Climate change, access to medicines, migration and Universal Health Coverage will be part of the agenda of the next World Health Assembly

06/05/2019

Aline Abreu, Coordinator of International Relations and Cooperation

The 72nd meeting of the World Health Assembly of the World Health Organization (WHO), which will be held in Geneva, Switzerland, from May 20 to 28, will be an opportunity to discuss the main issues in global health in accordance with the pre-established agenda by the Executive Council of the Organization at the end of January of this year.

Some of the most strategic issues to be discussed are: health emergencies and the International Health Regulations (IHR); the recent epidemics; the 2030 Agenda; climate change, access to medicines, human resources; migration; Universal Health Coverage and administrative matters of the Organization.

The financial situation of WHO is one of the administrative aspects that will be under debate, mainly because the greater part of the budget comes from voluntary donors. The budget segment for basic programs, according to the Report by the Director General on Financing of the Programme Budget 2018–2019, is financed with US $ 956.9 million of assessed contributions and US $ 2443.4 million of voluntary contributions. The risk is, in this context, the possible external influence in the organization’s agenda towards a donor-driven approach[1].

Consequently, the WHO reform processes also has sensitive points, such as the participation of non-governmental actors; the distribution of the organization’s financing to each subregion and its regional offices; the establishment of binding agreements depending on the theme, as in the case of the Framework Convention on Tobacco Control (FCTC); the incentive and/or greater intersectionality of health discussions; the articulation of WHO with other UN agencies; and how to address the needs of developing countries.

Another predominant theme is related to the Declaration of Astana[2] (2018) and to the revision of the principle of Primary Health Care[3] (PHC) as a fundamental strategy for the goal of health for all and with a comprehensive approach to the organization of health systems.

Predominantly, the Organization, has as a priority the universal health coverage as a form of protection of the poorest in their right to health. Aligned to the principles of the Sustainable Development Goals (SDG), the WHO set a goal to be reached by all countries by 2030, that governments meet these investments, ensuring the minimum services, examinations and procedures for their population.

However, in the context of South America, where 30% of the population still does not have access to medical attention due to multifaceted barriers[4], and where social inequality and inequity are still barriers to health, the achievement of universal health depends not only on having sufficient financing resources, but also on the assurance of the right to health for all – in legal and regulatory frameworks. These frameworks should be based on models of primary health care focused on people, respecting human diversity, through an integrated, efficient and organized approach, based on interdisciplinarity and social participation (High Level Commission “Universal Health in the 21st century: 40 years of Alma-Ata”[5])

 

 

Therefore, taking into account the specificities of our region requires a different interpretation, in which universal coverage is a tool for guaranteeing universal access to health. That is, social protection and PHC are complementary strategies in our region.

The importance of this issue for the WHA72 is also due to the 74th General Assembly of the United Nations (UNGA74)[6]  , to be held on September 23, 2019, on universal health coverage. The meeting “Universal Health Coverage: Moving Together to Build a Healthier World” will bring together heads of state, health and political leaders, policy makers and activists of universal health coverage to advocate for health for all.

UNGA74 aim is to bring countries together and to sustain investments in health, as well as financial and political commitments, which will be affirmed through a political declaration on universal health coverage, negotiated by member states and supported by the Heads of State. For this purpose, the WHA72 will serve as a previous meeting in which the terms of the debate can already be identified.

The join participation of South American countries in the WHA72 is important for the strengthening of the positioning of the region in the global arena as a relevant international actor. Specially, when this join participation allows the alignment of the countries regarding the main health issues for the region, and the common patterns that impact the national and regional policies, and the lives of the entire population of South America. From the ISAGS side, we maintain our mission to contribute to the strengthening of the regional integration process in South America and to the construction of a regional health agenda, seeking to enhance South America as a relevant international actor.

[1] In the first decades of WHO’s existence, the assessed contributions represented almost the entire financing of the Organization. However, as the Organization’s total budget increased, voluntary contributions surpassed assessed contributions to account for the bulk of the Organization’s revenues. Available at: https://www.who.int/about/finances-accountability/funding/voluntary-contributions/en/.

[2] The ” Global Conference on Primary Health Care” was organized by WHO, UNICEF and the Government of Kazakhstan in October 2018.

[3] Declaration of Alma Ata, 1978.

[4] Pan American Health Organization – PAHO.

[5] Report available in: http://iris.paho.org/xmlui/bitstream/handle/123456789/50742/9789275120682_eng.pdf?sequence=3&isAllowed=y.

[6] The meeting was convened in December 2017 when the UN adopted the resolution (A / RES / 72/139) on global health and foreign policy, which addresses the health of the most vulnerable for an inclusive society. It will be organized under the direction of the president of the UN General Assembly, in close consultation with the WHO.

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