Blueprint for future-proof and sustainable health sector unveiled by WHO

9th November 2023

A new operational framework for building climate-resilient, low-carbon and sustainable health systems across the world has been launched by the World Health Organization (WHO).

Published to coincide with the upcoming United Nations Framework Convention on Climate (COP-28), the framework includes a guide for healthcare professionals in addressing climate-related health risks to help safeguard the health of local and global communities.

It is ‘an opportunity for the health sector to lead by example by reducing its own greenhouse gas emissions while continuing to enhance quality of care’, the WHO said.

Greenhouse gas emissions from the health sector are now responsible for almost 5% of the global total. And if the sector were a country, it would be the fifth-largest emitter on the planet.

Dr Tedros Adhanom Ghebreyesus, WHO director-general, commented: ‘Around the world, health systems are vulnerable to the impacts of climate change, but they also contribute to it.

‘We therefore have a dual responsibility to build health systems that can withstand climate-related shocks, while at the same time reducing their carbon footprint. This framework gives countries a roadmap for doing just that.’

Sustainable health actions

Consisting of 10 key components, the framework outlines the various actions health organisations, authorities and programmes can take to better anticipate, prevent, prepare for and manage climate-related health risks and therefore decrease the burden of associated climate-sensitive health outcomes.

Of particular note is the second component, which details the need for countries to have a ‘climate-smart health workforce’ centred on three objectives: health workforce capacity; organisational capacity development; and information, awareness and communication.

Sample measurable outputs and indicators are listed for each objective, including up-to-date training for existing staff, the integration of climate-related curricula for new trainees, contingency plans for acute shocks such as extreme weather events, the sharing of best practice on reducing greenhouse gas emissions, and establishing solid communication between internal and external stakeholders.

With continuing themes of collaboration, additional components outlined in the framework relate to climate-transformative leadership and governance; research to provide an evidence-base for the development of policy and innovations; and a focus on infrastructure, technologies and supply chain, among others.

The WHO concludes that the ‘application of this framework would result in an important contribution to universal health coverage, global health security and specific targets within the UN Sustainable Development Goals’.

Cardiovascular polypill added to WHO List of Essential Medicines

7th August 2023

The World Health Organization (WHO) has added a cardiovascular polypill, which includes acetylsalicylic acid, ramipril and atorvastatin, to its List of Essential Medicines.

Developed by the Spanish National Centre for Cardiovascular Research (CNIC) in conjunction with the Ferrer Foundation, the cardiovascular polypill has been proven to be effective in preventing cardiovascular events after a heart attack.

Oscar Pérez, chief marketing, market access and business development officer at Ferrer, said: ‘The inclusion of this therapeutic solution in the WHO‘s List of Essential Medicines confirms our aim to make a positive impact in society and is an important step in our mission to bring significant and differential value to people with cardiovascular disease.‘

The polypill is currently marketed in 25 countries and the feasibility of extending its distribution to additional territories, including the United States, is under analysis.

The WHO defines essential medicines as ‘those that satisfy the priority health care needs of a population. They are intended to be available in functioning health systems at all times, in appropriate dosage forms, of assured quality and at prices individuals and health systems can afford.‘

Polypill clinical efficacy

The effectiveness of the polypill has been established in a clinical study published in the New England Journal of Medicine (NEJM) in the summer of 2022. The trial examined the effectiveness of the polypill as a secondary preventative measure in patients who had experienced a myocardial infarction.

The primary outcome for the study was a composite of cardiovascular death, non-fatal type 1 myocardial infarction, non-fatal ischaemic stroke or urgent coronary revascularisation. The results showed that the primary outcome occurred in 9.5% of patients in the polypill group and 12.7% in the usual-care group (hazard ratio = 0.76, 95% CI 0.60 to 0.96, P<0.001 for noninferiority; P=0.02 for superiority).

Dr Valentín Fuster, principal investigator of the NEJM study, said: ‘The SECURE results showed, for the first time, that the cardiovascular polypill developed by the CNIC and Ferrer achieves clinically relevant reductions in recurrent cardiovascular events in patients who have suffered a myocardial infarction.‘