city populations, which exposes more people to zoonoses; and changing patterns of land use, such as irrigation, together with new systems of animal farming, which may lead to changes in the ecology that disseminate and increase animal reservoirs of zoonoses.

The 1978 World Health Assembly adopted a resolution on «prevention and control of zoonoses and food-borne diseases due to animal products» in which member states were invited to formulate and implement appropriate country-wide programs for the control of zoonoses; to strengthen cooperation between national veterinary and public health services in improving the surveillance, prevention, and control of these diseases; and to collaborate further in ensuring the appropriate development of zoonoses centers. The resolution also requested the director-general of WHO to continue development of national, regional, and global strategies and of methods for the surveillance, prevention, and control of zoonoses, and to promote the extension of the network of zoonoses centers in all regions so that the necessary support could be provided to country health programs dealing with these diseases.

WHO cooperates with member states in planning, implementing, and evaluating their national zoonoses and food-borne disease control programs. WHO centers, such as those in Athens (Mediterranean Zoonoses Control Center) and Buenos Aires (Pan American Zoonoses Control Center), play an increasing role in direct collaboration with countries and in organizing intercountry technical cooperation.

Global Epidemiological Surveillance

In the Weekly Epidemiological Record, WHO publishes notes on communicable diseases of international importance and information concerning the application of international health regulations. In the past, the publication was chiefly a summary of the weekly or daily notifications of diseases under the regulations, with declarations of infected areas or of freedom from infection when attained. It then became the vehicle for timely reports, narrative summaries, and interpretative comments on a variety of communicable disease topics. Annual, semiannual, or quarterly summaries are published on major trends in diseases and on special programs, such as those on malaria and AIDS. Data from special surveillance programs, such as the global influenza program, the European program for salmonella, and dengue-hemorrhagic fever surveillance, are summarized and published at appropriate intervals. The Weekly Epidemiological Record also communicates important changes in international health regulations and policies of member states.

Global Programme for Vaccines and Immunization

Immunization, one of the most powerful and cost-effective weapons of disease prevention, remains tragically underutilized. Preventable diseases such as neonatal tetanus and poliomyelitis, which have been virtually eliminated in most of the developed world, continue to take a heavy toll in developing countries. Measles, whooping cough, diphtheria, and tuberculosis are serious health threats to children in developing countries, causing blindness, deafness, and even death. In 1993, WHO reported that 8 million children were dying annually in developing countries from viral and bacterial illnesses, and 900 million were becoming severely ill.

The Expanded Programme on Immunization (EPI). In 1974, with the help of UNICEF, UNDP, national donor agencies, and voluntary agencies, WHO initiated the Expanded Programme on Immunization, with the goal of providing immunizations for all children of the world by 1990.

In 1974, it was estimated that immunization coverage in the developing world was less than 5%. By 1987, coverage of children in developing countries in their first year of life with one dose of BCG and measles vaccines and three doses of DPT and poliomyelitis vaccines was reported to be between 45% and 55%. That level of immunization coverage was preventing over 1 million deaths and almost 200,000 cases of paralytic poliomyelitis a year in the developing world. In its coordinating role, WHO gave priority to the managerial training of health workers and the development of cold-chain systems in order to provide for the establishment of vaccine delivery mechanisms capable of achieving high coverage of susceptible populations with vaccines known to be safe and effective. WHO estimated that in 1990 alone, immunization programs reached more than 100 million infants each year, and saved 3.2 million children annually from measles, neonatal tetanus and pertussis. However, approximately 2.1 million children were still dying each year from the preventable diseases included in the EPI. Little progress had been made in extending coverage to hard-to-reach populations, and coverage in Africa had even begun to decline.

By 1999 the Global Programme for Vaccines and Immunization became the Department of Vaccines and Biologicals. Based on World Health Assembly targets, three major objectives were defined for the department: (1) innovation, including facilitating the development of new vaccines, simplifying immunization, and accelerating the introduction of new or improved vaccines (pneumococcal, Hib, rotavirus, and hepatitis B vaccines were given top priority); (2) establishing immunization systems, including increasing coverage to 90%, strengthening the system for epidemiological surveillance, and assuring the safety of vaccines; and (3) accelerated disease control through the eradication of polio by 2000, reducing measles cases by 90%, eliminating neonatal tetanus, and eliminating vitamin-A deficiency.

In June 2002, the European Region of the WHO was certified «polio free.» That region included 870 million people living in 51 member states, stretching from Iceland to Tajikinstan, and including the Russian Federation.

On 20 November 2002, the State of the World’s Vaccines and Immunization report was launched, which highlights the importance of immunization as one of the most effective public health inititatives, and advocates for international support to speed progress for child health and disease control in developing and industrialized countries. The report examines the progress made in the field of immunization, and outlines the vaccines research agenda for the 21st century. It also offers policy options for promoting investment into immunization systems.

B. Prevention and Control of Noncommunicable Diseases

Cancer

Cancer, a noncommunicable disease, has been ranked as the second or third main cause of death globally among persons who survive the first five years of life. Contrary to the general belief that cancer occurs mainly in the industrialized world, it is estimated that more than half of all cancer patients today are in developing countries. By the year 2015, the annual figure is expected to reach 15 million cases, and by 2020, 20 million new cases. Some 70% of these are expected to occur in developing countries, which, as of the late-1990s, together had less than 5% of the resources for cancer control. Dramatic increases in life expectancy, combined with changes in lifestyles, were expected to lead to global epidemics of cancer and other chronic, non-communicable diseases. In 1997 alone, cancer claimed more than 6 million lives, or 12% of all deaths worldwide, and these figures continued to rise through the end of the decade.

Cancer Strategies for the New Millennium, an international conference, was convened in London in October 1998. It was attended by more than 100 professionals from 26 countries. At the event, WHO Cancer Programme chief Karol Sikora said action was needed from national governments working in close partnership with the private sector. WHO announced plans to work to reduce the global incidence of cancer by five million per year and reduce mortality by six million per year by 2020. «It’s imperative that the private sector play its part since resources have become over-stretched and the lives of millions of people are seriously at risk. Together, we can make a difference,» said Sikora. WHO Director-General Dr. Gro Harlem Brundtland added that these goals were attainable given new strategies that are aimed at an integrated approach to cancer prevention, early detection, curative treatment, and palliative care. At the core of these strategies is the «cancer priority ladder,» which provides internationally accepted priorities for developing effective national control program. The steps of the ladder include tobacco control, a curable cancer program, a healthy eating program, effective pain control, referral guidelines, clinical care guidelines, nurse education, a national cancer network, clinical evaluation, a clinical research program, a basic research program, and an international aid program. WHO said it would support such efforts by offering to its 191 member states a comprehensive program of expertise, channeled through national ministries of health and health departments.

The International Agency for Research on Cancer, located in Lyons, France, is associated with WHO and conducts research on identification of carcinogenic factors in the environment, as well as lifestyle factors in cancer development.

Cardiovascular Diseases

The MONICA Project. WHO coordinated the Monitoring of Trends and Determinants of Cardiovascular Diseases (MONICA) which was established in 1979 and became operational in 39 collaborating centers located in 26 countries in October 1984. The MONICA project was the largest collaborative epidemiological study of these diseases ever carried out. It followed 25 million people between 25 and 64 years of age over a 10-year period, collecting data on coronary deaths, non-fatal heart attacks, coronary risk factors, and coronary care. By 1993, the main results from the MONICA study were: cross-sectional comparisons of risk factor levels; relations between various risk factors; five-year trends in risk factors; acute coronary care; medical services; cross-sectional comparisons of incidence rates for stroke; and management of stroke around the world. Several optional studies are being carried out in connection with MONICA on nutrition, anti-oxidant vitamins, polyunsaturated fatty acids, physical activity and psychosocial studies, and drug monitoring.

Substance Abuse

Tobacco Use. Cigarette smoking is one of the principal preventable causes of premature mortality and ill health, particularly in industrialized countries but also in developing countries, where it is spreading. As of 2002, approximately 1.1 billion people in the world smoked, or 1 in 3 adults. According to WHO estimates in early 2000, there are 4 million deaths a year from tobacco, a figure expected to rise to about 10 million by the 2020s or early 2030s. By that date, based on smoking trends, tobacco was predicted to be the leading cause of disease burden in the world, causing about one in eight deaths. Seventy percent of those deaths were expected to occur in developing countries. Smoking has been shown to be linked with circulatory complications in women using oral contraceptives, cause lower body weight in newborns of smoking mothers, decrease male and female fertility, and be associated with cancers of organs other than the lungs. Passive smoking causes a higher frequency of upper respiratory tract infections in children exposed to tobacco smoke. In adults, it is associated with a significantly higher risk of lung cancer among exposed nonsmokers. Tobacco chewing causes cancer of the mouth.

Tobacco use is considered as a dependence disorder in WHO’s International Classification of Diseases. WHO has taken the lead in international action to stem the spread of smoking and its harmful health consequences. It collaborates with numerous national smoking and health associations around the world, as well as with nongovernmental organizations and other UN agencies. WHO collaborating reference centers assist in analyses of toxic components of cigarettes. Seminars and conferences muster scientific knowledge and political support.

In 1988, the World Health Assembly declared 31 May as a «World No Tobacco Day» to focus public attention and recognize contributions to healthy life-style free from tobacco use. In 1989 the WHA approved a plan of action on a program called «Tobacco or Health.» The program promoted national tobacco control programs; provided advocacy and information services; and acted as a clearinghouse for activities in the field.

To improve the global response to tobacco as an important health issue, in July 1998, WHO Director-General Dr. Gro Harlem Brundtland established the Tobacco Free Initiative (TFI). The long-term mission of global tobacco control is to reduce smoking prevalence and tobacco consumption in all countries and among all groups, thereby reducing the burden of disease caused by tobacco. In support of this mission, the stated goals of the TFI are to: strengthen global support for evidence-based tobacco control policies and actions; build new partnerships and reinforce existing partnerships for action; heighten awareness of the social, human and economic harm of tobacco in all sectors of society, and the need to take comprehensive actions at all levels; accelerate national, regional, and global strategic planning, implementation and evaluation; commission policy research to support rapid, sustained, and innovative actions; mobilize adequate resources to support action; integrate tobacco into the broader agenda of health and development; and facilitate the development of an effective Framework Convention for Tobacco Control and related protocols. In achieving these goals, WHO stated that TFI would build strong internal and external partnerships with each WHO cluster and regional and country offices, and with a range of organizations and institutions around the world. WHO has also been instrumental in heightening awareness of World No-Tobacco Day (May 31 each year).

Alcohol and Drug Abuse. WHO is the executing agency for the United Nations Fund for Drug Abuse Control. In collaboration with the International Narcotics Control Board and the United Nations Division of Narcotic Drugs, WHO has prepared guidelines on drug-abuse reporting systems that give special attention to data on health, to complement the law enforcement data that are traditionally gathered. In 1991, WHO held an Inter-regional Meeting on Alcohol-Related Problems in Tokyo, which recommended a number of actions to reduce alcohol dependence in member states. In the 1992/93 biennium, the Abuse Trends Linkage Alerting System (ATLAS) was set up to gather health-related data from a variety of sources in order to assist in mobilizing efforts to reduce demand for dependence-producing substances. In 1993, WHO supplied global data on substance abuse for the World Bank’s publication of World Development Report 1993: Investing in Health.

To better lead the fight against substance abuse, WHO established a Substance Abuse Department (SAB), which promoted the agency’s «health for all» concept by working to reduce the incidence and prevalence of substance abuse. In the 1990s SAB began developing programs, coordinating research, and working with existing health departments and other organizations to curtail demand for alcohol and drugs (psychoactive substances). SAB placed emphasis on intervention research on the effects of urbanization and drug abuse among young people; developing a global database of model program and best practices; strengthening country capacity to reduce alcohol abuse; and reducing HIV/AIDS-associated risks and consequences of substance abuse. In 2000, the Substance Abuse Department was merged with the Department of Mental Health (see «Mental Health» below) to form the Department of Mental Health and Substance Dependence.

C. Primary Healthcare and Health Building

Family Health

«Health for all» requires that special attention be paid to specific population groups whose health and welfare have profound social, demographic, and economic implications for society. The health of mothers and children is particularly important because of the special biological and psychosocial needs inherent in the rapid process of human growth, needs which must be met in order to ensure the survival and healthy development of the fetus and the child, as well as to maintain the health and development of the mother. The health of young people is also important, since the energy and idealism of youth are important resources that can be channeled to the benefit of their societies.

WHO assists governments in the application of preventive, curative, and rehabilitative measures aimed at promoting and protecting the health of women and children and at strengthening the role of all family members in health care and child rearing. WHO’s primary approaches are the following: (1) to identify the extent and nature of the major health needs of mothers, children, and young people; (2) to develop and adapt methods for the promotion of healthy behavior and the protection of women, children, and adolescents during vulnerable periods of rapid physiological and social changes, particularly relating to reproduction; (3) to provide technical guidance in the planning, management, and evaluation of preventive and curative programs of maternal and child health, including family planning; (4) to introduce and adapt training approaches for improving knowledge and skills in interpersonal and group communication and counseling, the health rationale for family planning, and innovative maternal and child health/family planning technologies; (5) to disseminate information on the health needs of women, children, and adolescents and on new ways of addressing those needs; (6) to identify and support research in basic clinical and applied aspects of pediatrics, adolescent medicine, gynecology and obstetrics, social psychology, and health systems; (7) to collaborate in the activities of national and international organizations concerned with maternal and child health/family planning and young people; and (8) to contribute to the development of intersectoral policies and programs.

In 1992, the World Health Assembly established the Global Commission for Women’s Health (GCWH). The commission is composed of eminent persons from different professional fields and acts as an advisory body to the Directory General, providing independent scientific and technical advice on policies and strategies relating to women’s health. The commission meets once a year.

At the commission’s fifth meeting, in February 1997, US First Lady Hillary Rodham Clinton joined the GCWH in setting out a comprehensive agenda on the issue of maternal morbidity: According to WHO, the annual global estimated toll is close to 600,000 deaths (one woman dying every minute of every day) and eight million cases of disability from pregnancy-related causes. The GCWH dedicated itself to future advocacy to ensure that the tragedy of women dying in childbirth was not ignored. The First Lady noted WHO’s progress in women’s health made since 1995’s Beijing World Conference on Women. The Platform for Action, adopted by the Beijing Conference, highlighted the need to ensure universal access to appropriate, affordable and quality health care and services for women and girls as one of the 12 critical areas of concern requiring urgent attention by governments and the international community.

The agenda for women’s health was furthered at the Beijing+5 conference, «Women 2000: Gender Equality, Development and Peace for the Twenty-first Century,» held June 2000 in New York City. Among the topics that were discussed at the forum were death during childbirth, HIV/AIDS and other sexually transmitted diseases, women in control of their own fertility, and malnutrition.

Reproductive Health

Nutrition

In addition to developing criteria and norms for assessing nutritional status, WHO strives to strengthen the capacities of countries to assess and evaluate their nutritional problems and associated factors and to develop and implement sectoral strategies to deal with the causes of those problems. Increasing the awareness of the world community of those problems for which solutions have been designed and tested has resulted in a significant increase in national programs to control iodine-deficiency disorders and vitamin A deficiency. At the same time, improvements in factors that have an influence on nutrition, such as disease prevention and management, food production, and education, have resulted in a decreased prevalence of undernutrition.

The International Conference on Nutrition, held in Rome in December 1992, was the culmination of more than two years’ joint effort by WHO and FAO to promote awareness of the extent and seriousness of nutritional and diet-related problems. The conference was attended by more than 1,300 people representing 159 governments and some 160 international and nongovernmental organizations. The conference adopted the World Declaration and Plan of Action for Nutrition which declared its determination to eliminate hunger and reduce all forms of malnutrition, and called on the United Nations to declare an International Decade of Food and Nutrition. The conference attendees estimated that 780 million people in developing countries do not have access to enough food to meet their daily needs. It reaffirmed the right of women and adolescent girls to adequate nutrition. The conference set ambitious goals of eliminating famine and famine-related deaths by the end of the decade and reducing starvation and widespread chronic hunger, especially among children, women, and the aged. It also called for the total elimination of inadequate sanitation and poor hygiene, including unsafe drinking water. Governments were urged to promote national plans of action based on the strategies developed at the conference and to allocate the financial and human resources needed to implement the necessary programs. In its report, the conference referred to the nutritional goals set by the Fourth United Nations Development Decade and the World Summit for Children.

In 1995, WHO reported that 31% of the world’s children under the age of five who live in developing countries were under-weight. A 1994 report urged member nations to implement the International Code of Marketing of Breast-milk Substitutes, adopted by the WHA in 1981, to protect women in developing world from being manipulated into feeding their infants breast-milk substitutes, a practice which had been shown to put infants at risk. A wide range of illnesses and nutrition-related disorders are prevented by breast-feeding children. WHO considers direct advertising of infant formula to mothers with infants in the first four to six months of life singularly inappropriate. The 1994 report stated that large sums were being spent misguidedly to provide breast-milk substitutes to the countries of Central and Eastern Europe within the context of food aid programs. The report noted that an adequate diet is more crucial in infancy than at any other time of life because infants have a high nutritional requirement in relation to body weight. Faulty nutrition during the first months has been proved to influence future health and development.

At the end of the century, WHO reported that overall progress in reducing protein-energy malnutrition among infants and young children was «exceedingly slow,» and that the year-2000 goal of a 50% reduction in 1990 prevalence levels would not be met. This projected goal aimed at reducing global malnutrition by only 14.3% (89.8 million) in malnourished children under 5 years of age. In the year 2000, WHO reported an estimated 26.7% of the world’s children under age 5 (149.6 million children) were still malnourished when measured in terms of weight for age. Nevertheless, this clearly represented significant progress when compared with the 31% who were underweight in 1995 and the 37.4% (accounting for 175.7 million children) who were malnourished in 1980. In 2002, 150 million children (26.7%) are underweight while 182 million (32.5%) are stunted. Geographically, more than 70% of children who suffer from protein malnourishment live in Asia, 26% in Africa and 4% in Latin America and the Caribbean.

Rehabilitation of the Disabled

Since the early 1950s, WHO has had a program for rehabilitation of the disabled. The program was initially set up to increase awareness of the problems faced by war veterans and to stimulate governments to provide increased services for this group.

The basic idea governing the program is that training for disabled people can be successfully given by family members, under the guidance and supervision of a local health worker. Referral services are needed for some 30%, mostly for short-term interventions. The program stresses the importance of involving the family and community in rehabilitation.

New plans concentrate on development of the personnel needed for providing community-based rehabilitation services at the community and district levels. The aim is to broaden the population coverage so that most people with disabilities will have access to at least the essential services.

Occupational Health

WHO’s Occupational Health Program has four main aims: (1) health protection of the underserved working populations who constitute the bulk of the economically productive persons in developing countries; (2) strengthening of general health services through the application of occupational health technologies and approaches; (3) workers’ participation in their health care delivery systems; and (4) development of occupational health science, technology, and practice.

The program incorporates identification and control of «work-related diseases,» recognition of neuro-behavioral changes from occupational exposure to health hazards, control of occupational impairment in reproductive functions and other delayed effects and of adverse occupational psychosocial hazards, and the application of ergonomics as a factor in health promotion. WHO cooperates with countries in the development of their institutional framework for the health care of working people. Special attention is given to occupational health concerns of employed women, children, the elderly, migrant workers, and other groups.

Environmental Health

Safe drinking water, proper community sanitation (sewage disposal systems), rural and urban development, and housing standards are among the priorities of WHO’s environmental health program. Many of WHO’s projects in this area are carried out in collaboration with other United Nations agencies, including UNICEF, the World Bank, UNDP, and FAO.

Beginning in 1986, WHO sponsored a series of international consultations on cost recovery in community water supply and sanitation. Its Guidelines for Drinking-water Quality have been applied in developing countries. WHO has studied the technical aspects of wastewater reuse in agriculture and collaborated with UNEP, the World Bank, and FAO in formulating guidelines and defining strategies for safe wastewater reuse in agriculture.

WHO is also concerned with prevention and control of environmental pollution, and has produced technical manuals on the disposal of hazardous waste. The WHO/ILO/UNEP International Programme on Chemical Safety (IPCS) was established in 1980. It provides information on the risks to human health and the environment of potentially toxic chemicals, and guidance in the safe use of chemicals. The IPCS was designated by UNCED as the nucleus for international cooperation on environmentally sound management of toxic chemicals.

WHO’s environmental health activities include risk assessment and research, which help provide evidence for legislators to formulate laws and standards. In this work, WHO collaborates with national health and environment authorities. WHO also supports analysis of the current environmental situation and trends to assist in the development of international initiatives to combat hazards that cross national boundaries.

Mental Health

In 2002 the WHO estimated that approximately 450 million people are affected by mental, neurological, or behavioral problems at any given time. The vast majority of these people are believed to suffer from depression, anxiety disorders, schizophrenia, dementia, and epilepsy. One-third may be affected by more than one neuropsychiatric ailment and three-quarters of those affected live in developing countries.

In the 1990s World Health Organization substantially expanded its investment in mental health; the Department of Mental Health represented one of its major arms for this purpose. The mission of the department was to mainstream mental health within the UN system and the health sector of its member states; to increase parity between physical and mental health, and between the rights of those affected by mental problems and those not affected; to design effective mental health policies promoting social cohesion; and to identify, disseminate, and implement cost-effective interventions.

In 2000, the Department of Mental Health was merged with the Substance Abuse Department to form the Department of Mental Health and Substance Dependence. With respect to mental health, the department has two broad objectives: closing the gap between what is needed and what is currently available to reduce the burden of mental disorders worldwide, and promoting mental health. The department leads the mhGAP (mental health Global Action Programme) focusing on forging strategic partnerships that will enhance countries’ capacity to address the stigma and burden of mental disorders and promote the mental wellbeing of populations. Over 100 centers around the world collaborate with the WHO in pursuing mental health objectives.

A number of international collaborative studies have been sponsored and coordinated by WHO. These have focused on the form and course of mental disorders in different cultures, the development of prevention and treatment methods, the operation of mental health services, and psychosocial aspects of health and health care. International exchange of information is fostered through publications, training courses, seminars, and networks of collaborating research and training centers in some 40 countries.

The mental health program also includes projects concerned with the development of standardized procedures, diagnostic classifications, and statistics necessary for an improved mental health information system and collaboration in mental health research, and a major program concerned with the prevention and treatment of alcohol and drug dependence.

In the late 1980s WHO launched an Initiative of Support to People Disabled by Mental Illness, intended to facilitate the dissemination of information about good practice in community services for people with chronic mental illnesses. The initiative seeks to reduce the disabling effects of chronic mental illness and highlight social and environmental barriers which hinder treatment and rehabilitation. The Initiative sought to involve the patient in decisions affecting his or her care. The prerequisites to that involvement were considered to be: the right to be empowered; the right to representation; the right to have access to one’s own medical records; the right to be free of stigmatizing labels.

In 1989, WHO began a major study to investigate the types and frequency of psychological problems in 14 countries. By 1992, it had screened 25,000 patients aged 18 to 65. The patients were classified in different categories according to the symptoms, and their progress was followed for a one-year period.

WHO considers the promotion of mental health—that is, the improvement of the position that mental health occupies in the scale of values of individuals, communities, and societies—as one of its fundamental tasks and as being essential for human development and the quality of life.

D. Pharmaceuticals

Pharmaceutical Products in International Commerce

Since 1964, WHO has studied ways of ensuring that all drugs exported from a country comply with its domestic drug quality requirements. A Certification Scheme on the Quality of Pharmaceutical Products Moving in International Commerce was adopted by the World Health Assembly in 1969, and a revised version in 1975. According to the scheme, in which about 124 countries are participating, the health authorities of the exporting countries provide a certificate that the product is authorized for sale in the exporting country and that the plant in which the product is produced is subject to regular inspection to ensure that it conforms to good practices of manufacture and quality control as recommended by WHO. Also under the scheme, the importing country may request from the authorities of the exporting country additional information on the controls exercised on the product. In addition to the product certificate issued by the competent authority of the exporting country, batch certificates, stating that the quality of the batch complies with quality specifications and indicating the expiration date and storage conditions, may be issued either by the competent authority of the exporting country or by the manufacturer.

International Biological Standardization

Biological substances cannot be characterized entirely by physical or chemical means. Their activity can be controlled only by tests in which laboratory animals, microorganisms, cell cultures, or antigen-antibody reactions are used. Such assays use biological reference materials which have previously been determined, usually under the form of an international unitage system, by calibration against appropriate international reference materials.

Much work in this field was done under League of Nations auspices. By 1945, 34 international biological standards had been established for such substances as antibiotics, antibodies, antigens, blood products and related substances, and hormones. Since then, WHO has enlisted the collaboration of more than 100 laboratories to conduct international collaborative studies, and there are now more than 200 international standards available to national control authorities throughout the world.

The work on biological standardization has expanded considerably and comprises a number of additional activities, including the establishment of international reference reagents, mainly for the purpose of diagnosis and identification. Furthermore, in order for manufacturers and national control authorities to achieve the production of biological substances which are safe and potent, international requirements on production and control have been prepared and are published in the Technical Report Series, released each year by the WHO Expert Committee on Biological Standardization. Such requirements are kept up to date in the light of developing technology. By the end of 1999, 48 sets of international requirements had been published. In addition, guidelines have been published on such subjects as the setting up of biological standards, the testing of kits used for the assay of biological substances, and the use of interferon therapy.

A complete list of international standards and international reference reagents is published by WHO in Biological Substances.

Pharmaceutical Quality Control

International Pharmacopoeia. Attempts to establish internationally agreed-upon specifications for therapeutic agents have been made since the 1850s. By 1910, limited agreements were reached concerning certain potent drugs. Since 1951, WHO has published the International Pharmacopoeia, which provides internationally acceptable standards for the purity and potency of pharmaceutical products moving in international commerce that are available for adoption by member states in accordance with the WHO constitution and resolutions of the World Health Assembly.

The first edition, consisting of two volumes and a supplement, was issued between 1951 and 1959. The second edition was published in 1967; a supplement was added in 1971 and additional monographs in 1972. Work on the third edition, started in 1975, aims to accommodate the needs of developing countries by offering sound standards for the essential drugs. Four volumes were issued in 1979, 1981, 1988, and 1994, and as of December 2002, the fifth volume was in its final stages of preparation.

International Nonproprietary Names for Pharmaceutical Substances. Many pharmaceutical substances are known not only by their nonproprietary, generic, or scientific names but by various trade names as well. In order to identify each pharmaceutical substance by a unique, universally available nonproprietary name, WHO has set up a procedure to select international nonproprietary names for pharmaceutical substances. Such names are published regularly in the WHO Chronicle. By the end of 1987, over 5,400 names had been proposed and published in 48 lists. A ninth cumulative list was published in 1996, and includes over 6,500 names.

WHO Collaborating Center for Chemical Reference Substances. As a further service in the area of drug quality control, the WHO Collaborating Center for Chemical Reference Substances was established in Sweden, at the Apotekens Centrallaboratorium, in 1955. Its function is to collect, assay, and store international chemical reference substances and to make them available free to national and nonprofit laboratories and institutes and, for a nominal fee, to commercial firms. About 140 chemical reference substances needed for tests and assays described in the International Pharmacopoeia are available.

Good Practices in the Manufacture and Quality Control of Drugs. To assist member states with technical advice on adequate control processes in drug manufacture, the World Health Assembly, in 1969, recommended the requirements in a publication entitled Good Practices in the Manufacture and Quality Control of Drugs. A revised text was adopted in 1975 by the assembly. Today it is published in two volumes as Quality Assurance of Pharmaceuticals: A Compendium of Guidelines and Related Materials. The text contains requirements pertaining to personnel, premises, and equipment of manufacturing establishments and general hygienic and sanitation measures. Special requirements pertain to raw materials, manufacturing operations, and labeling and packaging of products. The organization and duties of a quality-control department and a quality-control laboratory are specified.

Essential Drugs. As early as 1975, the WHA had received reports of the experiences of a few countries who had adopted schemes of basic or essential drugs. The purpose was to help people in developing countries whose basic health needs could be met through the existing supply system by giving them access to the most necessary drugs. The WHA recommended that member states draw up national drug policies to ensure that the most essential drugs were available at a reasonable price, and to stimulate research and development to produce new drugs adapted to the real health requirements of developing countries. There was recognition that developing countries could not afford to waste scarce resources on drugs which either did not meet majority needs, or which were priced at a level which their societies could not afford.

In 1977, a WHO committee of experts met to determine how many drugs were really needed to ensure a reasonable level of healthcare for as many people as possible. It was determined that, in country after country, a surprisingly uniform picture of drug selection emerged. At the village health post or dispensary level, 10 to 15 drugs meet immediate needs. At the health center level, where the diagnostic and local facilities are better and the staff more highly trained, about 30 to 40 drugs will suffice for 80% to 90% of all complaints. District and provincial hospitals may need around 100 to 120 drugs, and the large referral and teaching hospitals the full range of 200 to 400. The committee’s first Model List of Essential Drugs appeared in 1977 and contained some 200 items. By 1994 the list numbered 270 drugs. All of the drugs and vaccines on the list were of proven safety and efficacy, and possessed well understood therapeutic qualities. Most were no longer protected by patent and could be produced in quantity at reasonable cost. The Model List is revised every two years in order to respond to evolving needs and pharmaceutical advances. The list is not meant to be definitive, but to serve as a guideline for each country to pick and choose from in order to adopt a list of essential drugs according to its own priorities. The 11th edition was published in 1999.

In 1981, WHO launched its Action Programme on Essential Drugs to help narrow the list of drugs that would be essential for small medical units in developing countries. This program assists countries in developing their own legislation and methods of financing comprehensive drug programs. It also assists them in implementing the quality control monitoring regimes mentioned above. The Action Programme also provides support for training personnel in the areas of drug management and rational use. It supports national and regional seminars at which hundreds of health staff from countries throughout the world receive practical training. In the area of research, the program encourages research aimed at filling gaps in existing knowledge about the best means of selecting, procuring, and distributing drugs. This research seeks to discover how providers make decisions on which drugs to prescribe, or how and why patients use—or fail to use—medicines. This research has direct bearing on the ways in which vital medicines can be made available and accessible to the greatest number of people. More than 100 countries have adapted the Model List to match their own patterns of disease and financial resources.

E. Research Promotion and Development

Through its advisory committees on medical research—one for each of the six WHO regions and one at the global level—WHO provides guidelines for research planning, execution, and implementation in health programs directly linked to national priorities. The committees also offer an appropriate forum for the discussion of national and regional experiences and for the detailed formulation of scientific and technological policies in the field of health. Research programs and activities are developed in close coordination with medical research councils or analogous bodies, with particular emphasis on the strengthening of managerial capacities at all levels.

WHO’s coordinating role in research calls for the development of a system for the exchange of scientific information and the enlistment of the collaboration of groups of scientists and research workers in various areas on solving key problems and developing methods for most effectively combining their efforts.

Over the years, more than 1200 institutions with the necessary expertise and facilities have been designated by WHO as «WHO Collaborating Centers.» WHO also designates expert advisory panels. Financial assistance is sometimes provided by WHO through technical services agreements, partially offsetting the much larger expenses borne by the centers themselves.

In order to increase the research potential of member countries, WHO has developed a program to train research workers. The duration of grants varies, but as far as possible, they are made sufficiently long to permit the candidate to gain an adequate knowledge of methods and techniques and, very often, to carry out, under supervision, a specific piece of research.

Communication among scientists is also promoted. A scientist from one country is enabled to visit scientists in other countries for a period of up to three months, thus facilitating personal contact and the exchange of ideas.

WHO promotes meetings, symposia, seminars, and training courses in special techniques, bringing together scientists from various parts of the world. Reports of such meetings are circulated, when appropriate, to the scientific community.

F. Health Personnel Development

WHO’s role in health personnel development is to collaborate with member states in their efforts to plan, train, deploy, and manage teams of health personnel made up of the numbers and types that are required (and that they can afford) and to help ensure that such personnel are socially responsible and possess appropriate technical, scientific, and management competence.

WHO is attempting to raise the political, economic, and social status of women as health care providers in the formal and informal health care system and in the community and to ensure that they receive the education, training, and orientation to enable them to expand the scope and improve the quality of the health care that they provide to themselves, each other, their families, and other members of the community.

Members of the World Health Organization
(as of 2002)

Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People’s Republic of
Korea, Republic of
Kuwait
Kyrgyz Republic
Lao People’s Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia (Federated States of)
Monaco
Mongolia
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Republic of Moldova
Romania
Russian Federation
Rwanda
St. Kitts and Nevis
St. Lucia
St. Vincent and the Grenadines
Samoa
San Marino
São Tomé and PríFncipe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovak Republic
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Tajikistan
Thailand
The Former Yugoslav
Republic of Macedonia
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United Republic of Tanzania
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Yemen
Yugoslavia
Zambia
Zimbabwe
ASSOCIATE MEMBERS
Puerto Rico
Tokelau

Promotion of community-oriented educational programs with team and problem-based methods of teaching/learning is another approach. The programs are designed to prepare personnel to perform tasks directly related to identified service requirements of specific concern to the country. Appropriate teaching and learning materials, including those for self-teaching and audiovisual purposes, adapted to different cultures and languages, are promoted for all categories of health personnel.

Fellowships occupy an important place in WHO’s program as one of the ways to provide opportunities for training and study in health matters which are not available in the fellow’s own country and for the international exchange of scientific knowledge and techniques relating to health. WHO encourages the nomination, selection, and evaluation of fellows based on and determined by a member state’s personnel development policy, in line with its national policy for health development, so that fellowships can contribute to the training of the type and amount of personnel needed to achieve the global target of «health for all.» WHO awards fellowships preferably to candidates who will be directly involved in primary health care programs.

In many countries, however, the problem is no longer one of shortage of health professionals, but rather of establishing or maintaining the right balance between them to ensure that the necessary knowledge and skills are available. WHO is sponsoring studies to develop information systems and methods to help countries achieve this balance.

Nursing. The WHA, in 1992, recommended that each country develop a national action plan for nursing. A global advisory group on nursing and midwifery was established by the 45th WHA, and held its first meeting in 1992. It recommended that, as the largest group of health personnel in any country, nursing and midwifery be declared a priority area for WHO action. A WHO study group on nursing beyond the year 2000 convened in July 1993. It adopted the Nursing Declaration of Alma-Ata, which recognizes that a multiprofessional, multidisciplinary approach is needed to prepare healthcare providers to work in a rapidly changing environment. As a starting point, every health ministry was urged to establish a position of chief nurse, with appropriate staff and budget.

G. Public Information and Education for Health

To integrate health education and information for health, WHO established the Division of Public Information and Education for Health. Its major tasks, in close cooperation with all regions, are to work with governments in developing coordinated information/education programs aimed at promoting healthy behavior and increasing self-reliance among individuals and communities, and to work with technical units in planning, developing, and implementing an information/education component in their programs.

The need for promotion, advocacy, and greater public awareness of health issues is a recurring theme in virtually all WHO programs. WHO considers health education as the sum of activities that will encourage people who want to be healthy to know how to stay healthy, to do what they can individually and collectively to maintain health, and to seek help whenever it may be needed.

WHO has developed many computerized information resources over the years, including WHOLIS, the WHO library information system, which is available on diskette and on the Internet. WHODOC, a regular listing of new WHO publications and documents is also available on diskette and on the Internet. See United Nations Databases for a descriptive listing of WHO’s computerized databases.

H. Health Legislation

While WHO is aware of the importance of health and related legislation to the delivery of personal and environmental health services in countries, it has no mandate to propose model legislation. On the other hand, it recognizes member states’ need for relevant and timely information. WHO is mandated to maintain an awareness of all significant new laws and regulations in the field of health, and to disseminate information thereon as rapidly as possible. The main vehicle for information transfer is its International Digest of Health Legislation which is now issued only in an electronic form. A demand for information on HIV/AIDS legislation prompted WHO to develop a computerized database that covers relevant legislation as well as literature on the legal, ethical, and judicial aspects of AIDS. Data on other subjects, such as legislation to combat smoking, have also been computerized.

In February 1994, the First International Conference of Medical Parliamentarians was held in Bangkok, organized by the Asian Forum of Parliamentarians on Population Development and the International Medical Parliamentarians Organization in close cooperation with WHO. More than 80 medical parliamentarians from 33 countries attended the conference to discuss five specific areas: environmental health, population and development; narcotics drug abuse; organ transplantation; public health and development; and maternal and child health and AIDS. The conference adopted the Bangkok Declaration and Call for Action which set forth goals and priorities for the establishment of national legislation in the five subject areas.

The International Medical Parliamentarians Organization (IMPO) was admitted into official relations with WHO in 1995, joining the ranks of the numerous NGOs that have working relationships with WHO. In 1999, IMPO had individual members in more than 30 countries, including many developing nations.