Health leaders at the seventieth session of the World Health Organization (WHO) Regional Committee for the Western Pacific today endorsed action plans to fight antimicrobial resistance (AMR) and further reduce smoking.
Fighting antimicrobial resistance
In response to the growing threat to health and development posed by infections that have become resistant to treatment, delegates today endorsed the Framework for Accelerating Action to Fight Antimicrobial Resistance in the Western Pacific Region. It sets out new ways to slow the emergence and spread of AMR and address its impact on health and economies in the Region. It guides countries on implementing sustained and forward-looking solutions, drawing on participation from all sectors of society.
Delegates recognized that efforts to combat AMR need to be stepped up, as so-called superbugs – bacteria, viruses, parasites and fungi that have become resistant to treatment – pose an ever-greater threat to the future. Without additional action, an estimated 10 million people are expected to die due to AMR by 2050, with some 4.5 million in the Asia Pacific. AMR threatens to reverse hard-fought gains in fighting tuberculosis, malaria, HIV and many common infections as well as broadly, the achievement of universal health coverage and the Sustainable Development Goals.
Reducing smoking in the Region
Tobacco industry interference is a major impediment to implementation of effective tobacco control measures. In recent years, the industry has attempted to rebrand itself as being committed to a so-called smoke-free future, through aggressive marketing and development of new products: heated tobacco products and electronic nicotine delivery systems, such as electronic cigarettes or “vaping” devices. These products, which have already addicted millions of people, threaten to reverse gains made against traditional tobacco products and derail progress towards achieving tobacco reduction goals. Tobacco smoking prevalence in the WHO Western Pacific Region fell from 29.9% in 2000 to 24.8% in 2015. However, with current tobacco control efforts, the projected decline is expected to fall short of the 2025 target.
Delegates today endorsed the Regional Action Plan for Tobacco Control in the Western Pacific (2020–2030). The resolution they adopted calls on WHO to support governments in: accelerating tobacco control measures set out in the WHO Framework Convention on Tobacco Control and its guidelines for implementation; prioritizing tobacco control in all relevant policies; applying a whole-of-government and whole-of-society approach; and preparing for emerging challenges in tobacco control, such as the concerning proliferation and use of electronic nicotine delivery systems and heated tobacco products – especially among young people.
The Regional Committee also took note of progress in the areas of infectious diseases, noncommunicable diseases including mental health, and newborn health.
Eliminating measles and rubella
Delegates noted that while several countries in the Region are making progress towards measles and rubella elimination, key challenges remain in ensuring the full population is protected by these lifesaving vaccines. A global and regional resurgence of measles is threatening progress towards elimination and causing preventable deaths and disability.
To date, only nine countries and areas in the Region have sustained measles elimination and five of these have also sustained rubella elimination. Elimination means there has been no prolonged local transmission of the virus for at least three years. But even in countries where measles has been eliminated, as long as the virus is circulating elsewhere, people who are not immunized remain at risk of infection from an imported case. This, in turn can lead to an outbreak or re-establishment of transmission.
In 2018, 23 countries in the Western Pacific reported national immunization coverage at or above 90% for the first dose of measles–rubella vaccine, 18 of which were above 95%. However, greater efforts are needed to reach every child. Because measles in particular is so infectious, it is capable of spreading and causing outbreaks among even small groups who are not fully protected. At least 95% of the population in all communities must be immunized with two doses of vaccine in order to prevent outbreaks.
Tackling HIV, viral hepatitis and sexually transmitted infections
Delegates welcomed progress in access to HIV treatment in the Region, which has grown from 34% in 2014 to 59% in 2018, with 1.11 million of an estimated 1.9 million people living with HIV on antiretroviral treatment. However, an estimated 120 000 additional people in the Region are still being infected with HIV each year, with a significant increase in new infections in the Philippines. Current HIV prevention efforts in the Region focus on key populations, such as men who have sex with men, people who inject drugs and sex workers. These efforts include the use of antiretrovirals as pre-exposure prophylaxis, community-based HIV testing and partner notification, and transitioning to newer and more effective drug regimens.
Hepatitis remains a key challenge for the Region, with an estimated 115 million people with chronic hepatitis B infection and 14 million with chronic hepatitis C infection. Currently, only 17% are diagnosed and a mere 3% are receiving treatment. Chronic hepatitis B and C are the most common causes of liver cirrhosis and liver cancer. Delegates welcomed progress, with 17 countries having developed or in the process of drafting national action plans. Delegates emphasized the need to overcome barriers to testing and treatment, since too few people are aware they are infected with hepatitis, or receive the medications to treat it. WHO will continue working with countries, experts and partners to develop a hepatitis regional action plan for 2021–2030.
Responding to rising rates of sexually transmitted infections (STIs) in some countries, delegates welcomed support from WHO to estimate the number of people infected, intensify surveillance and update treatment guidelines. Stigma, discrimination and inequitable access to services, particularly among key populations, still pose challenges in the Region for those with HIV, hepatitis and STIs.
Assessing progress on the strategy to end TB
Delegates reviewed progress in tuberculosis (TB) prevention and management. TB deaths declined 7% to 100 000 and infections dropped 3% to 1.8 million new cases in 2017 compared to 2015. The success rate for treating TB has remained high at more than 90% for the past several years, but 114 000 new TB infections in the Region in 2017 were multidrug-resistant and less than 20% of those cases began appropriate treatment.
Recent surveys indicate that a large proportion (30–70%) of patients and their families face catastrophic costs due to TB. The coverage of preventive TB treatment among high-risk groups, such as people living with HIV and children under 5 years of age who are in close contact with someone who has TB, has increased in the past few years, but remains low. Delegates recognized the need for faster progress in order to end TB by 2030. WHO will continue to work with countries, experts and partners to accelerate progress in the fight against TB.
Addressing noncommunicable diseases and improving mental health
Noncommunicable diseases (NCDs) such as heart disease, stroke, cancer and diabetes account for 86% of premature deaths in the Western Pacific Region. Depression is the single biggest cause of ill health and disability. Delegates recognized the efforts of WHO and Member States to combat the growing burden of NCDs. This includes work to strengthen NCD prevention and control in primary health care facilities, and boosting physical activity through healthy cities and health-promoting schools. As the Region is home to one third of the world’s smokers, particular attention has been given to tobacco control measures such as increased taxation, health warnings on packages and labels, and smoke-free laws. Efforts to address the double burden of malnutrition – undernutrition and overweight/obesity – were also highlighted, as was strengthening mental health services, including during and after disasters, as well as developing community-based dementia care services. The prevention and reduction of alcohol-related harm and the need to further intensify efforts to address mental illness were discussed.
Addressing NCDs and ageing is a key priority in For the Future: Towards the Healthiest and Safest Region—the vision for WHO’s work in the Region over the coming five years. It highlights the need to create environments that prevent NCDs, promote well-being, strengthen health systems and social services, and improve health sector support for better management of NCDs including mental health conditions, and healthy ageing.
Implementing action for healthy newborns
Delegates noted that since October 2016, the number of babies benefiting from WHO’s recommendations on Early Essential Newborn Care (EENC) has more than tripled. As of early 2019, EENC had been introduced in nearly 7000 health facilities across eight priority countries – Cambodia, China, the Lao People’s Democratic Republic, Mongolia, Papua New Guinea, the Philippines, Solomon Islands and Viet Nam. At least 80% of facilities providing childbirth services in Cambodia, the Philippines and Solomon Islands are implementing EENC.
Across the Region, more than 50 000 health professionals have been taught about routine childbirth and newborn care. Newborn care practices in those health facilities have improved significantly, with 87% of babies now receiving immediate skin-to-skin contact with their mother and 85% exclusively breastfed in their first days of life. While there is notable progress, challenges remain: countries must continue scaling up EENC, improving the quality of care, and ensuring babies born preterm, with low birthweight and by caesarean section, benefit from EENC.
The seventieth session of the Regional Committee will conclude tomorrow after discussions on climate change and environmental health and on the time and place of the seventy-first and seventy-second sessions of the Regional Committee.
Related links
Antimicrobial resistance
Tobacco control
Notes to editors
A livestream of the Regional Committee proceedings, official documents, fact sheets and videos on the issues to be discussed can be accessed here: www.who.int/westernpacific/about/governance/regional-committee/seventieth-session
Working with 194 Member States across six regions, WHO is the United Nations specialized agency responsible for public health. Each WHO region has its own regional committee—a governing body composed of ministers of health and senior officials from Member States. Each regional committee meets annually.
There are 37 countries and areas in the WHO Western Pacific Region: Australia, Brunei Darussalam, Cambodia, China, Cook Islands, Fiji, France (which has responsibility for French Polynesia, New Caledonia, and Wallis and Futuna), Hong Kong SAR (China), Japan, Kiribati, the Lao People’s Democratic Republic, Macao SAR (China), Malaysia, the Marshall Islands, Micronesia (Federated States of), Mongolia, Nauru, New Zealand, Niue, Palau, Papua New Guinea, the Philippines, the Republic of Korea, Samoa, Singapore, Solomon Islands, Tokelau, Tonga, Tuvalu, the United Kingdom of Great Britain and Northern Ireland (which has responsibility for Pitcairn Islands), the United States of America (which has responsibility for American Samoa, the Commonwealth of the Northern Mariana Islands, and Guam), Vanuatu, and Viet Nam.
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