A/HRC/19/73 action programme against noma, which comprised: prevention – ensuring training and awareness on early diagnosis and treatment for each public health structure and raising awareness and informing populations, especially mothers; epidemiology and surveillance – finding out the incidence and incorporating noma surveillance into existing epidemiological surveillance systems; etiological research – establishing the causes of noma and why it develops in some children but not in others; primary health care -–including making sure that the necessary antiseptics, drugs and nutritional supplements are available; and surgery and rehabilitation.112 50. In 1998, the WHO Regional Committee for Africa declared the disease a priority on the continent.113 Following a decision of the Regional Consultative Committee in 2000, the noma programme activities were transferred from the WHO headquarters in Geneva to the WHO Regional Office for Africa.114 In 2008, noma was integrated into the list of diseases targeted for eradication and elimination in the Technical Guidelines for Integrated Disease Surveillance and Response in the African Region. 115 51. This study cannot fully assess the effects of the transfer of responsibilities from the WHO Geneva headquarters to the WHO Regional Office for Africa on the fight against noma in Africa (see above). What can be clearly ascertained, however, is that, as a consequence of the transfer, there is no longer a global overview of the situation of noma. The fight against noma is coordinated by the WHO Regional Office for Africa exclusively on the African continent. The 1994 five-point action programme against noma and the technical guidelines are thus intended for application only in Africa, while children in Asia and in other regions are excluded from surveillance, health care, surgery and rehabilitation. From a public health perspective, the neglect of Asia and other parts of the world where malnutrition rates are disturbingly high and children may be exposed to noma is highly problematic. From a human rights point of view, it may amount to a violation of the rights of the children at risk or affected by noma. 52. In the African region, some progress in the fight against noma has been achieved. In this context, it is fundamental to note the crucial importance of the activity developed by NGOs, charities and private individuals based in Africa or abroad. These have been the driving force of the fight against noma, offering financial, logistical, medical, surgical and post-operatory support and assistance, and undertaking etiological research. 116 53. The Regional Noma Programme of the WHO Regional Office in Africa receives long-term funding from the Winds of Hope Foundation – which initiated the No-Noma International Noma Federation gathering over 30 members.117 The programme develops noma prevention, early detection and management activities in six West African countries: Benin, Burkina Faso, Mali, the Niger, Senegal and Togo.118 Other countries in Africa which 112 113 114 115 116 117 118 www.medecine.unige.ch/enseignement/apprentissage/module4/immersion/archives/2006_2007/travau x/07_r_noma.pdf. D.M. Bourgeois, M.H. Leclercq, “The World Health Organization initiative on noma”, Oral Diseases, vol. 5, 1999, pp. 153–154. WHO, “The World Health Organization Action Against Noma – Some Important Landmarks”, Noma Contact, July 2006, p. 2. Consultative Meeting on Management of the Noma Programme in the African region, final report; Bos, Surgical Treatment, p. 15. WHO Regional Office for Africa, Technical Guidelines for Integrated Disease Surveillance and Response in the African Region, 2nd ed., (Brazzaville, 2010). It goes beyond the capacity of the present study to provide a comprehensive list of all nongovernmental actors working on noma. See http://www.nonoma.org/index.php. Communication of J. Ziegler and I. Cismas with Dr. B. Varenne; WHO Regional Office for Africa, 17