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Against a backdrop of mounting global health challenges, the 72nd World Health Assembly (WHA) convened last week, with politicians, philanthropists, business executives, and civil society leaders all descending upon Geneva. GHTC was on the scene—attending side events, technical briefings, and following the official agenda. Here are our top four takeaways from this year’s assembly:1. Universal Health Coverage (UHC) dominates WHA.Considered the theme of this year’s WHA and a core component of the platform of the World Health Organization (WHO) Director-General, UHC was a ubiquitous topic in Geneva as stakeholders prepare for the United Nations (UN) High-Level Meeting on UHC in September. Multiple side events and briefings focused on the topic with discussions yielding numerous calls to action from bolstering the inclusion of low- and middle-income country (LMIC) voices, to investing in community health workers, to making primary health care the central pillar of UHC. During the official WHA sessions, there was also strong consensus around the importance of leaving no one behind, equity in health, and a people-centric approach to UHC. The hotly anticipated zero draft of the Political Declaration of the High-level Meeting on UHC was also released last week. The draft is meant to serve as a baseline for members states who will ultimately endorse a political declaration at the high-level meeting this fall and reflects some of the feedback that civil society provided during the consultative process. The document features some encouraging language on health research and development (R&D): calling for improved availability, access, and affordability of quality medicines, vaccines, diagnostics, and other health technologies, and it encourages incentives for R&D, including stronger public-private partnerships. The draft also underlines the importance of investment in new health technologies.While the R&D community can be heartened by these inclusions, there are notable omissions. There was no direct mention of specific diseases affecting vulnerable populations in LMICs and no specific request or direct call for increased investment in R&D for new health tools.2. Contentious access debate at WHA ends with compromise resolution on drug and health product price transparency.Advocates anticipated that the access to medicines issue would be the one of the most contentious topics at this year’s WHA. They were right.After long and arduous negotiations which delayed the access to medicines session by several days, member states adopted a compromise resolution at WHA urging greater transparency on drug prices. The resolution calls on members to “take appropriate measures to publicly share information on the net prices of health products.” The most contentious element of the initial draft, which urged disclosure of R&D costs, particularly for clinical trials, was ultimately amended to feature language emphasizing the purely voluntary nature of those disclosures. While the resolution was celebrated as a landmark by the WHO Director-General, many member states were unhappy with the process, with Germany, the United Kingdom, and the United States expressing their discontent with the approach and timing.3. Ebola crisis keeps emergency preparedness at the top of the agenda.The worsening Ebola crisis in the Democratic Republic of the Congo loomed large at WHA, as tributes to health workers were featured throughout the proceedings. There was a common refrain during the week about the need for improved coordination in emergency preparedness between global actors and local communities, with many delegates from the global south, including WHO Director-General Dr. Tedros himself, emphasizing the importance of building trust and integrating community health workers in the process. From an R&D perspective, many stakeholders called for strengthening in-country capacity, including laboratory and clinical trial capacity, as an integral pillar of developing effective countermeasures.To better support member states in improving preparedness, WHO set up a new division specifically for emergency preparedness, as part of its reform process earlier this year, which will work in tandem with its existing workstreams on emergency response. WHO also welcomed the appointment of a UN emergency Ebola response coordinator to facilitate interagency activities. 4. Follow-up meeting to the UN High-Level meeting on Tuberculosis (TB) shows promise with accountability as key.Several sessions at WHA focused on the follow-up to previous political commitments, including the declaration from the UN High-Level Meeting on TB. It was encouraging to hear the United States, several members of the European Union, and a few other member states call for additional R&D to combat TB and underscore the need to develop new drugs and vaccines, scale up diagnostic capabilities, and invest in innovative technologies.WHO also released a multisectoral accountability framework to accelerate progress to end the TB epidemic, which was previously requested in 2018 by the WHA and the UN General Assembly. Several countries, including the United States, endorsed the framework during the official session, and WHO is looking to facilitate its adaptation and use by member states and their partners at country, regional, and global levels throughout 2019. This year’s WHA cemented the need for new approaches, partnerships, and models in order to deliver on many of the promises that were made as part of the 2030 agenda. The next few months will see a continuation of advances on the UHC agenda, movement on WHO reform, and implementation of newly adopted resolution and political commitments.

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign-up now to receive our weekly R&D News Roundup email. World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus announced at the 72nd World Health Assembly that a WHO Foundation would be set up later this year. The foundation, which was first mentioned at the 144th Executive Board Meeting in January, aims to broaden the organization’s donor base and “enable us to generate funding from previously untapped sources,” said Dr. Tedros. Details about the proposed foundation’s structure, governance, operating model, and legal status are still being hashed out. According to WHO officials, the foundation would be totally independent of WHO—no longer requiring the approval of the World Health Assembly—but could potentially be linked by contract to WHO to help fundraise for the organization from the general public and high net worth individuals. WHO aims to raise US$14.1 billion between 2019-2023 to deliver on its triple-billion targets. On Wednesday, WHO officially declared Algeria and Argentina free of malaria. Algeria, the country where malaria was first discovered, is now the third African country—following Mauritius in 1973 and Morocco in 2010—to eliminate the disease, which kills more than 400,000 people annually. Argentina is the second country in the Americas, after Paraguay, in 45 years to eliminate the disease. Despite WHO declaring 38 countries malaria-free since 1955, progress against the disease has stalled as malaria-carrying mosquitoes have become resistant to certain drugs used to treat the disease and insecticides used in bednets that protect people from being bitten while sleeping. Researchers at McMaster University have developed an affordable, durable method of transporting temperature-sensitive vaccines to low-resource settings that is inspired by breath strips. The solution: mixing dried vaccines with two sugar powders used to create the dissolvable film structure of breath strips. By using this technique, vaccines can stay stable at temperatures up to 40 degrees Celsius for up to three months. This approach circumvents the need to maintain a “cold chain” during transport from supplier to patient—a task which poses logistical and financial challenges in the hot climates of developing countries where infectious disease threats are endemic. Water or saline can be added to dissolve the sugary combination, and the same reconstituted liquid can be used for injections or nasal sprays. The researchers have tested the approach in lab experiments, but not people, and are pursuing funding to refine and deploy the technology.

The following statement—from Global Health Council (GHC), supported by Global Health Technologies Coalition (GHTC), Infectious Diseases Society of America (IDSA), Management Sciences for Health (MSH), Partners In Health (PIH), and Elizabeth Glaser Pediatric AIDS Foundation (EGPAF)—was delivered at the 72nd World Health Assembly on agenda item 11.8: Follow-up to the high-level meetings of the United Nations General Assembly on health-related issues, ending tuberculosis.GHC supported by GHTC, IDSA, MSH, PIH and EGPAF applaud member states for adopting a strong political declaration at the UN High Level Meeting on TB. TB is the world's leading infectious killer, and if efforts to tackle TB continue at the current rate, 28 million people will die by 2030, at a global economic cost of USD $983BN. We call on the WHO and nations to deliver on the commitments of the HLM to diagnose and treat 40 million people by 2022, including 3.5 million children, and close the US$1.3BN funding gap for TB R&D annually.We urge WHO and funding partners to help countries roll out new treatment and prevention regimens, including rifamycin-based prevention regimens that cut therapy from 6 months to 3 and must be scaled up among people living with HIV and children. WHO and funding partners should promote pediatric treatment formulations, improved diagnostics, and child-focused case finding strategies such as community-based contact tracing and integration of TB care in MNCH services.Countries must invest in new medicines and technologies to treat multidrug-resistant TB, which drives increasing rates of antimicrobial resistance, and for rapid and equitable access to new medicines and technologies. Scale-up of new all-oral regimens to treat MDR-TB that are shorter, cheaper and better tolerated will ensure more people successfully complete treatment.We call for full implementation of the WHO Multisectoral Accountability Framework with global high-level review through a multisectoral panel chaired by an independent expert, supported by a secretariat and hosted by an existing organization. This panel should review whether targets set by countries match up with targets agreed to at the HLM.We urge countries to increase contributions to the Global Fund for the next replenishment cycle, as we won’t achieve the commitments of the HLM without greater resources.