UHC Forward: Towards Universal Health Coverage

The latest draft Rio +20 Earth Summit document, leaked to the Guardian on Friday, June 9th, shows a strong commitment to universal health coverage and health systems strengthening. According to the UN, approximately 20% of the wording has been agreed with just three days of formal negotiations remaining before world leaders arrive in Brazil on June 20.

Pages 42-45 of the document reference universal health coverage and health systems. The official text is pasted below:

We recognize that health is a precondition for, an outcome of, and an indicator of all three dimensions of sustainable development. We understand the goals of sustainable development can only be achieved in the absence of a high prevalence of debilitating communicable and non-communicable diseases, and where populations can reach a state of physical, mental and social well-being. We are convinced that action on the social and environmental determinants of health, both for vulnerable groups/persons in vulnerable situations and the entire population,is important to create inclusive, equitable, economically productive and healthy societies. We call for the full realization of the right to the enjoyment of the highest attainable standard of physical and mental health.Health 2. We also recognize that universal health coverage is fundamental to enhancing health, social cohesion and sustainable human and economic development. We pledge to strengthen health systems towards the provision of equitable universal coverage. [We call for the involvement of all relevant actors for coordinated multi-sectoral action to address urgently the health needs of the world’s population.

Health 3. We emphasize that HIV and AIDS, malaria, tuberculosis, influenza, polio and other communicable diseases remain serious global concerns, and we commit to redoubling efforts to achieve universal access to HIV prevention, treatment, care and support, and to eliminate mother to child transmission of HIV as well as to renewing and strengthening the fight against malaria,tuberculosis, and neglected tropical diseases.

Health 4. We acknowledge that the global burden and threat of non-communicable diseases(NCDs) constitutes one of the major challenges for sustainable development in the twenty-first century. We commit to strengthen health systems [toward the provision of equitable, universal coverage and promote affordable access to / to address – US] prevention, treatment, care and support related to NCDs, especially cancers, cardiovascular diseases, chronic respiratory diseases and diabetes. We also commit to establish or strengthen multi-sectoral national policies for the prevention and control of non-communicable diseases, with a focus on key risk factors. [We recognize that reducing air, water and chemical pollution, leads to positive effects on health. EU-moved from Health 1]

Health 5. We reaffirm the right to use, to the full, the provisions contained in the agreement on Trade-Related Aspects of Intellectual Property Rights, the Doha Declaration on the Agreement on Trade-Related Aspects of Intellectual Property Rights and Public Health, the decision of the World Trade Organization General Council of 30th August 2003 on the implementation of paragraph 6 of the Doha Declaration on the TRIPS agreement and public health, and, when formal acceptance procedures are completed, the amendment to article 31 of the agreement,which provides 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. [We also call for a broad and timely acceptance of the amendment to the article 31 of the Agreement on Trade-Related Aspects of Intellectual Property Rights, as proposed by the World Trade Organization General Council in its decision of 6 December 2005.

Health 6. We call for further collaboration and cooperation at national and international levels to strengthen health systems through increased health financing, improved [training / production,training and retention – New Zealand] of the health work force, improved distribution and access to essential [safe, high quality – US, New Zealand] and affordable medicines, vaccines and medical technologies, and through improving health infrastructure. We [support / note – Holy See] the [leadership role of the -US] World Health [Organization / Assembly – Holy See;Canada, Switzerland retain] as the directing and coordinating authority on global health.(G77 merge para 6 with para 2)

Health 7. We commit to systematically consider population trends and projections in our national, rural and urban development strategies and policies. Through forward-looking planning, we can seize the opportunities and address the challenges associated with demographic change including migration. [agreed ad ref]

Health 8. We [remain committed to the full implementation of the Programme of Action of the International Conference on Population and Development, the key actions for further implementation of the Programme of Action and the Beijing Declaration and Platform for Action, and – Holy See delete] intend to pay special attention to gender equality and women’s empowerment [, and sexual and reproductive health – Holy See delete]. [US, Canada,Australia, New Zealand, Switzerland, Norway, Iceland retain original formulation]

(G77 streamline with para 9) Health 9. We commit to reduce maternal and child mortality, and to improve the health of women, adolescents and children. We reaffirm our commitment to gender equality and to protect the human rights of women, men [and adolescents – Holy See delete] to have control over and decide freely and responsibly on matters related to their sexuality,[including sexual and reproductive health – Holy See delete], free from coercion, discrimination and violence. We will work actively to ensure that health systems provide the necessary information and health[care – Holy See] services addressing the [sexual and reproductive – Holy See delete]needs of women [giving particular attention to maternal and emergency obstetric care – Holy See][and their reproductive [rights/ health -G77], including ensuring universal access to safe,effective, affordable and acceptable modern methods of family planning, as this is essential for women’s health and human rights and advancing gender equality – Holy See delete].

[US,Canada, Switzerland, Norway, Iceland, New Zealand retain original formulation] (G77 streamline with para 8)

[Health 8 and 9 alt. We remain committed to the full implementation of the Programme of Action of the International Conference on Population and Development, the key actions for further implementation of the Programme of Action and the Beijing Declaration and Platform for Action, and in this regard recommit to achieving gender equality and to protect the human rights of women, men and adolescents to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health, free from coercion, discrimination and violence. We commit to reduce maternal and child mortality and to improve the health of women, adolescents and children and will work actively to ensure that health systems provide the necessary information and health services for addressing the sexual and reproductive health and reproductive rights of women, including ensuring universal access to safe, effective, affordable and acceptable modern methods of family planning, as this is essential for women’s health and human rights and advancing gender equality. – Iceland]

Click here to read the complete draft document.