By Claire Kilpatrick
Every year thousands of people pour into Geneva for the World Health Assembly (WHA); this year it was held 20-28 May.
WHA is the decision-making body of World Health Organization (WHO). It is attended by delegations from all Member States and focuses on a specific health agenda prepared by the WHO Executive Board. The main functions of the WHA are to determine the policies of the Organization, appoint the Director-General, supervise financial policies, and review and approve the proposed program budget. WHA is held annually in Geneva, Switzerland (UN Headquarters).
WHA is not a conference, you can’t apply and pay to attend. This is about people, namely delegations from both Member States and civil society aiming to influence and determine the policies and country led action that will help meet “health for all”, otherwise known Universal Health Coverage.
It’s about resolutions, which drive national policies. Two discussed this year will be critical in driving progress towards the Sustainable Development Goals and importantly water, sanitation and hygiene (WASH). Progress that means demonstrable commitment, and improvements that will affect patient and health worker safety due to higher standards of WASH. These were A72/26 ‘Patient Safety: Global action on patient safety’ and A72/27 ‘Patient Safety: Water, sanitation and hygiene in health care facilities’. Both were unanimously passed by Member States on 25 May.
From my side, historically speaking, if it weren’t for the first resolution on Quality of Care: Patient Safety in 2002 (at the 55th WHA) I probably wouldn’t have had the amazing opportunity to work with WHO, given that most of my roles since leaving Health Protection Scotland in 2008 have been built around the global patient safety agenda (importantly focused on the avoidable harm that is infection prevention in all communities).
So, having worked with WHO since 2008, this was my 10th opportunity to experience the Assembly. This means taking the opportunity to meet WHO country representatives (WRs) and Ministers for Health, attending plenary sessions but importantly attending technical briefings and side events where you have the opportunity to talk to a wide range of people who have an interest in the same topics as well as with NGOs in formal relations with WHO. For example, this year Water Aid supported the WASH in healthcare facilities side event. Soapbox has worked closely with Water Aid on a number projects over the years.
Side events are always challenging. The efforts required to set one up, thinking ‘will anyone be interested in this topic?’ when there are so many other events, and all with a similar focus – health for all. Preparing information and engaging people to attend is a big part of the work.
On 22 May, a packed room listened to a range of presentations in the UN building, describing the progress and challenges of WASH in health care. While Zambia had come forward as the leading sponsor country of the WASH resolution, a prerequisite for any resolution presented at WHA, many ministries also offered their support and spoke at the side event including Indonesia, Tanzania and eSwatini.
Then there was a moment. What we are calling the mop moment! Dr Tedros, Director General of WHO, arrived to give his input to the debate, just as Prof Wendy Graham, chief scientific advisor of our very own Soapbox Collaborative, was inviting interventions from the floor. Then we witnessed probably the best awareness to environmental cleaning that we could ever have got! Wendy had the opportunity to explain to Dr Tedros and the whole audience why cleaning and the role of cleaners is such a vital part of WASH and patient safety in healthcare, and do so very visually by presenting Dr Tedros with the mop she had brought along to emphasise the point. What followed was an engaged room where many vocalized their outrage, commitment and support for improved WASH now.
In summary, this side event wasn’t necessarily about presenting new information but about a discussion that would stimulate action and keep WASH in healthcare facilities on the global and national agendas. Conversations continued well after the event had ended that evening and Dr Tedros further showed his support through a tweet.
We now need to work together to promote practical actions. This includes using Soapbox’s TEACH CLEAN package, a resource designed to address the training of health facility cleaning staff in low- and middle-income countries.
We don’t truly know what these next years will bring for WASH in healthcare but #WHA72 (as it was known on social media) was another step in the right direction – ensuring that leaders, in fact everyone, truly accepts WASH as fundamental to quality healthcare.
The Resolution – way forward extract “WHO and UNICEF, in collaboration with over 30 partners and all regions, have developed a global work plan and architecture on WASH in health care facilities to respond to the Secretary General’s call to action, promoting a vision in which every health care facility has function WASH services and practices that enable essential, quality health services for everyone, everywhere.” Read more about these plans here./
And finally, from me, after a hectic but amazing WHA, and reminding yself that its ok to wear your most comfortable sneakers at such an important event as lasting the pace is the critical thing, I am even more enthused to support improvement. Saving lives through infection prevention is possible. Now, it’s time to focus on ICPIC, a biannual meeting where the best of infection prevention in health care is profiled, and the first global meeting on WASH in health care facilities to be held in September coordinated by WHO and UNICEF – Soapbox’s invaluable materials need to be a big part of this going forward!
So, another WHA is over and one final reflection…we also saw and heard the voice of the young professionals coming through strongly, including from a passionate student midwife leader, the International Federation of Medical Students’ Association (IFMSA), the People’s Health Movement and the International Pharmaceutical Students’ Federation (IPSF). That can’t be a bad thing for the future of WASH and patient safety.
Claire Kilpatrick, RN, PGDipIC, MSc. The Soapbox Collaborative and consultant to WHO.