Title: The EU role in Global Health
1The EU role in Global Health
2CommunicationThe 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".
3Attention 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
4Consultation
- 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)
5The 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.
6The 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.
7Global 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
8Factors 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.
9Health 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
10EU 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
11Health 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
12The 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.
13The challenge of governance
- Plethora of actors and initiatives
- Clearer and more efficient global leadership.
14The 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,
15The challenge of policy coherence
- Policy Coherence for Development
- trade and financing,
- migration,
- security,
- food security
- climate change.
16Global Health knowledge
- Equity and ownership in development of new tools
- To be acceptable, affordable, and accessible
- Evidence-based health policy decisions.
17An 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.
18Democratic 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
19Towards 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.
20Towards 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.
21Towards 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
22Coherence 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.
23Coherence 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.
24Coherence 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.
25Coherence 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
26Research 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