Live from the World Health Assembly: "World Health +SocialGood" of 22 May 2018

Live from the World Health Assembly: "World Health +SocialGood" of 22 May 2018

hello and welcome to world Health Plus social good I'm bismillah Gupta Smith and we're coming to you live from the 71st world health assembly here in Geneva Switzerland thank you for joining us here we are at the heart of the assembly and the top leaders from a hundred and ninety four countries are gathered in the room behind me anytime that many top leaders global health leaders are gathered in a room you can be sure that top actors and experts in global health are also around and that's who we have lined up for you this week on our shows we want you to be part of the conversation you can send us your questions on Facebook or you can tweet it to us tweet your questions to us at whu-oh using the hashtag wOHA and hashtag social good susana Rosenblatt from UN foundation is going to ask your questions hi Susanna hello welcome it's already been a very busy week before the World Health Assembly started WH o director-general dr. Pedro's Gabriella's led an event called walk the talk here in Geneva you're seeing some images from that event now there was more than 4,000 participants from Geneva and all around the world this event was part of the recognition of the important of health and well-being as you can see as you can see people took part in many events yoga dance and all kinds of physical activities and once the fun ended on Sunday well once the fun was over on Sunday the were assembly started so those were some images of w-h-o celebrating Member States celebrating WH o 70th anniversary and one of the first things we heard was the speech by dr. Ted Rose and in his speech this is his first year this this was his first year so he gave a report back and update to the member states and also looked ahead at the direction that WH o will take the bluee chose director-general reported back to member states about the projects that's been made so far and one of the most important goals of w-h-o is to ensure that people have access to quality health services and act not just access that the services are affordable and this is we refer to it as universal health coverage you may have heard the acronym UHC mentioned several times let's take a listen to the director-general talking about USC in his speech I know from my own experience in politics that with buy-in from highest levels of n from highest levels anything is possible without it progress is difficult that's why I have made a priority of engaging with leaders all over the world to advocate for political action on health and especially on imbecile hell is coverage what I have discovered is that most leaders I talk to need little convincing we're living in a time of unprecedented political commitment for health I saw this very clearly during my first week in the job when I was invited to speak at the g20 meeting in Hamburg it's clear that the twin messages of all security and in Versailles coverage resonate loudly with world leaders at the Executive Board meeting in January I issued a call to all countries to commit to three concrete steps toward this inverse al Hellas coverage several have already started rising to the challenge there you heard the director-general asking countries to commit to universal health coverage this is the concept of ensuring that affordable quality health services are available to people without them going into financial hardships we want to unpack this concept of universal health coverage a little more and to do that here with me is dr. now Kuya mimoto assistant director-general for universal health coverage and health systems here in w-h-o and with you dr. James Fitzgerald director of health systems and services for WH o–'s America regions welcome to both of you good afternoon I'm gonna start with you dr. Yamamoto because I know you have very little time you're gonna are we going to be losing you soon explain to us in simple terms what is universal health coverage what is it and what it isn't Universal hers cabarets is a social system the supports of people be healthy to support the people enjoy their hair C Drive and develop their own potentials their universal health coverage they also provide medical services and the care if he or she be sick or injured without hardship of the financial hardship so the universal health coverage is the system that make the people not not how to decide this already this is the social system and the universal health coverage is not a disease specific program and also it's not like a help order specific or limited people it's a whole oh and also universal health Cabrera is not mean that everything is free so I think so what are some of the challenges that countries are facing on the ground in implementing universal health coverage there are a couple challenges first by I should say universal health coverage is achievable it's a we could come up the universal news coverage in the reality but one of the biggest challenge is lack of resources especially for the human resources also the efficiency to use the resources and I should add another challenge is how to invest the Solidarity the over the society to help each other so I think the band they are durable a good example the over cameras are challenges dr. Yamamoto you have been part of the conversation about universal health coverage when it was being discussed even as part of the sustainable development goals as the global leaders were setting that goal in 2015 are you noticing a change in the mood in the commitment of people at the Assembly here differently I very strongly here does it change the couple years ago somebody doesn't know about you yet what is a UHG or somebody is suspicious that's achieved it but this time a during it establish a many leaders global readers not only the health ministers also the head of states Minister of Finance notable people believe and also committed that should be achieve so I think it I feel very strong movement and it's coming and so we have to keep this high level political commitment but at the same time we need to change their life over the people at the ground and not like a slogan or talking about UHC but we have to implement it labraccio hopefully and its brief to be a strong partner with the countries and people and the community people to achieve universal health coverage so doctor you ever wonder what do you think is causing this change what specifically are countries doing and committing to first of all as I say that strong political commitment but also the people we have a wonderful example of experience which has already he improves the health system and we share with them and many people understand how to work it so I think there is a commitment for the political about the commitment from the ground well it's coming so now we're the time that's a grand dr. Yamamoto I know you have a commitment of time and we have to live we'll be losing you now but thank you very much for sharing your time with us thank you very much for giving me this opportunity thank you now we we've heard this again and again that universal health coverage is not one size fits all if there are many it takes many shapes and sizes depending on health systems and many other factors I want to talk to you dr. Fitzgerald years many examples on the ground in the region that you work in share with us what are the approaches countries are taking to UHC well that's a great question you know in the Americas the whole question around universal health coverage came to us in 2014 and the the countries posed a question what is universal health coverage mean to health systems that are built on the principles of the right to highest attainable standard in health equity and solidarity and they really kind of went through a process whereby they looked at their health systems and they engaged in a dialogue across the 31 countries of the organization and they said okay what we need to really do is to make sure that we have universal access to health and within that concept universal health coverage that means expansion of health services are comprehensive from health promotion to Diagnostics to treatment to palliation developed based on primary health care it means increasing health financing particularly public health financing for primary health care elimination of out-of-pocket payments at particularly at the point of care and then really addressing the social determinants of health so that you know the health we can really make effective health for all within the concept of universal health explain social determinants of health to determine these are those factors that really impact the health condition of the individual it is like education it is like income level it is like living conditions healthy spaces all those external factors that impact the very essence of an individual and there are your health status right obviously access to health services is itself a social term so what are some of the challenges that you're seeing on the ground I think ad GI mimoto mentioned principally the two challenges you know I think that there is this political movement that is clear I think countries have clarity around how the models of organization the health system I think that's also good very much based on primary health care two main challenges we see constantly when we're working in health systems transformation in the Americas the availability of qualified Shumer resources for health we see a mismatch between what the education sector is producing and what the health system needs and the second is the progressive increase of public financing in health where we can progressively allocate more public finances to really reach those that are in each the vulnerable populations that we're all talking about here I want to stop there for a minute to take a question from Susanna from the audience Suzanna great thank you one question we're getting is we want to hear from from you all about some unit universal health coverage success stories around the world and what can we learn from nations who've been able to prioritize affordable and quality health care for all success stories yeah I think there are there actually many of them if we look at the more recent success success stories for example in large countries like Brazil that implemented the mais medicos program very much based on the family health program we're really expanding out into the I suppose more rural and underserved regions the family health program and resulting an increase of over 60 million people having access to to comprehensive health services based on primary health care or we see the examples that was well presented by the minister in Ecuador where he has a medical a barrio where the again the health teams go out and they reach half and they integrate the health services with an integrated network or in the Caribbean even in some of the health systems transformation processes that are being addressed through national health insurance reform where we begin to look at the comprehensiveness of the service offer of the whole population so irrespective of the income level of the countries there's always something we can do to make sure that we address the issue of universality and solidarity and equity so dr. Fitzgerald you touched upon it a little bit in earlier in this segment but tell us about regardless of what shape you Etsy takes some things that some key elements that must be part of you HC could you elaborate on that again right yeah I did touch a little bit on that for us we say that there are four critical elements that we really need to address as we as we move forward towards the achievement of universal health one a political commitment to expand comprehensive integrated health services based on primary health care and that is so important to to increase financing particularly public health financing with the progressive elimination of out-of-pocket expenditures at the point of care and optimizing cooling so that we can pool risk free to strengthen governance and stewardship of the health sector and not just within the health sector but within government as a whole and then for addressing the social determinants of health which we talked about already thank you very much dr. Fitzgerald for joining us today so you heard just now about UHC and this is mostly from the w-h-o perspective I want to now explore a little bit what does that look like on the ground and to do that we have with you Debra Tom's Debra you are the chief Nursing and Midwifery officer for the Commonwealth of Australia welcome tell us first of all explain a little bit to me what does the chief Nursing and Midwifery officer do thank you yes well the chief nursing of midwifery officer in my role in the Commonwealth Government is about providing advice to government from that nursing and midwifery perspective but also providing advice on how nurses and midwives can contribute to the achievement of various health policies so let's talk a little bit more about that what what do nurses and midwives bring to us see on the ground I think one of the things that nurses and midwives bring is an absolute understanding of how communities operate many nurses and midwives are embedded and live within these communities and they well understand the challenges that the various communities have and can build those relationships to bring about strategies and solutions for improvement right because they are in touch with communities so much right at one party touch I want to take an audience question before we go on thank you we also wanted to recognize that there are people tuned in to the broadcasts from all around the world right now Greece Colombia Malaysia Mexico the United States the Philippines India Somalia South Africa Italy and more so thank you to all those viewers one question is regarding the financial hardship imposed by healthcare cost more than a hundred million people are pushed into poverty each year due to healthcare costs so how can advancing universal health coverage help countries achieve other global goals you know help improve people's lives in other ways well I suppose I can speak more from my own experience whereby and I think as the previous speaker mentioned political will and financial commitment are important to bringing about those changes and you know in my own country the government we have a National Insurance Scheme and we have strategies to enable people to access health services at no cost particularly those that for example may be unemployed or have special needs and there are specific schemes and so I think it's looking at a range of opportunities to develop different strategies to perhaps meet the needs of different components of the population Deborah know access is a very important part of providing universal health coverage Australia has had universal health coverage in place for several years now long term how how have you overcome the access challenge of the access and remote areas well yes access can be a challenge in Australia from a geographical standpoint in particular given that most of our population lives on the coast coastline but we have smaller populations in very remote areas so we use a range of techniques obviously we have some small clinics where you will have doctors and nurses we will have other clinics where there will be nurses they are slid in even more remote communities we may have nurses who travel out by vehicle by Road and hold local clinics we also make great use of the Royal Flying Doctor Service so we fly people in to deliver clinics but also for emergency transport and treatment and increasingly we're seeing the use of technology whereby video technology enables perhaps a nurse with a patient to talk to a medical specialist who may be several thousand kilometres away but you can feel like you're all sitting in the room together so let's talk a little more about the role of technology innovation in delivering health look I think that we're perhaps only beginning to realize the potential that technology can bring but more and more through the use of things as I say like video technology but also the fact that you can take an ECG on someone and have that sent to us to it to someone to read it many thousands of miles of kilometers away x-rays can be taken and interpreted in another country and you you have almost instant feedback I think it enables us to really improve the services that we can provide to people who live in remote communities thank you very much Debra for joining us today so universal health coverage is part of our vision for the future but since we're also commemorating the 70th anniversary of w-h-o we'll spend the rest of the show looking back at some of the biggest public health achievements in the last 70 years let's take a look at public health then and now for seven decades the World Health Organization has been working to improve everyone's health whoever they are and wherever they live we have worked hand in hand with governments and a multitude of partners together we have made huge progress babies born 70 years ago lived an average of just 47 years whereas today they will live an average of 72 years that's 25 additional years of life seven decades ago one child in every five died before their fifth birthday today that figure has dropped to one in every 250 people would live in fear of infectious diseases with no known cure polio epidemics swept through community paralyzing millions of children in the past smallpox infected 50 million people every year now smallpox has been eradicated from the face of the earth in cases of polio have reduced by more than 99.9 percent but there is so much more we can do and we cannot afford to lose momentum more than half of the world's population is still missing out on essential health services non communicable diseases such as cancer diabetes and heart disease now account for 70% of all deaths and by 2030 climate change could cause an additional quarter of a million deaths annually in our interconnected world infectious disease outbreaks can spread more rapidly than ever before but together we have shown we can tackle the most complex global health challenges every month the World Health Organization screens 5,000 disease outbreak alerts and sends investigative teams into the field to track hundreds of potential threats more than 180 countries have signed up to her World Health Organization anti tobacco treaty covering at least 90% of the world's population and we are monitoring air pollution more than 4000 cities in 103 countries world health organization is committed to leading the global drive to promote health keep the world safe and protect the bone you saw many public health challenges that many public health achievements in the last 70 years and many challenges as we go ahead without a question though one of the most important public health achievements of the past seventy years was the eradication of smallpox it's the only disease that the world has wiped out now in the mid-60s outbreaks of smallpox were still occurring regularly in parts of Africa Asia and America and it took nearly 20 years but in 1980 a meeting at the World Health Assembly w-h-o announced that smallpox was eradicated smallpox was a devastating disease on average three out of ten people infected died those who survived were usually left with scars and sometimes very severe disfigurement because of the program's success there are very few of us who have seen a patient of smallpox of course one such person is sitting right here next to me mr. John wicked he spent 10 years in the bluee chose smallpox eradication program welcome mr. wicked very much so for our viewers this is quite a treat to have somebody to talk to somebody who was part of this eradication effort send us your questions we'll come to the Suzanna and she'll ask you a question from mr. wicked let me start with you though mr. wicked described to me what it was like during the eradication effort what was the what was the mood like if you could hold the mic a little closer to you please well the one word it describes it easily as a crusade you had to have believers in dedicate to that's interesting I've talked to I've had the privilege of talk to a few people who had who were part of that effort and those are the words we hear yes that's what it really was it was it was something that we were young to do it and it was just we worked really really hard it was amazing every day you had to invent something new it was one small episode I could tell you about as an example of solving problems within the structure of w-h-o making it work for you when I was in Bihar I was working running fleet of vehicles and we had a problem and that all the responsible for these vehicles there were ones we had bought and we'd given to some young doctors basically Indian doctors and what happened was they would be afraid to get the cars serviced so what we did we they would have come to Patna what I did we had a garage and it was looking after sorry what was it had the we had the the responsible officers we I make list of all the things they could have on the car to be repaired and with a price and so they could get their driver to say this is wrong but they were protected and they didn't have to worry about someone playing games and they were then we know many people coming in so since it was the first time we were eradicating a disease there were many challenges that you were facing on the ground you described to me that it was a very small team in WH er headquarters tell me about that well yes and we travelled into the field as well but the the chief of the the program of the unit doctor da Henderson spent a lot of time communicating with people he would bring it with personality to encourage people to do the work and so it wasn't the it was supervising helping people to run their own countries so right so it was a capitalist a catalyst to also work to to put people on the ground and and this was done together by the global public health community let me ask you what was it about smallpox that that that the experts decided this is a disease we can eradicate well you you've got the one can start with Jenner when he came up with a vaccination and then when we had vaccination there was still problem that even after 200 years we were still not eradicating the disease it was and we had the Russians in 1958 decided that they would give vaccine 80% of the population then we get rid of this not work out as saying and then ring vaccination was what was adopted that came in later on in closer to 1967 right when they had the intensified program and in West Africa I discovered when they were short of vaccine that they just vaccinated around the outbreak and isolated the cases in the house and then did we they got rid of the outbreaks just amazingly quickly and so this was the ring vaccination which was finding a case finding their contacts and forming concentric rings in that sense and vaccinating everybody around that's right anyone that was susceptible right anyone that was deemed susceptible tell me about this book mister wicked well this book it's called small and it's eradication this book tells you everything that you need to know about smallpox and it's comprehensive we had the problem with smallpox was that once it was eradicated we had to prove it was eradicated so people would stop vaccination and the and come up with the savings on the tune of billions of dollars so mister wicked tell me what was it like when it was announced that the disease was eradicated well there was in two stages we had the global Commission went and verified when they had some countries which were more susceptible to having been infected than others they would consider that maintaining surveillance would be adequate if to detect smallpox case if it had occurred within the past two years right and then this was all put together and that moment when at the World Health Assembly in 1980 it was declared that smallpox is eradicated what was that like that was like tearful it was really amazing I can just imagine and I can I can hear that in voices of vaccinators and I was voices of people like you who worked like warriors to eradicate that disease that's the right word I want to take a quick question from our audience Susanna got a question from Annie in Washington DC who wants to know why is it important to have a multilateral organization like the World Health Organization leading the charge against smallpox so the question the question is I know there's a lot of sound here the question is why is it important for a multilateral organization like WTO to have led this effort why why was that important that's important because the when when you're working in the country you have many different sectors and people that are interested in or not interested in a given program so what we had to do was get people together to cooperate and so and also use examples of where it's been successful replicate that in other countries well and coordinated across the globe right yes yes well thank you very much mr. wicket for sharing your time with us it was real slash assistant to meet Ian to talk to you thank you I want to close today's show with one of WH s most important roles that of protecting the world from the spread of disease outbreak and as you heard mr. wicket as well from the days of when we eradicated smallpox coordination with all countries to contain the spread of disease has always been a challenge but WH o does that everyday with member states with countries we detect outbreaks and we work to contain them and in this day and age of air travel and trade diseases traveled really fast sometimes in a matter of hours we'll talk more about that on Thursday show but I want to focus on one disease in 2003 SARS acute sudden acute respiratory syndrome was detected in Asia and the illness spread to more than two dozen countries before it was contained in the early days of that outbreak a whi infectious disease specialist by the name of dr. Carlo R Bonnie responded to a request from a hospital in Hanoi to assist with an investigation they thought that it was a case of acute of severe case of flu after examining the patient doctor our Bonnie's diagnosis was clear that this was an unknown contagious disease and he alerted the whu-oh headquarters shortly after that unfortunately doctor Urbani himself developed SARS and he died in March 2003 his prompt action helped contain the disease and triggered a global response which saved countless yesterday at the World Health Assembly doctor our Bonnie was honored and I had a the pleasure of sitting down with his son Luca our Bonnie to talk about him let's take a listen Luca tell me how old were you when your father died of SARS I was 8 and what do you remember about him how did he describe his work well he didn't speak too much with me about his board because I was young but I what I knew is that he was a doctor and he have to has to travel edit to travel a lot for his work and that's it I didn't know all all about his work only that he was a doctor or a simple doctor for me now your family moved with him to many duty stations for his work how was that childhood for you describe that for us and how did that influence your choices I loved my childhood because I I knew a lot of different culture different state different languages and these influences in my my in Fred's influence be because now I my desire is to work in my Italian context and forties I'm studying languages and I am studying languages your brother Tommaso also told us that he's working for a humanitarian agency in Iran is your choice of work influenced by your father's yes not by my father but by what I've done in my childhood where I believed where I knew different persons so you you spoke we learned that you spoke Khmer at very young age and how many languages do you speak now I speak Italian of course and Spanish French and English and I'm learning Russian also so look at what would you like the world to know about your father I would like that the world know how my father was doing his work like his he wasn't doing his work for only for money for fame or something else but it was helping other because it was the only thing he wanted to help people's with problems people's people with need someone's who help for them and your father was honored today here at the World Health Assembly the director-general said that your father dr. Carlo Urbani represents the essence of w-h-o what does that mean for your family we were very grateful to the WTO to remember him especially in front of all the states member that maybe they didn't know the story of my father but after today they know how my what my father did and this is a high hope will motivate all the person that we do this work to to do it better and for the other people for for the others for the for the people who need it thank you very much Luke especially for speaking in English with us you speak so many languages and I really thank you for your time to do that was Luca our Bonnie talking about his father dr. Carlo our Bonnie there are many others who lost their lives in the line of service to global public health and these people range from health workers frontline health workers and to people who work in global health at a regional and headquarters levels you also saw an image of dr. Mahmoud Vickery who was the Regional Director of WH AHS eastern Mediterranean region we lost him last year as well so as we close the show today we want to pay tribute to all these public health heroes and their families the world is truly a better place because of them and with that we want to end today's show we'll see you again tomorrow bye bye


  1. I am so glad that i am a Nurse and more fulfill that at this WHA nursing and midwifery has been more visible than ever before. We are making lot of progress. Hope West Africa Nurses will catch up with the trend!!

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