Our common vision for the positioning and role of health to advance the UN development agenda beyond 2015

By (*) Original Text

Pascal Canfin, Espen Barth Eide, Marty Natalegawa, Mankeur Ndiaye, Maite Nkoana-Mashabane, Antonio Patriota and Surapong Towichakchaikul, for the Foreign Policy and Global Health group.

Since the 2007 Oslo Ministerial Declaration, the Foreign Policy and Global Health group, comprising the governments of Brazil, France, Indonesia, Norway, Senegal, South Africa, and Thailand, has been committed to raising attention to global health issues in the international agenda, and to promoting foreign policies that respond to the various challenges of global health. Given the critical decisions to come on advancing the UN development agenda beyond 2015, we believe that health should continue to be adequately reflected in this context.

Three of the eight existing Millennium Development Goals (MDGs) give a central position to health, with special attention to combating maternal and child mortality as well as fighting HIV/AIDS, malaria, tuberculosis, and other communicable diseases. The health-related MDGs have succeeded in mobilising public opinion and political leaders, as well as international partners. Multilateral and bilateral aid for health has increased steadily, notably through new channels: global health initiatives, partnerships, and foundations, as well as South-South cooperation. During the past decade, aid flows going to these areas have proven to be effective, and impressive health progress has been achieved in many low-income and middle-income countries. Yet progress towards the MDGs remains uneven due to weak health systems and limited access to health services by populations, notably the majority rural poor. To achieve the health-related MDGs, eradicate poverty, and enhance health equity, it is important to provide equitable and universal access to health services by the population.

Therefore, more needs to be done to sustain the gains achieved, accelerate progress, and address the remaining gaps. We believe our efforts to progress towards the realisation of these objectives shall continue until 2015, and beyond. We are beholden to the Millennium Declaration and the commitments to the MDG agenda. The 2015 deadline for the achievement of the MDGs does not mean that unfinished business should be set aside.

Lessons learned from the MDGs such as ownership, inclusiveness, alignment, coordination, as well as mutual accountability, predictability, sustainability, and effective uses of aid should continue to apply in the context of advancing the UN development agenda beyond 2015, especially in the field of health where multiple and diverse stakeholders are involved, with long-term investments at stake.

The question of the scope of health issues to be included in the UN development agenda beyond 2015 is indeed challenging. We believe that, first, as we all recognised in the United Nations Conference on Sustainable Development (Rio+20), eradicating poverty is the greatest global challenge facing the world today. The health perspective must be reflected in poverty eradication and social inclusion strategies. In an age of great advancements in science and technology— when we are able to facilitate communication and transportation at a revolutionary pace and cure diseases we spent centuries fighting to no avail—we should reinforce our commitment and joint efforts to ensure the fundamental right of every human being to the enjoyment of the highest attainable standard of physical and mental health. Only healthy societies will develop in a sustainable way and eradicate poverty once and for all. The health agenda beyond 2015 must be well integrated with social protection policies and aim at promoting equity, human rights, and gender equality.

Second, there is the moral and rational obligation to sustain progress and address the unfinished business of the MDGs, particularly in reducing child and maternal mortality, as well as furthering the fight against HIV/AIDS, malaria, and tuberculosis.

Third, it is imperative to address the emerging threats posed by the social, economic, and environmental determinants of health, as well as the growing burden of non-communicable diseases. Production, trade, and marketing of addictive substances and unhealthy food, together with urban lifestyles that encourage physical inactivity, are closely linked to the growing burden of non-communicable diseases. Climate change induces higher risks of natural disasters and wider dissemination of infectious vectors, and water, air, land, and chemical pollution are major threats to global health.

Yet, in advancing the UN development agenda beyond 2015, we should bear in mind that the success of the MDGs is largely due to a limited number of clear, measurable, and fully understandable goals.

In exploring various options for health goals in the UN development agenda beyond 2015, we believe universal health coverage addresses many health concerns that jeopardise global development. Universal health coverage is crucial to increase life expectancy, to eradicate poverty, to promote equity, and to achieve sustainable development. Universal health coverage also presents an opportunity to improve the performance of health systems and service delivery outputs.

Universal health coverage implies that all people have access, without discrimination, to nationally determined sets of the needed promotive, preventive, curative, and rehabilitative basic health services and essential, safe, affordable, effective, and quality medicines. Universal health coverage is well recognised in the Rio+20 Declaration as “a key instrument to enhancing health, social cohesion and sustainable human and economic development”.

The role of health as “a precondition for, an outcome and an indicator of all three dimensions of sustainable development” is now fully recognised. We believe further global health advancement should rely not only on health-related development goals, but also on health indicators that could serve to measure our progress towards sustainable development in other sectors. We, therefore, call for a global mobilisation in favour of strengthening health in the UN development agenda beyond 2015, with universal health coverage as an important element of the future we want.

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(*) The authors are:

Pascal Canfin: Minister Delegate for Development, Government of France, France.

Espen Barth Eide: Minister of Foreign Affairs, Norway, Government of Norway, Norway.

Marty Natalegawa: Minister of Foreign Affairs, Government of Indonesia, Indonesia.

Mankeur Ndiaye: Minister of Foreign Affairs and Senegalese Abroad, Government of Senegal, Senegal.

Maite Nkoana-Mashabane: Minister of International Relations and Cooperation, Government of South Africa, South Africa.

Antonio Patriota: Minister of International Relations, Government of Brazil, Brazil.

Surapong Towichakchaikul: Vice-Prime Minister and Minister of Foreign Affairs, Government of Thailand, Thailand.

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