Download Emerging Health Issues Emerging Health Issues

Emerging Health Issues
Emerging Health Issues
At
Asia‐Europe Final Review of the Almaty Programme of Action for the Landlocked Developing Countries
Action for the Landlocked Developing Countries
5‐7 March 2013, Vientiane, Lao PDR
Khalil Rahman
Khalil
Rahman
WHO Liaison Office with UN ESCAP
Bangkok
WHY Health & EIDs are important?
• Health is inextricably linked to sustainable development
H lth i i t i bl li k d t
t i bl d l
t
• Majority of current MDGs are health related
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 discussed to be part of Post‐2015 Development Agenda and
discussed to be part of Post‐2015 Development Agenda and SDGs
• EIDs can have disastrous consequences on trade and economic development for any country, including LLDCs –
p
,
y
example of SARS, Avian Influenza in many Asia‐Pacific countries
Definition of Emerging Infectious Diseases
Definition of Emerging Infectious Diseases
• Used interchangeably with emerging diseases
– “Infections
Infections that newly appear in a population, or have existed but that newly appear in a population or have existed but
are [rapidly] increasing in incidence or geographic range.”
– Previously unrecognized (new) diseases, – Re
Re‐emerging
emerging and resurging known diseases like TB
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
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
Factors driving EIDs
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•
•
•
The majority of emerging infectious diseases in humans are zoonoses (origins in animals)
(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
i
– Population density (and unplanned urbanization)
– Environmental degradation
– Deforestation
D f
t ti (and contact of humans with previously un‐encountered ( d
t t fh
ith
i l
t d
animal species) – Indiscriminate use of antibiotics
– Effects of climate change
Effects of climate 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 infections in humans identified since 1976
infections in humans identified since 1976
IEbola virus Bats
HIV‐1 Primates 1981 E. coli O157:H7 Cattle 1982
1976
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
Infectious agent
2009
Animal Origin Emergence
WHO’ss Response to EIDs
WHO
Response to EIDs
• Both WHO SEARO and WPRO jointly developed The Asia Pacific Strategy for Emerging Diseases: APSED (2010) to guide
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 early detection and response to
strengthening early detection and response 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)?
at s
( 005)?
•
•
•
•
An internationally agreed instrument for global public An
internationally agreed instrument for global public
health security
Its purpose is to prevent, protect against, control and p
provide a public health response to the international p
p
spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid
unnecessary interference with international traffic and t ade
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 June 2012 –
LLDCs have been granted extension until
2014
IHR Provide a Legal Framework
IHR Provide a Legal Framework
• To
To strengthen and maintain
strengthen and maintain national systems
national systems and and
core capacities – for surveillance and response
f
– at designated international airports, ports and ground crossings
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g
international / regional / g
• To collectively strengthen
systems to detect, verify, assess and respond to any disease outbreaks or other acute public health p
events of international concern
Health and EIDs in Post 2015 Agenda
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
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; p
y
,
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