The Annual Report of the Regional Director covers the calendar year 2009 and comprises three chapters in line with the core areas outlined in the amended Medium-term Strategic Plan 2008–2013. It describes issues and challenges, actions taken, results achieved and future directions for all the 13 strategic objectives set for WHO’s collaboration with Member States. It illustrates the effectiveness of WHO’s contribution to the improvement of health in countries of the Region, highlighting progress and constraints. Specific examples of the impact of WHO’s technical cooperation are also given.
Under this agenda item, progress reports on the following subjects will be included as information documents:
(b) Eradication of poliomyelitis (EM/RC57/INF.DOC.1)
(c) Tobacco-Free Initiative (EM/RC57/INF.DOC.2)
(d) Achievement of the Millennium Development Goals (EM/RC57/INF.DOC.3)
(e) Strengthening primary health care-based health systems (EM/RC57/INF.DOC.4)
2. Strategic directions to improve health care financing in the Eastern Mediterranean Region: moving towards universal coverage 2011–2015 (Agenda item 3, document EM/RC57/Tech. Disc.1)
The share of out-of-pocket health expenditure remains relatively high in many countries of the Region. As a result, each year many households are exposed to the risk of financial catastrophe and impoverishment. At the same time, despite efforts made by WHO and other development partners, progress in implementing social health protection in low- and middle-income countries of the Region has been relatively slow. The paper assesses the major challenges facing health care financing globally and in the Region, and suggests strategic directions to improve coverage by social health protection and implement World Health Assembly resolution WHA58.33 aimed at moving towards universal health care coverage. The directions provide practical steps to expedite the move towards universal coverage, while recognizing the diversity among Member States and building on existing initiatives and policy reforms.
3. Maternal, child and adolescent mental health: challenges and strategic directions 2010–2015 (Agenda item 4(a), document EM/RC57/3)
Maternal, child and adolescent mental disorders constitute a public health problem. They are inextricably linked with each other, at the causal as well as at the intervention level, making it imperative to address the issue in an integrated manner. The estimated prevalences of 15%–36% for maternal mental disorders and 10%–36% for child and adolescent mental disorders in the Region is significantly higher than the estimates for developed countries. World Health Assembly resolution WHA55.10 called on Member States to strengthen action to protect children from and in armed conflict, a call echoed in the recommendations of the Commission on Social Determinants of Health to make available comprehensive packages for children, mothers and other caregivers for early child development. The strategic directions and actions suggested in the paper provide a foundation for development of national strategies and action plans.
4. Regional strategy on nutrition 2010–2019 (Agenda item 4(b), document EM/RC57/4)
Although improvements in nutrition have taken place as a result of economic growth and as a natural outcome of health sector development and services, the burden of disease associated with inadequate dietary intake is increasing in many countries of the Region. Malnutrition remains a serious health problem in the Region, while diet-related chronic diseases exert a heavy cost and contribute to morbidity and mortality rates. The regional strategy for nutrition 2010–2019 aims to support Member States to establish and implement action in nutrition, according to their national situation and resources. The goal of the strategy is to improve the nutritional status of people throughout the life cycle by encouraging countries to reposition nutrition as central to their development agenda.
5. Regional strategy for health sector response to HIV 2011–2015 (Agenda item 4(c), document EM/RC57/5)
The HIV epidemic continues to expand. Efforts to prevent further spread of the epidemic and to expand access to life-saving antiretroviral therapy have increased substantially. However, there are still major gaps in knowledge with regard to the local dynamics of the HIV epidemic and in programmes for those at increased risk. These gaps are the main reason for the continued transmission of HIV. The aim of the proposed regional strategy for health sector response to HIV 2011–2015 is to guide Member States on how to effectively contribute through health sector programmes to the achievement of universal access to HIV prevention, treatment, care and support, and ultimately, the United Nations Millennium Development Goals. It takes into consideration commitments made by the United Nations General Assembly in 2001 and 2006 and accommodates strategic directions for the achievement of universal access developed by WHO and UNAIDS. It builds on the current regional strategy for strengthening health sector response to HIV/AIDS and sexually transmitted infections, which comes to an end in 2010. The strategy accommodates the need for re-orientation based on better knowledge of HIV epidemiology in the Region, on lessons learnt from national HIV/AIDS programme successes and failures in the past, as well as the need to reinforce commitment and to address persisting challenges more efficiently.
6. Infection prevention and control in health care: time for collaborative action (Agenda item 4(d), document EM/RC57/6)
Infections acquired during health-care delivery––health care-associated infections––are a significant public health problem around the world. Although estimates of the global burden of health-care associated infections are hampered by limited availability of reliable data, it is estimated that in developed countries, between 5% and 10% of patients admitted to acute care hospitals acquire one or more infections. In developing countries, the risk of infection is 2–20 times higher and the proportion of patients infected can exceed 25%. Health care-associated infections appear to be a hidden, cross-cutting problem. The objective of this paper is to draw the attention of the Regional Committee to the hitherto unrecognized public health problem emerging from health care-associated infections in the Region and provide evidence that a considerable proportion of the burden of disease attributable to these infections can be prevented with low-cost interventions. The paper describes the magnitude of such infections at the global and regional level, and highlights the multi-dimensional and cross-cutting nature of infection prevention and control. The paper proposes a set of actions that can be implemented easily and readily across countries in the Region without major resource implications.
7. Programme and budget matters; (Agenda item 5 (a-c), documents EM/RC57/7 (a) & (b), 8)
(a) Programme Budget 2008–2009; performance assessment
The main purpose of the performance assessment, conducted at the end of each biennium, is to assess the achievements of the Secretariat and compare them to the commitments to results and related targets stated in the Medium-term strategic plan and programme budget. Changes were proposed by the Programme, Budget and Administration Committee of the Executive Board (EBPBAC9/3) and endorsed by the Executive Board with regard to timelines and reporting products. The performance assessment involves tracking evidence of achievements, in particular on the basis of agreed indicators, and the analysis of main achievements, including the review of programme delivery, in terms of products and services, as well as of success factors, impediments and lessons learnt.
(b) Report on the outcome of the Joint Government/WHO Programme Review and Planning Missions in 2009, including utilization of country cooperation strategies
The report on the outcome of the 14th round of the Joint Government/WHO Programme Review and Planning Missions for the biennium 2010–2011, implemented between June and December 2009, evaluates the process and elaborates on the impact of country cooperation strategy documents, revised guidelines and capacity-building workshops for application of the results-based management approach to the review and planning process.
(c) Amended medium-term strategic plan 2008–2013 and proposed programme budget 2012–2013; proposed programme budget for the Eastern Mediterranean Region 2012–2013
The World Health Assembly in resolution WHA60.11 endorsed the medium-term strategic plan 2008–2013 and requested the Director-General to use it to guide preparation of the three biennial programme budgets 2008–2009, 2010–2011 and 2012–2013 and operational plans through each biennium. The overall process for the 2012–2013 exercise is envisaged to be less intensive than that for 2010–2011. The programme budget document presented to the regional committees in 2010 and Executive Board and World Health Assembly in 2011 is a strategic document outlining the directions and priorities of the Organization for the coming biennium. It will not contain breakdown of resource requirements at the level of Organization-wide expected results (OWER). Strategic directions for the programme budget are informed by a better alignment between budget, funding and country cooperation strategies. Emphasis is also being placed on WHO core functions.
8. Report of the Regional Consultative Committee (thirty-fourth meeting) (Agenda item 6, document EM/RC57/9)
The Regional Consultative Committee held its thirty-fourth meeting in the Regional Office from 21 to 22 April 2010. The main topics on the agenda were health care financing, maternal, child and adolescent mental health, a regional strategy for nutrition, a regional strategy for health sector response to HIV 2011–2015 and infection prevention and control in health care facilities. These technical subjects are also included on the agenda of the Regional Committee, and will be discussed in detail under specific agenda items. The report of the thirty-fourth Regional Consultative Committee will be submitted to the Regional Committee for review and endorsement.
9. Resolutions and decisions of regional interest adopted by the Sixty-third World Health Assembly (Agenda item 7(a), document EM/RC57/10)
The paper highlights resolutions and decisions on global developments adopted by the World Health Assembly in 2010 that have direct relevance to or implication for the Region, and a direct link with many of the priority activities of the Region. In addition, it provides a summary of the steps and actions being taken in implementing specific resolutions relating to regional and country needs.
10. Review of the draft provisional agenda of EB128 (Agenda item 7(b), document EM/RC57/10-Annex I)
The Regional Committee will review and discuss the draft provisional agenda of EB128 (January 2011), providing comments, if any.
11. Nomination of a Member State to the Joint Coordinating Board of the Special Programme for Research and Training in Tropical Diseases, (Agenda item 8, document EM/RC57/11)
As of 1 January 2011, there will be one vacancy for a Member State from the Eastern Mediterranean Region to replace the Libyan Arab Jamahiriya, whose term of office will come to an end on 31 December 2010. The Regional Committee is requested to nominate one Member State to serve on the Board, for a three-year period from 1 January 2011 to 31 December 2013.
12. Collaboration between the countries of the Region and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), (Agenda item 9, document EM/RC57/INF.DOC.5)
13. Award of the Dr A.T. Shousha Foundation Prize for 2010 (Agenda item 10(a), document, EM/RC57/INF.DOC.6)
The Executive Board, at its 126th Session approved the nomination of Dr Faissal Abdul Raheem Mohammed Shaheen (Saudi Arabia) for the Dr A.T. Shousha Foundation Prize for 2010. The prize will therefore be awarded to Dr Shaheen during the opening of the Fifty-seventh Session of the Regional Committee.
14. Award of the Down Syndrome Research Prize (Agenda item 10(b), EMRC57/INF.DOC.7)
The Regional Committee, at its Fifty-sixth Session decided to award the Down Syndrome Research Prize to the following: Dr Hoda Abdullah Kattan, Saudi Arabia; Al Nahda Philanthropic Society for Women, Al Nahda Schools for Down Syndrome, Saudi Arabia; and Mrs Sabah Zemmama Tyal, Morocco, based on the recommendation of the Down Syndrome Research Prize Foundation.
15. Award of the State of Kuwait Prize for the Control of Cancer, Cardiovascular Diseases and Diabetes in the Eastern Mediterranean Region (Agenda item 10(c), document, EM/RC57/INF.DOC.8)
Following Decision No.3 of the Fifty-sixth Session of the Regional Committee, the State of Kuwait Prize for the Control of Cancer, Cardiovascular Diseases and Diabetes in the Eastern Mediterranean, which this year was solicited in all three areas, will be awarded to Dr Bagher Larjani, Islamic Republic of Iran (Diabetes) and Dr Ali Jaffar Mohamed, Oman (Cancer), during the opening of the Fifty-seventh Session of the Regional Committee.
16. Revision to the Down Syndrome Research Prize Statutes, (Agenda item 10(d), document EM/RC57/INF.DOC.9)
The Eighth Meeting of the Down Syndrome Research Prize Foundation Committee held during the Fifty-sixth Session of the Regional Committee in Fez, Morocco proposed to revise the Statutes to reflect a change under Article 7 whereby, invitation for nominations are now solicited from national health, education and social administrations of a Member State within the Eastern Mediterranean Region. The Committee endorsed the revision and the revised Statutes are submitted to the Fifty-seventh Session of the Regional Committee for approval.