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WHO-WPRO gathers in Brisbane

The World Health Organization Western Pacific Region (WHOWPRO) held its 68th meeting in Brisbane on 9–13 October 2017. I was fortunate to be invited as an observer, as an APA member, in partnership with the World Confederation for Physical Therapy (WCPT). I really had very little idea of what the meeting would entail and, to be honest, it was nothing like I thought. As outlined on its website: the WHO’s mission is to support all countries and peoples in their quest to achieve the highest attainable level of health, defined in the WHO Constitution as “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”.

The Western Pacific Region is made up of 37 nations, with the smallest recording a population of 1000 and the largest of over 1.2 billion. The ‘health’ of each nation is vastly diverse, with some unable to sustain tertiary healthcare services. To achieve its mission in such circumstances would be formidable for the WHO-WPRO.

I found the agenda of topics limited. However, I came to understand that having 10 items for consideration was a huge undertaking in 2017 (compared to the usual six). Also the yearly meetings rolled through different topics that were revisited or addressed across disparate years, with new agenda items and health topics proposed and voted on each year. Topics this year included:

  • measles and rubella elimination
  • protecting children from the harmful impact of food marketing 
  • health promotions in the Sustainable Development Goals
  • triple elimination of mother-to-child HIV, hepatitis B and syphilis 
  • transition to integrated financial priority public health services 
  • regulatory strengthening and convergence for medicines and health workforce 
  • food safety 
  • progress reports on technical programs previously advocated
  • health security and the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies
  • non-communicable diseases
  • tobacco-free initiative 
  • mental health 
  • tuberculosis 
  • hepatitis
  • traditional medicine
  • gender and health.
In general, many of the initiatives have achieved the goal of reducing reported cases of disease or increasing access to products within local populations. However, it was interesting to note that some countries still felt particular issues were not required to be addressed, such as food marketing impact on children, the cost benefit of implementing newborn immunisation or mother health screening.

At this point the true political nature of this meeting was evident, and I wondered how much change could such a meeting really enforce. Even the language being used was highly political, something as a grass roots physiotherapist (and possibly very foreign to me as an Australian). Was this meeting all about talk and no action? It appeared this may have been a common thought among member nations, as there were multiple points when such a concern was raised. Dr Tedros Adhanom Ghebreyesus, WHO Director-General voiced it multiple times; he was adamant, though, that under his leadership, action would outweigh talk.

You may think that the more industrialised and advanced countries would be at the front of health reform; however, it was clear that small nations had perhaps greater capacity for change. In Papua New Guinea, it was reported that death and disease from malaria has dropped significantly, while Cambodia and the Lao People’s Democratic Republic have eliminated trachoma. Unfortunately, only four countries have signed the protocol to eliminate illicit trade in tobacco products, with Australia still considering its position before the July 2018 deadline.

There was a large emphasis on climate control and the impacts on health. It is of no surprise that the smallest island nations, which have had the least impact on climate change, are the most at risk. These small islands are dependent on larger nations to supply many of their tertiary healthcare services, but there was a clear call for more self-sufficiency targeting health at the preventative stage, with greater education on causes, greater access to exercise and greater access to primary healthcare. This is where I feel the APA can have a voice and impact, by engaging the health communities of nations in terms of self-management of pain, disability management and prevention and optimising ‘wellness’. As we forge our alliance with China (the largest nation of the WHO-WPRO), we need to consider how to also support the smaller nations of the Western Pacific at the grass roots of the populous via education and skill development of local health professionals.

Several community groups made statements to the WPRO, including the International Federation of Medical Students’ Associations. I call on the APA, with the WCPT, to provide a statement at the next meeting in the Philippines, urging the committee to consider greater grass roots programs for the role of physiotherapists in contributing to the health of the WHO-WPRO nations’ people in a preventative manner to optimise participation and reduce the impact of disease burden and mental health concerns.

Further information about the meeting, including transcripts of speeches, can be found here.

Katrina Williams, FACP
Queensland Branch President


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