Seven things we learned from the World Health Assembly

6 min read

A delegation of WaterAid staff from Australia, Cambodia, Senegal, UK and the USA recently returned from the 69th World Health Assembly in Geneva, Switzerland. The team reflect on influencing health ministers to prioritise water, sanitation and hygiene in their pursuit of health for all. Here are seven things we learned.

1. Water, sanitation and hygiene are fundamental to preventing or mitigating many global health threats.

Much of the discussion in Geneva focused on how the global health community can rally and find new ways to fight threats such as Ebola, AMR (Anti Microbial Resistance), and Zika virus.

We called for recognition that water, sanitation, and hygiene (WASH) are fundamental to strengthening health systems to respond to such crises. We urged health ministers to match rhetoric with urgent action, learning the lesson that safe water, improved hygiene and sanitation approaches were pivotal in mitigating the spread of Ebola and saving lives, and would be vital to halting future health threats.

Apollos Nwafor, Regional Advocacy Manager for West Africa region for WaterAid, seized the opportunity to discuss with the delegations of Nigeria, Senegal, Mali and Ghana how WASH will be factored in to plans for a regional Centre of Disease Control (ECOWAS-CDC) to improve regional coordination of and responses to health emergencies.

Megan Wilson-Jones, Policy Analyst for Health and Hygiene for WaterAid UK, also discussed the need for WASH to be a central part of tackling Ebola and other disease outbreaks:

2. Achieving the hopes of Agenda 2030 will need whole new ways of working across sectors, issues, ministries and countries.

‘Integration’ is one of the key buzzwords of the new sustainable development agenda, but now we all need to turn that buzzword into tangible change in the way the development community acts, structures itself, speaks, and measures success.

In our statement on health in the 2030 Agenda for Sustainable Development, we called for access to WASH to be measured as a contribution to achieving health outcomes, despite being included under a separate Goal.

As WaterAid’s Healthy Start campaign emphasises, Goal 3 on healthy lives for all, and particularly the much-debated aspiration of Universal Health Coverage, cannot be achieved if hospitals and health clinics don’t have clean running water. How can we end malnutrition (Goal 2) without joint action with WASH (Goal 6) given that it is estimated that half of all stunting is associated with infections linked to dirty water and lack of toilets and handwashing?

Apollos Nwafor, Regional Advocacy Manager for West Africa region, gave a statement on the importance of WASH to achieving the health-related Global Goals within Agenda 2030:

3. Talking face-to-face is seriously underrated.

Advocacy, campaigning and lobbying (all terms with debated definitions!) have many different forms, but the World Health Assembly (WHA) reminded us that no amount of social media, letter-writing or petitions can deliver quite the influence and potential impact that face-to-face time can.

The Cambodian Government delegation were a powerful presence in support of integrating WASH with health, and Channa Sam OI from WaterAid Cambodia was able to establish a vital rapport with key Ministry of Health official Dr Lo Veasnakiry, who spoke in support of the need for urgent action on WASH in health-care facilities.

4. Some countries are making huge progress towards health for all – and WASH is central to their success.

It was fantastic to see some country delegations making significant strides in improving the health of their citizens, and doing so by prioritising WASH. Cambodia was one. The Ethiopian delegation, too, grasped the chance to highlight their powerful progress on WASH in health and to share important lessons with their fellow country delegations.

From making hospitals cleaner and safer to protecting the poorest and most vulnerable members of the population from the agony and poverty caused by neglected tropical diseases, the Ethiopian delegation’s dedication to public health was clear.

“The highlight for me, as always, was the opportunity to engage with member state delegations," said Yael Velleman, Senior Policy Analyst, Health and Hygiene, WaterAid UK.

"Away from our respective offices, the WHA provides an open space in which to foster new relationships and build collaboration.”

5. Chef Jamie Oliver means business on ending malnutrition.

One of the most lively and exciting events was ‘Accelerating National Progress on Tackling Child Obesity and Child Undernutrition in a Sustainable Way’, co-organised by an unlikely coalition of 12 organisations including WaterAid and celebrity chef Jamie Oliver. The event saw 12 member states make statements on their support of nutrition, many of which were SMART commitments. It also, uniquely, brought together organisations working on both overnutrition and undernutrition to mobilise collective action.

It is easy to be cynical about the ‘power of celebrity’, but Jamie Oliver’s call for a ‘Food Revolution’ caught the attention of a packed room of health experts, and his commitment to follow through and hold world leaders to account was admirable. For WaterAid, we called for much greater cross-government, cross-sectoral action integrating WASH in the fight to end malnutrition. With this summer’s ‘Nutrition for Growth’ summit at the Rio Olympics thrown into uncertainty by Brazil’s political and health crises, the buzz and energy we felt at this WHA event will need to be maintained if we are to secure the cross-sectoral political and financial commitments needed to end malnutrition by 2030.

In this video, Jamie talks to Professor Carinna Hawkes, co-chair of the Global Nutrition Report, about the need for ‘SMART’ commitments to ending malnutrition:

6. WASH in health-care facilities is beginning to get the attention it urgently needs.

A key highlight for us was engaging with member states, civil society, UN agencies and private sector organisations to share experiences on addressing the need for WASH in health-care facilities. This was achieved through the two side events we supported on global health security and women’s empowerment and health. The events showcased examples of national leadership and action from Ethiopia, Cambodia and Uganda on WASH in health-care facilities, and supported lively discussions with panel and audience members. Both events had strong leadership and support from WHO.

In response, we were able to make new connections, bring new members to be involved in the Global Action Plan on WASH in health-care facilities, and inspire others to take action. Most importantly, it led to renewed commitments from Ethiopia and Cambodia, who are already leading progress globally, to improve WASH in health-care facilities. The centrality of WASH to health was also brought into sharp focus by the WHA’s debate on how to tackle the rise of AMR.

At the Assembly, Alison Macintyre, Health Policy Lead for WaterAid Australia, provided a statement on why WASH needs to be emphasised within the global action plan to address Anti-Microbial Resistance:

7. The 70th World Health Assembly could be a major opportunity.

Many who work in international development ask themselves ‘Do global summits and conferences really achieve anything?’ Not on their own, certainly; but our experience at this year’s WHA, and the progress since WaterAid first attended the Assembly in 2010, give us a sense of optimism that change is possible, and that a global gathering of health ministers such as this can be an important lever and catalyst for improvement.

Our ambition is to see next year’s 70th WHA resolve to take even greater global and national action to ensure every mother giving birth or child being treated in a health clinic or hospital can receive the safe treatment and quality of care that is their right, because those facilities have access to clean water, sanitation and hygiene.

Dan Jones tweets as @danrodmanjones