Moreover, the 191 Member States of the WHA also agreed a US$15 million injection of "casual income" into WHO's regular budget for the 2000-2001 biennium and took an important decision vis-à-vis the destruction of known existing stocks of the variola (smallpox) virus. The WHA referred a draft resolution on the use of languages within the WHO Secretariat and WHO publications to the WHO Executive Board.

Framework Convention on Tobacco Control

The Assembly unanimously decided to open the negotiation process on the Framework Convention on Tobacco Control (FCTC) – a new legal instrument that will address issues as diverse as tobacco advertising and promotion, agricultural diversification, smuggling, taxes and subsidies. In committee discussions on 22 May, a record 50 nations took the floor to pledge financial and political support for the FCTC, including the five permanent members of the United Nations Security Council, major tobacco growers and exporters, as well as several countries in the developing and developed world which face the brunt of the tobacco industry's marketing and promotion pitch.

This is the first time in its 50-year history that WHO is exercising its constitutional mandate to negotiate a Convention. When ready, the FCTC will be the world's first global tobacco control treaty. ''It seems only right that we focus on tobacco – at the turn of a century packed with achievements in science and medicine, tobacco stands out as an area of appalling neglect,'' said WHO Director-General Dr Gro Harlem Brundtland.

A FCTC working group will soon begin work on proposed draft elements of the FCTC, thereby paving the road for formal negotiations to commence in about one year's time. WHO and its Member States plan to have the Convention process completed by 2003, after which it will be open for ratification.

Roll Back Malaria

In recognition of the enormous economic, health and social burden which malaria causes, especially in Africa, one of Dr Brundtland's first actions on becoming Director-General was to establish the Roll Back Malaria programme. This global partnership is committed to halving malaria-related deaths throughout the world by the year 2010. There are six core elements to the partners' programme: 1) early detection of malarial illness; 2) rapid treatment of those who are ill; 3) multiple means for preventing malaria infection; 4) well-coordinated actions; 5) a powerful global movement; and 6) determined, focused research to develop new products. This package is based on the best malaria practices of the past decade. It can be applied in any malaria situation, although the specific interventions to be used in each setting will vary widely .

The WHA unanimously endorsed the new approach to malaria control, saying in its resolution that it commended "the key features of the new approach, namely, increased focus on the needs of people at risk, better response to those needs with evidence-based action, greater use of existing tools, their full integration into the health sector as a horizontal programme, and innovative public-private partnerships to develop cost-effective products and tools in view of the emergence of drug and insecticide resistance".

Polio Eradication

The resolution on accelerating polio eradication addressed the financial shortfall problem by requesting the WHO Director-General to establish "an emergency fund to meet the needs of countries affected by conflict, countries classified as major wild poliovirus reservoirs, and other countries in particularly difficult circumstances".

With the target date for polio eradication now on the horizon, delegates at the World Health Assembly (WHA) were resolute in their commitment to rid the world of polio on time. All speakers agreed that civil strife and funding shortfalls now represent the two major obstacles to polio eradication.

"The first and last steps of this initiative are the hardest. We cannot allow financial constraints or conflicts to set us back during the all-important final stage", says Dr Gro Harlem Brundtland, WHO Director-General. Forty-six speakers took the floor to endorse the WHA resolution to accelerate the eradication initiative.

Revised Drug Strategy

Despite improved global availability, at least one-third of the world's population still lacks access to essential drugs. In the most impoverished parts of Africa and Asia, this proportion rises to over half. In developed countries a course of antibiotics can be bought for the equivalent of two or three hours' wages. One-year's treatment for HIV infection costs the equivalent of four to six months' salary. And the majority of drug costs are reimbursed. In developing countries, a full course of antibiotics to cure simple pneumonia may cost one month's wages. In many of these countries one year's HIV treatment – if it were purchased – would consume 30 years' income. And the majority of households must buy medicines with money from their own pockets.

When originally proposed at last year's WHA the resolution on the Revised Drugs Strategy, which seeks to improve access by developing countries to essential drugs, caused considerable debate and was referred back to WHO's Executive Board. The final text as passed unanimously by this year's WHA reflects a broad consensus which resulted from an Executive Board working group consisting of 59 countries.

Adoption of the resolution gives WHO the go-ahead to expand its work on a range of issues which affect access, quality, and rational use of drugs.

Destruction of Variola (Smallpox) virus stocks

World Health Assembly (WHA) agreed by consensus on 24 May to the "temporary retention, up to but not later than 2002, of the existing stocks of variola virus". The WHA said that the two known existing stocks of smallpox virus should not be destroyed on 30 June 1999, as had previously been foreseen, "for the purpose of further international research into antiviral agents and improved vaccines, and to permit high-priority investigations of the genetic structure and pathogenesis of smallpox".

In 1996, the World Health Assembly agreed to the destruction of the two known stocks of smallpox virus - at the Centers for Disease Control and Prevention in the United States of America and at the Russian State Centre for Research on Virology and Biotechnology in the Russian Federation – subject to confirmation by this year's World Health Assembly. Although that destruction has now been delayed, the WHA resolution affirms that "the final elimination of all variola virus remains the goal of the World Health Organization (WHO) and all Member States".

WHO will, not later than 2002, make a recommendation to the World Health Assembly and WHO's Executive Board on final destruction of the remaining stocks of smallpox virus.

Budget for 2000-2001 Biennium

The WHA commended the remarkable progress made in the presentation of WHO's budget and recognized the importance of "maintaining programme expenditure levels in compensation for possible cost adjustments."

The WHA decided to appropriate US$842.64 million as the effective working budget. It also decided to apply the balance of casual income available on Dec 31 1998 as follows: US$15 million dollars to high priority programmes, including programmes for eradication of polio, Roll back malaria, Tuberculosis, HIV/Aids, and the Tobacco Free Initiative. The balance of casual income above $US15 million will be returned to Member States.

The WHA also requested the WHO Secretariat to identify additional efficiency savings in the order of 2-3% for reallocation to high priority programmes, particularly at country level.

Use of official languages in WHO Secretariat

A draft resolution on the use of official languages in the WHO Secretariat and in WHO publications was also discussed in one of the WHA committees. However, after considerable debate, no consensus could be reached and the matter was referred to the 105^th session of WHO's Executive Board, which meets in January 2000, for further consideration.

For further information, journalists can contact Gregory Hartl, Office of Press and Public Relations, WHO, Geneva. Telephone (41 22) 791 44 58. Fax (41 22) 791 48 58. E-Mail: hartlg@who.int