Shinzo Abe

132 Pages·017.54 MB·English

Delivering
Universal
Health
Coverage

2030
Health:
A political

Edited by
choice John Kirton,
Global Governance Program,
Munk School of Global
Affairs and Public Policy,
and Ilona Kickbusch,
Global Health Programme,
Graduate Institute.
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Health:
Delivering
Universal
A political
Health
choice Coverage
2030
1 HEALTH: A POLITICAL CHOICE
2
CONTENTS
1
THE GLOBAL
EDITOR’S
COMMITMENT
INTROS
TO THE SDGS
2.1
Advancing universal
1.1 1.2 health coverage in 2019
through the gender
dividend
The race to achieve universal
The UN’s role in accelerating By Ilona Kickbusch, co-chair
health coverage
health coverage of UHC2030 and director of
By Her Excellency, María Fernanda
By Amina J. Mohammed deputy the Global Health Centre
Espinosa Garcés, president of the 73rd
secretary-general of the United Nations at the Graduate Institute
Session of the United Nations General
of International and
Assembly p08
Development Studies

p06
p16

1.4
1.3

2.2
Health is a political choice The ROI on health investment
By Dr Tedros Adhanom Ghebreyesus, By Achim Steiner, UNDP administrator
The political choice
director-general, World Health
p12 for universal health
Organization
coverage in global

p10 governance in 2019

By John Kirton, director

of the Global Governance
COUNTRY LEADERS SPEAK
Program

p20
OUT ON UHC
3.1 3.3 3.5 3.7
New health policies for Implementing Kenya’s social shift Transforming a
3
new health challenges Sustainable Development By Uhuru Kenyatta, President continent
A speech by Japan’s Prime Goal 3 of the Republic of Kenya By Paul Kagame, President of

Minister, Shinzo Abe A speech by German p36 Rwanda

chancellor, Angela Merkel
p26 p40
3.6
p30
3.2

3.4
Gender and heath: a
Inspiring Global Action political choice with
A speech by France’s (cid:189)(cid:395)(cid:425)(cid:303)(cid:425)(cid:234)(cid:455)(cid:584)(cid:405)(cid:3)(cid:470)(cid:303)(cid:310)(cid:417)(cid:3)(cid:234)(cid:303)(cid:234)(cid:315)(cid:348)(cid:405)(cid:417)(cid:3) major ROI
President Emmanuel Macron NCDs and tobacco By the Right Honourable
By Tabaré Vázquez, President Helen Clark
p28
of Uruguay

p38
p34
4
TOP ECONOMISTS SPEAK OUT FOR UHC
4.3 4.4
The economics of The crises in US
universal health health care
An interview with Lawrence An interview with Robert
6
Summers president emeritus Fauver, president of Fauver
of Harvard University Associates

p48 p50

4.1 4.2 4.5
Financing UHC in Financing universal In numbers
low-income countries health coverage Financing global health
By Jeffrey D. Sachs, By Peter Sands, executive and UHC
director of the Center for director, Global Fund to
p52
Sustainable Development at Fight AIDS, Tuberculosis
Columbia University and Malaria

p44 p46

6.4
WHY WE
Achieving the
WHAT TO EXPECT SHOULD BE impossible with
vaccines
By Dr Seth Berkley, CEO of
FROM THE UN OPTIMISTIC
Gavi, the Vaccine Alliance

p72
HIGH LEVEL
6.1

6.5
MEETING ON UHC
Lessons from Turkey’s
achievements in UHC
The technology
By Recep Akdağ, Former
transforming the future
Minister of Health, Turkey
of healthcare

p66 By Houlin Zhao, ITU
5.1 5.3
secretary-general

6.2
p74
Local action The political

driving universal choice for
Strengthening systems 6.6
achievements patient-centric
for equality
By Githinji Gitahi, and compassionate
By Agnès Buzyn, Minister of
CEO of Amref Health universal 5health UHC in small island
Solidarity and Health, France
Africa coverage developing states

By Kawaldip Sehmi p68 By T. Alafia Samuels,
p56
Caribbean Institute for
p60
6.3 Health Research, University
of the West Indies
5.2
Political choices that p76
5.4
transcend borders

Youth as an By By Shinichi Kitaoka, 6.7
accelerator to Protecting president of the Japan
achieve universal reproductive International Cooperation
Disruptive innovation
health coverage rights Agency
and multi-stakeholder
By Batool Alwahdani By Suzanne Ehlers,
p70 alliances
and Marian Sedlak president and CEO
By Hiromi Murakami and
of PAI
p58 Kiyoshi Kurokawa

p62
p78
2 HEALTH: A POLITICAL CHOICE
7
SUPPORTING THE KEEPING THE
VULNERABLE WORLD SAFE
7.1
8.1 8.3
Investing in equitable
societies
Addressing the Reaching
By Gunilla Carlsson UNAIDS
humanitarian the missing
executive director, a.i.
challenge millions
8
p82 By Peter Maurer, By Elhadj As Sy,

International secretary-gener-

7.2 7.4 Committee of the al,Internation-
Red Cross al Federation of
Red Cross and Red
The role of agriculture, Game-changing priorities p98
Crescent Societies
food and nutrition for UHC

By Laurette Dubé, Raphael By Françoise Girard, Katja Iversen, 8.2 p102
Lencucha, and Nick Drager Roopa Dhatt, and Kim van Daalen

p84 p90 An agenda to

tackle the

7.3 7.5 politics of
real problems
and real people
Protecting the brain Mental health is universal
By Mit Philips,
By Vladimir Hachinski, professor health
Kerstin Åkerfeldt
of neurology and epidemiology at By Vikram Patel and Shekhat Saxena
and Caroline Voûte
Western University
p94
p100
p87

ADDRESSING THE INTERSECTORAL

CHALLENGE OF THE SDGS

9.10
9.1 9.4 9.7
Health and social Biodiversity: the Pollution 5.0 Three steps to
justice foundation of human By Rolph Payet, executive universal health
By Guy Ryder, director- health secretary of the Basel, coverage
general of the ILO (cid:31)(cid:455)(cid:3)(cid:32)(cid:395)(cid:315)(cid:405)(cid:417)(cid:315)(cid:234)(cid:348)(cid:234)(cid:3)(cid:158)(cid:234)(cid:410)(cid:263)(cid:234)(cid:3)(cid:158)(cid:234)(cid:337)(cid:346)(cid:276)(cid:395)(cid:3) Rotterdam and Stockholm 9By Michel Sidibe, Minister of
executive secretary, UN Conventions p118 health and social affairs of
p106
Biodiversity the Republic of Mali p127

9.8
9.2 p112

9.5 Asia’s healthcare
Health and care: more
evolution
than a family
By Woochong Um, Asian
By Joachim Breuer,president Leaders in health
Development Bank
of the ISSA By C. James Hospedales,

executive director of CPHA p120
p108

p114

9.3 9.9

9.6
Nature is the ultimate Performance and
healthcare system In numbers progress
By Inger Andersen, UN Progress and challenges in By Brittaney Warren, Global
Environment Programme the health-related SDGs Governance Project

p110 p116 p122

HEALTH - A POLITICAL CHOICE 3
Health:
A Global
Governance
Project
A political
Publication

Published by: GT Media Group Ltd
choice

Produced in collaboration with
Delivering the World Health Organization
Universal
Co-Director: Tom Kennedy
Publisher & Co-Director: Khaled Algaay
Health Co-Editor: John Kirton
Co-Editor: Ilona Kickbush
Editor: Madeline Koch
CCoovveerraaggee
Managing Editors: Melanie Mingas & Emily Eastman
Art Director: Steven Castelluccia
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“Health: A Political Choice” is an offical demonstrate better collective governance, writers’ personal capacities and are their
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4 HEALTH: A POLITICAL CHOICE
1
THE
GLOBAL
R
E
T
P
A
H
COMMITMENC T
TO THE
SDGS
1.1 1.2
The race to achieve The UN’s role in
universal health accelerating health
coverage coverage
By Her Excellency, María By Amina J. Mohammed deputy
Fernanda Espinosa Garcés, secretary-general of the
president of the 73rd Session United Nations
of the United Nations General
p08
Assembly

p06

1.3
1.4
Health is a political The ROI on health
choice investment
By Dr Tedros Adhanom By Achim Steiner, UNDP
Ghebreyesus, director-general, administrator
World Health Organization
p12

p10
HEALTH - A POLITICAL CHOICE 5
The
race
to
achieve
universal
Of course, even if each of these reasons By Her
alone were not enough for us to continue Excellency
to push for universal health coverage, María Fernanda
we must be clear that health is a human Espinosa Garcés,
health right. Achieving universal health coverage President of
and guaranteeing that everyone has the 73rd Session
access to quality, essential health services of the United
are pivotal steps to ensuring that every Nations General
individual enjoys their fundamental Assembly
coverage human rights.
Furthermore, today in the era of the Sustainable
Development Goals, universal health coverage must be seen
for what it is: a powerful instrument to achieve not only
SDG 3 on health but the entirety of the 2030 Agenda. Last
September, in the very beginning of my mandate as the 73rd
president of the General Assembly, I had the honour to chair
The unique opportunity
two health-related high-level meetings, one on the fight
for action that will present against tuberculosis and one on the prevention and control
of non-communicable diseases. Now, on 23 September 2019,
itself at this September’s
when world leaders gather in New York to participate in the
high level meeting on United Nations General Assembly High Level meeting, to be
held under the theme of ‘Universal Health Coverage: Moving
health coverage
Together to Build a Healthier World’, we will have a unique
A opportunity to establish the foundation for achieving the goal
of universal health coverage by 2030.
t least half of the world’s population does not have There is no one-size-fits-all approach to meeting this goal.
full coverage of essential health services. Health Each country must explore its own tailor-made solutions to
expenses push more than 100 million people into strengthen its health systems. In doing so, priority must be
extreme poverty each and every year, forcing them given to preventing disease and promoting health, as well
into terrible choices that no one should ever have to as to ensuring access to medicines, vaccines, diagnosis and
make: Buy medicine or food? Education or health care? other health technologies.
These stark statistics make the case for universal health The United Nations has always stood ready to offer its
coverage compelling. expertise and assistance regarding global health. When I am
6 HEALTH: A POLITICAL CHOICE
“
THE GLOBAL COMMITMENT TO THE SDGS 1.1
Each country must explore its own
tailor-made solutions to strengthen The Interactive Multi-Stakeholder Hearing, held on 29 April,
brought together more than 600 representatives of member
its health systems. In doing so, states, as well as UN entities, civil society, non-governmental
organisations, academia and the private sector, among other
priority must be given to prevention” stakeholders. It demonstrated that achieving universal health
coverage is a collective and cross-cutting challenge.
In this regard, I want to recognise the valuable work of the
co-facilitators – the permanent representatives of Georgia and
asked to give examples of the UN’s biggest achievements, Thailand – as well as the members of the Group of Friends of
I often find myself speaking about the World Health UHC, under the leadership of the permanent representative
Organization. Consider the eradication of smallpox, for of Japan, in helping to lay the groundwork for the high-level
instance – a success we have nearly replicated with polio meeting. Additionally, I also want to praise the support
– the significant reductions in new HIV infections we saw received from WHO and the UHC2030 coalition, which have
during the first decade of this century, and the advances we proven to be essential in preparing a successful high-level
have made in the fight against malaria and tuberculosis. meeting in September.
And alongside these targeted campaigns – indeed, because The Universal Declaration proclaimed the right to health
of them – is the growing push for universal health coverage in 1948. Seven decades on, it remains a distant dream for half
and strengthened primary care services, culminating in the the world’s people. Let us seize the opportunities we have to
adoption of SDG 3. change that. Together, we can make universal health coverage
a reality by 2030. ▪
HEALTH IS WEALTH
Elsewhere, as so often, women and girls suffer disproportion-
ately when it comes to sexual and reproductive health and also
when it comes to accessing other basic services. Persons with
disabilities, Indigenous peoples, minorities and people living in
rural areas are also more likely to have poor health outcomes.
This is totally unacceptable, and profoundly wrong. It runs
counter to our commitment to leave no one behind. It is also
economically unsustainable.
The macro-level impact of poor health services is
enormous – estimated at trillions of dollars every year in
lost productivity, long-term impairment and short-term
expenditure. As the saying goes, health really is wealth.
HER EXCELLENCY
If we look at the full impact and cost of poor health
MARÍA FERNANDA
services, the case for prioritising universal health coverage
ESPINOSA GARCÉS
is clear. That Ebola outbreak in West Africa, for instance,
showed the world the importance of robust and inclusive
President of the 73rd Session
health systems. Our aim in September must be to accelerate
of the United Nations General Assembly
progress on coverage.
This will be a crucial opportunity for us to address all the Her Excellency María Fernanda Espi-
‘key asks’ of the universal health coverage movement, nosa Garcés, Ecuador’s foreign minister,
which are: was elected president of the 73rd session
of the United Nations General Assembly
▪ Ensuring political leadership and commitment across in June 2018. She has served as foreign
government and society; minister twice, and also as minister of na-
tional defence and coordinating minister
▪ Pursuing equity in access to quality health services with of natural and cultural heritage. Espinosa
financial protection; Garcés chaired the Group of 77 and China
until January 2018, and has also chaired
▪ Creating a strong, enabling regulatory and legal the Andean Community. She has been a
environment that responds to people’s needs; chief negotiator at the Conferences of the
Parties of the UN Framework Convention
▪ Building high-quality health systems that people and on Climate Change and the Conference
communities trust; on Sustainable Development. In 2008,
she was the first woman to become a per-
▪ Increasing and harmonising domestic and international manent representative of Ecuador to the
investment; and United Nations in New York, where she led
and supported negotiations at the Human
▪ Establishing multi-stakeholder mechanisms – so that Rights Council.
conversations continue in all countries.
(cid:2) (cid:683)(cid:189)(cid:114)(cid:559)(cid:158)(cid:70)(cid:4)(cid:0) (cid:58) un.org/pga
HEALTH: A POLITICAL CHOICE 7
1.2 THE GLOBAL COMMITMENT TO THE SDGS
The UN’s
role in
accelerating
health
coverage
By Amina J. Mohammed,
depuuty secretary-general,
T United Nations
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8 HEALTH: A POLITICAL CHOICE