TWN Info Service on WTO and Trade Issues (July09/17)
20 July 2009
Third World Network

ECOSOC adopts Ministerial Declaration
Published in SUNS #6740 dated 14 July 2009

Geneva, 13 Jul (Riaz K. Tayob) -- The UN Economic and Social Council (ECOSOC) adopted late Thursday evening a Ministerial Declaration on implementing the internationally agreed goals and commitments in regard to global public health.

The adoption by consensus of the Ministerial Declaration came at the conclusion of a four-day high-level segment of the annual substantive session of ECOSOC (6-31 July).

A demand by Japan for including a reference to "human security" in the document delayed its adoption until late Thursday evening. However, Japan later relented in its demand.

Speaking after the adoption of the Declaration, Japan said that it was extremely regrettable that reference to human security had not be made in the Ministerial Declaration. The concept of human security aimed to protect people from critical and pervasive threats to their daily lives and fulfilment and enjoyment of their rights.

In the Ministerial Declaration, the Ministers reaffirmed their commitment to the achievement of the Internationally Agreed Development Goals (IADGs), including Millennium Development Goals (MDGs), particularly those related to health, in a timely manner, and reiterated their resolve to expedite realization of the United Nations (UN) development agenda.

They recognized that health and poverty are interlinked and that achieving the health-related goals is central to sustainable development.

The Ministers reaffirmed that good public health is better achieved through a combination of good public health policies including multi-sectoral policies that stress better nutrition, safe drinking water, hygiene, sanitation and sustainable urbanization, and effectively combat major risk factors.

The Ministers emphasized the need for urgent and collective efforts to improve public health and address the public health challenges exacerbated by the current and emerging global "inter-related" challenges, in particular:

-- the global financial and economic crisis which is undermining and slowing or reversing the development gains of developing countries, in the achievement of the IADGs, including the MDGs;

-- the food crisis and the continuing food insecurity in many countries which has affected global health especially overall nutrition levels of populations in developing countries and the social and economic consequences which have direct negative impacts and impair nutritional status;

-- climate change that poses serious health risks and challenges to all countries, particularly to developing countries, especially the least developed countries, landlocked developing countries, small island developing States and countries in Africa, including those that are particularly vulnerable to the adverse effects of climate change.

The Declaration emphasised the need for further international cooperation to meet emerging, new and unforeseen threats and epidemics, such as the current H1N1 (swine flu) pandemic, H5N1 (avian flu) and other influenza viruses with pandemic potential, and acknowledged the growing health problem of antimicrobial resistance.

"We recognise the need for a fair, transparent, equitable and efficient framework for the sharing of H5N1 and other influenza viruses with human pandemic potential, and for the sharing of benefits, including access to and distribution of affordable diagnostics and treatments, including vaccines, to those in need, especially in developing countries, in a timely manner. We call for strengthening surveillance and response capacity at the national, regional and international levels through the full implementation of the International Health Regulations."

The Ministers also emphasized the need for strengthening health information systems and the need for the timely transmission of relevant data to WHO and similar bodies, when novel infection emerges, to generate essential knowledge about the characteristics of the disease and called for increased preparedness, as well as capacity building for risk assessment and technology transfer for risk response in developing countries.

The Ministers reaffirmed their commitment to strengthening health systems that deliver equitable health outcomes as a basis of a comprehensive approach. This will require appropriate attention to inter alia, health financing, health workforce, procurement and distribution of medicines and vaccines, infrastructure, information systems, service delivery and political will in leadership and governance.

They recognized the role of social determinants in health outcomes and took note of the conclusions and recommendations formulated by the WHO Commission on Social Determinants of Health which aim to improve living conditions, tackle the inequitable distribution of resources, and measure, understand and assess their impact.

They called upon the international community to support efforts of States including to address the social determinants of health and to strengthen their public policies aimed at promoting full access to health and social protection for, inter alia, the most vulnerable sectors of society including through, as appropriate, action plans to promote risk-pooling and pro-poor social protection schemes, including to support the efforts of developing countries in building up and improving basic social protection floors.

The Declaration called for action to promote gender equality and the empowerment of women and concerted action for equal access of women and girls to education, basic services, including primary healthcare, economic opportunities and decision making at all levels.

It stressed the importance of addressing stereotypes and eliminating all harmful practices which constrain the achievement of gender equality and empowerment of women, including concerted efforts to counteract violence against women and girls, which constitutes a severe threat to physical and mental health.

While noting some progress made in the past decade in advancing global health, the Ministers expressed concern at the lack of overall progress in improving global health, with the persistence across the board of inequities in health among and within countries. In particular, "we are deeply concerned that maternal health remains one of the largest health inequities in the world and by the slow progress in achieving MDGs 4 and 5 on improving child and maternal health."

In this context, they called on all states to renew their commitment to prevent and eliminate child and maternal mortality and morbidity, at all levels, "which is occurring globally at an unacceptably high rate."

They also called for the "full and effective implementation of the Beijing Platform for Action, the International Conference on Population and Development (ICPD) Programme of Action and their review conferences, including the commitments relating to sexual and reproductive health, and the promotion and protection of all human rights in this context.

"We emphasize the need for the provision of universal access to reproductive health, including family planning and sexual health and the integration of reproductive health in national strategies and programmes."

The Ministers recognized that communicable diseases which have been prioritized by the Millennium Development Goals such as HIV/AIDS, malaria and tuberculosis, as well as other communicable diseases and neglected tropical diseases (NTDs) pose severe risks for the entire world and serious challenges to the achievement of development goals.

The Declaration noted "with concern the lack, as well as the imbalanced distribution of health workers within countries and throughout the world, in particular the shortage in Sub-Saharan Africa, which undermines health systems of developing countries."

It emphasized the need for countries to review policies, including recruitment policies and retention policies that exacerbate this problem. It underlined the importance of national and international actions, including the development of health work force plans which are necessary to increase universal access to health services, including in remote and rural areas, taking into account the challenges facing developing countries in the retention of skilled health personnel.

While acknowledging the contribution of aid targeted towards the health sector, the Declaration said that much more needs to be done. It called for the fulfilment of all ODA (official development assistance) commitments, including the commitments by many developed countries to achieve the target of 0.7 per cent of gross national income (GNI) for ODA by 2015 and to reach at least 0.5 per cent of GNI for ODA by 2010, as well as the target of 0.15 to 0.20 per cent for least developed countries, and urged those developed countries that have not done so to make concrete efforts in this regard in accordance with their commitments.

It should be borne in mind that, "there is no one-size-fits-all formula that will guarantee effective assistance. The specific situation of each country needs to be fully considered."

On the issue of intellectual property rights (IPRs), the Declaration encouraged "all States to apply measures and procedures for enforcing IPR in a manner so as to avoid the creation of barriers to the legitimate trade of medicines and to provide for safeguards against the abuse of such measures and procedures."

It further reaffirmed the "right to use, to the full, the provisions contained in the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement), the Doha Declaration on the TRIPS Agreement and Public Health, the decision of the World Trade Organization's General Council of 30 August 2003 and, when formal acceptance procedures are completed, the amendment to article 31 of the Agreement, which provide flexibilities for the protection of public health, and in particular to promote access to medicines for all, and encourage the provision of assistance to developing countries in this regard."

It also called for "a broad and timely acceptance of the amendment to article 31 of the TRIPS Agreement, proposed by the WTO General Council Decision of 6 December 2005."

The Ministers also reaffirmed their resolve to address the adverse impact of climate change on global public health and called for successful conclusions of the intergovernmental negotiations on climate change under the United Nations Framework Convention on Climate Change (UNFCCC). +