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The EU role in Global Health

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Title: The EU role in Global Health


1
The EU role in Global Health
2
CommunicationThe EU role in Global Health
  • This Communication proposes
  • an EU vision on global health, defines the
    guiding principles that should apply to all
    relevant policy sectors and presents a number of
    areas where the EU could more effectively act.
  • The Communication is accompanied by three Staff
    Working Documents dealing respectively with
  • "Contributing to Universal Coverage of Health
    Services through Development Policy"
  • "Global health responding to the challenges of
    globalization"
  • "European Research and Knowledge for global
    health".

3
Attention to Global Health
  • The transnational and global dimension of health
    has gradually taken a priority space in the areas
    of
  • Foreign policies
  • national health strategies,
  • development partnerships and
  • global public goods.
  • Growing attention in
  • UN General Assembly
  • World Health Assembly,
  • ECOSOC

4
Consultation
  • At EU Institutions and within EU Member States
    (Spanish EU Presidency)
  • Stakeholders (monthly global health Policy Forum
    and online consultation 10-12/09, side event at
    WHO-EB 01/10)

5
The Global Health Challenge
  • Lights and shadows
  • Life expectancy doubled in last century.
    Prevention, treatment, and care have increased.
  • Gaps have widened.
  • Globalizations risks and opportunities
    Population growth, urbanization, migration and
    trade flows, aging, changing lifestyles,
    environmental degradation.

6
The EU in Global Health
  • Legal Framework
  • Treaty of the European Union
  • The Charter of Fundamental Rights
  • EU added value
  • The EU's social model,
  • Its global trade and development aid position.

7
Global health governance and international policy
frameworks
  • The World Health Assembly (WHA)
  • International Health Treaties
  • Non-binding resolutions and national
    capacities/political will
  • The health MDG 4, 5 and 6 ( all)
  • enhanced political and financial efforts of the
    international community
  • progress uneven and largely off track in many
    developing countries.
  • HIV/AIDS (MDG 6), ARVT increase
  • Maternal mortality rates (MDG 5) barely declined.
  • Sub-Saharan Africa alsio slow MDG 4

8
Factors undermining progress
  • Unbalanced and fragmented attention to health
    priorities
  • Health fragility (capacity/willingness)
  • Weak health systems. And weak links to MDG 1 on
    nutrition, MDG 3 on gender equality and MDG 7 on
    water/sanitation.

9
Health system fragmented
  • gt 100 global initiatives
  • Advocacies by problems, isolated funding gap
    analysis (consolidated gt 40 b, "extrapolated" gt
    120 b), vertical approaches, duplication and
    opportunity cost
  • The case of a safe delivery basic service
  • Vs. divided into?
  • MDG 4 reducing neonatal death
  • MDG 5 SRHRs reducing maternal deaths
  • MDG 6
  • AIDS PMTCT
  • Malaria AN PrTx
  • Tb BCG

10
EU challenges in development policy
  • Health finnancing/ MDG progress/ ODA
  • EU health aid
  • level /equity / aligned /predictable ?
  • Where aligned and predictable (GBS, MDGc)
    scale? dialogue?
  • EU health development policy
  • Focus on poverty diseases
  • Attention to human resources for health
  • Need to increase coherence, health sector
    assessment and dialogue capacity and links with
    research/evidence

11
Health policy areas
Situation analysis Health strategies (service delivery) Budegting HIS Monitoring
Reproductive health Child health Communicable diseases NCDs
Availability of HRH Access to medicines Fair finnancing Adequate Infrastructures/ logistics
Inclusive leadership Patient centred care Universal coverage Health in all policies
12
The EU and global health
  • The EUs leading role in international trade,
    global environmental governance and in
    development aid, as well as its values and
    experience on solidarity towards universal and
    equitable quality health care give it strong
    legitimacy to act on global health.

13
The challenge of governance
  • Plethora of actors and initiatives
  • Clearer and more efficient global leadership.

14
The challenge of universal coverage
  • Ensuring access to health services for all
  • Increasing domestic resources and development aid
    in the poorest countries.
  • Improving resource allocation within countries
  • Stepping up policy dialogue on holistic health
    systems linked to the aid effectiveness agenda,

15
The challenge of policy coherence
  • Policy Coherence for Development
  • trade and financing,
  • migration,
  • security,
  • food security
  • climate change.

16
Global Health knowledge
  • Equity and ownership in development of new tools
  • To be acceptable, affordable, and accessible
  • Evidence-based health policy decisions.

17
An Enhanced EU Response
  • The EU should apply the common values and
    principles of solidarity towards equitable and
    universal coverage of quality health services in
    all external and internal policies and actions.

18
Democratic and inclusive governance
  • At global level,
  • the EU should endeavour to defend a single
    position and to increase coordination and
    effectiveness of the UN system and WHO and
    gradually shift to fund its general budget.
  • At regional level,
  • the EU should promote regional health networks
    and inclusion of global health issues, and
    cooperation with ECDC
  • At national level,
  • the EU should enhance its support to the full
    participation of all stakeholders and promote
    parliamentary scrutiny

19
Towards universal coverage of basic quality
health care
  • Where
  • The EU should give priority to and increase its
    support for countries in fragile contexts, aid
    orphans and/or those worst off- track from the
    health MDGs.

20
Towards universal coverage of basic quality
health care
  • What
  • The EU should concentrate its support on
    strengthening of health systems
  • This approach is particularly important for MDG
    5.
  • International Health Partnership and Joint
    Assessment of National Strategies
  • The EU should promote this approach in global
    financing initiatives.

21
Towards universal coverage of basic quality
health care
  • How
  • Aid effectiveness objectives,
  • Predictability of at least three years and join
    MDGc
  • Partner countries owned development programmes
  • Partner countries' procurement and public
    financing management systems.
  • Additional innovative financing, role EIB
  • Joint health sector monitoring and dialogue
  • mobilise domestic revenues, fair financing of
    health systems (inc ab. user fees)
  • EU -WHO, national public funding gaps for
    delivery of basic health care.
  • Multi-sector nature of health
  • links to gender, nutrition (Interlinking health
    and food security interventions) water,
    sanitation, environmental quality and education

22
Coherence between relevant EU policies related to
global health
  • The EU should ensure that all relevant internal
    or external policies contribute to promoting
    equitable and universal coverage of quality
    health services.
  • impact assessment of the relevant policy areas
    should analyse the effects of policy options on
    global health
  • The linkage between the EU's humanitarian and
    development aid should be promoted.
  • Commitments made on policy coherence for
    development.

23
Coherence between relevant EU policies related to
global health
  • On trade,
  • more effective use of TRIPS provisions.
  • Ensure that EU bilateral trade agreements avoid
    clauses which may undermine access to medicines.
  • Generic competition and rational use of
    medicines.
  • Control of Falsified medicines and illicit drugs.
  • Health-relevant environmental agreements.

24
Coherence between relevant EU policies related to
global health
  • On migration,
  • availability of health professionals.
  • speed up progress towards the agreed commitments
    under the European Union Strategy for Action on
    the Crisis in Human Resources for Health in
    Developing Countries
  • contribute to the WHA Voluntary Code of Practice
    on the International Recruitment of Health
    Personnel.
  • EU Member States should step up their efforts to
    ensure that everyone - including migrants- in the
    EU has access to quality health services without
    discrimination.

25
Coherence between relevant EU policies related to
global health
  • On security,
  • access to health services for populations under
    stress in fragile contexts
  • global and third countries' national capacities
    of early prediction, detection and response to
    global health threats, under the International
    Health Regulations.
  • On food security, food assistance and nutrition
  • increase access to food and link with national
    health strategies that include nutrition services
    and monitoring of nutritional status in the
    population,
  • one-UN global leadership on nutrition and on
    developing of a Global Multi-sectorial Nutrition
    Framework
  • On climate change,
  • the EU will take global health objectives into
    account in implementing the collective commitment
    by developed countries

26
Research and evidence based dialogue and action
  • address the highly fragmented landscape
  • research that benefits the health of all people.
  • Balance the complete health research process of
    innovation, implementation, access, monitoring
    and evaluation.
  • Partner countries to build and sustain their
    national research capacity.
  • Improve health information systems to inform
    policies.
  • Promote the use of ICT, including eHealth.

27
  • The EU will promote with the global community the
    values and principles of solidarity towards
    equitable and universal coverage of quality
    health services in all external and internal
    policies and actions.
  • Thank you
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