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After swearing in as the new Director General of the World Health Organization, Dr. Gro Harlem Brundtland said, "the world is in transition. So accordingly WHO must be in transition. Looking ahead." She brought forward an "Agenda For Change" that called for putting in efforts place health at the core of the international development agenda. She is of the view that health sector development should be part of everything we do.
She voiced for improving equitable access to sustainable quality health care through effectively integrating health interventions, strengthening health systems, and fostering individual, family and community involvement.
WHO Constitution, in 1948, defined health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Later on, while responding to a call from its Eastern Mediterranean Region, the World Health Assembly recognized that the spiritual dimension must also be included in countries’ strategies towards achieving the goal of Health For All (HFA).
In order to achieve the goal, WHO is providing technical assistance to improve the capabilities of the individual member states to meet the health requirements of their people based on policies and priorities.
In Pakistan, there are about 27 WHO-Government collaborative programmes. Both WHO and the Ministry of Health appoint Joint Programme Review Mission (JPRM) to assess the collaborative programmes. The Mission meets every two years to carry out intensive programme evaluation, operational reviews, reprogramming and forward planning for the next biennium. JPRM also offers scope and opportunity for dialogues and exchange of experience.
Keeping in view the priorities here, WHO attaches top priority to Polio Eradication; Poverty Reduction through Basic Development Needs (BDN) Strategy; Integration of Primary Health Care; Control of Communicable Diseases particularly HIV/AIDS, Hepatitis, Malaria and TB; Childhood Illness Reduction; Mental and Environmental Health Improvement; Tobacco Free Initiative; Disease Early Warning System; and Prevention of Blindness.
WHO’s contributions to boost up polio eradication campaign in Pakistan were stepped up when the first round of National Immunization Days (NIDs) was carried in 1994. Since then, organization’s commitment towards wiping out poliovirus has multiplied.
A step forward, door-to-door campaign to administer polio drops to the children below five years of age begun in 2000. It has now become a continuous phenomenon. AFP surveillance has also been strengthened.
Moreover, WHO has been supporting laboratory at NIH for poliovirus identification and typing. It is now functioning as a Regional Reference Laboratory for a number of countries. Besides, efforts are also being made to strengthen country’s routine immunization programme called Expanded Programme on Immunization.
BDN is a community-based WHO-Government joint venture. It aims at addressing health aspects of sustainable development and poverty reduction. The BDN was launched in 1995 at a model site of Nizampur, District Nowshera. Now it is being implemented in six model area including AJK.
Feature of the BDN philosophy is bottom up planning and inter-sectoral collaboration making relevant government line departments working together as team. The programme empowers community to work as the owners. It enables them to work together to do the planning and implementation work themselves. WHO and Government are there to facilitate the people. Besides, WHO also gives loans against small scale income generation activities developed by the people on the basis of their priority needs. Recently, Youth Development initiative, part of BDN Strategy, has been launched in all sites. Again, priority needs of the youth will be the basis of the intervention. Capacity building and skill development are priority areas.
Loans, so far, have been given in the fields of irrigation, agriculture, live stock, small trades etc. The social projects that have so far been introduced are health promotion, literacy and women development. Women development is part of BDN initiative. They have also been given loans for sewing and knitting machines. Some have also got loan for live stock and small trade like flour mill etc.
Post BDN scenario paints a happy picture. The socio-economic indicators registered marked improvement. Infant and Maternal Mortality Rates have been reduced sharply. Family planning practices among married couples of those remote areas were improved. The school enrolment particularly of females has also shown upward trend.
WHO is working closely with the Government for adoption of the BDN as an proven approach for poverty reduction for its countrywide replication.
Integrated Primary Health Care is vital for country’s health needs. WHO has given technical input to introduce this new strategy in five model districts namely Jhelum, Pishin, Sukkar, Mardan and Mirpur.
Disease Early Warning System enables the concerned authorities to detect the epidemics in their early stages and control the onslaught of the diseases like meningitis, viral hepatitis, Crimean Congo Hemorrhagic Fever, Cholera, Dengue etc. To date, 1,400 health managers from across the country have been trained in this programme.
WHO in collaboration with the Government working on certain measures like bed-nets, health education, better and prompt treatment and effective surveillance system in order to control Malaria that is fast re-emerging.
Estimated 650,000 TB cases pose a significant public health burden on this country. WHO has introduced DOTS (Directlty Observed Treatment Short Course) besides strengthening capacity of the health personnel to combat TB.
Tobacco-Free Initiative is another priority area. WHO has sponsored a number of anti-smoking campaigns. Recently, it has provided technical and financial assistance to organize Quit & Win Programme in all BDN sites. It included anti-smoking tournaments and cash prize for those who have successfully quit smoking.
WHO has provided technical and financial assistance to the National AIDS Control Programme. Procurement of HIV kits, technical material and health education/awareness are major contributions.
Other programmes included: Mental Health, Prevention of Blindness, Improvement of Nutrition, Essential Drugs, Health Management Information, Nursing, Environmental Health, Integrated Management of Childhood Diseases, Community Oriented Medical Education, Traditional Medicine, Leprosy Control, Rabies Research and Control, School Health, and Laboratory Services Quality Assurance.