World Association of Societies of Pathology and Laboratory Medicine (WASPaLM)

World Health Organization

Fifty-Seventh World Health Assembly, May 17^th-May 22^th 2004

Report of Dr. U. P. Merten

WASPaLM representatives: Dr. Utz P. Merten, Professor Dr. Mario F. Paes e Alcântara and Dr. Lea Gerania Partakusuma. (Dr. Robby Bacchus was unable to attend, Professor Hardjoeno was registered)

Plenary meetings:

The meeting took place in the Palais des Nations, registration at the WHO Head Quarters connected by shuttle bus. Ministers of Health of nearly all accredited nations and their staff represented their countries.

Not all states are accredited some act as observers. Some states even do not hold this position like Taiwan , who failed in its eighth bid for a toehold in the WHO, amid opposition from China . After a lengthy debate (more than four hours) the governing committee of WHA, the decision making body of WHO, recommended the issue of Taiwan not to be included on the agenda of its annual meeting in Geneva.

On Tuesday His Excellency Dr Kim Dae-jung , former President of the Republic of Korea addressed the delegates with a very emotional and impressive speech on health and social related problems of mankind. ( It was quite impressive to listen to a man who before he became president was imprisoned for a longer period of time).

Dr. Lee Jong-wook, Director General WHO reported on the work of WHO with special reference:
- to poverty, areas of conflict, lack of clean water, environmental problems,
- to the death of over half a million women in childbirth every year (*1),
- to the treatment of certain diseases (tuberculosis, onchocerciasis),
- to the eradication of poliomyelitis, with special emphasis on the necessity to go on funding this program to clean polio from the last six countries
- to the urgent need for treatment of HIV/AIDS to fulfil the program “3 by 5” (mentioned in my former report) and enhance the availability of antiretroviral drugs and
- to the framework Convention on Tobacco Control, now signed by 112 countries plus the EU and ratified by 14 (when 40 countries will have ratified the Convention it will come into force)

On Wednesday His Excellency Mr Jimmy Carter, former President of the United States of America as invited speaker addressed the delegates with a very impressive speech on his work for more than two decades to forge partnerships to bring peace, health and human rights to all people, for which he was awarded the Nobel Peace Prize in 2002. His Atlanta-based Carter Centre, a non-profit, nongovernmental organization, has brought vision, leadership and collaboration to major efforts to prevent and control disease, improving life in more than 65 nations. A major point in his speech he outlined, that within ten years depression and suicide will be one of the leading health problems. ( His wife, Mrs. Rosalynn Carter, former First Lady of the United States of America, was a guest speaker at the WHO-Technical Briefing “Mental health and substance abuse”)

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The WHA has raised global public health to a new level, by resolving to take more action to prevent death and illness resulting from heart disease, diabetes, cancer, road safety, and lack of access to health services as well as from diseases spread by viruses, bacteria and other dangerous microbes.

It has to be seen which influence this will have on the medical community.

In general, most of the discussion took place in Commissions (A and B) meetings of delegations and Technical Briefings.

Commission A: Started on Tuesday with the discussion of different Technical and health matters.

“Draft global strategy on diet, physical activity and health” (WHA–A57/9 and A57/32).

Chronic diseases, accounting for almost 60% of deaths every year and 47% of the global disease burden, are increasingly affecting people in developing countries.

Of the most prevalent diseases cardiovascular, diabetes, some cancers and respiratory the first three are all diet related. These three are often linked and have overlapping risk factors which include obesity, high blood pressure, high cholesterol, and alcohol and tobacco use.

The latest scientific evidence demonstrates that changes in dietary habits, physical activity and tobacco control, can have a major impact on reducing the rates of this chronic diseases, often in a relatively short time.

WHO Secretariat reported again on this draft and again an intensive discussion started to find the correct wording, not to interfere with free trade ( or to harm certain industries). Representatives of NGO’s from food industry were actively consulting and there were statements of the World Heart Federation and others supporting the resolution.

At the Plenary Meeting of WHA the “ WHO Global Strategy on Diet, Physical Activity and Health” was unanimously endorsed by member states.

“Intellectual property rights, innovation and public health” (WHA56.27)

This resolution must be seen in connection with HIV/AIDS (resolution WHA56.30) and deals with the examination of intellectual property rights, i.e. patents on retroviral drugs.

The Committee decided to request the Director-General to delay submitting the final report until the 117^th session of the Executive Board (i.e. January 2006)

There were further documents discussed in Commission A which can be found WHO websitehttp://www.who.int

Road safety and health
Health promotion and healthy lifestyle
Family and Health
Reproductive Health
Health systems, including primary health care
Quality and safety of medicines: regulatory systems
Genomics and world health: report of the Advisory Committee on Health Research.

( Concerning the Genomics document the letter of RCPA arrived late and I could not go into detail. It is therefore suggested RCPA prepares a written statement to be presented at the Executive Board Meeting EB 115 in January next year or at the World Health Assembly in May next year.)

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Commission B: This commission started on Thursday with discussion on financial and budget related matters followed by staffing and legal matters.

The last point for discussion was
“Policy for relations with nongovernmental organizations. (WHA-A57.32)
A study of the document does not list items which are not fulfilled by WASPaLM its constitution and by-laws and the way WASPaLM operated during the last 20 years.

Technical Briefings: Patients safety and the establishment of an International Alliance

Health-care interventions are intended to benefit patients, but they can also cause harm. In May 2002 the WHA passed resolution WHA55.18 which urges countries to pay the greatest possible attention to patient safety.

The briefing included an overview of the global importance of patient safety and gave an insight into some personal patients reports.

Personal remarks:

WHO – Essential Health Technologies
At this occasion a meeting with Dr. Steffen Groth (WHO-Director of essential health technologies) and Dr. Gaby Vercauteren (WHO-Blood safety and clinical technology) could not be arranged. From information of WHO the EHT has the following staff:

Department of Essential Health Technologies (EHT)
Dr. Steffen Groth, Director
Tel +41 22-791-4387 e-mail: groths@who.int

Diagnostic imaging and Laboratory Technology (DIL)
Dr. Harald Ostensen, Coordinator
Tel +41 22-791-3649
e-mail: ostensenh@who.int

Dr Gaby Vercauteren, Scietist, Laboratory and Diagnostic Services
Tel: +41 22-791-4728 e-mail: vercautereng@who.int
(there are more subdivisions related to Blood Transfusion Safety and others)

Before we make further contact it seems to be necessary to define subjects of mutual interest to WASPaLM and WHO and prepare proposals. This will enable the Bureau to find ways of cooperation between WHO and WASPaLM.

From the discussion with the WASPaLM representatives the following suggestion is made:

Representation:

It was the first time (to my knowledge) that there were more than one representative of WASPaLM registered and present at a WHA. Hopefully this will be similar in the future.

Cooperation with Dr. Lea Gerania Partakusuma from Indonesia and Professor Dr. Mario F. Paes e Alcântara was excellent and the discussion fruitful on how to enter ideas and suggestions of WASPaLM into WHO. It was a great pity that Dr. Robby Bacchus was unable to attend.

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Post graduate education
There are problems arising in different countries with the acceptance of the contents of the specialty education in Laboratory Medicine/Clinical Pathology/Biopathology:

It is proposed to WASPaLM to define on an international level a basic post-graduate education in Laboratory Medicine/Clinical Pathology/Biopathology.

and define the inclusion of all specialties (i.e. haematology, clinical chemistry, immunology, genetics, blood banking and microbiology) in this educational programme.

This will help clinical pathologists in some countries not to be excluded from these specialties by WHO or other international or national organization with the argument that for example microbiology can only be performed by a microbiologist.

Having a “Generalist” in Clinical Pathology is as necessary as having a “Generalist” in Internal Medicine and Surgery.

Quality standards for laboratories in Countries in need

The idea was discussed by WASPaLM representatives that WASPaLM may define quality standards for laboratories in different countries and promote these standards together with WHO -EHT.

Interesting items of WHO:

International Programme on Chemical Safety (IPCS) established a scientific basis for the assessment of risk to human health and the environment from exposures to chemicals. It provides some technical assistance by having placed all documents on the IPCS website: http://www.who.int/pcs

*1) British Medical Bulletin: “Pregnancy – Reducing maternal death and disability”, scientific editor Charles Rodeck , Oxford University Press 2003,

This book was distributed by: “The partnership for Safe Motherhood and Newborn Health”

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