Governments to agree increased focus on people with disabilities in development strategies

20 September 2013 | Geneva - WHO welcomes the forthcoming agreement at a High-Level Meeting at the United Nations General Assembly which will further improve access to health care and related services for people with disabilities and ensure that they are able to contribute to the sustainable development of their communities.

On 23 September, Heads of State – in their first-ever global meeting on this topic – are scheduled to recommend:

• including people with disabilities in the setting and implementation of development agendas post-2015;
• addressing the many barriers people with disabilities face in daily life – such as difficulties in accessing health-care services, including rehabilitation and assistive devices;
• taking urgent action by all stakeholders, including the health sector, to ensure that all development policies benefit people with disabilities;
• improving collection and analysis of data on disability and devising ways to use it more effectively to guide development policies and programmes.

Improving access to health care

The more than 1 billion people living worldwide with disabilities all have the same general health needs as non-disabled people – such as immunization, cancer screening and reproductive health services. They may also have specific disability-related health conditions, such as ulcers, urinary tract infections, paralysis and depression associated with spinal cord injury. Many people with disabilities require rehabilitation, such as support to regain strength following hospitalization for diabetic coma or provision of a prosthesis after a limb amputation.

“Too often, people with disabilities face barriers in accessing health and rehabilitation services,” says Dr Margaret Chan, Director-General of WHO. “These include stigma and discrimination, lack of accessibility, and the inability to pay. The new UN agreement can help bring down such barriers.”

Today, people with disabilities are twice as likely to report that health care providers’ skills and facilities do not meet their needs. They are three times more likely to be denied health care and four times more likely to be treated badly in the health care system than people without disabilities.

Half the people living with disabilities worldwide are unable to afford the health care they need. They are 50% more likely than persons without disability to suffer catastrophic health expenditure, which pushes them into poverty.

Many people with disabilities are unable to access the assistive devices and related rehabilitation services they need. For example, 360 million people have moderate to profound hearing loss, but production of hearing aids meets only 10% of global need and 3% of developing country need; 200 million people need spectacles or low vision devices, but have no access to them. Some 70 million people need a wheelchair, yet only 5-15% have access to one.

The High-Level Meeting outcome document highlights the importance of:

• making quality health services available and affordable to people with disabilities, whoever they are and wherever they live;
• developing national disability policies and programmes that address the health and rehabilitation needs of people with disabilities, and allocating appropriate resources;
• improving data to better understand these health and rehabilitation needs and monitor and evaluate the impact of policies and programmes.

WHO is already scaling up efforts in line with the outcome document by preparing a seven-year global action plan "Better health for persons with disabilities". The action plan is based on approaches that have proved effective in improving the health and well-being of people with disability.

The draft plan also builds on the Convention on the Rights of Persons with Disabilities and the recommendations of the "World report on disability" (2011). It is currently being reviewed through a series of regional and targeted consultations and on an online consultation process which ends on 11 October 2013. It will be presented to the WHO Executive Board meeting in January 2014 in preparation for consideration at the Sixty-seventh World Health Assembly in May 2014.

For more information please contact:

Gregory Hartl
Coordinator
News, Social Media and Monitoring, WHO
Telephone: +41 22 7914458
Mobile: +41 79203 6715
E-mail: hartlg@who.int

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WHO urges governments to act on hepatitis threat

24 July 2013 | GENEVA - On World Hepatitis Day (28 July), WHO is urging governments to act against the five hepatitis viruses that can cause severe liver infections and lead to 1.4 million deaths every year. Some of these hepatitis viruses, most notably types B and C, can also lead to chronic and debilitating illnesses such as liver cancer and cirrhosis, and in addition to, loss of income and high medical expenses for hundreds of millions of people worldwide.

Viral hepatitis is referred to as a ‘silent epidemic’ because most persons do not realize that they are infected and, over decades, slowly progress to liver disease. Many countries are only now realizing the magnitude of the disease burden and devising ways to address it.

“The fact that many hepatitis B and C infections are silent, causing no symptoms until there is severe damage to the liver, points to the urgent need for universal access to immunization, screening, diagnosis and antiviral therapy,” says Dr Keiji Fukuda, WHO Assistant Director-General for Health Security and the Environment.

"Many of the measures needed to prevent the spread of viral hepatitis disease can be put in place right now, and doing so will offset the heavy economic costs of treating and hospitalizing patients in future."

Dr Sylvie Briand, Director, WHO Pandemic and Epidemic Diseases

This year, in the run up to World Hepatitis Day, the Organization is releasing its first-ever country hepatitis survey, covering 126 countries. The WHO "Global policy report on the prevention and control of viral hepatitis in WHO Member States" identifies successes as well as gaps at country level in the implementation of four priority areas. The priority areas are raising awareness, evidence-based data for action, prevention of transmission, and screening, care and treatment.

The findings show that 37% of the countries have national strategies for viral hepatitis, and more work is needed in treating hepatitis. It also highlights that while most of the countries (82%) have established hepatitis surveillance programmes, only half of them include the monitoring of chronic hepatitis B and C, which are responsible for most severe illnesses and deaths.

“Many of the measures needed to prevent the spread of viral hepatitis disease can be put in place right now, and doing so will offset the heavy economic costs of treating and hospitalizing patients in future,” says Dr Sylvie Briand, Director, Pandemic and Epidemic Diseases at WHO. “The findings underline the important work that is being done by governments to halt hepatitis through the implementation of WHO recommended policies and actions.”

The challenges posed by hepatitis were formally acknowledged by the World Health Assembly in 2010 when it adopted its first resolution on viral hepatitis, and called for a comprehensive approach to prevention and control. This has promoted a new era of awareness with more governments proactively working to address the disease. Reinforcing that call for action, WHO has been collaborating closely with countries and partners to build a strong global response. As a result, the new report notes, 38% of countries observe World Hepatitis Day (an annual event that began in 2010) with even more countries expected to mark the day this year.

In addition to collaborating closely with countries, WHO has been working on developing networks and mechanisms that can deliver results. The Organization is exploring with international funding agencies avenues that could allow hepatitis to be included in their current programme of activities. In June 2013, WHO launched the Global Hepatitis Network. One of its aims is to support countries with planning and implementation of viral hepatitis plans and programmes.

WHO is currently developing new hepatitis C screening, care and treatment guidelines, which will provide recommendations on seven key areas such as testing approaches; behavioural interventions (alcohol reduction); non-invasive assessment of liver fibrosis; and the selection of hepatitis C drug combinations.

”New, more effective medicines to prevent the progression of chronic hepatitis B and C are in the pipeline. However, these will be expensive and therapy will require monitoring with sophisticated laboratory tests. To cure and reduce the spread of these viruses, medicines must become more accessible,” says Dr Stefan Wiktor, Team lead of WHO’s Global Hepatitis Programme.

The complexity of hepatitis disease lies in the existence of different types of viruses. Hepatitis A and E are foodborne and waterborne infections which cause millions of cases of acute illness every year, sometimes with several months needed for a person to fully recover.

Hepatitis B, C, and D are spread by infected body fluids including blood, by sexual contact, mother-to-child transmission during birth, or by contaminated medical equipment. Hepatitis B and C have a greater health burden in terms of death because they can cause life-long infection (called chronic infection), which can lead to liver cirrhosis and cancer. In fact, chronic hepatitis is the leading cause of liver cirrhosis and cancer.

WHO-approved vaccines are available to prevent hepatitis A and B, while screening of blood donors, assuring clean needle and syringes, and condom use can prevent bloodborne and sexual transmission.

Hepatitis B can be prevented by reaching every child with immunization programmes that include hepatitis B vaccine. There is no vaccine for hepatitis C. In addition, infections can be prevented by protecting against mother-to-child transmission of the virus and ensuring the safety of blood, transfusion services, organ donation and injection practice (treatment can include antiviral medications if needed).Hepatitis A and E can be prevented by avoiding contaminated food and water; in addition, there is an effective WHO approved vaccine for hepatitis A. Hepatitis medicines are now included in the WHO Essential Medicines List, which Member States are encouraged to adopt. Essential medicines are selected based on disease prevalence, safety, efficacy, and comparative cost-effectiveness. The WHO Model List can be used by countries as a guide for the development of their own national list.

Mr Glenn Thomas
Communications Officer
WHO, Geneva
Telephone: +41 22 791 3983
Mobile: +41 79 509 0677
E-mail: thomasg@who.int

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