The wrap up blog: mental health at the World Health Assembly

Written by James Sale, Deputy CEO

Six years ago I started logging how many UN Member States (governments) mentioned mental health at the 71st World Health Assembly (WHA71) in their official statements, the total was five. A year later that nearly doubled to a whopping nine. This year at the 77th WHA (and we are still counting) nearly 80 member states, plus regional statements, have spoken of the importance of mental health to a wide range of issues and for the sake of mental health itself. Progress. 

Admittedly, this increase in discussion is in part due to the passing of Resolution A77/A/CONF./11 in which all member states agreed to strengthen mental health and psychosocial support (MHPSS) across all stages of emergencies (before, during and after), including conflicts, natural disasters and humanitarian crises. With the world experiencing many humanitarian emergencies, the MHPSS resolution is much needed and must be acted upon immediately. The WHA resolution follows the MHPSS resolution at the UN General Assembly last year: member states are in no doubt of the severity of the global situation and the need for coordinated action. Mental health financing for emergencies needs to increase, be well coordinated, and span the humanitarian-development nexus. This means the World Bank, regional development banks, and bilateral and multilateral donors must commit to increasing investment to address emergencies with a focus on building sustainable, national capacity, particularly the mental health workforce.

Member states discussed mental health in other areas, including in the resolution on climate change and health, something that did not happen in the last climate and health resolution. This is an important step in ensuring mental health is integrated across actions to respond to climate and environmental threats. Climate change is already having a direct impact on people’s mental health. One study found that the cost of mental health conditions as a direct result of climate-related hazards, air pollution and inadequate access to green space is projected to cost the global economy nearly $47 billion per year by 2030. But this climate change and health resolution is just the start. Mental health needs to be fully recognised as part of the WHO Global Plan of Action on Climate Change and Healthwhich has been requested as part of the resolution. My colleague Ale gives you an excellent one minute briefing here.  

There is always an overarching theme at the WHA. This year there were three: gender language, investing in WHO, and the pandemic treaty. The first point threatened to derail nearly every resolution as a small group of countries did not want the more progressive language “gender responsive” and were pushing for the less progressive language “gender sensitive”, with some states even wanting the phrase “gender inequality” removed from resolutions – Women Deliver has produced a very helpful guide to this. UnitedGMH fully supports those pushing for gender responsive mental health services and hopes that the world can progress to gender transformative services. 

A second theme was the 2025-2028 WHO Investment Case. Mental health is included, specifically, there is a commitment to expand the WHO special initiative for mental health to 24 countries, and the scale of mental ill health worldwide, and the importance of protecting mental health in emergencies and pandemics are all prominent within the investment case. This is good for the profile of mental health as this document will be presented to donors far and wide. The investment case is based on the new WHO General Programme of Work (GPW 14), the strategy for WHO to follow over the next three years. Never has mental health been so prominent in a GPW and shows the tide is turning on mental health, which was once seen as ‘nice to have.’ The big win is that mental health features prominently in the outcomes of 3 out of 6 of WHO’s strategic objectives. 

Finally, there was the NCDs and mental health debate. Mental health conditions have been aggregated with NCDs and treated as such in recent years under the 5×5 initiative. As well as this useful integration, mental health and mental health conditions have a set of characteristics that both cut across and are unique from physical health, requiring special attention and consideration. This is on the agenda at the moment because of the International Dialogue for Sustainable Financing of NCDs and Mental Health at the World Bank next month which is a stepping stone to the UN High-Level Meeting on NCDs (and mental health) in September 2025. This came up a lot outside of the Palais des Nations (where the WHA is held) in the many side events. Spearheaded by the NCD Alliance, the question ‘what do we need to achieve at the HLM on NCDs?’ was discussed at roundtables, panel discussions, and dinners. More about this in the coming weeks but for now see what our thoughts are in Increase, Improve and Integrate: the way forward for NCDs and mental health financing which we released last week. Here I am bumbling through the main points, Ale is going to give me some comms training… 

Sorry, that was a lot for a blog but there was a lot to talk about this week. Far more than the five governments did in 2018. I call this progress but words in Geneva don’t necessarily mean change in Santiago, Paris, Abuja, New Delhi, or Apia. We now need to support civil society around the world to insist governments turn words into action that helps those most in need.