As I queued in the rain to get through security I pondered life in a non-governmental organisation (NGO) rather than a Ministry of Health. It rarely makes the headlines in the press but every year the World Health Organization (WHO) has its general assembly in Geneva. It brings together government delegations from member countries from across the world to debate key health issues and set the strategic direction for the organisation. It’s also a honey pot for NGOs and lobbyists of various forms. Previously I have attended as part of the UK delegation, but this year I am attending this, the 65th World Health Assembly, on behalf of the World Federation of Public Health Organisations. Country delegates are exempt security checks but people from NGOs, and the press, have to queue to go through scanners as in an airport. The segregation also means, among other indignities, that one can’t walk into the main meeting rooms by the main doors, but have to enter the room by an anonymous back door. No wonder NGOs are critical of WHO and the role they are allocated. more…

As country delegations prepare for the 65th session of the World Health Assembly next week, the reform of the institution itself is only one topic on a list of 20 agenda items and 52 sub-items to be considered by the organisation’s governing bodies.

Setting priorities and fully funding those priorities has been a challenge for the organization; WHO currently runs 213 projects directed by eight organisational divisions and 15 regional and special offices.  In the context of limited resources with no explicit criteria to prioritize budgetary allocations, and no checks on new resolutions and declarations, underfunded and inadequately staffed “priorities” have multiplied, leading to a widening gap between the organization’s aspirational rhetoric and its capacity to deliver concrete results. more…

On Friday 4 May 2012 “Strengthening the Global R&D System: Innovation for Health Needs in Developing Countries” took place in Geneva.

The keynote address, ”Investing in Global Public Goods” was given by Joseph E Stiglitz, recipient of the Nobel Memorial Prize in Economic Sciences (2001) and professor at Columbia University. more…

Last week I enjoyed myself facilitating a lunchtime meeting of 90 health ministers at a meeting in Moscow on non-communicable disease. The meeting, like all global meetings, was something of a trial—see previous blog—but the lunch was fun.

I wasn’t clear exactly who was there, but the meeting included ministers from China, India, Russia, US, Kenya, Uganda, Egypt, Greece, Chile, and Britain—so much of the world’s population was represented. Margaret Chan, director general of WHO, was also there—so the whole world was represented in some way. more…

Some one billion people have no access to health care, while each year 150 million experience financial catastrophe and 100 million are pushed into poverty because of having to pay for health care. Those are some of the reasons why the world needs universal health coverage, said David Evans from WHO at the 13th Annual Scientific Conference of ICDDR,B (International Centre for Diarrhoeal Disease, Bangladesh) in Dhaka.

Evans was the main author of the World Health Report 2010, which discusses how universal coverage might be achieved. Universal health coverage has been part of the constitution of WHO since it was founded in 1948, but, said Evans, we are “a long way off globally.” more…

Carl Heneghan

The last few days has been hectic since the publication of our systematic review in the BMJ on the use of  antivirals in children.  By now, you are probably aware of the findings given the media interest. Basically, our study raised questions about the usefulness of antiviral flu drugs in preventing and treating flu in children, indicating the harmful effects may not be justified by the limited benefits provided. This puts us in direct conflict with the DOH policy of antivirals for all. I think what is important in the present pandemic is to remember how we spent a number of years preventing a similar strategy with the use of antibiotics in sore throat; especially when the published research showed limited benefits in mild disease and the emergence of resistance became a real issue.    more…

Calm settled over swine flu coverage this week as the northern hemisphere headed into the summer holidays; but much remains uncertain.

Stories tracking the Health Protection Agency’s weekly flu figures fell from the front pages. But based on the agency’s numbers, the press report that cases, consultations, admissions and deaths from swine flu are far lower in the UK this week than last – as predicted for the summer. more…

The spread of A/H1N1 flu has propelled Margaret Chan, director general of the World Health Organization, into the limelight. On 11 June she was on television and radio programmes across the world, declaring that “the world is now at the start of the 2009 influenza pandemic” and that “further spread is considered inevitable”  more…

Democracy means involvement in decision making but it may not always lead to the best outcomes. With this simple analogy, Gerd Gigerenzer (Berlin), captured the potential hazards of clinical shared decision making in his keynote address to the 5th International Shared Decision Making Conference in Boston (June 14-17). more…

In my work with Médecins Sans Frontières I constantly face dilemmas when trying to decide whether a patient has tuberculosis or not. In the countries where we work, diagnosis for tuberculosis still relies on the use of sputum microscopy, a test developed over 100 years ago, that will detect only 45-65% of cases when performed well. In children or people living with HIV the performance of the test is even worse. more…