Global Health Centre
02 October 2018

UNGA 2018 - high-level meetings for high-level action?

This year, the United Nations General Assembly (UNGA) discussed two important global health issues at a high political level. The high-level meetings on tuberculosis (TB) and non-communicable diseases (NCDs), which took place on consecutive days, pushed health up the political agenda and produced outcome documents that are designed to outline action to combat the diseases for years to come. How will the fact that two distinct health topics are being dealt with in the same busy week impact any future action?

There are many benefits to including global health meetings in the official UNGA agenda in New York. An obvious reason is the increased political attention from ministers, not just health ministers, but also from other sectors and, perhaps most importantly, finance ministers. In addition, meeting in New York allows many Geneva-based health organizations to interact and collaborate with other UN organizations headquartered in New York, such as UNFPA and UNICEF. Meeting in New York also enables collaboration with various philanthropic foundations and organizations, such as the World Bank, which is taking on an increasingly important role in health development and is becoming a major global health donor. Ultimately, inclusion at the UNGA not only helps the health message reach a broader audience, it also benefits the health community by bringing in fresh ideas, new perspectives and partnerships.

The presence and involvement of heads of state can also make a significant difference to the global health agenda. Commitment and strong public statements to support global public health – made most recently and vocally by the presidents of Uruguay and France, and the German chancellor – are examples of this positive influence. Moreover, the presence of the world’s media, as well as politicians and change-makers from all sectors, drew worldwide attention to these topics and created opportunities for innovative partnerships and funding models.

At the same time, some in the global health community feared that ‘health fatigue’ would set in, especially when, in addition to NCDs and TB, universal health coverage (UHC) was also widely discussed and is gaining attention. UHC is also likely to dominate the UNGA in 2019, with its own high-level meeting, meaning that another health-focused UNGA is already on the horizon.

While, in principle, taking issues to the political stage can be hugely beneficial for health, politicians who are already balancing multiple competing issues may be overwhelmed by the number of health topics being discussed. Having to deal with two (sometimes controversial) health issues simultaneously in a diplomatic negotiation may also lead to commitments to tackle different diseases being traded between countries. This can result in watered-down outcome documents and can, therefore, reduce the impact of high-level negotiations.

Many have argued that the outcome documents of this year’s high-level meetings were weak and unlikely to result in action at the levels required to curb the epidemics. At the same time, both resolutions were commended for the strong involvement of civil society. Indeed, compared with earlier high-level meetings on health, one notable difference this year was the emergence of new voices: that of patients and people living with NCDs and tuberculosis. Just as the involvement of people living with HIV produced a ground-breaking impact on global HIV and AIDS advocacy, and accelerated the development of treatment options, involving NCD and TB patients may influence the policy process further.

Health is, ultimately, a political choice and requires the political will and commitment of both the UN and heads of states. Taking health to a political arena, such as the UNGA, is a signal of the scale as well as the urgency of health issues. Now that the ink on the resolution papers has dried, actions, or the lack of, will be how progress is measured.