WHO: Topic B Forum : World Health Organization Issue #02 : Topic B: Preparing for a Global Health Crisis Student Officer : Samantha Portillo Position: Chair of the United Nations World Health Organization Background Guide
Table of Contents: Introduction to Committee: 2 Topic Overview: 2 Preventing Humanity from a Global Health Crisis: 3 Ebola Outbreak Burden of Communicable diseases 4 Historical Analysis: 4 Tuberculosis (TB) Yellow Fever Smallpox HIV/Aids (2005-2012) 1918 Influenza Pandemic Ebola Virus in West Africa (EVD) Organization Involvement: 5 World Health Organization Un Agencies and Fund Involved United Nations third Sustainable Goal: Global Outbreak Alert and Response Network (GOARN) 6 International Coordination Group (ICG) on Vaccine Provision 6 Current Situation: 6 Countries that play an important role: 6 Possible Solution: 7 Focus Questions: 7 Definition of Key terms: 8 Bibliography: 8 1
Committee Introduction: World Health Organization (WHO) is an agency of the United Nations (UN). Founded on April 7th, 1948, and composed of 193 member-states with its headquarters in Geneva, Switzerland. WHO current objectives are: Raise awareness of illness, suffering and death and its impact on health as social and economic development; increase understanding that solutions exist; and generate a movement that stimulates collective responsibility and action. Responses from WHO are very familiar such as response to outbreaks, emergency assistance to people affected by disasters, or campaigns to protect world s children. Other works have a high profile for global health such as HIV/Aids, tuberculosis, and malaria. WHO is responsible for the World Health Report, the World Health Survey, and World Health Day. Topic Overview: With an increase in epidemics and widespread diseases, the World Health Organization must find a proper solution to prevent humanity from a global health crisis. Ebola by taking the lives of many humans made a call to the prevention of global health crisis. The world has been guided by epidemics and outbreaks that have caused the death of millions of people. Now it s our job to either take action and make solutions to help prevent human health crisis or we can stay vulnerable to the loss of lives and consequences affecting the economy. 2
Preventing Humanity from a Global Health Crisis : Throughout the years many countries has been affected by health outbreaks. Ebola, tuberculosis, yellow fever, smallpox, HIV/aids, Influenza Pandemic and many other epidemics has caused the death of millions of people. Epidemics go beyond death, they have serious socio-economic consequences. Including the closing of schools, markets, events, and travel restrictions. Tourism and international trade start to collapse. Epidemics cause people to fear being next to someone; people began to avoid crowded places. Disease of poverty: Poverty is an important obstacle in global efforts to prevent communicable disease outbreaks and epidemics. Low sanitary and hygiene standards, poor sanitation infrastructure and lack of access to potable water facilitates infection. The international community has made serious and important contributions to protect itself better and reduce its vulnerability. But, it isn t enough to be completely prepare ourselves for a future health crisis. The cause of this is the lack of preparedness of the organizations in charge to take action in the proper amount of time. That is why there were recommendations to strengthen the global health architecture under the leadership of WHO. WHO needs to strengthen its operational capacities: The lack of reliability in the data led to WHO and others underestimate the scale of the outbreak. For example, in 2014, 390 people in Guinea have been in contact with an Ebola and WHO only reported 67. WHO s emergency has a low budget because it depends on voluntary funding. WHO s sensitivity. The production of new vaccines, therapeutics and diagnostics have played an important role in responding to communicable disease crisis. Discoveries in medical research has decreased morbidity and mortality from diseases such as rabies, polio, and even smallpox. Only one-third of the investment in Research and Development is devoted for vaccines and diagnostics. Still, too little Research and Development has been devoted to address the numerous communicable diseases. The lack of preparedness can be seen because Ebola has been known for 40 years and since then there has been 20 outbreaks. Meaning that there is something that WHO and the other organizations are missing to prevent it. Ebola Outbreak The Ebola Outbreak was preventable but still left millions of people suffering and left wounds in communities such as Guinea, Sierra Leone, and Liberia. Facts and statistics show that WHO started to take action until 1,600 people had been infected. When the epidemic was recognized as a global threat, the Secretary-general ordered the first UN-health emergency mission. Still, it was enough. Because they lacked resources, inadequate financial resources, lack of effective response method, poor condition, and ineffective community engagement. The lack of preparedness caused the death of 11,316 people and 28,638 reported infections. With regards to the economy, it brought a $2.2 billion economic loss in the most affected countries. 3
Burden of Communicable diseases: In 1918, a pandemic of H1N1 influenza killed approximately 50 million people. This outbreak of influenza virus could spread globally within 60 days and kill 33 million people or more. Historical Analysis: Tuberculosis (TB): Tuberculosis has been taking the lives of many humans. This epidemic first reached in Europe and North America during the 17th and 18th centuries. It s a contagious infection the generally seeks for the lungs, spreading to other parts of the body, like the brain and spine. This disease is caused by Mycobacterium tuberculosis. Tuberculosis is spread through the air, when someone coughs, sneezes, laughs or talks. Current Situation, TB caused a leading death in the United States. Which was cured with antibiotics. Even though it s easy to cure, it takes at least 6 to 9 months. Yellow Fever: Yellow fever is transmitted by infected mosquitoes. Forty-seven countries in Africa and Central and South America were found with yellow fever. This disease will cause internal bleeding and liver failure by making your skin become yellow. WHO took over the situation in regions where the disease was prominent. More than 105 million people were vaccinated, resulting no more yellow fever reported in West Africa during 2015. Smallpox: Smallpox, arguably the most devastating disease, is a contagious disease caused by the variola virus. Eradicated worldwide by 1980, a disease transmitted from person to person. With symptoms such as fever, a headache, severe fatigue, severe back pain, and overall discomfort. Red spots start to appear on your face, hands, and on your whole body. HIV/Aids (2005-2012): Human immunodeficiency virus destroys white blood cells by harming your immune system. Acquired immunodeficiency syndrome, final HIV stage. HIV symptoms are swollen glands and flu-like symptoms (two-four weeks). There is no cure for the disease, but there are medicines to help fight the infection and lower the risk of being contagious. 1918 Influenza Pandemic: One of the most deadly outbreaks in history. Pandemic responsible for the death of 50 to 100 million people, even though it only lasted a year. Spread from people to people, from country to country, during the WWI. People experience symptoms such as excessive fluid in the lungs. Ebola Virus in West Africa (EVD): Ebola virus disease, severe and fatal illness in humans. WHO has the responsibility to determine when a country is declared free of Ebola virus transmission. In March 2014, West Africa experienced the largest outbreak of Ebola. Even though the transmission of Ebola in West Africa has been controlled, additional cases may occur. In 2016, Sierra Leone was declared free of Ebola after 42 days had passed since the last person had a negative test for the second time. 4
Organization Involvement: World Health Organization: WHO s objective is to have a healthier future for people all over the world. This organization tries to ensure the safety of the air we breathe and the water we drink.with offices in more than 150 countries. WHO is an organization that unites with various groups to fight and combat diseases, whether they are infectious or noncommunicable (cancer). Ministries of health provide assistance on prevention, treatment, and care services. WHO establishes International Health Regulations (IHR) by which each country must follow in order to identify disease outbreaks and stop the spread of the disease. In May 2014, the IHR was invited to participate in the Ebola Outbreak and Response. With the role of notification and related incentives, recommendations, and measures. WHO coordinates international outbreak response using resources from GOARN In 1948, WHO became responsible for the International Classification of Diseases in which you can include polio, tuberculosis, Malaria, Children s mortality, heart disease, cancer, etc. Outbreak analysis and mathematical modeling help respond to infectious disease outbreaks. By quantifying the risk to human health. Rapidly interpret the stages of an epidemic and predict future developments. Statistics 2016: - 303,000 women die because of pregnancy complications. - 5.9 million children die before they turn five years old. - 2 million people are infected with HIV. - 9.6 million TB cases. - 214 million malaria cases. - 3 million people die because of pollution. Un-Agencies and Fund Involved: WHO has the help of the General Assembly and the Economic and Social Council which are engaged with the global health crisis as well. The United Nations Population Fund supports the maternal, reproductive, and adolescent health; and the United Nations Children s Fund (UNICEF) help during epidemics with the rights to improve the rights of the child and food transport issues. The Office for the Coordination of Humanitarian Affairs (OCHA) provides basic necessities for those in need. United Nations third Sustainable Goal is to: Ensure healthy lives and promote well-being for all of all ages. Goal 3 has various targets including: - The reduction of premature mortality by one-third from noncommunicable diseases. - Halve the number of road traffic accidents. - Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks. For this to become possible, the development of vaccines and medicines will take place. http://www.un.org/sustainabledevelopment/health/ 5
Global Outbreak Alert and Response Network (GOARN): During outbreaks, the Global Outbreak Alert and Response Network ensure that the right technical expertise and are skills are on the ground where and when they are needed most. GOARN consists of institutions and networks, with rapid responses to outbreaks of international importance. International Coordination Group (ICG) on Vaccine Provision: ICG established in 1997, which aims to deliver vaccines to respond to disease outbreaks; provide equitable vaccine allocation through careful risk assessment, based on epidemiological and operation criteria... as a mechanism to coordinate emergency vaccine supplies and antibiotics in the outbreaks of meningitis in Africa. Current Situation: With regards to smallpox, WHO coordinates preparedness and response activities from any outbreaks of smallpox. WHO tries to monitor the situation and conduct risk assessment based on the latest information. On April 8th 2016, Uganda suffered a yellow fever outbreak. WHO s advice is to strengthen the control of immunization(vaccine) status of travellers to endemic areas and the surveillance of potential yellow fever cases. Today recent outbreaks have been taking place such as H1N1 and H5N1, severe acute respiratory syndrome and middle-east respiratory syndrome. Countries that play an important role: Guinea : Emile Ouamouno died when she was two years old. Not being aware that this would create a chain of events that would lead to the deaths of more than 11,000 people. Guinea suffered an Ebola outbreak in 2014, consisting of 122 suspected cases and 78 deaths. An epidemic of magnitude never seen before. Taking six weeks for the country to identify the virus. Causing the virus to become difficult to control because it has already spread through every location. This outbreak caused rice production fell by 20 per cent in 2014, coffee production by 50%. And self-employment and wage-employment decreased. In May 2015, participated in WHO-led trial to develop the first trail vaccine against Ebola. Guinea was free of Ebola virus after 42 days of incubation periods since the last person had a negative test. Uganda: Suffered of a Yellow Fever outbreak in 2016. Switzerland: Is one of the first countries to adopt an inter-ministerial global health strategy. Switzerland is open to the contribution of global health: - Interaction with international organizations active in global health. - Member State of Who since founded. - Bilateral cooperation in health development. - Reduce burden of communicable and noncommunicable diseases - Improve maternal health - Strengthen health systems/ - Financial contributions to support global health activities. - Total contribution to WHO was about $25.6 millions. http://www.who.int/ihr/alert_and_response/outbreak-network/en/. 6
United States: Which is one the most wealthier countries is willing to participate in international efforts to stop outbreaks. By helping financially this will lead to advanced technology. Possible Solution : WHO must build a Centre for Emergency Preparedness and Response with real command and control capability. The Centre must have enough resources so that they are prepared for any outbreak. It must obtain the best technology to be able to identify any threat possible. In order to function properly all countries must follow all IHR obligations. The economy is very important so a fund must be required in order to be able to support having the Centre and help for additional vaccines and for any other lack of resources. Countries with Strong Healthcare Systems must help this organization financially as well. Focus Questions: 1. Which group does your nation support? a. Is your group being affected? b. Will your group contribute? 2. What improvements can be made to prevent a global health crisis?what steps can be taken to manage outbreaks to its minimum? 7
Definition of Key Terms : H1N1 Influenza - An influenza virus originating in pigs that was cause of a pandemic in 2009, but is now season allly circulated worldwide. H5N1 Influenza - An avian influenza virus with a mortality rate of about 60 percent that has thus far demonstrated little human to human transmission. Pandemic- Worldwide spread of a disease. Global Outbreak Alert and Response Network GOARN International Coordination Group International Health Regulations Tuberculosis Ebola Virus Disease ICG IHR TB EVD 8
Bibliography http://www.un.org/news/dh/infocus/hlp/2016-02-05_final_report_global_response_to_health_cris es.pdf https://www.webmd.com/lung/understanding-tuberculosis-basics#1 http://www.who.int/mediacentre/factsheets/fs100/en/ http://www.who.int/csr/disease/smallpox/en/ https://www.mayoclinic.org/diseases-conditions/smallpox/symptoms-causes/syc-20353027 https://medlineplus.go v/hivaids.html http://www.who.int/ihr/alert_and_response/outbreak-network/en/. 9