LAHORE: The World Health Organization (WHO) has identified hepatitis, antibiotic resistance and unavailability of essential drugs as the emerging challenges South Asia in particular and the rest of the world in general may face in near future.
“It has particularly focused on the sorry state of health affairs in Pakistan due to disease burden, failure to achieve the required targets like eradication of polio, diphtheria and low coverage of the Expanded Programme on Immunization (EPI),” a senior official of the health department told Dawn.
He said the provision of standard drugs had been a major issue in the country after the Punjab Institute of Cardiology scam.
The WHO shared with Pakistan and other 191 member states fresh statistics about global impact of the hepatitis that continued to increase and some other diseases besides the magnitude of antibiotic resistance declaring it the “most emerging issue” of South Asia and the rest of the world.
The WHO at a meeting of its Executive Board had accorded approval to a number of recommendations to devise future strategies and meet the challenges. The recommendations were prepared on the basis of the draft resolutions submitted by many countries and subsequently approved in the 134th session of EB-2014 held in the last week of January.
The draft resolutions are to be put in the next sixty-seventh meeting of the World Health Assembly in coming May for final consideration. The WHO asked the member states to prepare themselves in accordance with the proposed draft and send their representatives to the Assembly with concrete strategies and policies to address the major health issues.
Some of the key recommendations on the health issues are: Combating antimicrobial resistance including antibiotic resistance, hepatitis, focusing on global vaccine action plan, monitoring the achievement of the MDG-related goals and health in the post-2015 development agenda. It has also highlighted the importance of traditional medicines, strengthening palliative care as a component of integrated treatment through the life course, health intervention and technology assessment and access to essential medicines.
The EB at its meeting showed major concern towards a threat posed by antimicrobial resistance that has emerged as a most important global health problem. A draft resolution in this regard was proposed in the meeting by Australia, China, Costa Rica, Ghana, Japan, Libya, Mexico, the Netherlands, Qatar, Sweden, Thailand, the UK, Northern Ireland and the USA. The EB accorded approval to this draft for adoption at the upcoming meeting.
According to the draft “access to effective antimicrobial drugs constitutes a prerequisite for most of modern medicines, and that hard-won gains in health and development, in particular those brought about through the health-related Millennium Development Goals, are at risk due to increasing resistance to antimicrobials.”
It said the health and economic consequences of antimicrobial resistance constituted a heavy and growing burden on high, middle- and low-income countries, requiring urgent action at the national, regional and global levels, particularly in view of the limited development of new antimicrobial agents.
The meeting stressed strengthening of the tripartite collaboration between the WHO, the FAO and the OIE for combating antimicrobial resistance in the spirit of the “One Health” approach.
Brazil, Columbia, Costa Rica, Egypt, Iran, Kuwait, Lebanon, Libya, Republic of Moldova, Oman, Qatar, Saudi Arabia, South Africa and Tunisia proposed a draft resolution on the hepatitis at the EB meeting. These countries showed concern that currently the global hepatitis B vaccine coverage for infants was estimated at 75pc and was therefore below the 90pc global target.
“The viral hepatitis is now responsible for 1.4 million deaths every year (compared to 1.5 million deaths from HIV/AIDS and 1.2 million deaths from each of malaria and TB). Around 500 million people are currently living with viral hepatitis and some 2 billion have been infected with hepatitis B virus (HBV).
“Most people with chronic hepatitis B or C are unaware of their infection and are at serious risk of developing cirrhosis or liver cancer, contributing to global increases in both these chronic diseases,” the draft said.
It shared that millions of acute infections with hepatitis A virus (HAV) and hepatitis E virus (HEV) occurred annually and resulted in tens of thousands of deaths almost exclusively in lower- and middle-income countries.
“While hepatitis C is not preventable by vaccination, current treatment regimens offer high cure rates which are expected to further improve with upcoming new treatments; and that while hepatitis B is preventable with a safe and effective vaccine, there are 240 million people living with HBV infection and available effective therapies could prevent cirrhosis and liver cancer among many of those infected,” it said.
In Asia and Africa, it noted, hepatitis A and E continued to cause major outbreaks while a safe effective hepatitis A vaccine had been available for nearly two decades and that hepatitis E vaccine candidates had been developed but not yet certified by the WHO.
“The injection overuse and unsafe practices account for a substantial burden of death and disability worldwide, with an estimated 2 million HBV and 500,000 hepatitis C virus (HCV) infections in 2010,” the draft said.
It requested the WHO director general to provide the necessary technical support to enable countries to develop robust national viral hepatitis prevention, diagnosis and treatment strategies with time-bound goals; to develop specific guidelines on adequate, effective, affordable algorithms for diagnosis in developing countries; and in consultation with Member States, to develop a system for regular monitoring and reporting on the progress in viral hepatitis prevention, diagnosis and treatment.
As for access to essential medicines, China, Libya, Republic of Korea and South Africa presented a draft resolution at the EB session, underlining challenges of worldwide shortage of essential medicines, greater access to and availability, affordability and rational use of safe, effective and quality-assured essential medicines.
It requested the WHO director general to urge member states to recognise the importance of effective national medicine policies, and their implementation under good governance, in order to ensure equity of access to affordable, safe, effective and quality-assured essential medicines and their rational use in practice.
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