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Executive summary The purpose of the research overseen by the WHO Advisory Committee on Variola Virus Research, as mandated by the World Health Assembly, (1) is to develop medical countermeasures [...]

Since 2018, a neurosurgery delegation has been actively engaged and consistently present at the World Health Assembly. Recognizing the growing impact of neurosurgical diseases, the neurosurgery delegation participated in the 76th World Health Assembly in May 2023, advocating for timely, safe, and affordable global neurosurgical care. The delegation focused on forging new collaborations, strengthening the World Health Organization-World Federation of Neurosurgical Societies official relations, and actively supporting resolutions that impact the neurosurgical patients. However, there is a long advocacy journey ahead to address unmet neurosurgical needs. Patient-centered advocacy is an inherent task of our profession and the essence of the Global Neurosurgery Bogota Declaration of 2016. The highlight of the 76th World Health Assembly was the adoption of the first neurosurgery-driven resolution calling for micronutrient fortification to prevent spina bifida and other micronutrient deficiencies. For the last 4 years, the Global Alliance for Prevention of Spina Bifida, a group spearheaded by neurosurgeons, advocated for spina bifida prevention. This Alliance collaborated with many stakeholders, notably, the Colombian government to promote the resolution: "Accelerating efforts for preventing micronutrient deficiencies and their consequences, including spina bifida and other neural tube defects, through safe and effective food fortification." This is a proud milestone for the neurosurgical profession. There are many strategies available for neurosurgeons, when working together with elected leaders, other stakeholders, and allied professionals, to implement initiatives that can prevent future cases of spina bifida and other neurological disorders and reduce the burden of neurosurgical disease. [ABSTRACT FROM AUTHOR]

In 2020, the World Health Assembly endorsed the Immunization Agenda 2030 (IA2030), the 2021-2030 global strategy for a world in which everyone, everywhere, at every age fully benefits from vaccines. This report reviews trends in WHO and United Nations Children's Fund (UNICEF) estimates of global, regional and national immunization coverage up to 2022 and documents progress in improving coverage to reduce the number of children who have not received the first dose of a diphtheria-tetanus-pertussis-containing vaccine (DTPcvl) (zero-dose children) worldwide by 50% and to increase coverage with 3 DTPcv doses (DTPcv3). Worldwide, coverage with [greater than or equal to]1 dose DTPcvl increased from 86% in 2021 to 89% in 2022, remaining below the 90% coverage achieved in 2019. Estimated DTPcv3 coverage increased from 81% in 2021 to 84% in 2022 but also remained below the 2019 coverage of 86%. Worldwide in 2022, 14.3 million children were not vaccinated with DTPcv1, a 21% decrease from 18.1 million in 2021 but an 11% increase from 12.9 million in 2019. Most children (84%) who did not receive DTPcv1 in 2022 lived in low- and lower-middle-income countries. Global immunization rates recovered from the reduced levels associated with the coronavirus disease 2019 (COVID-19) pandemic in 2022, but progress was unevenly distributed, especially in low-income countries. Urgent action is needed to provide incompletely vaccinated children with catch-up vaccinations that were missed during the pandemic, restore national vaccination coverage to pre-pandemic levels, strengthen immunization programmes to build resilience to future unforeseen public health events, and further improve coverage to protect children from vaccine-preventable diseases. En 2020, l'Assemblee mondiale de la Sante a approuve le Programme de vaccination a l'horizon 2030 (IA2030), la strategie mondiale 2021-2030 pour un monde oU chaque individu, oU qu'il se trouve et quel que soit son age, beneficie pleinement des vaccins. Ce rapport examine l'evolution des estimations de l'OMS et du Fonds des Nations Unies pour l'enfance (UNICEF) de la couverture vaccinale mondiale, regionale et nationale jusqu'en 2022 et documente les progres accomplis dans l'amelioration de la couverture vaccinale visant a reduire de 50% le nombre d'enfants qui n'ont pas recu la premiere dose du vaccin antidiphterique-antitetanique-anticoquelucheux (DTC1) (enfants dits <>) dans le monde et a augmenter la couverture vaccinale par la troisieme dose de DTC (DTC3). A l'echelle mondiale, la couverture vaccinale par [greater than or equal to]1 dose de DTC a augmente, passant de 86% en 2021 a 89% en 2022, mais reste inferieure a la couverture de 90% atteinte en 2019. La couverture estimee par la DTC3 a egalement augmente, passant de 81% en 2021 a 84% en 2022, mais demeure inferieure a la couverture de 86% en 2019. En 2022, dans le monde, 14,3 millions d'enfants n'ont pas recu la DTC1, un chiffre en baisse de 21% par rapport aux 18,1 millions d'enfants en 2021, mais en augmentation de 11% par rapport aux 12,9 millions d'enfants en 2019. La plupart des enfants (84%) qui n'ont pas recu la DTC1 en 2022 vivaient dans des pays a revenu faible ou intermediaire de la tranche inferieure. Les taux de vaccination ont progresse a l'echelle mondiale, apres un recul associe a la pandemie de maladie a coronavirus 2019 (COVID-19) en 2022, mais de maniere inegale, en particulier dans les pays a faible revenu. Il est urgent d'agir pour rattraper la vaccination des enfants incompletement vaccines parce qu'ils n'ont pas pu etre atteints lors de la pandemie, retablir la couverture vaccinale nationale aux niveaux d'avant la pandemie, renforcer les programmes de vaccination afin d'accroitre la resilience face a de futurs evenements de sante publique imprevus et ameliorer encore la couverture vaccinale pour proteger les enfants contre les maladies evitables par la vaccination., Introduction The Expanded Programme on Immunization was established by WHO in 1974 to ensure that every infant in the world receives vaccines against diphtheria, tetanus, pertussis, poliomyelitis, measles and tuberculosis. [...]

The importance of strong coordination for research on public health and social measures was highlighted at the Seventy-fourth World Health Assembly in 2021. This article describes efforts undertaken by the World Health Organization (WHO) to develop a global research agenda on the use of public health and social measures during health emergencies. This work includes a multistep process that started with a global technical consultation convened by WHO in September 2021. The consultation included experts from around the world and from a wide range of disciplines, such as public health, education, tourism, finance and social sciences, and aimed to identify research and implementation approaches based on lessons learnt during the coronavirus disease 2019 pandemic. To prepare for future epidemics and pandemics, it is essential to adopt a more robust, comparable and systematic research approach to public health and social measures. Such comprehensive approach will better inform agile, balanced and context-specific implementation decisions during future emergencies. This article describes the methods used to develop global research priorities for public health and social measures and the next steps needed. La soixante-quatorzieme Assemblee mondiale de la Sante en 2021 a souligne l'importance d'une coordination solide pour la recherche sur la sante publique et les mesures sociales. Le present article decrit les efforts entrepris par ('Organisation mondiale de la sante (OMS) pour elaborer un programme de recherche mondial sur l'utilisation des mesures de sante publique et des mesures sociales lors de situations d'urgence sanitaire. Ce travail comprend un processus en plusieurs etapes qui a commence par une consultation technique mondiale organisee par l'OMS en septembre 2021. La consultation a reuni des experts du monde entier issus d'un large eventail de disciplines telles que la sante publique, l'education, le tourisme, la finance et les sciences sociales. Elle visait a identifier des approches de recherche et de mise en reuvre fondees sur les enseignements tires de la pandemie de maladie a coronavirus de 2019. Pour se preparer aux futures epidemies et pandemies, il est essentiel d'adopter une approche de recherche plus solide, comparable et systematique en matiere de sante publique et de mesures sociales. Cette approche globale permettra de mieux eclairer les decisions de mise en reuvre agiles, equilibrees et adaptees au contexte lors des futures situations d'urgence. Le present article decrit les methodes appliquees pour definir les priorites mondiales de recherche en matiere de sante publique et de mesures sociales, ainsi que les prochaines etapes a franchir. En la 74.a Asamblea Mundial de la Salud, celebrada en 2021, se destaco la importancia de una solida coordinacion en la investigacion sobre salud publica y medidas sociales. Este articulo describe los esfuerzos que ha emprendido la Organizacion Mundial de la Salud (OMS) para desarrollar un programa mundial de investigacion sobre el uso de medidas sociales y de salud publica durante las emergencias sanitarias. Este trabajo incluye un proceso de varios pasos que comenzo con una consulta tecnica mundial que convoco la OMS en septiembre de 2021. La consulta incluyo a expertos de todo el mundo y de una gran variedad de disciplinas, como la salud publica, la educacion, el turismo, las finanzas y las ciencias sociales, y tuvo como objetivo identificar enfoques de investigacion y aplicacion basados en las lecciones aprendidas durante la pandemia de la enfermedad por coronavirus de 2019. Para prepararse ante futuras epidemias y pandemias, es esencial adoptar un enfoque de investigacion mas solido, comparable y sistematico en materia de salud publica y medidas sociales. Este enfoque integral informara mejor las decisiones de aplicacion agiles, equilibradas y adaptadas al contexto durante futuras emergencias. En este articulo se describen los metodos utilizados para elaborar las prioridades mundiales de investigacion sobre salud publica y medidas sociales, asi como los proximos pasos necesarios. [phrase omitted], Introduction Public health and social measures refer to non-pharmaceutical interventions implemented by individuals, communities and governments at all levels. Public health and social measures are a key strategy to offer [...]

The COVID-19 pandemic presented an unprecedented challenge for the World Health Organization (WHO) and international community. The outbreak and ongoing pandemic prompted States to reassess the efficacy of the International Health Regulations (IHR). In November 2021, the World Health Assembly (WHA) decided to develop a new agreement to increase international pandemic preparedness. This paper analyzes the current gaps in the IHR to present a pragmatic approach wherein the WHA would amend rather than replace the IHR. It starts by examining the purpose and history of the IHR, including past revisions. It then addresses the constitutional framework of the IHR, and legal authority granted to the WHO to enact global health agreements. The paper analyzes specific articles of the IHR and their purported objectives to provide context for the IHR's shortcomings. The paper argues that amendments are the pragmatic approach to strengthen the existing foundation laid down by the IHR. Specific amendments that prioritize improved detection and surveillance systems, greater multisectoral cooperation, and mitigation of resource scarcity will promote improved preparedness and prevent future outbreaks. The paper includes new language and substance for each proposed amendment that integrates with the existing IHR framework. [ABSTRACT FROM AUTHOR]

The projected WHO Pandemic Agreement, as currently under negotiation, will most likely contain a detailed prescription of a One Health approach (Art. 1(d) and Art. 5 of the INB negotiating text of 30 October 2023). This contribution examines the legal potential of a One Health approach for laws and policies towards animals raised, kept, and slaughtered for providing meat, milk, fur, and other body products for human consumption. My main argument will be that, taken seriously, the idea of One health defies a hierarchy between the health of humans, animals, and ecosystems. The inner logic of One Health is to exploit the positive feedback loops between safeguarding human, animal, and ecosystem health. This approach should modify the still prevailing unreflected and unchecked prioritisation of measures in favour of human health at the expense of and to the detriment of animal health and life. I will illustrate my claim with two policy examples.

Many stakeholders agree that the WHO has not been able to adequately address the political and social problems, global health emergencies triggered or exacerbated by epidemics and pandemics, malnutrition, and access to clean water in recent years. Against this backdrop, there is a widespread call for more equity and solidarity in the global health system. Most of the proposals concerning the reform of the WHO deal with the possible goals and outcomes of such a reform. However, it is just as important to consider how such a reform should be carried out so that the ambitious goals are not compromised by the implementation process itself.

The Seventy-seventh World Health Assembly (WHA77) passed amendments to the International health regulations (2005) (IHR) and committed to finalizing a global pandemic agreement within a year. The amendments focus on [...]

In 2020, the World Health Assembly endorsed the Immunization Agenda 2030 (IA2030), the 2021–2030 global strategy that envisions a world where everyone, everywhere, at every age, fully benefits from vaccines. This report reviews trends in World Health Organization and UNICEF immunization coverage estimates at global, regional, and national levels through 2022 and documents progress toward improving coverage with respect to the IA2030 strategy, which aims to reduce the number of children who have not received the first dose of a diphtheria-tetanus-pertussis–containing vaccine (DTPcv1) worldwide by 50% and to increase coverage with 3 diphtheria-tetanus-pertussis–containing vaccine doses (DTPcv3) to 90%. Worldwide, coverage ≥1 dose of DTPcv1 increased from 86% in 2021 to 89% in 2022 but remained below the 90% coverage achieved in 2019. Estimated DTPcv3 coverage increased from 81% in 2021 to 84% in 2022 but also remained below the 2019 coverage of 86%. Worldwide in 2022, 14.3 million children were not vaccinated with DTPcv1, a 21% decrease from 18.1 million in 2021, but an 11% increase from 12.9 million in 2019. Most children (84%) who did not receive DTPcv1 in 2022 lived in low- and lower-middle–income countries. COVID-19 pandemic–associated immunization recovery occurred in 2022 at the global level, but progress was unevenly distributed, especially among low-income countries. Urgent action is needed to provide incompletely vaccinated children with catch-up vaccinations that were missed during the pandemic, restore national vaccination coverage to prepandemic levels, strengthen immunization programs to build resiliency to withstand future unforeseen public health events, and further improve coverage to protect children from vaccine-preventable diseases. [ABSTRACT FROM AUTHOR]

In their latest ‘WHO transformation’ (which began in 2017), the WHO hired at least six consulting firms, praised by the Director-General as the ‘best firms in the world’. Despite their prominent role in WHO processes and reform efforts, there is a clear accountability gap in their role at WHO. Consultant engagement contributes to a trend towards informal governance and public-private collusions in an organization that looks less and less like a public authority.

Background: Spina bifida (SB) is a neural tube defect that affects more than 200,000 pregnancies globally. Folic acid fortification has been shown to be the most effective public health strategy to prevent SB. Patients with SB require surgical and non-surgical orthopaedic care to correct a variety of deformities associated with spina bifida. The benefits of SB prevention compared to its costs — including surgical expenses, healthcare burden, and psychosocial effects — make folic acid fortification necessary. Methods: We conducted a literature review to explore the role of orthopaedic surgery in the care of patients with SB and the role of folic acid fortification in SB prevention. Results: Orthopaedic surgery has a crucial role in spina bifida care with the goal to maximize a patient's functional status. The lifetime economic cost of SB through direct, indirect and educational costs is estimated to be greater than $600,000. Folic acid fortification has been shown to reduce the need for orthopaedic surgeries by decreasing the incidence of neural tube defects. This has been shown to have a high cost benefit ratio for countries. SB prevention leads to better psychosocial, economic and health outcomes for patients. Conclusion: Folic acid fortification has significant economic and health benefits by preventing SB and reducing the number of orthopaedic procedures necessary. We call on governments and healthcare organizations to support the World Health Assembly resolution for folic acid and micronutrient fortification in the prevention of neural tube defects.

The article reports on updates in the efforts by the World Health Assembly to eradicate poliomyelitis around the world under its Global Polio Eradication Initiative (GPEI) from January 2021 to March 2023. Also cited are the cases of wild poliovirus (WPV) observed in countries like Pakistan, Mozambique, and Afghanistan, and the possible outbreaks due to circulating vaccine-derived polioviruses (cVDPV).

In an era of globalisation, health issues, particularly the prevalence and severity of infectious diseases, have become a recurring issue. This article uses public health emergencies of international concern as case studies to explore the intergovernmental approach (including the World Health Organization) in diplomatically addressing health emergencies while simultaneously highlighting the interdependent nature of such emergencies. This study examines the efficacy oj intergovernmental approaches towards health outcomes as characterised by the overall incidence, infectivity, severity, and mortality of these global health emergencies. By using historical and scientific data and scholarly articles referencing these health emergencies, this article assesses the often realist approach that states pursue in their multilateral approach to controlling and mitigating global health emergencies. Keywords: diplomacy, global health diplomacy, globalisation, health emergencies, interdependence, public health emergencies of international concern, realism, vaccine diplomacy, vaccines, World Health Organization. A l'ere de la mondialisation, les questions de sante, en particulier la prevalence et la gravite des maladies infectieuses, sont devenues recurrentes. Cet article utilise les urgences de sante publique de portee internationale comme etudes de cas pour explorer l'approche intergouvernementale (y compris l'Organisation mondiale de la sante) dans le traitement diplomatique des urgences sanitaires tout en soulignant la nature interdependante de ces urgences. Cette etude examine l'efficacite des approches intergouvernementales sur les resultats sanitaires caracterises par l'incidence globale, l'infectiosite, la gravite et la mortalite de ces urgences sanitaires mondiales. A l'aide de donnees historiques et scientifiques et d'articles savants faisant reference a ces urgences sanitaires, cet article evalue l'approche souvent realiste que les Etats adoptent dans leur approche multilaterale du controle et de l'attenuation des urgences sanitaires mondiales. Mots-cles: diplomatie, diplomatie sanitaire mondiale, mondialisation, urgences sanitaires, interdependance, urgences sanitaires de portee internationale, realisme, diplomatie vaccinale, vaccins, Organisation mondiale de la sante. En la era de la globalizacion, los problemas de salud, en particular la prevalencia y la gravedad de las enfermedades infecciosas, se han convertido en un problema recurrente. Este articulo utiliza las emergencias de salud publica de importancia internacional como estudios de caso para explorar el enfoque intergubernamental (incluida la Organizacion Mundial de la Salud) a la hora de abordar diplomaticamente las emergencias de salud, destacando la naturaleza interdependiente de dichas emergencias. Este estudio examina la eficacia de los enfoques intergubernamentales frente a los resultados de salud caracterizados generalmente por la incidencia, la infectividad, la gravedad y la mortalidad de estas emergencias de la salud global. Mediante el uso de datos historicos y cientificos y articulos academicos que hacen referencia a estas emergencias de salud, este articulo evalua el enfoque a menudo realista que los Estados siguen en su enfoque multilateral para controlar y mitigar las emergencias de la salud global. Palabras clave: diplomacia, diplomacia de la salud global, globalizacion, emergencias de la salud, interdependencia, emergencias de salud publica de importancia internacional, realismo, diplomacia de las vacunas, vacunas, Organizacion Mundial de la Salud., INTRODUCTION Since its inception in 1948, the World Health Organization (WHO) has sought to be the pillar of diplomatic engagement between states in an area that reflects their interdependent vulnerability [...]