World Health Assembly 77.

CHIC AT WHA

The World Health Assembly is the decision-making body of WHO. It is attended by delegations from all WHO Member States and focuses on a specific health agenda prepared by the Executive Board.

The main functions of the World Health Assembly are to determine the policies of the Organization, appoint the Director-General, supervise financial policies, and review and approve the proposed programme budget.

The Seventy-Seventh World Health Assembly takes place 27 May – 1 June 2024 in Geneva, Switzerland.

This is a resource to support us all in advocating for proCHWs at WHA77. You’ll find:

WHA77 objectives
Engagement details
CHIC event(s)
proCHW messaging
Social toolkits and graphics
One-pagers and tools

Objectives.

Based on the WHA agenda our overall objectives for WHA77 are:

Leverage WHA to influence Gavi prioritization of CHWs within the Gavi 6.0 Strategy and investment round
Engage countries with active policy review windows
Influence the inclusion of evidence-based and technically sound proCHW statements on the official WHA proceedings
Build relationships with disease and issue-specific communities, and other potential allies, in order influence their talking points and add in proCHW language to other conversations

CHIC EVENT

Reaching the unreached: unlocking immunization equity through chw investments.

We will be hosting a side event on Wednesday 29 May at 8:00 – 9:30am CET. Together we will explore the strategic priorities needed to reach zero-dose and unvaccinated communities through health systems strengthening.

Recognizing Gavi’s increased focus in primary health care and CHWs to reach zero-dose and unvaccinated communities in the immunization response, we will:

identify Gavi’s unique role in supporting comprehensive and responsive PHC systems.
explore insights from high-level government stakeholders, funders, Gavi stakeholders and non-state implementers.
discuss ideas on how Gavi can respond to gaps in the immunization response by investing in CHWs.

Through this session, attendees will gain further clarity on the role that Gavi can play in supporting comprehensive and responsive PHC by leveraging CHWs, in order to reach the unreached for immunization.

Agenda

A Community Health Worker extracting liquid from a vial using a syringe while people stand behind her

Advocating for prochws

Messaging.

Coalition activities and dialogues at WHA77 will be built around the following key messages to create a “surround sound” presence for proCHW messages.

CORE MESSAGING.

For every CHW program to reach its full potential, CHWs must be salaried, skilled, supervised and supplied.
- Half of all CHWs in low- and middle-income countries (LMICs) are not salaried, including 86% in Africa.
- Worldwide, CHWs face essential medicine stock-outs 1/3 of the time.
- Underfunded CHW programs are inefficient and ineffective. They result in CHWs being absent, ill-equipped, or facing grave dangers—like the lack of PPE during COVID.
Making professional CHWs (proCHWs) the norm is possible when we all work together.
- As laid out in the Monrovia Call to Action, we must reinforce our mutual commitment to fund, scale, and strengthen community health programs as an integral part of primary health care for the realization of UHC.
Our goal is to see the majority LMICs adopt proCHW policy, and we’re keeping score.
According to CHIC’s Policy Dashboard, 39/90 countries currently have one or more CHW groups who are accredited and salaried.

Universal health coverage (UHC).

Progress on Universal Health Coverage will be discussed during Agenda item 11.1
Undeniable evidence shows that CHWs deliver primary health care in a way that improves access, increases equity, and saves lives. So CHWs are essential for realizing Universal Health Coverage (UHC).
- CHWs have played a vital role in many global health efforts, including reducing childhood mortality and morbidity and increasing access to effective treatments.
- It is estimated that if CHWs were scaled globally and supported to deliver evidence-based interventions, preventable deaths could be reduced by up to 32% globally – with 58% of these on the African continent.
- But good health only happens if there are good working conditions, so CHWs must be recognized as professionals and supported with salaries, skills, supervision and supplies.
In 2023, all UN member states agreed to a Political Declaration that included key commitments to take action on a number of issues relevant to the health and care workforce within the efforts to achieve UHC. There is specific inclusion of community health workers in these commitments (paragraphs 92, 93, 95, 104).
At the WHA, member states have an opportunity to provide details on steps they are taking to carry out these commitments, during the discussion on Agenda item 11.1 on UHC.
These steps should include scaling up training, providing appropriate remuneration, decent and safe working conditions, and inclusion in decision-making and governance, in accordance with specific commitments in the Declaration.
Member states should not miss this opportunity to showcase their country’s actions to implement the Political Declaration and inspire other member states to follow their leadership.
It is important for member states to openly communicate the challenges they’re encountering along with possible solutions.
Member states ought to discuss the innovative financing mechanisms they’re employing to support these endeavors.

IMMUNIZATION.

Immunization is on the official WHA Agenda as Item 11.4 – Immunization Agenda 2030. This is in the context of the “The Big Catch-up”, a targeted global effort to boost vaccination among children following declines driven by the COVID-19 pandemic, as well as a rising number of outbreaks, particularly measles.
As members of the communities within which they work, CHWs are ideally placed to overcome barriers to essential health services, and achieve these critical objectives on immunization
Not only do CHWs have a strong track record of delivering a wide variety of primary health care services, they have proven invaluable in the management of viral outbreaks and infectious diseases as varied as Ebola, HIV, tuberculosis, malaria, and Zika virus.
Practical tasks CHWs can implement in immunization programs include:
- Identification of target populations
- Increase vaccine acceptance and uptake, including through role modeling and sharing personal experiences
- Community mobilization for service delivery
- Vaccine rollout tracking and follow-ups
CHWs will be able to carry out these critical tasks more effectively if they’re supported and recognized like the professionals they are, by being salaried, skilled, supplied, and supervised.
Based on the experience with COVID-19, CHWs should also be engaged in vaccination planning and coordination, in order to benefit from the unique insights CHWs have about the communities they serve, and to ensure the CHW role is protected financially and from a health systems perspective:
- Include CHW representatives on national and subnational planning committees
- Include CHWs as part of the first wave of vaccinations of the essential health workforce as well as subsequent booster vaccinations. This requires counting CHWs by maintaining a national, georeferenced CHW Master List.
- Clearly define and cost the role of community health workers as part of vaccine rollout efforts