Health policy/special contribution
World Health Assembly Resolution 60.22 and Its Importance as a Health Care Policy Tool for Improving Emergency Care Access and Availability Globally

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The recent adoption of World Health Assembly Resolution 60.22, titled “Health Systems: Emergency Care Systems,” has established an important health care policy tool for improving emergency care access and availability globally. The resolution highlights the role that strengthened emergency care systems can play in reducing the increasing burden of disease from acute illness and injury in populations across the socioeconomic spectrum and calls on governments and the World Health Organization to take specific and concrete actions to make this happen. This resolution constitutes recognition by the World Health Assembly of the growing public health role of emergency care systems and is the highest level of international attention ever devoted to emergency care systems worldwide. Emergency care systems for secondary prevention of acute illnesses and injury remain inadequately developed in many low- and middle-income countries, despite evidence that basic strategies for improving emergency care systems can reduce preventable mortality and morbidity and can in many cases also be cost-effective. Emergency care providers and their professional organizations have used their comprehensive expertise to strengthen emergency care systems worldwide through the development of tools for emergency medicine education, systems assessment, quality improvement, and evidence-based clinical practice. World Health Assembly 60.22 represents a unique opportunity for emergency care providers and other advocates for improved emergency care to engage with national and local health care officials and policymakers, as well as with the World Health Organization, and leverage the expertise within the international emergency medicine community to make substantial improvements in emergency care delivery in places where it is most needed.

Introduction

The development of emergency care delivery systems has traditionally been prioritized lower than primary prevention efforts in low- and middle-income countries because of the view that emergency care is costly and benefits relatively few patients, as well as the epidemiology of the burden of disease in these countries, which has historically been dominated by infectious conditions. Recent studies have begun to suggest that there is increasing evidence for the effectiveness of emergency care as a public health strategy for secondary disease prevention, as well as a growing shift in the international global burden of disease toward a greater incidence of acute illness and injury in low- and middle-income countries. Despite these trends, emergency care systems remain inadequately developed in many low- and middle-income countries. As a result, the World Health Assembly passed Resolution 60.22, titled “Health Systems: Emergency Care Systems,” in 2007. This resolution establishes an important health care policy tool for improving emergency care access and availability globally. However, for this resolution to achieve the maximum effect in terms of improving global emergency care delivery, emergency care providers and other advocates for improved emergency care must be familiar with the justification for and contents of World Health Assembly 60.22.

Section snippets

Efficacy of Emergency Care Systems

Secondary disease prevention by the emergency care system is a core public health strategy used by societies and health care systems to reduce preventable mortality, morbidity, and disability resulting from acute illness and injury.1 Emergency care delivery systems vary widely by country and region, depending on the socioeconomic level, local tradition, and legislation; however, the core concepts and strategies of emergency medicine have applicability across socioeconomic strata.2 There is

Shifting Trends in Global Burden of Disease

The rates of noncommunicable diseases, such as diabetes, cardiovascular disease, and cerebrovascular disease, are increasing in low- and middle-income countries as western lifestyle habits and diet become increasingly popular.41, 42 Currently, more than 80% of worldwide deaths from cardiovascular disease occur in low- and middle-income countries.43 Advances in the treatment of these and other conditions have led to more people living longer with chronic diseases and an increase in the frequency

Efforts by the International Emergency Medicine Community to Improve Emergency Care

Formal international efforts within the global emergency medicine community to improve emergency care worldwide began in 1985 when the emergency medicine specialty societies from the United Kingdom, United States, Canada, and Australia began a collaboration that led to the establishment of the International Federation for Emergency Medicine (IFEM) in 1991.

IFEM was established as a federation of national emergency medicine professional societies from countries in which emergency medicine was a

World Health Assembly Resolution 60.22

The World Health Assembly is the governing body of the WHO and consists of all of the ministers of health or their designees from all WHO member states. Members of the assembly meet annually to discuss health-related issues and to debate actions for addressing these, to set WHO's priorities for the coming year, and to make suggestions for member states. The assembly can adopt resolutions, which may urge member states to take specific actions related to particular problems or may request the

How Can the Emergency Medicine Community Assist With Implementation of World Health Assembly Resolution 60.22?

Since the passage of World Health Assembly Resolution 60.22, several countries have indeed increased their attention to trauma and other emergency care services, including passage of legislation or other increased attention and emphasis by ministries of health in Colombia, Ghana, Romanis, Sri Lanka, and Vietnam, among others.54 It is difficult to say whether or not any of these activities were catalyzed by the World Health Assembly resolution. Even if they all were, there is certainly much more

An Opportunity for Improving the Care of the Acutely Ill and Injured

This resolution represents an opportunity to increase the attention and resources given to emergency care delivery globally, especially in the difficult settings in which these are most needed. However, it must be proactively used to fulfill this potential. There are several steps that can be taken by those who care for acutely ill or injured patients or by anyone who wishes to advocate improved emergency care.

  • 1

    Contact the WHO country office. There are approximately 140 WHO country offices,

Summary

World Health Assembly Resolution 60.22, “Health Systems: Emergency Care Systems,” highlights the role that strengthened emergency care services can play in decreasing the global burden of disease resulting from acute illness and injury. It calls on governments and WHO to take specific and concrete actions to make this happen. This resolution constitutes some of the highest levels of attention ever devoted to emergency care worldwide. However, to ensure that this resolution has the greatest

References (68)

  • International Federation for Emergency Medicine model curriculum for emergency medicine specialists

    CJEM

    (2011)

  • ACEM Training & Examination Handbook [web-based book]Australasian College for Emergency Medicine web site

  • D. Rimple et al.

    An emergency department–based vaccination program: overcoming the barriers for adults at high risk for vaccine-preventable diseases

    Acad Emerg Med

    (2006)
  • E. Pearson et al.

    Successful implementation of a combined pneumococcal and influenza vaccination program in a Canadian emergency department

    CJEM

    (2005)
  • M.A. Charfen et al.

    Detection of undiagnosed diabetes and prediabetic states in high-risk emergency department patients

    Acad Emerg Med

    (2009)
  • A.A. Ginde et al.

    Point-of-care glucose and hemoglobin A1c in emergency department patients without known diabetes: implications for opportunistic screening

    Acad Emerg Med

    (2008)
  • R.E. Rothman et al.

    Preventive care in the emergency department: should emergency departments conduct routine HIV screening? a systematic review

    Acad Emerg Med

    (2003)
  • T.S. Wu et al.

    Establishing a nationwide emergency department–based syndromic surveillance system for better public health responses in Taiwan

    BMC Public Health

    (2008)
  • K. Hope et al.

    The public health value of emergency department syndromic surveillance following a natural disaster

    Commun Dis Intell

    (2008)
  • K. Moore

    Real-time syndrome surveillance in Ontario, Canada: the potential use of emergency departments and telehealth

    Eur J Emerg Med

    (2004)
  • M.M. Wagner et al.

    Syndrome and outbreak detection using chief-complaint data—experience of the Real-Time Outbreak and Disease Surveillance project

    MMWR Morb Mortal Wkly Rep

    (2004)
  • E. Molyneux et al.

    Improved triage and emergency care for children reduces inpatient mortality in a resource-constrained setting

    Bull World Health Organ

    (2006)
  • P. Fournier et al.

    Improved access to comprehensive emergency obstetric care and its effect on institutional maternal mortality in rural Mali

    Bull World Health Organ

    (2009)
  • H. Husum et al.

    Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from north Iraq and Cambodia

    J Trauma

    (2003)
  • F.P. Rivara et al.

    The 1,000,000 Lives campaign

    Inj Prev

    (2005)
  • N.C. Mann et al.

    Systematic review of published evidence regarding trauma system effectiveness

    J Trauma

    (1999)
  • A.B. Nathens et al.

    The effect of organized systems of trauma care on motor vehicle crash mortality

    JAMA

    (2000)
  • A.B. Nathens et al.

    Effectiveness of state trauma systems in reducing injury-related mortality: a national evaluation

    J Trauma

    (2000)
  • R. Laxminarayan et al.

    Intervention Cost-Effectiveness: Overview of Main Messages

  • Health Systems: Emergency care systems - report by the secretariat [web-based WHA report A60/21]World Health Organization web site

  • World Development Report 1993 [web-based report]The World Bank web site

  • C. Mock et al.

    Evaluation of trauma care capabilities in four countries using the WHO-IATSIC guidelines for essential trauma care

    World J Surg

    (2006)
  • T. Baker

    Pediatric emergency and critical care in low-income countries

    Paediatr Anaesth

    (2009)
  • A.C. Levine et al.

    Measuring access to emergency obstetric care in rural Zambia

    Int J Emerg Med

    (2008)

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    Publication dates:Available online February 11, 2012.

    Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist.

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