World Health Organization

???????????! (Hello! In Russian!)

First of all, Russia would like to say that we are so excited for BMUN this year. It is going to be a great conference, and we look forward to sharing ideas and debating with all of you. All the delegates have rightly acknowledged and addressed the growing issue of pandemics. The emergence of H1N1 has shed light on many health problems including distribution of vaccination, distribution of pharmaceuticals, and preventative measures. Many countries have made valid points regarding the best ways to handle these issues, but Russia would like all delegates to consider the following issues which haven’t been mentioned yet.

·        Vaccination- It is imperative that vaccines be distributed so that we control the spread of H1N1. However, there are many problems in doing so. First, mass distribution of any vaccine on a global level in a cost efficient and timely manner is impossible. It is simply not feasible for many countries to do so, regardless if developed nations contribute majorly or not. The world economy would not support such a mass distribution, especially since in developed nations inflation rates are at 4% and in developing nations inflation rates are at 12%. Furthermore, to distribute vaccines at this vast scale, we would need the full cooperation of pharmaceutical companies and we would need countries to work with these companies. Developing nations do not have great relationships with pharmaceutical companies since a majority of them are struggling to meet pharmaceutical companies’ price demands.

·        Distribution of pharmaceuticals-The H1N1 virus can be treated using antivirals, specifically oseltamivir or Tamiflu or zanamivir or Relenza. These medications have a 70 to 90% success rate, and have been used by many health care providers. The most efficient and best way for these drugs to be work is within 48 hours of contraction of the virus. (Please see link 1 for additional info about antivirals). For many people, this is not a reality, especially for those people without access to these medications. Tamiflu and many other drugs are protected by patents which developing countries only get access to by paying high fees. Many of these nations are vulnerable because of this and lack medication. Through the WTO’s TRIPS  agreement, many countries can produce generic forms of these products, but they still need help from developed nations.

Russia feels that we need to collaborate to produce sound resolutions and solutions to this problem, however there are some ideas we would like all delegates to consider. First, according to WHO update 89 (see link 2), not all regions are heavily contracted with H1N1, and many regions are barely affected. North Africa and Western Asia continue to have low contraction rates of the virus. Russia believes that we should focus on reducing contraction rates in countries with high risk. We should not distribute vaccines this quickly at a global scale, but we should and can distribute them on a need-basis. Russia suggests a UN body be created to oversee this process. It can include various member states, and the goal of this body would be to help with distribution of vaccines, obtaining contracts for patent rights, etc. This body can also oversee funding in regards to research with edible vaccinations and vaccine patches, ideas mentioned by various other delegates through the blogs.

Alright, we hope to see all of you in committee. We are looking forward to a really good time!

Link 1 http://www.cdc.gov/h1n1flu/antiviral.htm <http://www.cdc.gov/h1n1flu/antiviral.htm>

Link 2 http://www.who.int/csr/don/2010_02_26/en/index.html

Hello Delegates,

Most of the countries in Sub-Saharan Africa are in dire economic situations and are not able to purchase many necessary pharmaceutical goods. In places that are able to buy medical goods, a substantial portion goes to the urban areas when most of the population lives in the rural areas. A new health care system will be a major hurdle as some countries in Africa lack the infrastructure to do so.

In response to this, the United States believes that the first solutions have to be simple and cost effective. With malaria persisting as an issue in Africa, the usage of mosquito nets is one of them is a simple solution as one only costs five dollars. Furthermore, instead of investing in the development of vaccines for new diseases, countries should invest in vaccines that have been proven to work to have a more immediate effect.

Countries that are in a better economic position, like India and Kenya should start to use more low cost technologies like cell phones to transfer medical data to qualified doctors that live across the countries.

In addition, the lack water is also a serious problem. Those who do get access to water have no guarantee that it is potable, but with simple and inexpensive techniques like boiling it, much of the harmful elements of the water will be gone.

As the simple and low-priced solutions are implemented, more complex ideas will have to be used to improve the situation

See all of you on Friday!

-the United States

Hey Delegates!

What a day, our high school had a bomb threat in the middle of second period (some Neo-Nazi sophomore wanting to recreate Columbine) and we thought it was just a fire drill so now we got evacuated and all of our stuff is at school. On the plus side no homework or tests tomorrow!

As the conference is coming closer, China would simply like to display our policy prior to committee in order to ensure a clear and concise understanding of our beliefs.

First, on the topic of Pandemics, we believe that a brief history on pandemic prevention in our own country is vital towards understanding our policies. China has enacted strict regulatory measures which have been in response to the outbreak of SARS in our country in 2003. SARS stands for Severe Acute Respiratory Syndrome and display initial flu-like symptoms that may include fevers, lethargy, cough, sore throat Ever since, China has allowed for the creation of a World Health Organization database in our country to allow for research and control of pandemic outbreaks. The SARS outbreak in China was detected by Canada’s Global Public Health Intelligence Network (GPHIN) which immediately sent reports to the World Health Organization. China thus has now implemented its own monitoring systems into our country to ensure total prevention.

In addition to this China has also implemented the establishment and training of Rapid Response Teams which works with our Communicable Disease Surveillance and Response Team to set technical guidelines and training manuals on epidemiological disease surveillance and on the required responses of district health workers revised and updated. China would thus like to focus on monitoring and the ultimate prevention of pandemics from occurring. We have set guidelines and procedures on the conduct needed to sufficiently respond during times of crisis and we believe that in addition to prevention, alleviating current ailment is necessary to eradicate pandemic outbreak as a whole.

Second, China has also had a rich history when dealing with health care reformation. At the creation of the People’s Republic of China in 1949, our government covered over ninety percent of the financial costs in order to provide medical provisions for urban residents, while rural citizens were provided with free fundamental healthcare. Currently, we have stimulated the economy through creating a market-oriented health care system. In 2009, we publicized new health care reform policies in the hopes of providing “safe, effective, convenient and affordable” health care to all 1.3 billion Chinese citizens by 2020, both majority and minority. We have implemented 850 billion Yuan ($124 billion USD) towards improving healthcare benefits for our citizens, in addition to ensuring that healthcare is a right, not a privilege towards the Chinese people.

As the People’s Republic of China, we have created solutions that revolve around these previously stated beliefs, and we are excited to introduce and discuss our solutions in committee!

Salutations!

Now, in response to the delegation of Liechtenstein’s concern about cost-effective measures, the United Kingdom also places a heavy emphasis on them and believes that they should be a priority when discussing and drafting various solutions combating access to rural healthcare and emerging pandemics. For example, the delegation representing Liechtenstein mentioned that besides nevirapine, an anti-retroviral drug, other more economically wise solutions could be used instead, such as peer-based sex worker education. The United Kingdom strongly supports the idea of an educational workshop, as this would prove to be quite effective in areas where media is not as readily available, but believes that both nevirapine and the workshop could be used to tackle the problem of HIV/AIDs. The United Kingdom wants to use nevirapine as not part of highly active antiretroviral therapy(HAART), seeing as how costly it would be to treat patients with three or four other combined antiretroviral drugs, but as medicine to reduce the rate of HIV/AIDS transmission from mother to child. A single dose of nevirapine costs as low as US$ 8 and can reduce HIV transmission rates by at least 80%. A trial conducted in Uganda by The Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda has proven nevirapine to be 50% more successful compared to Zidovudine, another antiretroviral drug. The effectiveness of nevirapine is what leads it to being recommended by the US Public Health Service Task Force for mother-to-child transmission(MTCT) prevention and it to being a part of the World Health Organization Model List of Essential Medicines for MTCT prevention purposes. Additionally, what would further lower the cost of nevirapine is that the drug is part of the United Kingdom’s solution to globally bulk purchase vaccinations and other such needed drugs.

The United Kingdom has mentioned in its previous posts that international organizations such as the Supply Chain Management System(SCMS), WHO, and UNICEF have previously bulk purchased vaccinations to buy them at a low cost, and the United Kingdom believes that international organizations such as the mentioned three could negotiate with international pharmaceutical companies like GlaxoSmithKline and Baxter to further lower the cost. As the United Kingdom has stated, cost-effectiveness is one of our main priorities and that in order to achieve cost-effectiveness in purchasing vaccinations, the UK encourages that all vaccines proposed by other Member States could be streamlined through the solution of bulk purchasing.

The solutions proposed by Liechtenstein, such as improved remuneration and training in South East Asia and Sub-Saharan Africa, to plug the brain drain are something to be noted, particularly by more developed nations such as the G8. The G8 and other developed nations shoulder the burden of revitalizing Africa and Asia’s healthcare systems through funding of health centers to provide incentives such as increased salaries for healthcare workers to stay within their native countries. The United Kingdom believes that in addition to increasing remuneration, the funding could also be directed to supporting medical schools in Africa and Asia. One of the main reasons that health workers leave to developed nations such as the United States of America, the United Kingdom, and New Zealand is because of the promising medical education that we can provide. Therefore, the United Kingdom supports redirecting funds to programs dedicated to providing medical schools with proper equipment and education. One example of such an initiative is the Malawi Link exchange program by the United Kingdom’s own North Cumbria University Hospitals. Established in 2003 by nurses at the Cumberland Infirmary with the Beit CURE International Hospital in Blantyre, Malawi, the Malawi Link program looks to help potential healthcare workers by providing training at the Cumberland Infirmary and then sending them back to Malawi with newly acquired medical experience, skills, education. The Malawi Link program has also helped provide truckloads of medical equipment, journals, and other medical materials to hospitals in Malawi. For more information, the United Kingdom encourages delegates to visit this link: http://news.bbc.co.uk/2/hi/health/4471739.stm

Furthermore, the United Kingdom pushes for a code of ethical recruitment to be established with the World Health Organization and developed nations to decrease the number of healthcare workers from Asia and Africa being imported. The code of ethics, already implemented by the United Kingdom itself, states that developed nations will not actively recruit medical personnel from certain developing countries, setting a limit as to how many workers can be imported/exported annually.

The United Kingdom of Great Britain and Ireland looks forward to debating this topic with you all this weekend.

Cote d’ Ivoire would like to emphasize the need of prevention in the H1N1 epidemic. H1N1 has shocked the nation this past year. Because this disease is more frequent in children, pregnant women, and the elderly, we need to focus upon reaching out to those age groups in particular. Prevention is the key to countering the H1N1 virus. Prevention will cause a major decrease in the epidemic. The means of are honestly prevention endless. H1N1 is highly contagious 1 day prior to symptoms and 7 days of contracting the disease. If one has contracted the H1N1 virus they should do their best to keep the virus from spreading. In order to do this, the H1N1 patient should refrain from leaving their home. It is in everbody’s best interest, if the h1N1 patient avoids the emergency room or urgent care facilities. They should also avoid high contact with doctors, nurses, and medical professionals without the strong purpose of their own treatment. The most important and effective method of prevention is proper sanitation methods. Its important to wash hands frequently and thoroughly. A quick 10 second soap and rinse is not enough.  If possible, communities should make use of hand sanitizers. Washing hands is very effective in killing the H1N1 germs that live on the surface of a person’s hands. Germs are also present on counter tops, door knobs, and other surfaces that are constantly in human contact. Disinfectant sprays are available for the purpose of eliminating germs. Eliminating the germs are a major step in the prevention of the H1N1 virus. Prevent the virus with the H1N1 vaccine. It is highly recommended that pregnant women, children and the elderly take advantage of the availability. Prevention is key to creating a gap in the H1N1 epidemic. It will be very helpful in our goal to counter H1N1.

Cote d’ Ivoire

Hello Delegates!

Denmark has seen many, many posts written on the blog about the need for an improved method of vaccination and vaccine production and a call for cost-effectiveness, which is, of course, imperative. But a question remains unanswered: What are countries to do with the leftover vaccines? Vaccines expire and pathogens change. In Denmark, only 380,000 of the 3.1 million doses of vaccines were distributed and used.

http://www.cphpost.dk/news/national/88-national/47805-h1n1-epidemic-passes.html

This leaves approximately 2.7 million doses left. As a reminder, WHO confirmed over 600,000 cases in November 2009, not even 1/4 of the number of vaccines unused by only Denmark.

This is neither cost-effective nor environmentally friendly. Delegates, instead of clamoring for new and improved methods of vaccination creation, why not make the method for international vaccine distribution more effective? Of course, this would require international cooperation and WHO to monitor the distribution of vaccines so that countries with the most need receive the vaccines. Of course this does not mean that Denmark discourages research into faster methods of vaccine production such as using insect cells, which would reduce manufacturing times to ten weeks, but would rather push for better means of prevention.

http://www.in-pharmatechnologist.com/Materials-Formulation/Insect-cells-could-cut-vaccine-production-to-10-weeks

The speed at which H1N1 Influenza A spread across the world scathingly points towards the ineffectiveness of our current quarantine and prevention methods. Denmark proposes setting an International Quarantine Bill of Rights, which would clearly lay down the do’s and don’t’s of quarantine. Moreover, Denmark proposes stricter monitoring in airports: the easiest way for a virus to reach point A to B. Using thermal imaging devices and other technology that does not inconvenience the travelers, Denmark believes that WHO will be able to prevent pandemics from raging across the globe like a wildfire.

Thanks for reading and see you all Friday! Super excited for the conference!

From Denmark with Love,

Howon and Hina

Hello Fellow Delegates,

Liechtenstein believes that the aggrandized use of vaccines globally is the most preventive and cost-efficient method by which pandemics can be mitigated in the present and in the future. However, in order to do this, the WHO pandemic response infrastructure must be reformed. Most importantly, the UN Central Fund for Influenza Action (CFIA) must be enlarged in order to facilitate UN efforts to aid developing countries in pandemic response. The UNCFIA is ineffective in funding the WHO pandemic response system because of the grave lack of resources available to it. For example, the United States’ Centers for Disease Control and Prevention alone has an infectious disease budget of almost 2 billion dollars, while the UN fund only has a budget of 30 million for 194 countries. Money must also be appropriated to increase vaccine production capacity because currently only 350 million doses of influenza vaccines can be produced per year for the earth’s 6.7 billion people. Because of lack of monetary and fiscal resources, the WHO was able to provide only 200 million doses of vaccine to be divided among the populations of 95 countries. To put this into perspective, the US was able to purchase 250 million doses for just its own population.

http://www.undp.org/mdtf/influenza/overview.shtml

In order to alleviate the lack of resources available to the UN pandemic response system, Liechtenstein proposes that individual governments must contribute more funds to the UN Central Fund. It must be impressed upon the affluent nations that the prevention of pandemics lies in the hands of the entire world – not just in the capabilities of singular nations. The only way that the WHO’s Global Alert and Response (GAR) system can be effective is if all nations, both rich and poor, possess the ability to respond. The international community will be required to shoulder some of the financial burden of: a) improving seasonal influenza vaccine coverage in resource-constrained countries, and b) establishing vaccine production-capacity. This can be done by means of direct investment or technology transfer in developing or middle-income countries. The private sector will also be required to invest in expanding its manufacturing capacities and developing new production technologies.Taking these steps to ensure the equality of pandemic response in all nations will serve to greatly advance the effectiveness of the UN’s preventative measures.

www.who.int/vaccines-documents/DocsPDF06/863.pdf

See you all in less than a week!

Liechtenstein

Hello Fellow Delegates,

The government of Liechtenstein believes the only way to sufficiently improve rural health care is to decentralize health systems. Liechtenstein believes that instead of governments throwing billions at the health ministry and seeing no improvements, governments should disperse healthcare money directly to the people and let them select their healthcare providers. In the current system rural areas are shortchanged. For example, in Rwanda 80% of public health spending is in urban areas while 75% of the population is rural. Most of the national health-systems seem to provide very minimal service, especially for rural people If the people of the richest nation in the world cannot trust their government to provide healthcare how can the people of some of the poorest countries in the world expect their distant governments to provide healthcare? Already healthcare in Africa is becoming essentially privatized, as corruption is rampant especially among rural health care workers, and 60% of healthcare financing in Africa comes from private sources. By putting patients in charge of health, doctors will serve their patients instead of a far off and ineffective government bureaucracy. Private providers will be able to easily expand and improve the human and technical infrastructure that they believe will best improve service. Private health providers have been shown to be effective and efficient in rural areas, though not very profitable. This IFC, a division of the World Bank report, deals with in depth the strength and weakness of private health care in Africa.

http://www.ifc.org/ifcext/healthinafrica.nsf/Content/FullReport

Utilizing technology and redirecting spending would dramatically improve the viability of private health care providers in rural areas. We propose that governments spend their health care budgets on health care vouchers which will be progressively distributed among the population. These vouchers will only be redeemable at licensed health care providers traditional, private, or public. Only these licensed providers will be able to convert the vouchers into money. NGO’s can also be licensed providers of medical care. In areas where it is feasible the vouchers could take an electronic form with villagers typing an account number into a provider’s cell phone in order to transfer funds. It will be vital for governments or international organizations such as the WHO to monitor the providers, especially the traditional ones, to ensure that they provide services based on medical science not their pocket books. Private providers desperately need regulation too, as this Oxfam video shows.

http://www.oxfam.org/en/video/2009/reality-healthcare-people-developing-countries

Patients will also be allowed to purchase insurance; there are some very good non-profit health insurance schemes.

http://www.brookings.edu/opinions/2007/1129_aids_van_der_gaag.aspx

By allowing for regulated private providers to grow, practices such as ehealth will be implemented more rapidly. Also, personnel issues will be handled more effectively. Large private providers could more easily tailor benefit packages to draw workers to rural areas, and private providers will also be able to offer merit-based pay to insure health workers are working honestly. Finally, the rise of strong private competition will force public providers to reform or die. No longer will doctors be allowed to take “tea breaks” that last all day without punishment. The only way to reform Africa and South Asia’s health systems is to strengthen and regulate the private sector.

See you in a few days,

- Liechtenstein