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Prepared By: Anand Mrinalini Chairperson(World Health Organization)-RomeMUN 2013 Attrams Siaw Prince Director (World Health Organization)-RomeMUN 2013
CONTENTS
World Health Organization ............................................................................................................................................1 Background Guide .........................................................................................................................................................1 PRESENTATIONS CHAIR AND DIRECTOR-ROMEMUN 2013 ...........................................................................................4 TOPIC a: MDG6-Target 6.A/target 6.b ...........................................................................................................................6 Have halted by 2015 and begun to reverse the spread of HIV/AIDS ......................................................................6 Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it .....................................6 INTRODUCTION .........................................................................................................................................................6 CURRENT SITUATION .................................................................................................................................................7 HIV/ AIDS ...............................................................................................................................................................7 MALARIA ................................................................................................................................................................9 TUBERCULOSIS .....................................................................................................................................................10 CONCLUSION ...........................................................................................................................................................12 TOPIC B: TARGET 8.E ....................................................................................................................................................13 In cooperation with pharmaceutical companies; provide access to affordable essential drugs in developing countries ..................................................................................................................................................................13 INTRODUCTION ...................................................................................................................................................13 CURRENT SITUATION ...............................................................................................................................................15 ESSENTIAL MEDICINES .............................................................................................................................................17 FUNDS TO BRIDGE THE GAP ....................................................................................................................................17 TRIPS (Trade Related Aspects of Intellectual Property Rights) ................................................................................18 WHO/HAI (WORLD HEALTH ORGANIZATION / HEALTH ACTION INTERNATIONAL) ................................................18 CONCLUSION ...........................................................................................................................................................19 GUIDING QUESTIONS ...............................................................................................................................................21
VERY IMPORTANT: PLEASE REMIND THAT EACH COUNTRY HAS TO PRESENT A COPY OF THE POSITION PAPER ABOUT THE TWO AGENDA TOPICS OF THIS COMMITTEE BY MARCH 1ST , EMAILING IT AS ATTACHMENT IN WORD FORMAT TO position_paper@romemun.org ALL THE INDICATIONS ABOUT HOW TO PREPARE A POSITION PAPER IS NOT IN THIS GUIDE BUT IN THE DELEGATE GUIDE (AVAILABLE ON ROMEMUN FORUM)
Guatemala Guinea-Bissau Haiti Honduras Iceland India Italy Jamaica Kazakhstan Kiribati Kuwait Liberia Lithuania Luxembourg Mali Malta Mauritius Micronesia (Federated States of) Morocco Myanmar Pakistan Paraguay Republic of Korea Russian Federation Rwanda Slovakia Togo United Kingdom United States
HAVE HALTED BY 2015 AND BEGUN TO REVERSE THE SPREAD OF HIV/AIDS ACHIEVE, BY 2010, UNIVERSAL ACCESS TO TREATMENT FOR HIV/AIDS FOR ALL THOSE WHO NEED IT
INTRODUCTION
We are working towards a shared vision of the future for health among all the worlds people. A vision future in which we develop new ways of working together at global and national level. A vision which has poor people and poor communities at its center. -Gro Harlem Brundtland
With almost two years to go, MDG 6 is still a major worry for a lot of nations.HIV AIDS has predominantly taken lead ,incidence and prevalence wise, as compared to other diseases.
HIV (Human Immunodeficiency Virus) is commonly transmitted sexually and parenterally. AIDS (Acquired Immunodeficiency Syndrome) is the set ofcomplications that develop in HIV positive patients later on. Since the beginning of the epidemic, more than 60 million people have been infected with the HIV virus and approximately 30 million people have died of AIDS. More than 2 million children under 15 are infected with HIV, and 15 to 24-year-olds accounted for half of all new HIV infections.1.8 million people died in the WHO African Region in 2010, making it the most effected region [1].
Also, the male latex condom is the single, most efficient, available technology to reduce the sexual transmission of HIV and other sexually transmitted infections.[4]The wide distribution and marketing strategies of various condom brands and campaigns have made a significant impact e.g. the Great American Condom Campaign. As far as the future of this viral infection is concerned, we need to make sure that all effective preventive and prognostic interventions are in place. Success stories like Ugandas National HIV program, which lead to significant drop in HIV infection rates, provides a huge motivation to the rest of its counterparts.
MALARIA
Malaria is primarily a tropical disease which spreads through mosquito bites. The complications depend on the underlying microorganism involved. Malarial precipitating factors are wet surroundings, poor immunity, poor sanitation and poor access to health care. In 2010, an estimated 216 million cases occurred, and the disease killed approx. 655 000 people most of them children under five in Africa. On average, malaria kills a child every minute and around3.3 billion people are at risk of contracting malaria. The human toll is tragic, and the economic cost is enormous. Most of these deaths could be avoided, however, as effective and affordable ways to prevent and treat malaria exist. In recognition of the scope of the problem, malaria control is embedded in one of the millennium development goals of the United Nations: to Combat HIV/AIDS, malaria and other diseases.[5]. Some basic preventive measures are using insecticides, ITNs (Insecticide treated mosquito nets), avoiding stagnant water collections and using the correct medications based on chloroquine/artemisine/primaquine. UNICEF, along with the United Nations Development
Tuberculosis (TB) is a bacterial disease that is primarily associated with the lungs. Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent.In2011; 8.7 million people fell ill with TB and 1.4 million died from TB. Over 95% of TB deaths occur in low- and middle-income countries, and it is among the top three causes of death for women aged 15 to 44. In 2010, there were about 10 million orphan children as a
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TB is a curable and preventable disease. The proper medications, preventive measures and prognostic measures such as DOTS (Directly supervised therapy), can make an impact. Since 1995, over 51 million people have been successfully treated and an estimated 20 million lives saved through use of DOTS and the Stop TB Strategy recommended by WHO. A multidimensional approach involving medical careers, governmental organizations, research and pharmaceutical negotiations seems to be a silver lining. Nepal has emerged one of the successful fighters of TB. In 1990, only 45 percent of people were cured of TB, now it up to 90 percent. In addition, Nepal has also seen improvements in other health factors such as malaria, maternal health, and AIDS. This has been primarily achieved through a centrally controlled governmental strategy .To deal with further complications of child and maternal health. Nepal has recently also signed contracts with, DFID, the World Bank, and the GAVI Alliance.
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Its time to prove that actions actually do speak louder than words! The mere factual knowledge of the main contributors of morbidity and mortality wont help. Its time we realize how important their prevention and cure are. Constructive ideas and precise resolutions should take lead in making a positive impact on society. 2015 is a year by which we need to ensure that no child dies sweating of malaria, no mother gets worried about her developing baby and no man ails with something preventable like TB.At a simulated platform like Rome MUN and as the future leaders of tomorrow, we need to analyze the past, present and future.
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IN COOPERATION WITH PHARMACEUTICAL COMPANIES; PROVIDE ACCESS TO AFFORDABLE ESSENTIAL DRUGS IN DEVELOPING COUNTRIES
INTRODUCTION
If countries are to maintain and accelerate progress towards the MDGs, then people need equitable access to a health system that can deliver high quality services, where and when they are needed. Health is an established human right. In a review, 135 of 186 national constitutions (73%) include provisions on health or the right to health, and access to essential affordable medicines has been recognized as one part of that right to health (Hogerzeil et al., 2006; Perehudoff, 2008). Most illnesses, especially infectious diseases, are either preventable or to some extent treatable with a relatively small number of medicines. Despite this fact, a large proportion of the worlds population today still has either only limited access to appropriate medicinal treatment, or no access at all. The effect of this shortfall constitutes huge losses of life from diseases that are highly preventable or treatable. Most of such diseases include tuberculosis, pneumonia, malaria, diabetes and hypertension. The dire aspect of this unfortunate situation is particularly common among the poor and susceptible populations of the world. Illness has also been identified as one of the major factors that slide the nearly poor into profound poverty. It decreases the efficiency of the human capital of every nation and supporting access to medicine for more than 2 billion poor people is directly in line to the fundamental principle of health as a human right.
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CURRENT SITUATION
Currently, one of the key barriers to access of medicines is the poor medicine availability particularly in the public sector. Notably, public-sector availability of a selection of generic medicines is less than 60% across WHO regions ranging from 32% in the Eastern Mediterranean Region to 58% in the European Region (WHO, 2011). WHO defines generic medicines as Pharmaceutically equivalent or pharmaceutically alternative products that may or may not be therapeutically equivalent It is also reported according to the WHO general report 2006, as Multisource pharmaceutical products that is therapeutically equivalent or interchangeable. Prices of these medicines and their availability serve as strong indicators to treatment in both public and private sectors. In order to define the medium by which medicines are obtained, some factors must first be considered. Some of these factors include: safeguarding all health and supply systems and assuring their accessibility, making sure that both government and individuals have the capacity to afford medicines highly required for maintaining good health, guaranteeing the availability of funds for these medicines as and when the patients need them, and ensuring that all patients have appropriate medicine in their right dosages depending on their ailment. Most health goals mainly relate to individuals. International commitments thus comes in the form of developing access but these efforts are restricted to either taking pragmatic preventive measures such as provision of insecticide-treated bed nets, vaccines, and potable water or yet still curative measures such as the provision of medicines such as ARTs for HIV/AIDS. Most importantly, it is of great importance that these measures are tailored to those who need them and most especially the poor, the aged, and the disabled in each and every country.
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Essential medicine is a highly important factor to consider when measuring the adequacy of access. This is because the evaluation of the products that are supplied should be assessed and checked to meet the requirements of the patient population. WHO identified essential medicines as medicines that is considered to meet high-priority health care needs of a population and they are selected with regard to disease prevalence, evidence of efficacy, safety, and comparative cost - effectiveness. Yet, India and Africa together account for 54 percent of the worlds population without access to essential medicines. Recent global economic crisis has also contributed to the increase of the population of people in developing countries without access to affordable medicines. Another challenge the crisis brings is the rise in demands on public health services. This is due to rising unemployment and lower incomes which will in turn make people less capable to maintain their health and consequently expose them to greater health risks. In order to measure the impact of the global economic crisis on health systems, the World Health Organization (WHO), in cooperation with IMS Health, has put in place a program to track the consumption of medicines.
[4]
However,
South Africa remains the only country in sub-Saharan Africa with available IMS Health data.
FUNDS TO BRIDGE THE GAP
Also, the creation of the High Level Taskforce on International Innovative Financing for Health System has prompted efforts to approximate the cost of intensifying health systems and reaching the health-related MDGs in low-income countries [5]. This incorporated the costing of essential medicines needed to treat a selection of severe conditions in 49 countries mostly in sub-Saharan Africa with a gross national income (GNI) per capita of $935 or less in 2007. Estimated Results shows that, to attain the health related MDGs in these countries, funding for treatments excluding those covered by MDGs 4, 5 and 6 should be increased by about $630 million in 2009. It also estimates that incremental costs per year would increase from $150
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The Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS) is an international agreement administered by the World Trade Organization (WTO) that sets down minimum standards for many forms of Intellectual Property (IP) regulation as applied to nationals of other WTO members. The DOHA declaration is a WTO statement that also clarifies the scope of TRIPS, stating for example that TRIPS can and should be interpreted in light of the goal to promote access to medicines for all.[6] Despite this fact, the agreement is leading to the patenting of new medicines in countries that traditionally have been important producers of generic essential medicines. As a result, generic versions of new medicines will become only available after 20-year patent has expired. Patented medicines are in general more expensive. To meet the deadline to achieve the MDGs target 8.E, it is imminent that contrary action taken will be very useful. WHO recommended first-line regimen for HIV/AIDS for a year costs $87 when generic medicines are used whiles originator products costs $613 and $1,033.
WHO/HAI (WORLD HEALTH ORGANIZATION / HEALTH ACTION INTERNATIONAL)
Collaborative efforts between the department of medicine policy and standards of the World Health Organization and Health Action International (HAI) have seen the priority to improve access to essential medicines throughout Africa and particularly among the most resource
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Delegates in this committee have the enormous task of coordinating efforts to bring pragmatic and feasible solutions to the problems and challenges that impede the success of the MDGs. Solutions must be time-bound and goal oriented as the time frame is very short to the final deadline - 2015. Delegates should therefore take a critical look at the above mentioned challenges and come up with approaches that can aid in attaining the Target 8.E In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries.
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These Questions serve as guidance to the resolution needed at the end of all deliberations. It is not by any means restrictive.As such, other useful questions and corresponding answers are highly encouraged.
Topic A
1) How do you think can cost effective treatments be accessed in better ways as far as HIV is concerned? 2) Could the youth play an active role in advocating preventive measures in regards to HIV? If yes, what ways could they be? 3) What changes should be brought about in healthcare systems, to lower the incidence rates of HIV, Malaria and TB? 4) What kind of measures should be in place where the public and healthcare professionals can together control the impact of these major diseases? 5) What key points do you think have not been stressed upon enough in the past, that eradication of HIV/Malaria/TB still seems like a dream?
Topic B
1) What efforts should countries intensify to regularly measure and monitor prices and availability?
2) What role does the World Health Organizations have to play considering the current status of the issue?
3) What measures can be taken to reduce prices of medicines in the private sector or should they remain the same?
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4) Should policies be regulated to avoid excessive add-on costs in the supply chain?
5) Is there a need to take contrary actions regarding the existing TRIPS (Trade Related aspects of Intellectual Property Rights) Agreement?
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BIBLIOGRAPHY
TOPIC A
[1][7][8] World Health Organization, Health topics, MDG 6, Retrieved on 24/11/2012 from
http://www.who.int/topics/millennium_development_goals/diseases/en/ [2] British Medical Journal, Clinical Review, Sarah Chippindale-Lesley French, HIVcounselling and the psychosocial management of patients with HIV or AIDS.BMJ 2001;322:1533. Retrieved on 24/11/2012 from
http://www.bmj.com/content/322/7301/1533 [3] RHL ,The WHO Reproductive Health Library, Weller SC, Davis-Beaty K. Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD003255. DOI: 10.1002/14651858.CD003255.Retrieved http://apps.who.int/rhl/hiv_aids/cd003255/en/index.html [4] CDC, 'Male latex condoms and sexually transmitted diseases', Fact sheet for public health personnel.Retrievedon24/11/2012 from http://www.cdc.gov/condomeffectiveness/latex.html [5] British Medical Journal, Paper-Achieving the millennium development goals for health, Chantal Morel, Jeremy A Laue, David B Evans Cost effectiveness analysis of strategies to combat malaria in developing countries, BMJ 2005;331:1299.Reviewed on 24/11/2012 fromhttp://www.bmj.com/content/331/7528/1299 [6] UNICEF website, Millenium development goals, MDG 6.Reviewed on 24/11/2012 from on 24/11/2012 from
http://www.unicef.org/mdg/index_disease.htm
TOPIC B
[1] MDG Gap Task Force Matrix of Global Commitments August 2011 [2]The World Medicines Situation 2011 - Medicines Prices, Availability and Affordability [3] Local Production for Access to Medical Products World Health Organization. www.who.int/entity/phi/Local_Production_Policy_Framework.pdf
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