Emerging Health Issues At Asia Europe Final Review of the Almaty Programme of Action for the Landlocked Developing Countries 5 7 March 2013, Vientiane, Lao PDR Khalil Rahman WHO Liaison Office with UN ESCAP Bangkok
WHY Health & EIDs are important? Health lthis inextricably i linked to sustainable ti development Majority of current MDGs are health related Rio+20 Declaration has clearly recognized once again this ink Health issues are among the most important issues being discussedto be part of Post 2015Development Agenda and SDGs EIDs can have disastrous consequences on trade and economic development for any country, including LLDCs example of SARS, Avian Influenza in many Asia Pacific countries
Definition of Emerging Infectious Diseases Used interchangeably with emerging diseases Infections that newly appear in a population, or have existed but are [rapidly] increasing in incidence or geographic range. Previously unrecognized (new) diseases, Re emerging emerging and resurging known diseases like TB Known epidemic prone diseases. Around 30 EIDs, incluidng HIV/AIDS, hepatitis C, bovine spongiform encephalopathy (BSE)/variant Creutzfeldt Jakob disease (vcjd), Nipah virus, several viral hemorrhagic fevers, including dengue and, most recently, Severe Acute Respiratory Syndrome (SARS) and Avian Influenza. Noncommunicable Diseases (NCDs)
Factors driving EIDs The majority of emerging infectious diseases in humans are zoonoses (origins in animals) Animals living in close contact with humans; Animals also do not recognize borders between States and there is a significant spread of Avian Influenza in poultry by the ground route; Rabies in wild dogs Increasing Population density (and unplanned urbanization) Environmental degradation Df Deforestation tti (and contact tof humans with previously un encountered animal species) Indiscriminate use of antibiotics Effects ofclimate change Migration examples of Lao PDR, Tajikistan, Kyrgyzstan, Nepal Other factors that have been important Unsafe injection practices Unsafe sex Increasing travel (rapid spread of infections)
Breaches in the species barrier: selected emerging infectionsinhumansidentified identified since1976 IEbola virus Bats 1976 HIV 1 Primates 1981 E. coli O157:H7 Cattle 1982 Borrelia burgdorferi Rodents 1982 HIV 2 Primate 1986 Hendra virus Bats 1994 BSE/vCJD Cattle 1996 H5N1 influenza A Chickens 1997 Nipah virus Bats 1999 SARS coronavirus Palm civets 2003 Influenza H1N1(2009) Swine 2009 Infectious agent Animal Origin Emergence
WHO s Response to EIDs Both WHO SEARO and WPRO jointly developed The Asia Pacific Strategy for Emerging Diseases: APSED (2010) to guide and support national and regional preparedness for future threats focuses primarily on building capacity for emerging diseases through reducing their risk, strengthening earlydetection andresponse to outbreaks of emerging diseases APSED (2010) serves as a road map towards meeting the International Health Regulation (IHR) core capacity requirements
What is IHR (2005)? An internationally agreed instrument for global public health security Its purpose is to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade Represents the joint commitment for shared responsibilities and collective defence against disease spread Legally binding for WHO Member States since June 2007 and required States Parties to establish core capacities to detect, assess and report potential health threats by 15 June 2012 LLDCs have been granted extension until 2014
IHR Provide a Legal Framework To strengthen and maintain nationalsystems and core capacities for surveillance and response at designated international airports, ports and ground crossings To collectively strengthen international / regional systems to detect, verify, assess and respond to any disease outbreaks or other acute public health events of international concern
Health and EIDs in Post 2015 Agenda MDGs while significant progress has been made in LLDCs, progress is uneven and the issue of equality and equity in access and others are there; the agenda thus should continue; New issues like UHC and NCDs deserves inclusion; UHC can significantly ensure access to health care; Partnership for addressing EIDs should be strengthened; especially for LDCs, LLDCs and SIDs
WHO s Special Efforts for LDCs, LLDCs & SIDs WHO is mindful of UNGA and ECOSOC Resolutions/Decision in relation to support to LDCs, LLDCs and SIDs, including Istanbul Plan of Action, Almaty Plan of Action and incorporate them in the WHO Country Cooperation Strategy which is done in close consultation and approval of the Member States to ensure special support to their needs and priorities in health (social) sector