Don’t Delay Reforms to Prepare for Next Pandemic, Urges WHO Chief

Director-General of the World Health Organization (WHO) Dr. Tedros Adhanom Ghebreyesus attends the World Health Assembly at the United Nations in Geneva, Switzerland, May 21, 2023. (Reuters)
Director-General of the World Health Organization (WHO) Dr. Tedros Adhanom Ghebreyesus attends the World Health Assembly at the United Nations in Geneva, Switzerland, May 21, 2023. (Reuters)
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Don’t Delay Reforms to Prepare for Next Pandemic, Urges WHO Chief

Director-General of the World Health Organization (WHO) Dr. Tedros Adhanom Ghebreyesus attends the World Health Assembly at the United Nations in Geneva, Switzerland, May 21, 2023. (Reuters)
Director-General of the World Health Organization (WHO) Dr. Tedros Adhanom Ghebreyesus attends the World Health Assembly at the United Nations in Geneva, Switzerland, May 21, 2023. (Reuters)

The head of the World Health Organization urged countries on Monday to carry out reforms needed to prepare for the next pandemic, hailing their "historic" decision to accept a major budget hike at the UN agency's annual assembly.

Speaking at the assembly weeks after ending the global emergency status for the COVID-19 pandemic, Tedros Adhanom Ghebreyesus said it was time to advance negotiations on preventing the next pandemic.

"We cannot kick this can down the road," the WHO director-general said in a major address to the agency's member states, warning that the next pandemic was bound to "come knocking".

"If we do not make the changes that must be made, then who will? And if we do not make them now, then when?" he said.

The 10-day annual World Health Assembly in Geneva, which coincides with the WHO's 75th anniversary, is set to address global health challenges including future pandemics, eradicating polio and supporting steps to ease Ukraine's health emergency triggered by Russia's invasion.

The WHO's 194 member states are now drafting a pandemic treaty which is up for adoption at next year's assembly.

"A commitment from this generation (to a pandemic accord) is important, because it is this generation that experienced how awful a small virus could be," said Tedros.

At the same meeting, countries approved a $6.83 billion budget for 2024-25 - a decision that tested national commitments to fixing a WHO funding model which was seen as too small and overly reliant on the vagaries of donors.

The budget includes a 20% increase in member states' mandatory fees under a preliminary agreement reached last year in exchange for a commitment to reforms including on budget, governance and finance policies.

US Assistant Secretary for International Organization Affairs Michele J. Sison said future increases would be "contingent upon continued reform progress". Central and South American countries also called for the WHO to address what they described as chronic underfunding of their region.



Blood Tests Allow 30-year Estimates of Women's Cardio Risks, New Study Says

A woman jogs in a park in Saint-Sebastien-sur-Loire near Nantes, France January 19, 2024. REUTERS/Stephane Mahe/File Photo Purchase Licensing Rights
A woman jogs in a park in Saint-Sebastien-sur-Loire near Nantes, France January 19, 2024. REUTERS/Stephane Mahe/File Photo Purchase Licensing Rights
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Blood Tests Allow 30-year Estimates of Women's Cardio Risks, New Study Says

A woman jogs in a park in Saint-Sebastien-sur-Loire near Nantes, France January 19, 2024. REUTERS/Stephane Mahe/File Photo Purchase Licensing Rights
A woman jogs in a park in Saint-Sebastien-sur-Loire near Nantes, France January 19, 2024. REUTERS/Stephane Mahe/File Photo Purchase Licensing Rights

Women’s heart disease risks and their need to start taking preventive medications should be evaluated when they are in their 30s rather than well after menopause as is now the practice, said researchers who published a study on Saturday.

Presenting the findings at the European Society of Cardiology annual meeting in London, they said the study showed for the first time that simple blood tests make it possible to estimate a woman’s risk of cardiovascular disease over the next three decades.

"This is good for patients first and foremost, but it is also important information for (manufacturers of) cholesterol lowering drugs, anti-inflammatory drugs, and lipoprotein(a)lowering drugs - the implications for therapy are broad," said study leader Dr. Paul Ridker of Brigham and Women’s Hospital in Boston, Reuters reported.

Current guidelines “suggest to physicians that women should generally not be considered for preventive therapies until their 60s and 70s. These new data... clearly demonstrate that our guidelines need to change,” Ridker said. “We must move beyond discussions of 5 or 10 year risk."

The 27,939 participants in the long-term Women’s Health Initiative study had blood tests between 1992 and 1995 for low density lipoprotein cholesterol (LDL-C or “bad cholesterol”), which are already a part of routine care.

They also had tests for high-sensitivity C-reactive protein (hsCRP) - a marker of blood vessel inflammation - and lipoprotein(a), a genetically determined type of fat.

Compared to risks in women with the lowest levels of each marker, risks for major cardiovascular events like heart attacks or strokes over the next 30 years were 36% higher in women with the highest levels of LDL-C, 70% higher in women with the highest levels of hsCRP, and 33% higher in those with the highest levels of lipoprotein(a).

Women in whom all three markers were in the highest range were 2.6 times more likely to have a major cardiovascular event and 3.7 times more likely to have a stroke over the next three decades, according to a report of the study in The New England Journal of Medicine published to coincide with the presentation at the meeting.

“The three biomarkers are fully independent of each other and tell us about different biologic issues each individual woman faces,” Ridker said.

“The therapies we might use in response to an elevation in each biomarker are markedly different, and physicians can now specifically target the individual person’s biologic problem.”

While drugs that lower LDL-C and hsCRP are widely available - including statins and certain pills for high blood pressure and heart failure - drugs that reduce lipoprotein(a) levels are still in development by companies, including Novartis , Amgen , Eli Lilly and London-based Silence Therapeutics.

In some cases, lifestyle changes such as exercising and quitting smoking can be helpful.

Most of the women in the study were white Americans, but the findings would likely “have even greater impact among Black and Hispanic women for whom there is even a higher prevalence of undetected and untreated inflammation,” Ridker said.

“This is a global problem,” he added. “We need universal screening for hsCRP ... and for lipoprotein(a), just as we already have universal screening for cholesterol.”