WHO Executive Board consideration of Health in the 2030 Agenda for Sustainable Development

At its meeting in January, the Executive Board (EB) of the World Health Organization in preparing the agenda for the World Health Assembly discussed under agenda item 7: Promoting health through the life course discussed together sub-items on reports of the Secretariat on monitoring the MDGs and Health in the 2030 Agenda for Sustainable Development (2030 Agenda). The document before the EB was Health in the 2030 Agenda for Sustainable Development. Report of the Secretariat. See also our posting of 14 January WHO Paper Recommends ‘Governance for Health’ to Achieve SDGs. Key points are summarized below:

Comments from EB Members

Nepal on behalf of the SE Asia region EB members, took note of the experiences of MDGs and the challenges faced. He focused on disaggregation of data. Health demands require a wider engagement of actors beyond the normal domain, stressing healthy lives for all at all levels. He referred to Universal Health Coverage (UHC), vaccines and diagnostics and the need for developing appropriate capacities at all levels. Nepal appreciates the work of the UN Statistical Commission in working to finalize indicators. He requested WHO to support processes at country and regional level. 

South Africa on behalf of the African Region said that the MDGs provided a catalyst with significant gains being made, yet they remain unfinished. The SDGs will complete the unfinished agenda. Health is tied in with better education, employment and social services. It requires high political commitment and Member States will lean on WHO for technical and other kinds of support and it should take global leadership on health SDGs. WHO has been forward-looking covering all areas in the programme budget. Regional and Country Offices will require adequate resources for their work on SDGs in UHC as Member States need technical support. WHO should also come up with clear monitoring mechanisms. All Member States should take an active role in developing the draft resolution. 

Malta on behalf of the European Union, welcomed the 2030 Agenda with its 17 goals. It will require integrated cross-sectoral action. Goal 3 is of particular importance for the health sector. The EU is convinced that a human-rights based approach is crucial, including combatting inequality and emphasizing economic and social determinants. There should be access to quality health services and there is a need for strong integrated health systems. The SDGs give an opportunity to WHO to engage constructively with other partners and appropriate capacity, resources and structures required. National ownership was important and Member States should step up their efforts for sustainable transformation. The work under the Statistical Commission was the next step. Data would be necessary on healthy life expectancy and WHO should support local data capacity-building. Global challenges pose a serious threat. There is a need for global commitment and enhanced collaboration and the importance of the unfinished business of MDGs should be included under the SDGs.

Sweden speaking on behalf of a number of other countries highlighted sexual and reproductive health and rights (SRHR) and its centrality, as is recognized in many international commitments. She referred to the rights to physical integrity of all women and men as to whether, for example, they want to marry. There are acceptable methods of family planning. There should be a renewed commitment to work in this area so that no one will be left behind and there should be universal respect for human rights and dignity. Several goals and targets are relevant to SRHR including Goals 3, 5 and 16. SRHR are cross-cutting issues that also cut across numerous issues on WHO agenda, including violence against women.

China said that the report gave important guidance and covered a wider range of diseases. The SDGs emphasize UHC. An important lesson learned in MDGs is integration. The “Healthy China Plan” is being implemented. There is rapid ageing in China, which is facing new challenges. The health-related SDGs require a new dialogue. China supports the role of WHO. 

DPR of Korea referred to inspiring achievements on AIDS, malaria and UHC. Each country should be responsible for its own work. The role of WHO should be strengthened to support Goal 3 and countries should strengthen their national health structures and resilience. 

Argentina (on behalf of the Americas) said that the Agenda set out the role of health in transforming the world. They commended the progress made over past 15 years, with major advances in all areas. They support UHC and see links between different goals. They referred to the social determinants of health and to national plans, as well regional implementation, 

United States aligned itself with the Argentinian statement and that of South Africa, highlighting the unfinished agenda of MDGs in maternal health and HIV. They reaffirmed both the intrinsic value of good health in other areas including gender. Also referred to reproductive and newborn health. The 2030 Agenda may needf some rebalancing of WHO’s work, with increased emphasis on data and measurement. 

Japan was grateful that UHC is included as an integral component of the SDGs and also referred to health system strengthening.

Thailand shared the concerns about the unfinished agenda of the MDGs. There will be a need to do better in next 15 years. Weak health systems lead to weak primary health care. Ebola is the best test of health systems resilience. In addition to Goal 3, health also links with other goals, thereby going beyond Goal 3. They support the statement made by Sweden, also saying that they should not lose sight of the other SDGs. UHC should be alongside tackling other health issues and they emphasized improving health systems strengthening. 

Egypt for the Eastern Mediterranean region) said there was a need to take stock of the past 15 years, including an assessment of different aspects of MDG experiences. He also referred to women and children’s health; health system strengthening and the social determinants  of health. 

Kazakhstan said that the documents on SDGs have created interest in countries. Intersectoral cooperation is crucial at all levels., as well as cooperation on a sustainable basis They were looking at primary health care and at new ways to improve health. 

Jordan said that in spite of the highest level of political will, work on the MDGs had been hampered by difficulties synonymous to those faced by others, including conflict, internal strife and the influx of refugees. 

Kuwait highlighted the MDGs as being integral and should be implemented at the same time. The new plan should impact on both developed and developing countries. Special attention should be paid to demands on data, as it won’t be possible to report without it and they should concentrate on sectors other than the health sector. 

Brazil said that the report on the MDGs includes shortcomings as well as successes.. They believe that inter-sectorality is key to the implementation of the agenda and that the individual and integral nature of the SDGs is important. They encourage a national commitment, with strengthening of national health information system and dialogue between WHO and the Country Offices. There should be a careful review of all data that is available.

Canada pointed out that there should be multi-level collaboration and they expect WHO to promote coherence in support of 2030 Agenda at all levels using its convening power. They are pleased that at UHC is at the centre. Overcoming persistent inequalities will be required including gender inequality and strengthening health systems. They support the statement made by Sweden on SRHR, which is critical to saving lives. Canada also looks forward to an integrated approach to maternal, newborn and child health and to adolescent health and the Global Strategy on Women, Child and Adolescent Health. They will collaborate with WHO on a global consultation on how to measure and monitor action on social determinants.

Russian Federation supports the document. Achieving SDGs is not possible without WHO being involved at all levels. Governments can establish national goals in accordance with the Global Agenda.  They are particularly interested in maternal health and road safety particularly and would like antimicrobials to be included, as they are one of the most important challenges that are being faced. As the monitoring will be under ECOSOC, WHO should cooperate very closely with it in the future.

Dominican Republic agree with the report submitted. Countries must support a state of integral well-being and therefore must focus on economic and other determinants of health. WHO must be able to advocate strongly. Countries will have to have policies to reach goals including improving education and social justice. There is a lack of a frontal attack on corruption limits resources and the Human Development Index should be looked at. People are falling ill and need a healthcare system that addresses all aspects of health. Human resources are fundamental and the model must be focused on PHC with proper budget. 

Philippines said that the adoption of 2030 Agenda set a great challenge to Member States in moving towards the SDGs. They note the impact of Goal 16 and recognize the implications of 2030 Agenda, which contribute to broad determinants of health. There is a need for full commitment and strong leadership. WHO has a crucial role and there is an opportunity for the organization to demonstrate its own leadership.

New Zealand supports the comprehensive framework, where they build on the MDGs. They support the Dominican Republic and Sweden. There is a need to address the wider social, economic and environmental determinants of health.

Suriname referred to a need for technical assistance.

Republic of Korea referred to maternal and under-5 mortality rates and cross cutting cooperation. Urban planning is also essential. 

Comments from Non-EB members 

Colombia supported Sweden and said that SDGs are interrelated. WHO must be able to coordinate along with the rest of the UN. Financial and human resources to avoid duplication of effort. It would be important to monitor coordination. The 2030 Agenda is an opportunity to bring in health into all the goals. 

Monaco said that UN agencies have to find new ways of working. WHO needs a thorough-going transformation. The question is how and what its role is in achieving Goal 3.

Bangladesh referred to its determination to achieve the SDGs. On the Goal 3 target on UHC it is important that national target setting is in line with the creation of health programmes and lack of coordination. There are risks of fragmentation and a need for a new model at all levels. Countries will need intra- and inter-coordination

Germany said that guidance in achieving goals will be required from WHO. Health as a human right is a prerequisite. The target on UHC offers new opportunities. There is a need to reduce vulnerabilities and a need for resilience and health security. UHC is path to achievement of Goal 3 and others. Health systems should be strengthened. 

Finland said it was essential to monitor progress. The target of UHC should include integrated primary health services. There is a need for sustained funding, social protection and having essential public health functions in place. Finland was proposing a resolution on public health functions. 

Vietnam acknowledged the connection between the MDGs and SDGs and the commitment to sustainable development, as well as implementation of the health related SDGs. There should be stronger multisectoral collaboration and they would be requesting support from WHO and other partners to set up national targets.

Belgium pointed to integrated SDGs which mutually reinforce each other. The challenge for WHO will be not to starts tackling SDGs in a fragmented manner. There is a need for a plan with clear priorities. WHO should think how they interact at the country level.

Morocco said that the report summarizes various stages of the plan and stressed the value added. Health is directly or indirectly related to other targets. All partners should be included in South-South cooperation.

Sudan commended the efforts saying that SDGs have benefited from MDGs in becoming inclusive. There should be and open and flexible new partnership, put ting more effort into implementation. It should look for universal health for all, which needs a global movement.

Panama referred to the focus on human rights and social development and the social determinants of health, which provide an opportunity. The focus should be on several aspects. The issue is how to bring forward economic growth for better social equality. They also commented on the role of UHC,  NCDs, research and development, and early warning and risk managements. It will not be possible without shared effort of international input and local efforts.

Australia welcomed the adoption of 2030 Agenda and Addis Ababa Action Agenda. They referred to NCDs and sexual and reproductive health, as well as sources of funding to be used to fund health systems. The needs of small island developing states (SIDS) should be recognized. They also commented on the to review process including HLPF and the progress on global indicators for health and the role of WHO in this regard. 

UNFPA concurred with views on maternal mortality, how it should be addressed and what type of interventions should be used. There is a need to ensure that adolescent girls should also enjoy  services. They also pointed to the importance of women and girls reproductive rights under SDG 5. 

Statements were also made by the:

International Fed of Red Cross Societies, the International Council of Nurses, Save the Children, the Union for International Cancer Control and NCD Alliance and the International Federation of Medical Students 

In summing up Dr Flavia Busteo, WHO included a reference to the highlighting of the centrality of sexual and reproductive health and rights and also said that they have begun working with the SDG agenda in developing the Global Strategy for Women Children and Adolescents. 

The EB took note of the reports and adopted a resolution EB138.R5 Strengthening essential public health functions in support of the achievement of universal health coverage (ADD LINK http://apps.who.int/gb/ebwha/pdf_files/EB138/B138_R5-en.pdf) later in the meeting.