2023: WHAT‘S IN THIS WHA?

Every year,?government representatives from around the world?congregate?at the World Health Assembly (WHA) to?discuss, negotiate and shape?the World Health Organization ’s agendas, strategies and responses to?some of the most pressing global health challenges the world is facing today.

This year’s World Health Assembly?couldn’t have taken place?at a?more?momentous time in history.?COVID-19 was officially?declared?no longer a “Public Health Emergency of International Concern” ?a scant?few?weeks ago.?Governments and stakeholders are negotiating?a new Pandemic Accord that will lay the?foundation for?emergency and?pandemic prevention, preparedness?and response.?And in September, world leaders will descend in the UN General Assembly in New York to take stock of the progress?on?Universal Health Coverage ?and the?Sustainable Development Goals , and renew their commitments.

The COVID-19 pandemic has had an unprecedented impact on populations across the globe,?reversing decades of progress ?in socio-economic development.?The most vulnerable and marginalised communities are not only often the first to be affected, but also the least capable of coping with and recovering from crises.

We must not return to the status quo.?If we are to achieve the ambition to “leave no one behind”, world leaders and the international community need to anchor our discussions?on the lessons learned from the global COVID-19 pandemic response, and ensure communities that have been left furthest behind have universal and equitable access to quality health services.

Consider the?Zero-Dose children .?These are the children who have not received?a single dose of any?basic vaccine. They are often found?clustered?in vulnerable and marginalised communities?facing multiple deprivations and inequity, including gender-related barriers, lack of?official identity,?or?living beyond the reach of existing public services such as healthcare, nutrition and education.?In 2021 alone,?there were?25 million?un- or under-vaccinated?children around the world ?– 6 million more than in 2019.

The COVID-19 pandemic?has?also?highlighted deep inequities between countries and populations for timely access to pandemic-related products, including vaccines, and?demonstrated that greater geographic diversity of vaccine manufacturing will be important as a readiness in future pandemics.

This is why Gavi, the Vaccine Alliance ?will be at the World Health Assembly this year to?advocate for five priorities.

First, to prioritise reaching?Zero-Dose children?and missed communities with routine immunisation services.

Routine immunisation is often delivered at the door-step of communities. As such it can serve as a useful platform to co-deliver other?primary health care?services closer to community and promote equity.?Reaching Zero-Dose children with routine immunisation would also mean?an entire service delivery infrastructure, the?supply chains, data systems and community engagement needed to deliver vaccines?is made available to?their?communities.?This would lay the?foundation?building their resilience and preparedness, enabling a cycle of better health outcomes and wellbeing.

Second, to leverage routine immunisation as a platform to build resilient?primary health care?systems, not only?as a cornerstone of?Universal Health Coverage,?but also?as a pathway to reach the most vulnerable communities.

Evidence?has?shown?that health services, in order to be equitable, need to be delivered in the community settings rather than only at fixed facilities, and a?strong, people-centered?PHC approach ?would be critical to address individual and family health needs and barriers to health by providing care?in?the community, and?through?the community.Routine immunisation today reaches 86% of children worldwide, more than any other health service, making it the ideal building block to?strengthen delivery of other primary health care services.

Third, to?support?participatory governance and a coordinated whole-of-society approach, especially by?including civil society and communities in?global health architecture reform as well as in national health strategies, for example on polio?eradication, transition and integration

This is because civil society organisations often have better understanding of the local?context and?help give agency to communities to design tailored interventions.?When empowered with knowledge, training, and material, they can initiate interventions that complement clinical responses to outbreaks and?support?governmental efforts.?In particular, health workers, including community health workers, play a vital role in reaching Zero-Dose children and engaging with communities in hard-to-reach settings. We must ensure they are appropriately?compensated and?are granted safe and decent work conditions with adequate protections including gender sensitive workplace policies that ensure equal pay and protect female health workers from sexual harassment and exploitation.

Fourth, to call for government support?to diversify?and expand?regional manufacturing capacity as a measure to increase vaccine supply security during pandemics, and expand access to other life-saving vaccines, at sustainable, affordable prices.

Experience from the pandemic have shown that, without?diversifying?manufacturing capability and capacity, rapid and equitable global access to life-saving vaccines can be compromised, leading to delays that put lives at risk.?By creating facilities?to increase global supply of vaccines against infectious diseases like measles, rubella, cholera and malaria, as well as other diseases for which no vaccines currently exist, we can?protect more people from deadly and debilitating diseases.

Fifth,?to?ensure?any dose donation mechanism for?pandemic prevention, preparedness and response?enables equitable distribution of pandemic-related vaccines.

Gavi firmly believes?donated?doses?must be?made available at the same time to all countries,?and?must be?safe, effective and have adequate shelf life to be practically deployable in a low-income or fragile settings.?Governments?therefore needs?to?ensure lead?agencies and mechanisms specialised on diagnostics, vaccines or treatment,?are?part of the benefit sharing system and play a key role on the distribution of medical countermeasures alongside WHO, to ensure we can leverage the hard won lessons learnt during the pandemic, and have?greater transparency with?the?many design aspects pre-agreed by all relevant stakeholders.

Failing to do so would?only?leave low-income economies and high-risk groups paying the highest price in the next pandemic.