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Annual report of the Regional Director for the year 2018
1. Tehran,
Islamic Republic of Iran
14 –17 October 2019
Introduction of the
Annual Report
1
Dr Ahmed Al Mandhari
WHO Regional Director for the Eastern Mediterranean
Agenda item 2(a)
3. Working together for greater
impact in countries
3
Our goal is
clear – to make
WHO a modern
organization
that works
seamlessly to
make a
measurable
difference in
people’s health
at country level.
20. Expanding universal health
coverage
1 billion more
people
benefiting from
universal health
coverage
1 billion more
people better
protected from
health
emergencies
1 billion more
people enjoying
better health
and well-being
20
39. The hospital sector needs to be transformed
740 000 hospital beds in the Region
(80% in the public sector)
Range: 3.932/10 000 population
Bed
utilization
In sub-district
and rural
areas
<30%
Destroye
d
hospital
s Syrian
Arab
Republic
46%
Treatable
at PHC
level
Overcrowded
large
hospitals
80%
Direct
access to
emergenc
y units
Non-
emergency
cases
60%
Hospital
expenditu
re
50
80%
Advers
e
events
Inpatients
Up to
18%
39
41. No UHC without nurses
Nurses
make up
more than
50% of the
health
workforce
41
42. Framework
for action
Strengthening nursing
and midwifery in
Region
66th Regional
Committee
Resolution to
strengthen nursing
workforce in Region
Global strategic
directions
For strengthening nursing
and midwifery 20162020
2008 2011 2016 2017 2019 2020
WHA
resolution
RC55 resolution
Framework
for action
Health workforce
development in
Region
Year of
the Nurse
NURSING NOW
CAMPAIGN
Global and regional momentum
to strengthen nursing
42
44. WHO’s Eastern Mediterranean Region
has highest rate of hepatitis C viral
infections
7
10
11
14 14
15
0
2
4
6
8
10
12
14
16
AM SEA AF EUR WP EM
Estimated number of persons living with hepatitis C virus (millions) by
WHO region
44
45. Estimated malaria cases (millions)
by WHO region, 2017
The number of malaria cases in the Region increased from 3.9 million
in 2015 to 4.4 million in 2017. Six countries account for more than
99% of cases in the Region.
45
46. The HIV infection rate is rising,
treatment rates are low
59
76
18
54
50
63
0
10
20
30
40
50
60
70
80
AFR AMR EM EUR SEAR WPR
ART Coverage by WHO Region (%)
46
60. Protecting people from emergencies
1 billion more
people better
protected from
health
emergencies
1 billion more
people
benefiting from
universal health
coverage
1 billion more
people enjoying
better health
and well-being
60
64. WEEKLY SIGNALS AND EVENTS TOTAL NUMBER OF GRADED
EMERGENCIES
39 1 1 18
3
Grade 3
8
Grade 2
2
Grade 1
15
Signals
Detected
Signal
Followed-
up
New
Events
Ongoing
Events
0
Protracted
3
2
Protracted
2
0
Protracted
1
Total number
of graded
emergencies
and events
64
72. 72
The Dubai Hub: a game changer
14 000m2 temperature-
controlled space
Rapid response and large
volumes
Medical supplies to 24
countries across three WHO
regions
Strategic forecasting to
enhance preparedness
Supply chain dashboard
73. Point of entry training
18 countries
of the Region
have now
completed the
joint external
evaluation
process
73
80. 80
Eastern Mediterranean Region polio
situation and risk categories
20192020
Endemic countries:
Afghanistan and Pakistan
Countries with outbreaks and
at very high risk:
Somalia, Syrian Arab Republic,
Yemen
Countries at high risk:
Djibouti, Iraq, Libya, Sudan
89. Promoting healthier populations
89
1 billion more
people
benefiting from
universal health
coverage
1 billion more
people better
protected from
health
emergencies
1 billion more
people enjoying
better health
and well-being
1 billion more
people
benefiting from
universal health
coverage
106. Health in All Policies approach
“Ensuring that health
issues are factored into
all government decisions,
not just ministry of
health policies”
10
6
107. The Region
has the third
highest road
traffic
fatality rate
in the world
10
7
111. Probability of dying from cardiovascular disease,
cancer, diabetes, chronic respiratory disease
between the ages of 30‒70 in countries of the
Region
Source: World Health Organization. Global Health Estimates 2015: Deaths by Cause, Age, Sex and Country, 2000-2015. Geneva, WHO, 2016.
111
115. Translating commitments into action
To support countries
to achieve food
security, end all
forms of
malnutrition and
improve nutrition
throughout the life
course by 2030
11
5
116. Rheumatic heart disease
• A significant public
health burden in
the Region
• Strongly associated
with overcrowded
living conditions
• Eminently
preventable
11
6
117. What is new in the updated
framework?
NCD investment case High-level multisectoral
mechanism
GOVERNANCE
Reduce exposure to air
pollution*
A system to monitor air quality
Estimations of health impact
PREVENTION AND REDUCTION OF RISK FACTORS
NCD integration in PHC in stable and emergency settings
Implementation of regional framework on cancer
HEALTH CARE
Population-based cancer
registry
SURVEILLANCE, MONITORING AND EVALUATION
* In line with Plan of action for the regional implementation
of the roadmap to enhance the global response to the
adverse health effects of air pollution 2017–2021
117
118. Screening and brief
intervention in only 3
countries
Receive evidence-based
treatment
1 medication for detox 1 medication for maintenance
No specialized facilities
Outreach services for
people who inject drugs
Harm reduction programmes
11
8
130. Scaling up contributions by WHO
collaborating centres
WHO supported establishment
of a new WHO collaborating
centre on ethics in Karachi,
Pakistan
13
0
UHC is a priority to the Eastern Mediterranean Region (EMR) and the region is facing major challenges in responding to the consequences of protracted emergencies, and the burden of communicable and noncommunicable diseases increasing the demand on health services and stretching the already strained health systems with implications on availability, skill mix, roles and competencies of nurses.
The need to strengthen nursing in order to achieve UHC has been well articulated in global and regional WHO resolutions and evidence based strategic directions to guide MS’s efforts to address challenges facing nursing workforce.
Having nursing on the agenda of this RC also highlights the importance of strengthening nursing in achieving the regional vision health for all by all
More recent efforts include the three-year Nursing Now campaign (2018–2020) which has been initiated to raise the profile and status of nurses worldwide. Nursing Now rolled in eight countries,
Narrative:
A number of other countries in the Region are at high risk of outbreaks caused by importation of WPV1 or development of vaccine-derived poliovirus: Djibouti, Iraq, Libya, Sudan, Syrian Arab Republic and Yemen.
All are experiencing varying degrees of complex emergency and have access or security constraints that hamper efforts to maintain high population immunity and sensitive surveillance
This image beautifully demonstrates how all of the units within the regional programme interact to have an impact.
This is an image taken from an environmental collection site in Mogadishu, Somalia, in July this year.
This was the first formal documentation of environmental surveillance in Somalia. To get this shot, it took coordination between the External Relations team, the Laboratory and Surveillance teams, the country support team. From this, we have developed a guidance video on environmental surveillance and collection which will be an important tool for the programme as environmental surveillance expands in the Region, and globally.
This work is also really important in highlighting the real value of maintaining such close collaboration with the technical team in Amman. Materials are developed based on a need determined by the country teams with the technical guidance of the people in this room.
About 50% of countries either do not have any specialized treatment facilities or these are only available in the capital city.
Fewer than one in 7 people with a substance use disorder worldwide receive evidence-based treatment, while in countries of the Eastern Mediterranean Region only one in 13 receives treatment.
Screening and brief interventions are only available in < 10% of primary health care services in three countries.
Only 1/3 of countries have needle/syringe exchange programmes and condom distribution programmes.
Outreach services for injecting drug users are available in only 25% of countries.
63% of countries have at least one medication available for detoxification treatment.
50% of countries report the availability of at least one medication for maintenance treatment (either methadone, buprenorphine or buprenorphine/naloxone).