Taking Stock of Global Health Goals and the Road Ahead
Global health priorities at 77th UN General Assembly
By Stacy Montejo
When Ambassador Csaba Kőrösi of Hungary was elected President of the 77th session of the United Nations General Assembly (UNGA), he committed to “solutions through solidarity, sustainability and science”. As countries around the world emerge and recover from the COVID-19 pandemic, nowhere has this call to action been more relevant and important than in healthcare.
Over the past 2+ years, the global response to the pandemic demonstrated that in times of crisis, the global health community can come together, forge partnerships and deliver scientific innovations at record speed. How to leverage these learnings and channel this level of collective effort toward other pressing public health challenges was a key theme at the end of September when leaders from around the world gathered in New York for the first in-person meeting of the UN General Assembly in more than two years.
Over the course of two weeks, in speeches, meetings and side events, the global health community grappled with several fundamental questions: How can we address both urgent public health needs, such as those related to infectious diseases, and long-term population health including management of chronic conditions? How can we more sustainably fund and finance health care? And most importantly, how can we create a world where healthcare is more equitable between countries and within each country?
While there is no easy answer or one-sized-fits-all solution to these questions, several key themes emerged through the dialogue:
Achieving health equity goals requires more than a commitment — it requires sustained action.
Inequities in access to health care became glaringly apparent during the pandemic, and as a result, we have seen renewed efforts to close gaps, address systemic barriers to care and introduce new initiatives to solve historic challenges. But at UNGA, many leaders from the Global South expressed their dissatisfaction and frustration at promises that have fallen short or commitments that were not delivered on. (Read more in Devex.)
Ensuring there is follow through and transparent reporting on commitments made to global health challenges is critical to ensure changes are meaningful and long-term. For policy, program and communications leads, this offers an important reminder: before communicating intent, think long-term about how you will progressively share updates, learnings and information along the way.
Health is still viewed as a cost, but we must shift our mindset to see health spending as an investment in the future.
At the first high-level meeting on Universal Health Coverage (UHC) in 2019, the World Health Organization and partners released a report calling on countries to increase spending on primary healthcare by at least 1% of their gross domestic product (GDP) in order to close coverage gaps and meet global health targets. But with the pandemic further straining already stressed health systems, most countries are not on track to reach this goal. With the second high-level meeting on UHC scheduled for 2023, the global health community took stock of progress to-date at UNGA and discussed what actions can be taken in the next year.
One way to address underinvestment in health is with innovative models and multi-sectoral collaboration. In 2021, Roche (client) and IQVIA released a white paper “Innovative Funding Models for High-Cost Non-Communicable Diseases (NCDs)” that explored innovative funding trends and models that could be deployed to improve patient access to necessary care while protecting individuals from financial burden.
Progress on infectious and chronic diseases was halted or reversed — and we must act now before gaps grow further.
As resources were diverted to address COVID-19, programs and treatment for other health priorities from tuberculosis and malaria, to cancer and heart disease were disrupted and delayed.
The world’s leading killer — noncommunicable diseases (NCDs) — is still dramatically underfunded and must be prioritized.
NCDs, like heart disease, cancer, diabetes and lung disease now outnumber infectious disease as the top killers globally. Collectively, they are responsible for 17 million premature deaths every year — meaning every two seconds, someone under the age of 70 somewhere in the world dies of an NCD.
Despite this massive burden — and the disproportionate toll it takes on low- and middle-income countries — the share of ‘development assistance for health’ dedicated to NCDs has remained at 1–2% of the total since 2000 and while international aid for NCDs from the world’s major NCD donors was growing in absolute terms, the COVID-19 pandemic reversed that trend.
During UNGA, Dr. Tedros Adhanom Ghebreyesus, Director-General of the WHO, called on global leaders to urgently prioritize NCDs. To accelerate action, he also renewed the two-year appointment of Michael Bloomberg as WHO Global Ambassador for Noncommunicable Diseases and Injuries (client), to lead a global, national, and local agenda to protect people from NCDs and injuries.
Global partnerships for infectious diseases found renewed investment.
In addition to rising rates of chronic disease, the world’s most fatal infectious diseases like HIV, tuberculosis and malaria similarly faced rising rates and decreased access to screening, testing and treatment over the past two years.
The 7th Global Fund Replenishment Conference and campaign sought to raise $18 billion needed to save 20 million lives and build a healthier, more resilient and equitable world. While the campaign ultimately missed that target, $14.25 billion was raised — a record for a multilateral health organization. Japan became the fourth country to donate more than $1 billion and the replenishment campaign raised more than ever from private donors.
Health and climate are irrevocably intertwined.
The consequences of climate change have been front and center this year, from devastating floods in Pakistan to record-breaking heat waves across the U.S. and Europe, and extreme food scarcity in the horn of Africa. The impact of climate on health is clear and indirect and direct effects are strongly associated with environmental, social and public health determinants.
Notably, Denmark made a historic announcement during UNGA (which coincides with Climate Week) that it will pay other countries for “loss and damage” related to climate change. The first UN Member State to take such a step, this announcement is an acknowledgement of the consequences faced in many developing countries and a true demonstration of solidarity and leadership that is necessary for meaningful impact on the climate crisis.
As we look ahead to other moments where the global health community will come together this fall, such as at the World Health Summit in Berlin later this month, finding opportunities to build relationships, foster new partnerships and communicate impact will continue to be vital. We are hopeful that the conversations started at UNGA will lead us toward a more collaborative, healthier future.
