藥學四蔡侑霖
World Health Assembly of WHO
高雄醫學大學藥學系 藥學四蔡侑霖
今年很榮幸在海選中代表International Pharmaceutical Students' Federation
(IPSF)，也是以高雄醫學大學藥學系及台灣人身分前往WHA開會，而在期間我們不斷的線上開會寫了申明稿:Ensuring Universal Health Coverage (UHC) by Addressing the Global
Shortages of Accessible, Safe and Quality Medicines; Strengthening the Pharmacy
workforce and services; and, Optimizing protection of various populations from
vaccine-preventable diseases through the Global Vaccine Action Plan (GVAP)，這些都是只能在國際會議才會學到如何撰寫，除了這樣我們也把WHA所有的議題都寫成小小的summary 讓大家能快速閱讀快速進入狀況。
在WHA會議當中，每個人都有自己的任務及責任讓我們可以捍衛IPSF的權利，以及台灣的榮譽，本次也是以台灣的身分前往的，會議期間也遇到了不少衛福部的官員，也了解目前台灣衛生議題的想法，以及和各國的分享治療目前棘手的疾病的政策。
各國重視心理健康，除二位大會主席報告中強調外，並有「No health without mental health, the time to act
is now」等倡導的展示。同時也期盼持續有更多同胞以NGO名義參加WHA，提高國內對世界各國關注議題的了解，及加強國際能見度。也希望學校以及藥學系以後可以多支持這類的國際活動，不只能增加高雄
醫學大學的能見度，也可以讓台灣在國際能佔有一席的地位。
The World Health Assembly is the decision-making body of WHO. It is
attended by delegations from all WHO Member States and focuses on a specific
health agenda prepared by the Executive Board. The main functions of the World
Health Assembly are to determine the policies of the Organization, appoint the
Director-General, supervise financial policies, and review and approve the
proposed programme budget. The Health Assembly is held annually in Geneva,
Switzerland.
會議記錄
Antimicrobial resistance
Key facts
Antimicrobial resistance threatens the effective
prevention and treatment of an ever-increasing range of infections caused by
bacteria, parasites, viruses and fungi.
It is an increasingly serious threat to global
public health that requires action across all government sectors and society.
Antimicrobial resistance is present in all parts
of the world. New resistance mechanisms emerge and spread globally.
In 2012, WHO reported a gradual increase in
resistance to HIV drugs, albeit not reaching critical levels. Since then,
further increases in resistance to first-line treatment drugs were reported,
which might require using more expensive drugs in the near future.
In 2013, there were about 480 000 new cases of
multidrug-resistant tuberculosis (MDR-TB). Extensively drug-resistant
tuberculosis (XDR-TB) has been identified in 100 countries. MDR-TB requires
treatment courses that are much longer and less effective than those for
non-resistant TB.
In parts of the Greater Mekong subregion,
resistance to the best available treatment for falciparum malaria,
artemisinin-based combination therapies (ACTs), has been detected. Spread or
emergence of multidrug resistance, including resistance to ACTs, in other
regions could jeopardize important recent gains in control of the disease.
There are high proportions of antibiotic
resistance in bacteria that cause common infections (e.g. urinary tract
infections, pneumonia, bloodstream infections) in all regions of the world. A
high percentage of hospital-acquired infections are caused by highly resistant
bacteria such as methicillin-resistant Staphylococcus aureus(MRSA) or
multidrug-resistant Gram-negative bacteria.
Treatment failures due to resistance to treatments
of last resort for gonorrhoea (third-generation cephalosporins) have been
reported from 10 countries. Gonorrhoea may soon become untreatable as no
vaccines or new drugs are in development.
Patients with infections caused by drug-resistant
bacteria are generally at increased risk of worse clinical outcomes and death,
and consume more health-care resources than patients infected with the same
bacteria that are not resistant.
WHO's response
WHO is guiding the response to antimicrobial
resistance by:
bringing all stakeholders together to agree on and
work towards a coordinated response; strengthening national stewardship and
plans to tackle antimicrobial resistance; generating policy guidance and
providing technical support for Member States; actively encouraging innovation,
research and development.
WHO is already working closely with the World
Organisation for Animal Health (OIE) and the Food and Agriculture Organization
of the United Nations (FAO) to promote best practices to avoid the emergence
and spread of antibacterial resistance, including optimal use of antibiotics in
both humans and animals.
Cardiovascular diseases (CVDs)
KEY FACTS
CVDs are the number 1 cause of death globally:
more people die annually from CVDs than from any other cause.
An estimated 17.5 million people died from CVDs in
2012, representing 31% of all global deaths. Of these deaths, an estimated 7.4
million were due to coronary heart disease and 6.7 million were due to stroke .
Over three quarters of CVD deaths take place in
low- and middle-income countries. Out of the 16 million deaths under the age of
70 due to noncommunicable diseases, 82% are in low and middle income countries
and 37% are caused by CVDs.
Most cardiovascular diseases can be prevented by
addressing behavioural risk factors such as tobacco use, unhealthy diet and
obesity, physical inactivity and harmful use of alcohol using population-wide
strategies.
People with cardiovascular disease or who are at
high cardiovascular risk (due to the presence of one or more risk factors such
as hypertension, diabetes, hyperlipidaemia or already established disease) need
early detection and management using counselling and medicines, as appropriate.
WHO response
Under the leadership of the WHO, all Member States
( 194 countries) agreed in 2013 on global mechanisms to reduce the avoidable
NCD burden including a "Global action plan for the prevention and control
of NCDs 2013-2020". This plan aims to reduce the number of premature
deaths from NCDs by 25% by 2025 through nine voluntary global targets. Two of the
global targets directly focus on preventing and controlling CVDs
Dengue and severe dengue
Key facts
Dengue is a mosquito-borne viral infection.
The infection causes flu-like illness, and
occasionally develops into a potentially lethal complication called severe
dengue.
The global incidence of dengue has grown
dramatically in recent decades. About half of the world's population is now at
risk.
Dengue is found in tropical and sub-tropical
climates worldwide, mostly in urban and semi-urban areas.
Severe dengue is a leading cause of serious
illness and death among children in some Asian and Latin American countries.
There is no specific treatment for dengue/ severe
dengue, but early detection and access to proper medical care lowers fatality
rates below 1%.
Dengue prevention and control depends on effective
vector control measures.
A dengue vaccine has been licensed by several
National Regulatory Authorities for use in people 9-45 years of age living in
endemic settings.
WHO response
WHO responds to dengue in the following ways:
supports countries in the confirmation of
outbreaks through its collaborating network of laboratories; provides technical
support and guidance to countries for the effective management of dengue
outbreaks; supports countries to improve their reporting systems and capture the
true burden of the disease; provides training on clinical management, diagnosis
and vector control at the regional level with some of its collaborating
centres; formulates evidence-based strategies and policies; develops new tools,
including insecticide products and application technologies; gathers official
records of dengue and severe dengue from over 100 Member States; and publishes
guidelines and handbooks for case management, diagnosis, dengue prevention and
control for Member States.
Ebola virus disease
Key facts
Ebola virus disease (EVD), formerly known as Ebola
haemorrhagic fever, is a severe, often fatal illness in humans.
The virus is transmitted to people from wild
animals and spreads in the human population through human-to-human
transmission.
The average EVD case fatality rate is around 50%.
Case fatality rates have varied from 25% to 90% in past outbreaks.
The first EVD outbreaks occurred in remote
villages in Central Africa, near tropical rainforests, but the most recent
outbreak in West Africa has involved major urban as well as rural areas.
Community engagement is key to successfully
controlling outbreaks. Good outbreak control relies on applying a package of
interventions, namely case management, surveillance and contact tracing, a good
laboratory service, safe burials and social mobilisation.
Early supportive care with rehydration,
symptomatic treatment improves survival. There is as yet no licensed treatment
proven to neutralise the virus but a range of blood, immunological and drug
therapies are under development.
There are currently no licensed Ebola vaccines but
2 potential candidates are undergoing evaluation.
WHO response
WHO aims to prevent Ebola outbreaks by maintaining
surveillance for Ebola virus disease and supporting at-risk countries to
developed preparedness plans. The document provides overall guidance for
control of Ebola and Marburg virus outbreaks: Hepatitis B
Key facts
Hepatitis B is a viral infection that attacks the
liver and can cause both acute and chronic disease.
The virus is transmitted through contact with the
blood or other body fluids of an infected person.
An estimated 240 million people are chronically infected
with hepatitis B (defined as hepatitis B surface antigen positive for at least
6 months).
More than 780 000 people die every year due to
complications of hepatitis B, including cirrhosis and liver cancer1.
Hepatitis B is an important occupational hazard
for health workers.
However, it can be prevented by currently
available safe and effective vaccine.
WHO response
In March 2015, WHO launched its first
"Guidelines for the prevention, care and treatment of persons living with
chronic hepatitis B infection". The recommendations:
promote the use of simple, non-invasive diagnostic
tests to assess the stage of liver disease and eligibility for treatment; prioritize
treatment for those with most advanced liver disease and at greatest risk of
mortality; and recommend the preferred use of the nucleos(t)ide analogues with
a high barrier to drug resistance (tenofovir and entecavir, and entecavir in
children aged 2–11 years) for first- and second-line treatment.
These guidelines also recommend lifelong treatment
in those with cirrhosis; and regular monitoring for disease progression,
toxicity of drugs and early detection of liver cancer.
WHO is working in the following areas to prevent
and control viral hepatitis:
raising awareness, promoting partnerships; formulating
evidence-based policy and data for action; promoting prevention of transmission
through vaccination, safe injection practices and blood safety; and promoting
wider access to monitoring and screening, care and treatment services for
hepatitis B.
Obesity and overweight
Key facts
Worldwide obesity has more than doubled since
1980.
In 2014, more than 1.9 billion adults, 18 years
and older, were overweight. Of these over 600 million were obese. 39% of adults
aged 18 years and over were overweight in 2014, and 13% were obese. Most of the
world's population live in countries where overweight and obesity kills more
people than underweight. 42 million children under the age of 5 were overweight
or obese in 2013. Obesity is preventable.
WHO response
Adopted by the World Health Assembly in 2004, the
WHO Global Strategy on Diet, Physical Activity and Health describes the actions
needed to support healthy diets and regular physical activity. The Strategy
calls upon all stakeholders to take action at global, regional and local levels
to improve diets and physical activity patterns at the population level. The
Political Declaration of the High Level Meeting of the United Nations General Assembly
on the Prevention and Control of Noncommunicable Diseases of September 2011,
recognizes the critical importance of reducing unhealthy diet and physical
inactivity. The political declaration commits to advance the implementation of
the WHO Global Strategy on Diet, Physical Activity and Health, including, where
appropriate, through the introduction of policies and actions aimed at
promoting healthy diets and increasing physical activity in the entire
population.
WHO has developed the "Global Action Plan for
the prevention and control of noncommunicable diseases 2013-2020" which
aims to achieve the commitments of the UN Political Declaration on NCDs which
was endorsed by Heads of State and Government in September 2011. This Action
Plan aims to build on the WHO Framework Convention on Tobacco Control and the
WHO Global Strategy on Diet, Physical Activity and Health. The plan will
contribute to progress on 9 global NCD targets to be attained in 2025,
including a 25% relative reduction in premature mortality from NCDs by 2025 and
a halting of the global obesity rates to those of 2010.
To better inform and develop a comprehensive
response to childhood obesity in particular, WHO’s Director-General established
the high-level Commission on Ending Childhood Obesity (ECHO), which comprises
15 accomplished and eminent people from a variety of relevant backgrounds. The
Commission will review, build upon and address gaps in existing mandates and
strategies, raise awareness and build momentum for action to address childhood
obesity
Zika virus
Key facts
Zika virus disease is caused by a virus
transmitted primarily by Aedesmosquitoes.
People with Zika virus disease can have symptoms
that can include mild fever, skin rash, conjunctivitis, muscle and joint pain,
malaise or headache. These symptoms normally last for 2-7 days.
There is no specific treatment or vaccine
currently available.
The best form of prevention is protection against
mosquito bites.
The virus is known to circulate in Africa, the
Americas, Asia and the Pacific.
WHO response
WHO is supporting countries to control Zika virus
disease by taking actions outlined in the “Zika Strategic Response
Framework":
Define and prioritize research into Zika virus
disease by convening experts and partners.
Enhance surveillance of Zika virus and potential
complications.
Strengthen capacity in risk communication to help
countries meet their commitments under the International Health Regulations.
Provide training on clinical management, diagnosis
and vector control including through a number of WHO Collaborating Centres.
Strengthen the capacity of laboratories to detect
the virus.
Support health authorities to implement vector
control strategies aimed at reducing Aedes mosquito populations such as
providing larvicide to treat still water sites that cannot be treated in other
ways, such as cleaning, emptying, and covering them.
Prepare recommendations for clinical care and
follow-up of people with Zika virus, in collaboration with experts and other
health agencies.
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