World Health Organization Annual Meeting: New Flu, Coronavirus Urgent Priorities

In Geneva today, the World Health Assembly — that is, the annual meeting of the 194 governments whose collective commitment support the World Health Organization — opened as traditional, with a speech by the WHO’s director-general, Dr. Margaret Chan. It is a very interesting time, not just for the WHA to be meeting, but for Dr. Chan to be addressing them. That’s because, 10 years ago when SARS exploded into the world from China, she was the director of health for Hong Kong, the city that was hit first and hardest. Ten years later, with H7N9 flu emerging from China, and a viral relative of SARS — the novel coronavirus now being dubbed MERS — bubbling in the Middle East, the questions and lessons of SARS are bizarrely resonant. That has been true for the past several weeks, but is even more so today, with one more case of MERS announced, in one more country: Tunisia, this time.

Here are the opening paragraphs from Chan’s speech (full text online here). To me it’s quite interesting how much she praises China for its transparency in dealing with H7N9 flu — while not extending the same praise to the Kingdom of Saudi Arabia, where MERS is concentrated. In fact, she doesn’t even mention Saudi Arabia by name; whether that is meant to give offense, or to avoid it, other public-health tea-leaf readers can say better than me. Though her closing comment — “the current situation demands collaboration and cooperation from the entire world” — sounds pretty pointed to me.

Mister President, Excellencies, honourable ministers, distinguished delegates, friends and colleagues, ladies and gentlemen,

Ten years ago, the World Health Assembly met under a cloud of anxiety. SARS, the first severe new disease of the 21st century, was spreading explosively along the routes of international air travel, placing any city with an international airport at risk of imported cases.

By early July of that year, less than four months after the first global alerts were issued, WHO could declare the outbreak over. Rarely has the world collaborated, on so many levels, with such a strong sense of shared purpose.

Experiences during the SARS outbreak sparked extensive revisions of the International Health Regulations. These revisions gave the world a greatly strengthened legal instrument for detecting and responding to public health emergencies, including those caused by a new disease.

We are dealing with two new diseases right now.

Human infections with a novel coronavirus, from the same family as SARS, were first detected last year in the Eastern Mediterranean Region. To date, 41 cases, including 20 deaths, have been reported.

Though the number of cases remains small, limited human-to-human transmission has occurred and health care workers have been infected.

At the end of March this year, China reported the first-ever human infections with the H7N9 avian influenza virus. Within three weeks, more than 100 additional cases were confirmed. Although the source of human infection with the virus is not yet fully understood, the number of new cases dropped dramatically following the closing of live bird markets.

I thank China for collecting and communicating such a wealth of information, and for collaborating so closely with WHO. Chinese officials have promptly traced, monitored, and tested thousands of patient contacts, including hundreds of health care workers.

At present, human-to-human transmission of the virus is negligible. However, influenza viruses constantly reinvent themselves. No one can predict the future course of this outbreak.

These two new diseases remind us that the threat from emerging and epidemic-prone diseases is ever-present. Constant mutation and adaptation are the survival mechanisms of the microbial world. It will always deliver surprises.

Going forward, we must maintain a high level of vigilance. I cannot overemphasize the importance of immediate and fully transparent reporting to WHO, and of strict adherence to your obligations set out in the International Health Regulations.

As was the case ten years ago, the current situation demands collaboration and cooperation from the entire world. A threat in one region can quickly become a threat to all.




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