ECOSOC: High-Level Political Forum
Note: A complete summary of today's Economic and Social Council meeting will be available after its conclusion.
The first panel of the day, titled “review of implementation of Sustainable Development Goal 3 (ensure healthy lives and promote well-being for all at all ages)”, was moderated by Nata Menabde, Executive Director, New York Office, World Health Organization (WHO). Francesca Perucci, United Nations Department of Economic and Social Affairs, provided a statistical snapshot. Panellists included Laura E. Flores, Permanent Representative of Panama to the United Nations, Member of the United Nations Population Fund (UNFPA) Executive Board, and Michael Myers, Managing Director, Rockefeller Foundation. The lead discussants were Rachel Cohen, Regional Executive Director, Drugs for Neglected Diseases Initiative and Marie Hauerslev, Vice-President for External Affairs, International Federation of Medical Students' Associations.
Ms. MENABDE said that the discussion would provide an opportunity to review achievements in maternal and child health, and in combating HIV and AIDS and malaria. She stressed the need for rigorous monitoring, and in that context, welcomed the voluntary national reporting currently under way. She emphasized the right of every individual to basic health services, whoever they may be and wherever they may live. Universal health care was at the centre of all efforts to achieve the other Goals, not only Goal 3. When people were healthy their families, communities and countries benefitted.
Ms. PERUCCI noted that the rate of maternal death fell by 37 per cent between 2000 and 2015, which was impressive progress, however there were still 303,000 maternal deaths each year, most of which were preventable. Even more rapid progress had been seen in child survival, although in sub-Saharan Africa the current child mortality rate was more than double the world average and most of those deaths were preventable. Progress was also made regarding the incidence of communicable diseases, including a 46 per cent reduction of HIV and AIDS, as well as an impressive reduction in tuberculosis. There was also a decline in premature deaths, although the rate was not sufficient to achieve the 2030 target.
Ms. FLORES stressed that the achievement of sustainable development was a human right and would require tackling inequalities and generating opportunities for those who had been left behind. The multidimensional aspect of poverty demonstrated the need for a holistic understanding that went beyond per capita income. Although Goal 3 dealt specifically with health, most of the other Goals could be linked to health-related targets. The data showed that there were still major challenges in the face of reduced or eliminated resources for maternal health, sexual and reproductive health, child mortality, communicable diseases and other areas. Reliable monitoring and evaluation of Goal 3 indicators were essential. To refocus actions and report on what had been achieved, Governments needed political will and to effectively address the social drivers of health. The results of those efforts would only be visible in the medium- and long-term. Among the emerging issues that would affect achievement of Goal 3 were ageing, disabilities, resistance to antimicrobial drugs, the effects of climate change, pollution, mental health and migration.
Mr. MYERS said that universal health coverage was a priority due to issues related to equality. His organization had worked to help set the political conditions for Governments to work towards universal coverage and also to meet the technical needs of countries as they sought to achieve that goal. Further, the Foundation had brought together economists who affirmed that investments in health were good for growing economies. Equality would not just “happen”. Intentional efforts would be required to meet the needs of neglected populations, and in that context, leaders must design programmes and execute policies to help people in need.
An important lesson learned was the need to look to the future and not simply attempt to address present challenges, he said. Climate change was affecting the nutritional content of foods, which was a major problem that would only increase if not adequately addressed. Another important lesson learned was the need to operate in a multisectoral fashion. Education, clean water and sanitation, clean energy and the environment were all important and linked with the Goal on health. There must be recognition that those were mostly political questions related to the organization and use of domestic resources.
Ms. COHEN pointed to what she described as a “little-known” target contained within Goal 3, which was related to the research and development of vaccines and medicines for communicable and non-communicable diseases that primarily affected developing countries. Over the past several years, consensus had emerged that the current system for financing biomedical research was “broken” and that it would be impossible to achieve any of the Goals given the dearth of innovation and the impossibly high costs of medicines that remained out of reach for millions of people, regardless of the income level of the country in which they lived. There must be more biomedical enterprises that put public health and patient needs at the centre of the process and strategies that promoted collaboration in science rather than competition. There must be greater commitment to delivering medicines at an affordable price so the fruits of innovation could be equitability shared. Doing so would require leadership, public funding and priority-setting.
Ms. HAUERSLEV said that, to achieve Goal 3, there must be political will, policy coherence and investments in health. Non-communicable diseases should not be considered “diseases of the rich”, as they affected people irrespective of socioeconomic status or age. Sexual and reproductive health rights should seek to equip young people with the knowledge, skills, attitudes and values required to enjoy their sexuality, achieve good health and prevent disease. It was “nonsense” to simply address one part of a person’s health, which highlighted the fact that the Goals were indeed interlinked. Climate change could, in fact, be an opportunity for health, as many of the policies that promoted the mitigation of climate change could also have benefits for better health. The commercial determinants of health must be taken into account in a comprehensive manner. The current funding model was imbalanced as donor support disproportionately focused on areas such as maternal health and communicable diseases, despite the fact that non-communicable diseases were in fact leading to far more preventable deaths.
In the ensuing discussion, the representative of the Netherlands — speaking also on behalf of Argentina, Australia, Belgium, Canada, Colombia, Denmark, Estonia, France, Finland, Germany, Iceland, Mexico, New Zealand, Norway, Sweden, Switzerland and Uruguay — pointed out that Goal 3 and Goal 5 on gender equality were inherently and strongly connected. Women, girls and adolescents continued to be subjected to discrimination, violence and harmful practices and denied the full realization of their human rights. Often they could not access the information required to make health decisions or get the health services needed to effectuate their choices. Investments in women, girls, adolescents and youth were an investment in the world’s collective future.
The representative of Sierra Leone said that it was clear that global human development challenges were deeply rooted in Goal 3 on human health. He recalled that his country struggled with its maternal mortality rates, which it was trying to address through investments in health infrastructure and by increasing medical literacy. The representative of Vanuatu said that good health was a key pillar for achieving all the Goals, although small island developing States, such as his own, faced unique challenges like the lack of a holistic approach to improving health systems and a shortage of financial and human resources, as well as a lack of adequate official development assistance (ODA). The representative of Kenya said that her country was focused on providing high-quality, universal health coverage, as well as social health insurance that covered as many people as possible through reforms aimed at efficiency and responsiveness. Mobile health clinics were another key aspect of those efforts.
The representative of Indonesia stressed that the lack of available data and disaggregation of existing data were some of the key obstructions that had to be resolved in his country’s efforts to achieve the 2030 Agenda. The representative of Switzerland stressed the role of the private sector in achieving Goal 3 and the need to promote research and development for vaccines and medicines for health issues that particularly affected low- and medium-income countries.
The representative of the indigenous peoples major group expressed concern about the lack of data on the health and social conditions of indigenous peoples, as well as the absence of information on programmes and services for indigenous populations’ health. Health was a productive economic sector and a source of jobs, particularly for women, highlighted the representative of workers and trade unions.
Also speaking were the representatives of Azerbaijan, Cuba, Maldives, Malaysia, China, Rwanda, Algeria, Sudan and Nigeria, as well as the European Union.
A statement was also delivered by a representative of United Nations Environment Programme (UNEP).
Speakers from the children and youth, local authorities, business and industry, women, persons with disabilities, non-governmental organizations and stakeholder group on ageing major groups also participated.