NEW YORK CITY – Monday’s long-awaited United Nations Climate Summit produced no dramatic surprises, but a long list of modest commitments offered a glimmer of a way forward. Government leaders, CEOs, and heads of major philanthropies announced a string of new initiatives to clean up the air, restore oceans, advance more sustainable food systems, phase out coal, plant forests, protect small island states, and better align trade rules with climate goals.

Leaders of the planet’s two most polluting nations, China and the United States, were absent from the summit stage – although US President Donald Trump, who has said he would withdraw from the Paris Climate Agreement, made a brief, unannounced appearance in the audience during the morning’s remarks by India’s Prime Minister Narendra Modi, before heading to a meeting on religious freedom. Chinese president President Xi Jinping sent a representative who recited an impressive litany of Chinese innovations in areas such as renewable energy and e-transport, but stepped gingerly around the debate over controversial new projects such as China’s massive Belt and Road project through Asia, which critics say could stimulate new sources of climate emissions.

A cluster of new initiatives by businesses, philanthropies and governments, however, offered at least some new directions and fresh models for stepping up action on climate drivers that are undermining the fundamental requirements of life on earth – as well as damaging health more visibly than ever before.

Opening ceremony of the Climate Action Summit.

Those announcements included the launch of a new US$50 million “Clean Air Fund” by a number of leading philanthropies and a “One Planet Business for Biodiversity” initiative led by the corporate giant Danone – which aims to restructure food systems that have “broken the cycle of life” in the words of Danone CEO Emmanuel Faber.  Over 40 countries and 70 cities signed a Summit commitment to a WHO Clean Air Initiative to reduce air pollution from sources that also drive climate change by 2030. Together those clean air commitments represent some 750 million people worldwide, WHO sources told Health Policy Watch. Some 60 countries at the Summit pledged to reach net zero climate emissions by 2050, so as to keep average temperature rise below 1.5 C, although climate scientists have warned that even at that level, impacts could still be severe and unpredictable.

Former New York City Mayor Michael Bloomberg, founder and head of Bloomberg Philanthropies, declared that his massive foundation would accelerate its  “Beyond Coal” initiative to ensure that “no new coal plants” would be built anywhere in the world after 2020, and those already constructed would be phased out.  French President Emmanuel Macron spoke of the critical need to harmonize trade rules with climate goals – a clear reference to the fact that global trade now incentivizes a carbon-intensive global economy based on the long-distance transport of many goods. And among a range of green finance initiatives, the insurance giant Allianz committed to net zero emissions for its investment portfolios of some US$2.4 trillion.

Parts of the Solomon Islands are submerged by rising sea levels.

Norway’s Prime Minister Erna Solberg said that her country would step up ocean-based climate initiatives, which could reduce global emissions by as much as 20%, generate sustainable energy and ensure sustainability of ocean based food sources.

Pakistan’s Prime Minister Imran Khan, as well as the leaders of Indonesia and the Democratic Republic of Congo, laid out ambitious plans for reforesting vast swathes of their countries. Indonesian and DRC rain forests comprise the green lungs for much of South-East Asia and Africa, their leaders noted. And in the case of Pakistan, forests could help sustain the Himalayan glacier systems that regulate water supplies for millions of people, Khan said.

Small island states, which are most directly affected by climate change, announced initiatives in insurance, finance as well as in coastal ecosystems and fresh water preservation. They included Barbados’ “Roofs to Reefs” initiative, which would “help protect our fresh water resources and vital coastal reefs” which provide a buffer from storms as well as rich grounds for fish breeding and aquatic life.

Desperate Cry by Swedish Youth Activist Greta Thunberg sets the Tone  

Greta Thunberg, young climate activist, passionately appeals to world leaders to take stronger climate actions.

The summit began with yet another in a recent series of calls by UN Secretary General Antonio Guterres to redouble action: “Nature is angry, … and nature is striking back with fury,” Guterres said. He was followed by a desperate and angry cry from the Swedish youth activist Greta Thunberg. She began her remarks saying, “this is all wrong. I shouldn’t be standing here. I should be back in school on the other side of the ocean…

“You have stolen my dreams and my childhood with your empty words. And yet I’m one of the lucky ones. People are suffering. People are dying. Entire ecosystems are collapsing. We are in the beginning of a mass extinction. And all you can talk about is money and fairy tales of eternal economic growth. How dare you!” cried Thunberg.

Clean Air and Healthier Foods  

Corporate, philanthropic and government leaders repeatedly referred to the cries of youths like Thunberg in their responses, although it was clear that all were groping to provide sufficient robust answers.

“We beg you to listen to our youth because they are demanding this regenerative culture, and listen to that inner voice that whispers to us that life is sacred,” said Danone’s Faber, sounding an almost mystical note.  “The food system that we have built over the last century is a dead end for the future…. We thought we could engineer the life we needed and kill the rest in the fields… The resulting mono-cropping consequences are standing right in front of us now. We depend for two thirds of our food on this planet on only nine plants today. Some 40% of land is degraded.”

(Left to Right) CEO of Danone, Emmanuel Faber; President of Republic of Guatemala, Jimmy Morales; President of the Democratic Republic of Congo, Félix Tshisekedi; Norway’s Prime Minister, Erna Solberg.

Faber said that the “One Planet” business coalition of 20 of the world’s largest food and agro-based companies representing some US$500 billion in sales would work to restore soil health with regenerative agricultural practices; create consumer demand for more varieties of crops; rein in agro-based deforestation; and put “nature-based solutions at the heart of our strategies and our priorities.”

But he added that government agricultural subsidies also need a major overhaul so as to shift farm incentives from “killing life” to protecting biodiversity.

Meanwhile, Jane Burston, Executive Director of the Clean Air Fund, said that the new initiative would tackle air pollution that kills some 7 million people annually, transforming it into an “opportunity to not only save millions of lives but to avert  dangerous climate change.

“I want you to imagine what that means for a second. Imagine the families losing a parent to lung cancer …the schoolgirl gulping for air on the roadside because of an asthma attack brought on by traffic pollution …the baby whose brain and lungs will never develop properly because of the air his mother could not avoid breathing, And many millions more are living with chronic conditions caused and exacerbated by air pollution.

“This is a public health emergency, and it is getting worse,” said Burston.

She added that since “the causes of climate change are often the same as the causes of air pollution – two thirds of outdoor air pollution is from burning fossil fuels – like coal – for power, transport and industry. The solutions can also be the same: renewable energy, electric mobility, more walking and cycling.” And in economic terms, she cited World Bank and OECD data saying that cleaner air would save trillions of dollars every year in avoided health costs that drag down economic productivity.

Jane Burston announcing the launch of the Clean Air Fund.

Burston said that the US $50 million in clean air commitments was halfway to its target of US$ 100 million that the Fund hopes to recruit.  The initiative is backed by IKEA Foundation, Children’s Investment Fund Foundation, Oak Foundation, Bernard van Leer Foundation, FIA Foundation and the Guys and St Thomas’s Charity.

“I urge the leaders gathered here today to respond to the World Health Organisation’s call to action, and to put tackling air pollution at the top of your agenda, because clean air is a human right and together we can make it a human reality,” added Burston.

“The real cost of carbon is felt in our lungs,” said WHO’s Maria Neira in an op-ed published Monday in The BMJ. But it is also felt in national economies, she added, noting that air pollution’s health impacts cost OECD economies on average 4% of their annual GDP, and close to 10% for some countries in Asia. The countries and cities that joined WHO’s Clean Air initiative, led by Spain and Peru, would aim to reach WHO air quality guidelines by 2030, in the context of the Climate Summit’s social and political track of commitments.

Certainly the ears of many delegates in the hall were ringing throughout the day with words of Thunberg, who in the close of her remarks had said, “The eyes of all future generations are upon you. And if you choose to fail us I say we will never forgive you. We will not let you get away with this. Right here, right now is where we draw the line. The world is waking up. And change is coming, whether you like it or not.”

Whether her words will echo further in the coming weeks and months remains to be seen.

 

Youth climate activists protest outside the Oil and Gas Climate Initiative’s closed-door meeting, held the day before the UN Climate Action Summit.

 

This story was published as part of Covering Climate Now, a global collaboration of more than 250 news outlets to strengthen coverage of the climate story, co-founded by The Nation and Columbia Journalism Review.

 

  • Updated 24 September, 2019

 

 

Image Credits: UN Photo/Cia Pak, UN Photo/Eskinder Debebe, Thelma Young/350.org.

NEW YORK CITY – Despite advances in Universal Health Coverage (UHC), as many as 5 billion people would be left without full access to healthcare in 2030 at the present rate of progress, according to a new report led by the World Health Organization. And financial protections that shield families from catastrophic health expenses have been eroded in some countries, says the report, released just ahead of Monday’s High Level Meeting on UHC here at UN Headquarters.

The Universal Health Coverage Global Monitoring Report 2019 calls on governments to redouble the pace of expanding coverage, and commit to spending at least 1% of their GDP on primary health care. The report was published just ahead of Monday’s expected adoption of a UN political declaration on UHC, committing UN member states to ensure that people worldwide can access quality healthcare affordably by 2030.

“Despite the progress, UHC coverage is stalled or not on track, and only about half the world population will be covered in 2030. Therefore, progress must markedly accelerate, and we need to double the coverage in order to reach the target of UHC for all by 2030,” said Samira Asma, WHO Assistant Director-General for Data, Analytics and Delivery, in a press briefing last week, just ahead of the start of the 74th UN General Assembly, where the UHC High Level Meeting is taking place.

People wait in line for medical consultations in Bamako, Mali.

The report was prepared by the WHO with contributions from the World Bank, the Organisation for Economic Co-operation and Development, the United Nations Population Fund, and UNICEF. The report was released today.

Primary health care is another key focus of the report’s findings. “Investing an additional US$ 200 billion a year on scaling up primary health care across low and middle-income countries would potentially save 60 million lives, increase average life expectancy by 3.7 years by 2030, and contribute significantly to socio-economic development,” WHO said in a press release. “It would represent a 5% increase on the US$ 7.5 trillion already spent on health globally each year.”

The 163-page report filled with the latest-available data and analysis shows an increase in the “UHC service coverage index” (SCI) measuring progress on SDG indicator 3.8.1 (financial protection and coverage of essential health services). The SCI rose from a global average of 45 (of 100) in 2000 to 66 in 2017, and all regions and income groups recorded gains, according to the report.

“This level of political commitment is more welcome than ever because it is essential on two fronts: first, to accelerate progress in areas where we have seen improvements; and second, to remove the barriers that are slowing down access to services in some countries and among certain populations,” WHO Director General Tedros Adhanom Ghebreyesus said in the report, referring to the High Level Meeting on UHC.

According to the report, “Progress has been greatest in lower income countries, mainly driven by interventions for infectious diseases and, to less extent, for reproductive, maternal, new-born and child health services. But the poorest countries and those affected by conflict generally lag far behind.”

But the pace of progress on UHC has slowed since 2010. Based on current trends, by 2030 only 39%- 63% of the global population would be covered for essential health services, the report projects. “Therefore, progress must markedly accelerate – and coverage needs to double – to reach the SDG target of UHC for all by 2030.”

In addition, levels of catastrophic health expenditures (SDG indicator 3.8.2), which represent out-of-pocket spending in proportion to household income, rose continuously from 2000 to 2015. Nearly a billion people spent more than 10% of household income on health in 2015, and over 200 million spent more than 25%, the report found.

Experts Speak on Report, High Level Meeting

The report comes against a backdrop of a UN General Assembly where the UHC meeting is a key highlight, said WHO officials.  In fact, this may be the first time the UN General Assembly has spent so much of its session on health and health-related climate issues, said WHO Chief of Staff Bernhard Schwartlander at last week’s press briefing.

“I think it is clear health is at the core of the Sustainable Development Agenda,” Schwartlander said. “In many ways, it’s a docking station for development overall for many other of the Development Goals, and UHC in a sense brings it all together.”

“The good news is that all around the world, across all income groups, health service coverage is improving, has improved in this time period. Unfortunately, the rate of progress is declining, in relation to issues such as non-communicable diseases, limitations in health systems, and the fact that the group of lower income countries are falling tragically behind,” Peter Salama, WHO’s executive director of  Universal Health Coverage & Life Course, told reporters.

Reaching the “Natural Limit” of the Previous Global Health Model?

“In many ways, we may have reached the natural limit of our previous global health model,” he said. “We see what is left in terms of coverage are some of the hardest countries – fragile states in particular – the poorest and most vulnerable, and also some of the hardest to reach people within countries: the rural poor, the peri-urban poor, for example,” he added.

On financial hardship, on one hand the world is getting richer, and overall poverty rates are declining, he said. But poverty related to health care expenditure is actually increasing. “So the improvements in service coverage are coming at a real cost to individuals and their families,” said Salama. “This cost is measured by out-of-pocket expenditures, which are increasing. One way we measure that is catastrophic expenditures, households that are spending over 10% or 25% of their overall income or consumption on basic health care. And they are both increasing.”

Both of these problems can be addressed by universal health coverage, the “cornerstone” of UHC as argued in the report, said Salama. On the price tag for UHC, he said, “Even though it seems like a large sum, we know that most countries can afford to do this based on their domestic resources. Only a handful of countries require international aid in order to scale up their primary health care.”

“If we do this, we will have up to 5 billion more people receiving UHC by 2030, and will save up to 100 million lives,” he said.

Francesca Colombo, Head of the Health Division at OECD, said that “a lot of good progress has been made,” but added that “it is quite shocking” to see the increasing number of people who are at risk of poverty due to health spending.

“And even in high-income countries where we have the lowest exposure to such risks, there has been a growth in the share and the number of people who spend large proportions of their household budgets on health. The out-of-pocket expenditures are mainly for pharmaceuticals and out-patient care, she said.

While high-income countries score better overall in terms of access to services, there remain many important gaps, she said, particularly in relation to preventative services, especially for the poorest. And there are inequalities which persist, such as at-risk women not getting breast cancer screenings.

“Make the Last Mile the First Mile”

Speaking at the same press briefing, Stefan Swartling Peterson, chief of health at UNICEF, stressed the importance of primary health care as a cornerstone of universal coverage. “As a parent, what I need whether I’m rich or poor is local access to good quality health services that I can afford. That service is primary health care, it’s not the big expensive hospital which is far away,” he said, adding that primary health care (PHC) can take care of 80-90% of a country’s healthcare needs.

“My message is that we need to make the last mile [to the household door] the first mile,” Peterson said. PHC is the pathway to reach UHC, and it is “very exciting,” he said to see the digital innovations that can deliver PHC more effectively. “This is really the cutting edge of health care delivery.”

Muhammad Pate, Global Director for Health, Nutrition and Population at the World Bank, stressed that UHC is key to human capital accumulation. It drives labour mobility, job creation, and also mitigates the risk of pandemics and other health emergencies, he said. While primary health care is the cornerstone for UHC, it needs to include access to essential drugs, he said, noting that costly drugs are a key driver of catastrophic health expenses. And such access needs to include not only drugs to treat common infectious diseases and maternal health conditions, but also the most prevalent NCDs, including mental health conditions.

On financial protection, Pate said increasing domestic resources is necessary but it is not sufficient by itself to improve financial protection. How domestic resources are organized is key, he said. The World Bank is working with over 100 countries to leverage investments toward UHC, and progress needs to be accelerated.

Benoit Kalasa, Director, Technical Division at UNFPA, focused on areas where there are gaps in data and in services,  the first being maternal/newborn/children health, where he noted that  low-income countries continue to suffer from high rates of maternal and child mortality. More attention is needed to areas such as reproductive health, as well as to exploring why some women don’t use maternal/newborn or reproductive health services, due to social and gender concerns.

“The improvements will be accelerated if we pay attention to the human rights of girls and women to make decisions over their own bodies and strategically,” he said. Kalasa also mentioned the “population dynamic” placing a burden on health systems as the global population is expected to reach 8.5 billion by 2030 and will also be changing in terms of age, mobility and urbanization.

Monday’s High Level Meeting on UHC is expected to be filled with grand statements, but it will remain to be seen what concrete commitments are made during this General Assembly, and how they will be implemented going forward.

Image Credits: UN Photo/Marco Dormino, WHO.

NEW YORK CITY – WHO said Sunday that it was launching a “Clean Air Coalition” led by the Governments of Spain and Peru, while a group of philanthropic organizations and foundations were poised to launch a new “Clean Air Fund” at Monday’s Climate Summit to spur investment in reducing sources of air pollution, which also contribute to climate change.

A factory in the United States emitting smoke into the atmosphere.

Some 29 countries and over 50 subnational entities have pledged to join the coalition committed to achieving healthy air quality by 2030, as part of their Climate Summit pledges, said Spain’s Health Minister María Luisa Carcedo, speaking at a WHO-organized side event on Sunday, the day before the UN Secretary General’s Climate Action Summit brings together heads of state.

The Clean Air Coalition is also being supported by the UN Secretary General’s Office and the Climate and Clean Air Coalition of UN Environment, said WHO’s Director of Public Health and Environment, Maria Neira.

As for the new Clean Air Fund being formally launched tomorrow, Executive Director Jane Burston, said that the fund brings together “a group of like-minded philanthropic foundations” which have recognized that tackling air pollution will have “huge benefits for health as well as for climate.”

“Clean Air Fund” launch announced at a WHO-sponsored side event.

Burston said that a report being published by the new fund tomorrow surveyed the funding landscape and found that philanthropic investment in air quality initiatives is disproportionately low in comparison to the burden disease caused by air pollution – which is estimated to kill some 7 million people around the world every year.

Additionally, the report found that most money is spent only in a few countries – even though WHO estimates that over 90% of people around the world breathe unhealthy air.

“As a result of very limited funding on air quality, deaths from outdoor air pollution and ozone alone are forecast to double by 2050… we just cannot let that happen,” Burston said.

She said that the new Clean Air Fund aims to support projects that “democratize” air quality data, making knowledge about air quality more widely accessible to large numbers of people in cities, through projects such as the Breathe London project.  Breathe London has created a network of mobile sensors that allow children to decide how best to walk to school and parents to identify pollution hot spots.

The new Clean Air Fund will also support “ambitious local government action,” Burston added, noting that they were working with cities that are part of the C-40 network to broaden air quality monitoring as well as with Pure Earth on a mapping of potential air quality interventions and documentation of how those support climate and health goals.

Although she did not put a dollar amount, more details of the Fund are to be revealed Monday. Observers predicted that it would amount to an investment of tens of millions of dollars in new air quality efforts.

Any investment, said Burston, would be starting from the current, “incredibly low base” of financial commitments to better air quality.  “We don’t have anywhere the basis that we need to tackle the crisis.”

 

This story was published as part of Covering Climate Now, a global collaboration of more than 250 news outlets to strengthen coverage of the climate story, co-founded by The Nation and Columbia Journalism Review.

Image Credits: UN Photo/John Isaac.

NEW YORK CITY – Thousands of people attended a Sunday morning walk/run event here in Central Park to raise awareness for Universal Health Coverage, co-hosted by the World Health Organization and the City of New York. The “Walk the Talk: Healthcare for All Challenge” kicks off a week of high-level talks at the 74th United Nations General Assembly, including tomorrow’s long-anticipated High-Level Meeting on Universal Health Coverage (UHC) as well as the UN Secretary General’s Climate Action Summit.

Participants mill around Central Park at “Walk the Talk.”

“Today we are walking for our own health. But we are also marching to demand health for all,” said Dr. Tedros Adhanom Ghebreyesus, director-general of the WHO, at the opening of the event.

The event brought together both New York locals, UN officials, and people from all around the world to commit to health and wellness on an individual and global level. Staff from UN offices around the world such as UNICEF, WHO’s Western Pacific Regional Office and Pan-American Health Organization attended the event, and many major global health organizations such as Vital Strategies also showed up to support.

A number of world leaders also participated in the fun-run, including the President of Palau, Thomas Remengesau Jr., and Norway’s Minister of Health, Bent Høie.

The event was positioned around the larger conversation underway this week at the UN regarding both UHC and action on climate change.

Ricky Kej, Grammy-award winning musician, shares the stage with a multicultural ensemble at “Walk the Talk.”

Grammy-winning artist and activist Ricky Kej performed at the closing ceremony, raising awareness on climate change and hearing loss in youth. WHO estimates that over 1 billion youth are at risk of hearing loss from unsafe listening devices.

Other speakers reiterated the challenges to achieving universal health coverage.

“We are not doing enough to safeguard the future of our children, not when there is very little being done when young people reach the age of 10,” said Zoleka Mandela, activist and granddaughter of Nelson Mandela, pointing to gaps in access in healthcare, and neglect of sexual and reproductive health, injuries, and non-communicable diseases on the adolescent health agenda.

Zoleka Mandela, granddaughter of Nelson Mandela, calls for a Global Adolescent Summit.

Barely 2% of current global health funding is targeted towards adolescent health. Overall, some 51-67% percent of the world’s population does not have access to universal health coverage, according to a new report released today by the World Health Organization.

Dr. Gro Harlem Brundtland, former director-general of the WHO and a founding member of the group of statesmen and stateswomen known as “The Elders”, pointed to the United States’ lack of publicly-funded healthcare and urged states to fulfill their responsibilities to “provide effective and comprehensive public health care to all citizens.”

European Union Health Commissioner Vytenis Andriukaitis gave a rousing speech along similar lines, urging US participants to push for higher health coverage and “make this country great again.”

Dr. Tedros ended the event by reiterating that universal health coverage is a “political issue.”

“By walking today,” he said, “We are asking our world leaders to honor their commitment on September 2015 when they agreed to achieve universal health coverage for all by 2030.”

Image Credits: Gabby Stern/WHO, Ricky Kej, G Ren/HP-Watch.

NEW YORK CITY – Youth leaders from around the world clamored for more action on climate change Saturday at a first-ever United Nation’s Youth Climate Summit – even as the actual government commitments lined up for Monday’s formal meeting with heads of state appeared likely fall far short of making the dramatic changes that scientists say would be needed to limit global warming to 1.5° C.

Youth activists and the Secretary-General of the UN give opening remarks at the Youth Climate Summit.

Sources told Health Policy Watch that some 50 national commitments were due to be announced Monday at the UN Climate Summit. But these would not be sufficient to sharply reduce the pace of climate change that right now has the world heading for 3°C or higher temperatures by the end of the century. That, health experts have warned, would trigger an unprecedented spiral of threats to human health, food security, disease transmission and to the very survival of small island states and coastal communities.

(Left to Right) Christiana Figueres, former UNFCCC executive secretary, WHO’s Maria Neira, UN High Commissioner for Human Rights Michelle Bachelet.

Against the dark scientific predictions, Saturday’s assembly was a further reflection of how civil society organizations of all stripes – from climate researchers to public health advocates, students and urban leaders– have been mobilizing to seize initiative where governments have so far failed.

On Thursday, a consortium of scientists published The Exponential Roadmap, outlining 36 strategies that could slash greenhouse gas emissions 50% by 2030 if they were scaled up rapidly.  These 36 solutions – ranging from solar and wind to electric bikes, commercial shipping and reduced red meat consumption – could “stabilize earth’s temperatures and significantly reduce risks to societies” said the authors of the report by the Future Earth consortium, led by the Potsdam Institute for Climate Impact Research, Germany. “This is now a race against time, but businesses and even entire industries have made many significant transitions in less than 10 years,” said report author Johan Rockström, director of the Potsdam Institute for Climate Impact Research, Germany and co-chair of Future Earth, an international research programme, in a press release.

Saturday’s Climate Youth Summit also came in the wake of Friday’s historic global climate strike that mobilized 4 million people worldwide, many from youth-led movements, who demanded more accountability from government and industry leaders.

“I want the leaders of the world to respect the rights of future generations, respect the right to a habitable planet… We are not insurance policies, We are communities, we are human communities. Is it really too much to ask you to walk the talk?” Kamal Karishma Kumar, a young activist from the island of Fiji, a country threatened by rising sea levels, told the world leaders at the Youth Summit inside UN Headquarters.

Youth participants also demanded greater accountability from industry representatives who were present at the Summit. One activist challenged Microsoft’s Chief Environmental Officer, Lucas Jappa, over recent business deals with fossil fuel companies.

“If Microsoft is so committed to sustainability, why did Microsoft partner with Chevron and Schlumberger this week to accelerate oil extraction?… Do you care more about profit than you care about us?” she asked.

Making new business deals with the fossil fuels industry is an issue that “the entire tech sector  and everybody who is living in the world today, which is predicated upon an oil and gas economy, has to answer,” Microsoft’s Jappa responded.

“It’s a conversation that we’re having inside the company and it’s one that I think you’ll be hearing more about, both from Microsoft and our peers in the broader tech sector…. Know that Microsoft will be engaging in this dialogue moving forward,” Jappa added.

Monday’s Summit Portrayed as a “Beginning” not a “Milestone”

The Youth Summit took place against a background of sober recognition that the level of commitment from global leaders moving into Monday’s high-level Climate Action Summit was likely to be muted. And leaders were busy recasting the Monday meeting as the beginning and not the end of the process.

“We have 50 commitments, that is not negligible,”  said Christiana Figueres, former head of the United Nations Framework Convention on Climate Change (UNFCCC). “There is nothing in life that is black or white, everything is shades of grey and I am absolutely sure that this [summit] will take us to the next level,” Figueres, now a lead actor in Mission 2020, a partner organisation in the Exponential Roadmap, told Health Policy Watch in a brief interview.

Figueres said she had been “inspired and called to account” by young people speaking out at  events such as the Youth Summit, “They have said our generation has not done our job – nobody is exempt, everybody has to do something.”

UN Secretary-General, António Guterres.

The youth movement and leaders such as Greta Thunberg will be remembered as making “the biggest difference” in the climate movement, said Norway’s Environment and Climate Minister, Ola Elvestuen, at the UN meeting.

Speaking at today’s Youth Summit event, UN Secretary General Antonio Guterres, sounded a note of hope. “When I started two years ago… I felt very discouraged in relation to the perspectives about climate action. We were already facing a climate emergency… At the same time, there was an apathy, there was a sense of difficulty in getting people to act.”  Now, he said, public sentiment is finally turning around.

But asked later by Health Policy Watch if he had “high hopes” that Monday would be a milestone, The Secretary General paused and said only “I have… hopes.”

Health Mobilizing More Aggressively

Recognizing that climate impacts people’s health can also help motivate climate action, said Thunberg upon a visit to a “Pollution Pods” exhibit on the UN lawn, sponsored by the World Health Organization.  The traveling exhibit, by British artist Michael Pinsky, recreates the experience of pollution in five cities of the world, ranging from highly polluted Delhi and Beijing to moderately polluted London and Oslo.

Greta Thunberg at WHO’s Pollution Pods exhibit.

“If we can connect the climate crisis with air pollution, it is just so connected and we cannot solve one without solving the other,” said Thunberg.

WHO has been leading research and policy synthesis  on climate and health issues for nearly two decades.

Now some of the largest humanitarian and health civil society organizations are speaking up more assertively. The International Federation of the Red Cross (IFRC) and Médecins Sans Frontières/Doctors Without Borders (MSF) both issued statements just ahead of the Summit about the urgency of addressing climate change.

The International Federation of the Red Cross report, The Cost of Doing Nothing, warned that by 2050 some 200 million people a year will be in need of humanitarian assistance due to climate related events, double today’s level.  Costs of responding to humanitarian crises will balloon to USD$20 billion.

The global health and humanitarian aid communities are facing a “climate emergency,” said the Executive Director of MSF USA, Avril Benoît, in another statement, issued on Thursday.

Vital Strategies, a longtime health actor on tobacco control, NCDs, and traffic injuries has also become active in the climate space (see interview).  And dedicated NGOs, such as Health Care without Harm, and the Global Climate and Health Alliance, have also appeared on the scene to address health workers about the urgent health impacts of climate change, as well as to advocate for reducing the climate footprint of the health sector, which is responsible for as much as 4.5% of climate emissions, according to a recent report.

New Roadmap Provides 36 Solutions to Cut Climate Emissions 50% by 2030 Worldwide

Among scientists, as well, there is a stronger note of activism, as reflected in reports such as the Exponential Roadmap.  The report identifies a number of “tipping points” it says could accelerate transformation toward a more sustainable global economy, including:

  • Low cost solar, wind, and battery technologies, which are on profitable, exponential trajectories that if sustained, will be enough to halve emissions from electricity generation by 2030;
  • Electric vehicle growth, which has the potential to reach a 90% market share by 2030 if sustained, but only if strong policies support this direction;
  • Growing social movements changing the public conversation in parallel with companies and cities stepping up climate action;
  • Emerging political support for more ambitious targets, for example countries such as the UK, France, Norway and Sweden adopting laws to reach net-zero emissions by 2050 or earlier.

Along with that, digital technology could support a rapid transformation of economic systems – although if it is not managed, digital transformation also could drive emissions higher, the report’s authors warn.

Of the report, Figueres said, “I see all evidence that social and economic tipping points are aligning. We can now say the next decade has the potential to see the fastest economic transition in history. The 2019 Exponential Roadmap is an excellent guide for the necessary journey to net-zero emissions.”

Manuel Pugal-Vidal, leader of the climate and energy practice at WWF, a partner of the report said in a statement, “Governments must introduce national targets to reach net-zero emissions by 2050 with targets to cut emissions 50% by 2030. Immediate removal of fossil-fuel subsidies is a priority. Yet policies must be equitable and fair or risk failure.”

“Developed nations with significant historic emissions also have a responsibility to reduce emissions faster. Cities and states – not only countries – will also be important change makers,” he adds.

More from HPW’s interview with Maria Neira, Christiana Figueres, and Michelle Bachelet:

 

 

 

For more about the story of the “Pollution Pods” see here.

Grace Ren also contributed to this story. 

 

This story was published as part of Covering Climate Now, a global collaboration of more than 250 news outlets to strengthen coverage of the climate story, co-founded by The Nation and Columbia Journalism Review.

 

 

Image Credits: UN Photo/Kim Haughton, Fletcher/HP-Watch.

NEW YORK CITY (September 20, 2019) – Thousands of people have flooded streets here today as part of a worldwide movement to demand climate action. 4 million people in over 150 countries around the world took to the streets in a global Climate Strike. The New York Climate Strike is one of over a thousand registered strikes in the US alone.

Students and adults alike walked out of schools and workplaces to join the strike today, many with institutional support. Over 1500 employees at companies such as Amazon, Facebook, and Twitter, have pledged to walk out to join the protest. Employees from major NGOs such as Amnesty International and Doctors Without Borders/Médecins Sans Frontières (MSF) have also planned walk-outs, sources told Health Policy Watch.

Students and adults at the New York City Climate Strike

In a show of institutional support, all public New York City schools announced that they will excuse student absences due to the strike last week on Twitter.

At Foley Park, the venue for the Climate Strike in New York City, the air is humming with energy, and the most prominent thing about the crowd is how young it is. High-school and middle school students make up a majority of the people chanting for change, and the presence of whole families is felt as parents walk hand-in-hand with their kids and strike for their children’s futures.

Health Policy Watch asked some people why they were striking today. Here is what they said:

Valerie, architectural designer, holds her list of climate action demands.

 

 

“I’m striking because…we don’t have much time left. I’m only 23, so I want my kids to enjoy what I enjoyed when I was younger, and I think there is no other way to do it other than to demand accountability for the actions that were made, and try to solve them right now because we have all the tools and resources. People just need to start taking action.” – Valerie, Architectural Designer.

 

 

 

The Schoor family holds their Climate Strike signs.

 

“For my husband and I, one of the reasons why we’re striking is for our daughter. We want to make sure she has a healthy place to live, or a place to live at all. And with climate change going on, we know there are a lot of issues with more people having breathing problems, different cancers, and we just really want to make sure our daughter and our grandchildren have a safe place to live.”- Schoor Family.

 

 

Student from East York Middle School of Excellence in Brooklyn, New York, holds a sign

 

“Climate justice and social justice flower from the same seed. So we know that people of color are disproportionately affected by the climate crisis, so it’s important that we hear people of color’s voices, and to protect our planet.” – Ms. Sweet, teacher at East York Middle School of Excellence, on why her school is supporting their students to attend the Climate Strike.

“We are here to fight for climate change. We are not here to skip school or skip work, we are not here to watch. We are here to fight for our lives, we are here so climate change will not kill us. [The government] will not listen to our heeding, or listen to scientists either, so now we come here to fight.”- Stephan, student at East York Middle School of Excellence.

 

Leo, age 7, has been protesting on the stairs of New York City Hall since December 2018

 

 

 

“It’s not good for the earth, every time it makes another thing, it pollutes the air more. [Climate change is important for health] because we won’t get to live a long life, and I want everyone to have a long life.”- Leo, 7 years old.

 

 

 

Justin and Andrei, Artists, hand out free signs they created to strike participants.

 

“We need to bridge ourselves back into the natural world, we’re very disconnected from the natural world so I think this movement is important. I worked with Greta Thunberg… and so I support all these projects she’s doing, and all the students and adults who are out here”- Justin Brice Guariglia, Artist and Climate Activist.

“Today’s the day we decided to gather around the world, it’s the most important issue of our day. Everything comes together with climate change – income inequality, changing economies, the loss and gain of jobs, there is absolutely no area of civic life that is not touched by the disaster ahead if we don’t do something.” – Andrei Codrescu, Romanian-American Poet.

 

 

 

 

 

Today’s global Climate Strike movement began with school walk-outs organized by students around the world, inspired by Greta Thunberg’s first strike in 2018. Greta, along with youth climate leaders around the world, have been invited to New York to attend meetings during the 74th United Nations General Assembly.

The strikes come just one day before the Youth Climate Summit hosted by the United Nations, where over 100 youth leaders in the climate movement have been invited to participate in discussion around climate action, and three days before the planned Climate Action Summit, where UN Secretary-General Antonio Guterres will be calling on countries to share concrete plans for tackling the so-called “climate-crisis.”

 

This story was published as part of Covering Climate Now, a global collaboration of more than 250 news outlets to strengthen coverage of the climate story, co-founded by The Nation and Columbia Journalism Review.

 

 

September 21 2019 – This story was updated to reflect new attendance numbers for the global climate strike.

NEW YORK – Over half of new cancer drug approvals granted by European authorities between 2014-2016 may have been made based on evidence from biased clinical trials, according to a new study published in The BMJ. The study, led by Dr. Christopher Booth, professor of oncology from Queens University Cancer Research Institute, raises serious questions about the quality and strength of evidence used by the European Medicines Agency (EMA) to approve new cancer drugs.

Half of the 32 new drug approvals relied on evidence from trials that were “at high risk of bias,” according to the study. And an additional 7 of those used results from at least one randomised-control trial (RCT) that was at “low risk” of bias, researchers found in the study, which was partially funded by a civil society group that has protested cancer drug prices and championed access to medicines issues.

A nurse injects medicine into a cancer patient. Photo: WHO/ G. Reboux

Only 7 of the new drugs were approved based on trials that actually measured improvements in survival or quality of life outcomes.

 

Noting that some bias in trials is unavoidable due to the complexity of cancer, the authors were concerned that a number of studies did not give clear reasons for why they may have excluded data from their analyses.

While the authors note that the results may not be generalizable to all new drug approvals, civil society groups were quick to say that the

paper strengthens the case for revamping  the drug approval regulatory process to ensure that new medicines brought to market are indeed effective.

“…Many newly marketed medicines bring negligible or non-existent improvements to survival rates and quality of life for patients, while becoming ever-more unaffordable to already stretched health systems,” Jaume Vidal, senior policy advisor at Health Action International, the group that partially funded the study in a press release.

“Regulators must take on the findings to help ensure new medicines on the market are there for the benefit of the patient and society and not pharmaceutical companies and shareholders.”

 The World Health Organization tends to follow the lead of regulatory agencies such as the EMA or the US Drug and Food Administration in the consideration of new medicines for “pre-qualification” as drugs that developing countries could obtain at negotiated prices. WHO approval, in turn, may be interpreted as a green light to developing countries to begin reviewing and registering new therapies nationally.

 

Image Credits: WHO/G. Reboux.

Daniel Kass

Health is becoming more prominent in the climate debate in light of the mounting human toll from extreme weather – and that’s only the tip of the ’iceberg’, in terms of what lies in store, says Daniel Kass, senior vice president at Vital Strategies and former Deputy Commissioner of Health for New York City. But health alone is not enough to move the political needle. As the world leaders gather Monday for the UN Climate Summit, to face what UN Secretary General António Guterres, has described as the “Battle of our Lives”, health advocates need to band together with other constituencies in a united front. Kass talked with Health Policy Watch about the issues at stake in the lead-up to Monday’s Summit.

Health Policy Watch:  What do you expect to be the main health-related aspects of climate change that will be discussed at the UN Climate Summit?

Daniel Kass: The evidence about the health impacts is growing, and that will help to focus attention on health at the meeting. It is always easiest to discuss the direct effects of climate change – in particular, weather-related mortality and illness, for example heat stroke and heat-related mortality, coastal flooding and drowning.

But more emphasis needs to be placed on the indirect impacts, and rightfully so, as they are far greater, and more far-reaching. These include impacts that are already with us – heart disease, respiratory disease and deaths from global increases in air pollution; deaths from resurgent vector-borne diseases like malaria as well as from novel vector-borne infections like Zika virus, which tend to spread more widely to human settlements as a result of deforestation, urbanization and related habitat changes.

Still, with the rapid pace of change, there needs to be more discussion about still more indirect impacts. This would include consideration of issues such as:  catastrophic outcomes including malnutrition from disruptions in food supplies; health impacts of water stress/shortages and indirect impacts from increases in water-related conflict and migration; and the potential for social safety net collapse as more resources are diverted to coping with climate-related mitigation.

A woman carries supplies through a flooded street. Thousands of people were displaced by unprecendented flooding in Haiti in 2014. Photo: Logan Abassi UN/MINUSTAH

HP Watch: This is a formidable list.  What are the main challenges to addressing it more effectively?

DK: The current breakdown in global economic and political cooperation is a huge impediment to progress. It is extremely difficult to manage more sustainable production of energy; standards for industrial processes and global commodities like vehicles; and harmonized trade rules and manufacturing standards necessary to address climate-related emissions. Progress depends on finding common ground based upon mutual self-interest. Perhaps the catastrophic threats from climate change will unify the world. But rising nationalism and the political marketing of self-interest does not make me hopeful, in the near term.

HP Watch:  The recent IPCC report also highlighted threats to food security, including the need to reduce meat consumption to ensure a sustainable food supply for a growing population. Do you see this as broadening the health agenda? And what are the concrete implications for the health sector? After all, a recent WHO nutrition report ignored warnings of health risks associated with red meat consumption, including from its own cancer researchers.[1]

DK: Carbon emissions reductions from greater reliance on renewable energy will have enormous health and economic co-benefits. So too will shifts in land use, in particular from reducing the impact of meat production— mammalian in particular.

Diets lower in meat and higher in variety and with greater caloric and nutritional needs met by grains, fruits, and vegetables, bring health benefits at individual and population levels. Remember, as well, that most of the world already lives without ready access to meat – especially beef. While it’s important for health advocates to join the call for more rational and less carbon-intensive food production, it is also important that as population and net global wealth grows, this does not come with a proportional increase in meat consumption. The challenges for nutritionists, agronomists and others are different while they work toward the same aims.

Climate advocates in the West should not get caught in the trap that may be set by proponents of the status quo. Industry wants to frame this as a consumer freedom issue, and sometimes advocates direct their efforts at consumers rather than the corporate and governmental policy actors that bear primary responsibility for reversing trends in CO2 emissions. That’s just what the food, fossil fuel and land oligarchs want to happen.

HP Watch:  Reducing climate emissions from fossil fuel sources, which also cause health harmful air pollution, means scaling back industries such as coal, automobiles, etc., which are lobbying hard to maintain their economic foothold, and even expand in low- and middle-income countries. What forms of political action and policy measures will be necessary to ensure change? 

DK: All of the work that must be done is ultimately political. There is greater public acknowledgement that the status quo cannot be maintained, and there remains no rational economic argument for doing so (once the true health and planetary costs of pollution and climate emissions are accounted for). Broad categories of policies that must be expanded or initiated include:

  • Eliminating subsidies on dirty fuels; shifting incentives to support clean tech innovation and solutions;
  • Prohibiting the dumping of dirty, inefficient vehicles and the export of superannuated technologies like coal-to-electricity to developing countries;
  • Incentivizing healthy and sustainable shifts in consumer and individual behavioural choices, around food, transport, and diet, for example;
  • Reorienting regulations toward steep improvements to achieve specific benefits and outcomes, rather than modest incremental improvements on the status quo.

This will require redirecting development funding toward green industries, and imposing conditions with sanctions for failing to meet goals. The greatest spending must happen where the greatest emissions are, and those countries (middle- and high-income countries) will only do so if there is a strong political movement to demand it. There are very positive signs that this is occurring – enabling health and climate advocates to advance calls for policy change. And people are mobilizing around the difficult issues of societal reorganization. The world’s nations spend nearly USD $2 trillion each year on militaries. Investing in planetary survival has a far greater return on investment than war.

HP Watch: Can you speak to the role of cities in reducing climate change and its related health impacts? And do you see the Climate Summit as a key event in planning and preparing for such changes?

DK: There is good reason to think cities will be central to the Summit, and central to potential solutions. The challenges are profound: The world is increasingly urbanized, and this trend is projected to continue. Cities suffer a commensurate global health and economic burden from climate change and air pollution, and a large proportion of urban populations are extremely vulnerable to climate change, loss of habitable area from rising sea levels, drought and flooding, all made worse by the informality of new urban settlements in low-income countries.

Cities can lead the way in mitigation and adaptation, but they typically don’t have the fiscal, political or regulatory authority to do it alone. There is good reason to believe that greater urbanization will ultimately support mitigation. Cities in the industrialized world typically have lower per capita CO2 emissions compared to their suburbs because of their efficiency, density, verticality, and availability of mass transit. Some cities are rethinking the place of automobiles and moving to regulate their own purchase of energy from renewable sources. We need to ensure that we increase knowledge and promote uptake of successful strategies so that more cities follow suit.

HP Watch:  While awareness of the human health impacts of climate change is growing, it still doesn’t seem to be sufficient to drive the kind of dramatic commitments that the SG has in mind.  Will some countries deliver? And if not, what does the world do on the day after the Climate Summit? 

DK: I think of health impacts as a necessary but insufficient way to mobilize additional constituencies around the impacts of climate change. Research and modelling show that the burden of death and disease from more extreme weather, population displacement, more widespread and novel infectious and vector-borne diseases, stress, negative birth outcomes (and the list goes on and on) will overwhelm even wealthy countries’ health systems and exhaust governmental resources in lower income countries. And these impacts are already being felt. Some people, organizations and institutions are motivated by health concerns and they need to be mobilized. Others are mobilized by environmental concerns or economic risk, others by their faith. The threat of irreversible and dramatic climate change can unify these communities. And the desire to avoid dissent is a great motivator for governmental action.

Some countries are already delivering, both in terms of energy transformation and funding to support global work. Others are cynically running in the wrong direction. Local governments, which feel the impacts earliest, are responding globally, but require national and international commitments to make an impact. Following the Climate Summit, the world needs to study the results and ask whether their representatives are serious, whether they are prepared to take rapid action, whether they can be counted on. If the answers are “no,” they should do everything they can to ensure that their term in office is short-lived.

Note: Kass is senior vice president of environmental health at Vital Strategies, a global health organization that works with governments and civil society in 73 countries to help them make rapid progress against cancer, heart disease, obesity, tobacco use, epidemic diseases, drug overdose, road crashes and other leading causes of disease, injury and death. Previously, Kass was Deputy Commissioner for the Division of Environmental Health Service at the New York City Department of Health and Mental Hygiene.

Elaine Ruth Fletcher contributed to this article

 

This story was published as part of Covering Climate Now, a global collaboration of more than 250 news outlets to strengthen coverage of the climate story, co-founded by The Nation and Columbia Journalism Review.

 

[1] International Agency for Research on Cancer (IARC)

Image Credits: Logan Abassi UN/MINUSTAH.

NEW YORK – As heads of state and international organisations gather for the 74th United Nations General Assembly, Monda‎y’s High-Level Meeting on Universal Health Coverage (UHC) is one of the key events of this session. It aspires to elevate access to quality healthcare for the global population by 2030, and one billion more people by 2023.

The stated aim of the event, “Universal Health Coverage: Moving Together to Build a Healthier World,” is to “accelerate progress toward universal health coverage (UHC), including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.”

A draft UHC political declaration (note: text starts on p.3) – stripped of controversial language over thorny issues like sexual and reproductive health, and finalized last week – is to be approved at the High Level Meeting. It commits governments to the stated UHC aim of covering one billion more people by 2023, and all people by 2030 (paragraph 24). It also commits governments to halt rising out-of-pocket health expenditures by providing greater financial risk protection (such as insurance) for healthcare procedures.

A nurse consults her patient with family planning needs. Sexual and reproductive health has been a controversial issue in the UHC debate. Photo: Dominic Chavez/World Bank

While the lofty vision of this far-reaching effort is further detailed in the 11-page declaration text, observers will look to leaders’ statements for signals of how concrete actions may follow.

Some two dozen heads of state are said to be planning to attend Monday’s UHC session at the General Assembly (GA), which began Wednesday and runs to 30 September.

The draft agenda for the one-day UHC meeting shows a mix of plenary segments with government statements, and two panels. There may be more than two dozen heads of state in attendance, according to sources.

In the draft version of the agenda, panel speakers included: the prime ministers of Bangladesh and Spain; the heads of the UN, WHO, World Bank, UNHCR, GAVI, Oxfam, and Medtronic; and well-known political figures such as former WHO Director General Gro Harlem Brundtland (the “Eminent High-Level Champion of UHC and member of the Elders”); Jeffrey Sachs founder of Columbia University’s Earth Institute; former New Zealand Prime Minister Helen Clark, now the Board Chair of the Partnership for Maternal, Newborn & Child Health; and Keizo Takemi, member of the Japanese House of Councillors and WHO UHC Goodwill Ambassador.

A series of side events are taking place around the High-Level Meeting, many of which are open to all. A list of side events UHC2030 is hosting or co-organizing during the General Assembly is here. A list of further events during the General Assembly is in the UNGA guide 2019.

The UN has, in recent years, stepped up its high-level political attention to health issues, with a landmark declaration on AIDS, and in last year’s GA session, high-level meetings on non-communicable diseases, and tuberculosis. Observers argue, however, that such meetings lead to optimistic language but not enough concrete progress. From a development perspective, achieving UHC will require governments to take the broad declaration and fit it to their specific national needs, while increasing outlays for stronger health systems.

“Next week’s High Level Meeting on Universal Health Coverage is a window of opportunity that we need to seize,” Francesca Colombo, head of OECD’s Health Division, told Health Policy Watch. While acknowledging that the declaration sets ambitious aims, she said that drawing attention to the UHC issue at the UN’s highest level was already a “tremendous achievement.”

However, she acknowledged that the declaration and the High Level Meeting were just the beginning of the journey. “It’s unfinished business.” she said. “Much more needs to be done to draw attention to health as a critical economic development issue.”

Political Declaration

The final political declaration contains 83 paragraphs that capture the remarkably broad scope of global and public health issues such as health systems, financing, emergencies, health workers, gender, children, aging, migrants and refugees, discrimination and violence, communicable and non-communicable diseases, digital health and data, access to health technologies, and partnerships.

The declaration contains calls to use all levels of policymaking, governments, regions and the multilateral system and existing agreements, and details dozens of specific topics, such as eye and oral care, mental health, protection in armed conflict and humanitarian issues, sanitation, safety, healthy diets, and neglected diseases. It has numerous references to improving women’s health and involving them more completely in health care, and it stresses that primary health care is essential for UHC.

A core focus of UHC efforts is on financing and budgets, but no specific commitments are made, despite the many mentions throughout. The declaration does, however, cite the WHO’s recommended target of public spending of 1 percent of GDP or more on health. It also cites WHO estimates that an additional US$ 3.9 trillion in global spending by 2030 could prevent 97 million premature deaths and add between 3.1 and 8.4 years of life expectancy in LMICs.

The declaration repeatedly cites the need for affordable health care and medicines, vaccines and diagnostics, and urges bolstered domestic budgets and global coordination through financial groups like the Global Fund for AIDS, Tuberculosis and Malaria. It also mentions a growing strategy of pooling resources allocated to health, and it gives a clear message about the importance of private sector funding and contributions.

The declaration also highlights statistics showing the magnitude of need for stronger health systems to fulfill the aims of UHC – such as the shortfall of 18 million health workers especially in low- and middle-income countries.

And it declares “that action to achieve universal health coverage by 2030 is inadequate and that the level of progress and investment to date is insufficient to meet target 3.8 of the [SDGs], and that the world has yet to fulfill its promise of implementing, at all levels, measures to address the health needs of all.”

SDG 3.8 states: “achieve universal health coverage (UHC), including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all.”

The text’s preamble of 23 paragraphs describe problems and shortfalls in the global, regional and national efforts in health, stating that in many cases efforts are not on track to fulfill the SDGs by 2030 and must be stepped up. Paragraphs 24 to 81 are action items to be undertaken across every front, from national governments to the UN system.

The UHC declaration calls for another high-level meeting to be held at the UN in New York in 2023 to review implementation of this year’s declaration. Next year’s General Assembly will receive a progress report on implementation of the declaration, and a report on recommendations on implementation. Next year’s General Assembly will decide the modalities for the 2023 meeting.

The UHC political declaration text is accompanied by a letter from the President of the General Assembly, María Fernanda Espinosa Garcés and the two co-facilitators of the political declaration negotiations, Georgia’s Ambassador Kaha Imnadze and Thailand’s Ambassador Vitavas Srivihok.

Sexual and Reproductive Health Settled

In the final agreed text, negotiators resolved an issue over references to sexual and reproductive health rights, which had prevented consensus on an earlier draft negotiated over the summer.

Negotiators removed the controversial reference to sexual and reproductive health at the end of paragraph 29, according to the letter from the co-facilitators’, Imnadze and Srivihok. The paragraph previously stated:

  1. “Take measures to reduce maternal, neonatal, infant and child mortality and morbidity and increase access to quality health-care services for newborns, infants, children as well as all women before, during and after pregnancy and childbirth, including in the area of sexual and reproductive health;”

The final text of paragraph 29 now ends after the word “childbirth”.

However, the text retained intact the reference to sexual and reproductive health in paragraph 68, which also hearkens from the SDGs. That states:

  1. “Ensure, by 2030, universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes, which is fundamental to the achievement of universal health coverage, while reaffirming the commitments to ensure universal access to sexual and reproductive health and reproductive rights in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences;”

Meanwhile, reference to sexual and reproductive health was also removed from a third paragraph, 69, on gender rights, which had previously stated:

  1. “Mainstream a gender perspective on a systems-wide basis when designing, implementing and monitoring health policies, taking into account the specific needs of all women and girls, with a view to achieving gender equality and the empowerment of women in health policies and health systems delivery and the realization of their human rights, consistent with national legislations and in conformity with universally recognized international human rights, acknowledging that the human rights of women include their right to have control over and decide freely and responsibly on all matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination and violence;”

It now reads:

  1. “Mainstream a gender perspective on a systems-wide basis when designing, implementing and monitoring health policies, taking into account the specific needs of all women and girls, with a view to achieving gender equality and the empowerment of women in health policies and health systems delivery;”

The co-facilitators also noted that negotiators moved paragraph 12 up to paragraph 6, with no change to the text, effectively raising its profile somewhat. That paragraph emphasises the importance of “national ownership and the primary role and responsibility of governments at all levels to determine their own path towards achieving universal health coverage….”

Measuring Impact

The overarching set of guideposts for the UHC declaration work is the 2030 Sustainable Development Goals (SDGs), which include many objectives related to health throughout the 17 SDGs, along with the dedicated “Good health and well-being” goal of SDG 3. The declaration is filled with undefined goals, but it also contains numerous references to measuring progress. It will remain to be seen whether the momentum, pressure and language of the commitments will be strong enough to bring about the much-hoped for UHC achievements.

 

Image Credits: Dominic Chavez/World Bank.

Kenya initiated a national pilot of the world’s first malaria vaccine today, joining Ghana and Malawi to introduce the landmark vaccine as a tool against a disease that remains a leading killer of children under the age of 5 years, particularly in Sub-Saharan Africa.

The vaccine, known as RTS,S, will be rolled out nationally in phases to children from 6 months of age in eight counties across the country, beginning in Homa Bay, in western Kenya, said a WHO press release. It is the first vaccine with the potential to significantly reduce malaria infection in children, including life-threatening severe malaria, which claims the life of one child every two minutes.

Malaria vaccine launched in Kenya. Photo: WHO Africa Region

“Africa has witnessed a recent surge in the number of malaria cases and deaths. This threatens the gains in the fight against malaria made in the past two decades,” said Dr Matshidiso Moeti, WHO Regional Director for Africa, speaking at the Kenya launch event. “The ongoing pilots will provide the key information and data to inform a WHO policy on the broader use of the vaccine in sub-Saharan Africa. If introduced widely, the vaccine has the potential to save tens of thousands of lives.”

WHO said that the aim is to vaccinate about 120,000 children per year in Kenya. The WHO-coordinated pilot is a collaboration with the ministries of health in Ghana, Kenya and Malawi, as well as international and local NGOs. PATH and GSK, the vaccine developer and manufacturer, are donating up to 10 million vaccine doses for the pilot. Financing for the pilot programme has been mobilized through a collaboration between Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and UNITAID.

WHO said that the vaccine has a proven track record from Phase 3 clinical trials, which were conducted between 2009 and 2014 through a network of African research sites, including three sites in Kenya (Kombewa, Siaya and Kilifi) and enrolling more than 4,000 Kenyan children. Children receiving four doses of RTS,S experienced significant reductions in malaria and malaria-related complications in comparison to those who did not receive RTS,S. Health benefits of the vaccine were added to those already seen through the use of insecticide-treated bed nets; prompt diagnosis; and effective antimalarial treatment. The vaccine, where available, will be given in four doses: three doses between 6 months and 9 months of age, and the fourth dose at 24 months (age 2).

After thirty years under development, WHO said that the vaccine is soon to be added to the core package of WHO-recommended measures for malaria prevention. Other key measures include use of insecticide-treated bed nets, indoor spraying with insecticides and access to malaria testing and treatment.

Kenya is one of three countries selected from among 10 African country applicants for the RTS,S pilot. Key criteria for selection included well-functioning malaria and immunization programmes and areas with moderate to high malaria transmission.

For more about the initiative, see the WHO Press release

 

Image Credits: WHO Africa Region.