This means that good quality health services should be available to everyone when they need treatment. Efforts should be made to reduce the impact of infectious and other chronic diseases. Both the funding and the organization of health systems should suit the needs of the country and its citizens.
Discussions focused on the health theme have re-confirmed how central health is to any future development agenda. Health enables people to reach their potential. Healthy children learn better. They become healthy adults. Healthy adults work longer and more regularly, earning higher and more regular wages and are better able to contribute to the success of their communities.
There is considerable evidence to suggest that the current health MDGs will remain priorities after 2015. Despite impressive progress in lowering mortality rates, in 2015 far too many people will still be dying from causes that are preventable by a broad set of preventive and curative interventions including: adequate nutrition, access to safe drinking water, good sanitation and hygiene practices (such as hand washing), vaccination, reduction of indoor air pollution, and access to health care services.
- 1. HEALTH CHALLENGES AND PRIORITIES
A considerable body of evidence points to health being an even more pressing and complex global challenge in 2015 than it was in 2000. The growing burden of non-communicable diseases, especially among poor, marginalized and disadvantaged people in countries of all income levels, and emerging global threats to health security such as anti-biotic resistance and new infectious diseases.
In the Secretary General’s report on advancing the Post 2015 Agenda, “A Life of Dignity for All,” the following health prioritieswere identified:
- Address universal health-care coverage;
- Access and affordability;
- End preventable maternal and child deaths;
- Realize women’s reproductive health and rights;
- Increase immunization coverage;
- Eradicate malaria and realize the vision of a future free of AIDS and tuberculosis;
- Reduce the burden of non-communicable diseases, including mental illness, and road accidents; and
- Promote healthy behaviors, including those related to water, sanitation and hygiene.
Do you agree with these priorities? What would you add or subtract or change? Which of these do you think are most important?
- 2. UNIVERSAL HEALTH CARE – QUALITY AND ACCESS FOR ALL
A broad consensus emerged from the global consultations, as well as the High Level Panel Report, calling for steady progress in ensuring universal health coverage and access to quality essential health services. This means reaching more people, broadening the range of integrated, essential services available to every person, and ensuring that services are affordable for all. Countries at all income levels have work to do to reach this ideal. Universal health coverage and access is put forward as a desirable goal for several reasons:
- People have a right to access a health system that prevents and treats illness effectively and affordably within their homes and their communities;
- Health and well-being can only be achieved by reducing inequalities and ensuring universal access to basic healthcare;
- Discrimination creates barriers to health services for vulnerable groups and lack of protection leaves many individual and families exposed to sudden illness and the catastrophic financial effects this can bring.
While there is still discussion among those involved with the health consultation on whether and how to integrate universal health coverage as a potential priority for the new development agenda, there is agreement on the premise of ill health as both a consequence and a cause of poverty.
Every year 100 million people are either pushed into poverty by health-related costs, including out-of-pocket expenses for health care, or unable to afford essential health services so that pre-existing sickness is aggravated. The human capital cost of illness is part of the call for governments to invest in social protection systems to make progress towards universal health coverage.
What do you think? Should universal health coverage be included in the new framework?
Do you think access to health service is a human right?
- 3. SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS
Almost 7 million children die before their fifth birthday, every single year. For the most part, these deaths are easily preventable. We know that the solutions are simple and affordable: having skilled birth attendants present, keeping babies warm and getting them safe water, nutritious food, proper sanitation, and basic vaccinations. Many children who die before they reach their fifth birthdays are born to mothers living in poverty, or in rural communities, or who are still in adolescence or otherwise vulnerable.
Women continue to die unnecessarily in childbirth. The World Health Organization estimates that every minute and a half, a woman dies from complications of pregnancy or childbirth. Women living in poverty, in rural areas, and adolescents are especially at risk. Timely access to well-equipped facilities and skilled birth attendants will drastically reduce this risk.
Universal access to sexual and reproductive health and rights (SRHR) is an essential component of a healthy society. There are still 222 million women in the world who want to prevent pregnancy but are not using effective, modern methods of contraception. This results in 80 million unplanned pregnancies, 30 million unplanned births and 20 million unsafe abortions every year. Every $1 spent on modern contraception would save $1.40 in maternal and newborn health care, but access, especially by adolescents, is low. The public health case is clear – ensuring these rights benefits not only individuals, but also broader communities.
Discussion around sexual and reproductive health and rights can be controversial. What do you think – is universal access to sexual and reproductive health and rights (SRHR) essential in the world you want?
- 4. THE THREAT OF NON-COMMUNICABLE DISEASES
New attention has been given to the reducing the burden of major non-communicable diseases by focusing on cardiovascular diseases, cancers, chronic respiratory diseases and diabetes (the four non-communicable diseases causing the most deaths), as well as, mental illness. It has been suggested that some targets could be based on the World Health Assembly resolution of a 25 percent reduction in deaths due to these four non-communicable diseases by 2025 and other targets could be aimed at reducing morbidity and disability from non-communicable diseases (including mental illness) at all ages, and reducing the prevalence of related risk factors.
Should the Post 2015 MDGs address the major non-communicable diseases?
- 5. STRENGTHENING HEALTH SYSTEMS
The national consultations indicated that improved governance at national and sub-national levels is fundamental for ensuring that quality health services are delivered outside capital cities, and that inequalities in access to and quality of services available are addressed. The health thematic consultation identified enhanced management competence and capacity, as well as, improved accountability to avoid the inefficient use of available resources as a priority for health system strengthening.
How should the new agenda address the need to strengthen health systems and improve the (equitable) delivery of quality health services?
How can new technology be used to address access to services, improve the quality of services and help strengthen health systems?
- 6. UNIVERSAL VS. NATIONAL TARGETS
The consultations and interim reports on the Post 2015 agenda, acknowledge that one-size global targets can be both unfair and uninspiring at the country level. While the goals and associated targets and indicators should in the aggregate, represent a pathway to sustainable development and the future we want – the targets may be differentiated for countries taking into account the different levels of development. The health theme is likely one of the most glaring examples of this. For example, while many developing countries continue to fight hunger and rely heavily on official development assistance, in many high-income countries obesity is a growing problem and rising health costs are a major threat to fiscal stability and long-term economic growth.
Do you agree or disagree with the following, “While every country is home to families and individuals who lack the financial means, nutrition, medicine or care to prevent, treat and manage illness – no two countries are the same: targets and indicators must be adaptable to a country’s health priorities and circumstances”
If you disagree – why?
If you agree, how should national targets be incorporated into the Post 2015 agenda?
- 7. MEASURING WELL-BEING
The health consultation concluded that sustainable well-being for all could be an overarching goal for the wider post-2015 agenda and that this goal should recognize health as a critical contributor to and outcome of sustainable development and human well-being. This reflects a growing call among some groups to look beyond a country’s gross domestic product (GDP) when assessing healthy growth and sustainable development, and to address issues of equity.
How should we define and measure well-being and should it be included as a goal in the Post 2015 Agenda?
- 8. RESOURCES
Implementation of the health goal will require sustainable and predictable financing, improved global governance and a review of the current global health architecture. The results of the consultations highlighted the importance of long-term, predictable and sustainable financing from domestic, as well as, international resources. There was also, a call for experimenting with new innovative financing mechanisms.
Here are some thoughts on the need for investment and financing. What do you think?
- Good health is both a driver and a beneficiary of economic growth and development. Ill health is both a consequence and a cause of poverty. Every year 100 million people are either pushed into poverty by health-related costs, including out-of-pocket expenses for health care, or unable to afford essential health services so that pre-existing sickness is aggravated. Ensuring universal access to quality and effective health services — and protecting their population from financial risk when doing so — is a challenge facing all countries.
- The benefits of investing in health are immediate and obvious, both for specific interventions and for strengthening health systems more broadly. Every $1 invested in health generates up to $30 through improved health and increased productivity. Investing more in health, especially in health promotion and disease prevention, like vaccinations, is a smart strategy to empower people and build stronger societies and economies.
- New partnerships should be explored, includingwith the private sector, which could stimulate more investment in public health.
- 9. LINKAGES
All of the thematic consultations reiterated the call for multi-dimensional and inter-sectorial solutions. Participants in the consultations said, emphatically, that the challenges (and indeed opportunities) they face are complex and interlinked.
Health is a precondition for,an outcome and an indicator of all three dimensions of sustainable development (economic, environmental and social), and sustainable development can only be achieved in the absence of a high prevalence of debilitating communicable and non-communicable diseases. The linkages and relationships between health and education, climate change and other environmental threats, financial and natural resource constraints, less poverty but greater inequities, population growth and rapidly ageing populations, unplanned urbanization and new diseases all affect progress on health and well-being. Addressing food and nutrition issues (including obesity) also has a direct effect on health outcomes, as does water security and water quality. Failure to address vulnerabilities to disaster will place further strain on already overstretched health services in many parts of the world. Conflict situations place considerable extra strains on health services both in the countries affected directly by conflict, as well as, their neighbors.Good health is determined, not only by preventing and treating disease, but also by many other aspects of development, including education, gender equality, sustainable energy and nutrition, water and sanitation, and climate change adaptation and mitigation.
This points to the need to go beyond a silo approach and arrive at a future sustainable development agenda that is more integrated and holistic.
How should this be reflected in the goals and priorities set out in the Post 2015 Agenda?
What partnership’s do you see as crucial to creating solutions in this area?