EXCERPTS OF THE DIRECTOR-GENERAL SPEECH TO THE 65 WORLD HEALTH ASSEMBLY
I can suggest three general lines of advice.
First, get back to the basics, like primary health care, access to essential medicines, and universal coverage (...)
Second, as public expectations rise, costs soar, and budgets shrink, we must look to innovation as never before. And I mean the right kind of innovation. Innovation does the most good when it responds to societal concerns and needs, and not just to the prospects of making a profit. These days, the true genius of innovation resides in simplicity. This is not rocket science (...)
Obstructed labour is a major killer of young women and adolescent girls. The real reasons are these: poverty and health systems that are impoverished by lack of medicines, equipment, skilled staff, and transportation.
"The Odon device, developed by WHO and now undergoing clinical trials, offers a low-cost simplified way to deliver babies, and protect mothers, when labour is prolonged. It promises to transfer life-saving capacity to rural health posts, which almost never have the facilities and staff to perform a C-section. If approved, the Odon device will be the first simple new tool for assisted delivery since forceps and vacuum extractors were introduced centuries ago."
As we promote primary health care and universal coverage, we must not let a deteriorating economic outlook compromise the quality of clinical care. Primary health care is not cheap, and it must not be a "B-team" version of what people get when they pay for private care. We must never forget the importance of high-quality clinical care. Here, too, frugal innovation helps. Just a few years ago, WHO estimated that surgical errors were killing around one million people worldwide each year. To address this problem, WHO adapted a simple checklist used by pilots in the airline industry, one of the safest industries in the world. The WHO surgical safety checklist was introduced in 2008 and has since been widely applied, significantly reducing surgical errors. Studies suggest that, if fully implemented, nearly half of those one million deaths would be averted. Building on this success, WHO has developed a safe childbirth checklist to address the huge burden of preventable maternal and newborn deaths, especially in low-income settings.
What good does it do to offer free maternal care and have a high proportion of babies delivered in health facilities if the quality of care is substandard or even dangerous? A pilot study of the checklist, conducted in India and published last week, demonstrated a 150% increase in adherence to accepted clinical practices for maternal and perinatal care in an institutional setting. No additional resource investments were made. Just a paper checklist, like pilots use. A large randomized controlled trial is under way to quantify the impact on reducing morbidity and mortality, but results will take some years. In the meantime, WHO will soon release the checklist as part of a call for collaborative research (...)