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Staid and steeped in parliamentary rules, the annual World Health Assembly is a mostly predictable exercise. Delegates from 194 member states of the World Health Organization gather each May to plod through a lengthy agenda and haggle over policies and priorities for the WHO’s upcoming year. A few decisions are momentous, most mundane. Yet the May gathering always yields some surprises. This year’s meeting, which ended Tuesday, was no exception. From royalty to kissing bugs and sexual rights to snakebites, the 72nd World Health Assembly offered some unexpected moments and decisions. Fireworks Over The Cost Of Medicines Intense marathon debates broke out at the Assembly over revealing the true costs of medicines. Italy proposed a resolution calling for public reporting of the research and development costs of pharmaceutical companies. Knowing how much it costs to develop a given medicine would give countries leverage in price negotiations. WHA watchers were surprised to see Germany isolated in seeking to block transparency, aligned with the U.K. and Hungary but not with normal allies on such issues like France and the U.S. In fact, the U.S., normally a supporter of Big Pharma on the international stage, leaned more on the side of Italy. A last-minute, weakened version of the resolution was finally approved on Tuesday. Snakebite Fast Track While the words “WHO” and “speed” rarely seem to go together, the organization achieved what may be a personal best by officially launching its new global snakebite strategy on May 23 — just a year after a World Health Assembly resolution urged action on the issue. WHO’s quick response is needed given than an estimated 5.4 million people are bitten each year and up to 138,000 people die, according to WHO. The strategy seeks to cut snakebite deaths and disability by 50% by 2030. Sexual and Reproductive Health and Rights As expected, U.S. representatives moved to eliminate any reference to sexual and reproductive health and rights from a resolution on universal health coverage. (It appears to be part of a Trump administration effort to remove language around sexual health from U.N. resolutions, according to documents obtained by Foreign Policy.) What wasn’t expected was a surge in pushback against the U.S. Let by Sweden, 43 countries from Europe, Latin America and Asia asserted that sexual and reproductive health and rights are essential to universal health coverage (which is the main focus of this year’s WHA), according to Health Policy Watch. Discussions on the resolution are expected to continue through July in advance of a U.N. high-level meeting on universal health coverage in September. A Royal Guest Just before a May 22 meeting on mental health began, more than 200 attendees suddenly began scooting back their chairs so they could stand. WHO Director-General Tedros Adhanom Ghebreyesus had arrived, but he usually doesn’t receive that kind of welcome. The reason for the mass respect? Her Majesty Mathilde, Queen of the Belgians, was in the house. The royal advocate for mental health told attendees that the issue has not been prioritized on the global agenda. “This means care is far too modest,” Queen Mathilde said. “Care for mental health must be mainstreamed.” Chagas Disease Finally Has Its Day More than a century after its discovery, the lethal, kissing-bug-transmitted disease known as Chagas finally got some recognition. WHA member states voted to officially establish April 14 as World Chagas Day. Chagas kills up to 10,000 people annually, primarily in Latin America, according to WHO. Trypanosoma cruzi parasites, transmitted by blood-sucking triatomine bugs, can ultimately cause cardiac arrhythmias or progressive heart failure that kills victims. The current Chagas strategy emphasizes better surveillance of the disease and increasing access to treatments. Stars On The Streets On May 19 attendees proved they can do more than just talk about health. WHO sponsored a “Walk the Talk” event the day before the assembly began. The event sent an estimated 1,000 participants to walk or run the streets of Geneva ostensibly to promote WHO’s health agenda and celebrate “healthy lifestyles.” But it was also an occasion for world health celebrity watching: Joining Tedros for the event was Lady Gaga’s mom Cynthia Germanotta, who has just been named a WHO Goodwill Ambassador for Mental Health; Nigerian singer Korede Bello; and Kenya’s First Lady Margaret Kenyatta, who drew attention to WHO’s goals by stating “physical activity has always been the lifelong secret to healthy lives and longevity for the people and communities around the world” but also garnered attention for her track suit, emblazoned with “FLOKE” — First Lady of Kenya. Brian W. Simpson is editor-in-chief of Global Health NOW, a news website and daily email published by the Johns Hopkins Bloomberg School of Public Health.Copyright 2019 NPR. To see more, visit https://www.npr.org.