Geneva, 25 May 2016 (PAHO/WHO) - At a plenary session of the 69th World Health Assembly, ministers and delegates from the countries of the Americas addressed the health-related aspects of the 2030 Agenda for Sustainable Development. In their presentations, the speakers covered subjects ranging from the management of outbreaks of the Zika virus and other communicable diseases to the challenge of achieving universal health coverage.
In all, representatives of 24 countries of the Americas were heard from. Their contributions, in the order presented, are summarized below.
Argentina: No country exempt from outbreaks of Ebola, Zika, or dengue
Jorge Lemus, Minister of Health of Argentina, warned that outbreaks of Ebola, Zika, and dengue have shown that these diseases are far from being eliminated and that no country is exempt from their effects. He therefore appealed to all Ministers of Health around the world to "work together to fight these diseases, which know no borders."
Referring to the 2030 Agenda for Sustainable Development agreed upon in September 2015, Lemus noted: "While it is very ambitious, it is also realistic. It can be achieved if we in the health sector give our best effort to meeting the Sustainable Development Goals (SDGs), thereby guaranteeing a healthy life and promoting well-being for people of all ages."
The Argentine minister went on to point out that the Millennium Development Goals (MDGs) have yet to be reached, while at the same time new challenges for global public health are emerging. "Not only do we still have to fight maternal and child mortality, HIV/AIDS, and other communicable diseases, but we are now also faced with an epidemic of chronic noncommunicable diseases, mental health problems, addictions, deaths from traffic accidents, hazardous chemical substances, and the challenge of achieving universal health coverage."
United States of America: Facing the challenge of emerging diseases
Sylvia Matthews Burwell, United States Secretary of Health and Human Services, pointed out that countries are now so interconnected that they increasingly share global problems. For example, the Ebola outbreak last year put the entire world on alert, and this year countries everywhere are concerned about Zika, as well as the recent reappearance of yellow fever. She stressed that "overcoming these challenges should be a high priority for all."
The U.S. Secretary noted that the 2030 Agenda of Sustainable Development renews the commitment to put an end to HIV, tuberculosis, and malaria, and that it also calls for addressing maternal and child mortality from the perspective of the most vulnerable populations. Approaches that go beyond the Ministries of Health are required, said Matthews. She maintained that organizations like WHO are becoming more important in the management of new outbreaks of infectious diseases and the affected populations. In addition, she praised Dr. Margaret Chan, Director-General of the World Health Organization, as a "bold" promoter of reforms within the Organization, citing improvements in emergency response and management.
Canada: Social determinants are key to guaranteeing health for all
Jane Philpott, Minister of Health of Canada, said that "achieving health is about more than just good medicine for all." It also means having access to drinking water, good working conditions, and housing; being free of violence; and other factors that contribute to well-being and health.
Philpott emphasized that "the social determinants of health are the responsibility not just of the Ministries of Health, but of the entire government." She added that without just access to these drivers of health, inequities will continue to be perpetuated. The minister detailed the actions that Canada is taking in an effort to close the gap in the area of mental health, particularly for indigenous populations, as well as in providing access to water and sanitation for these communities, among other initiatives.
She also stressed to need to work with the G7 countries to strengthen implementation of the International Health Regulations so that disease outbreaks can be prevented, detected, and responded to efficiently. In concluding her intervention, she condemned the attacks on health workers engaged in humanitarian missions and warned that "they will not be tolerated."
Brazil: Zika research and measures being taken for the Olympic Games
Speaking to the 69th World Health Assembly, Ricardo Barros, Minister of Health of Brazil, announced that research is under way to study possible damage to the development of children whose mothers were infected with Zika virus. He also noted that in August, when the Olympic Games will be held in Rio de Janeiro, it is winter in the Southern Hemisphere and the period of lowest transmission of mosquito-borne diseases. Barros gave assurances that specific vector-control measures are being taken to ensure that the Olympic Games "will proceed safely for the entire Olympic family and all the visitors."
Barros went on to say that his country endorses the overall strategy for addressing HIV/AIDS, viral hepatitis, and sexually transmitted diseases, and he outlined the challenges that his country faces in achieving universal access to diagnosis and treatment, especially for hepatitis C.
The minister also indicated that in order to meet the targets of the 2030 Agenda of Sustainable Development it will be necessary to implement intersectoral policies in areas ranging from aging to healthy diet and road safety, to cite a few examples.
Cuba: What is needed is a true world association for development
Roberto Morales Ojeda, Cuban Minister of Public Health, observed that the main challenge is to turn the targets that were agreed upon in the 2030 Agenda into reality." Leaving no one behind will require "a true world association for development."
"This is an opportunity to coordinate within our countries and to establish South-South and North-South cooperation ties," noted Morales Ojeda, "sharing positive experiences and working as a team toward the enhancement of our health systems and the achievement of universal health coverage."
The minister listed Cuba's health achievements so far toward meeting the Millennium Development Goals by 2015, with a description of the Cuban health system and the training program for health workers, many of whom work in Cuban medical brigades in other countries.
Mexico: The SDGs can only be met if universal health coverage is achieved
In his presentation, Pablo Kuri, Minister of Health of Mexico, emphasized that the Sustainable Development Goals will only be reached if there is "effective universal coverage with quality preventive and curative services, which will require the committed participation of all: government, society, and the international community."
Kuri reported the steps that Mexico has taken so far to address the various health-related social challenges. Actions have been undertaken to reduce maternal mortality; eliminate AIDS, tuberculosis, and malaria; and reduce premature deaths from noncommunicable diseases. In this last regard, for example, he cited coordinated efforts between the government and Mexican society, under the National Strategy for the Prevention and Control of Overweight, Obesity, and Diabetes, to reduce the burden of these diseases.
The minister also mentioned that health is no longer being regarded from the medical-curative perspective in Mexico; instead, public policies are being constructed at the local, national and global levels within an interdisciplinary and multisectoral context.
Colombia: Technological pressure and high prices for medicines could threaten compliance with the SDGs
The Minister of Health of Colombia, Alejandro Gaviria Uribe, emphasized that "technological pressure and high prices for medicines could threaten fulfillment of the Sustainable Development Goals and stand in the way of achieving equity." He called on WHO to "support the Member States in their search for sustainability through the use of technical tools, such as: the regulation of monopolistic markets, the promotion of competition, transparency, and the rational use of medicines." He said that this kind or support is key to Colombia achieving sustainable development.
Gaviria Uribe added that Colombia has almost completely achieved universal coverage. But the road to access to essential drugs, he explained "has not been easy," even though his country has been looking for mechanisms to get around those difficulties. "One of the instruments available is the so-called "flexibilities in the intellectual property system." Many multilateral agencies, including WHO, have urged the Member States to use these flexibilities. But in practice, he said, there are many obstacles.
"Unsustainable health systems also are unjust health systems," recalled the minister, who called for "a search for solutions."
Panama: Turn policies into actions in order to change health
Francisco Javier Terrientes, Minister of Health of Panama, stated that his country has taken up the challenge to turn political commitments into practical actions to bring about change in the health of the population and thus achieve sustainable development based on human rights and an integrated approach to health.
Terrientes pointed out that the Sustainable Development Goals provide WHO and its Member States with the opportunity to settle "the social debt, despite persistent inequality." He noted that in Panama's efforts have focused more on indigenous peoples and the more vulnerable populations, where poverty and mortality rates are higher. He said that health system strengthening is central to remediating these differences.
Following a brief review of his country's progress in addressing noncommunicable diseases and access to health services, the minister pointed out that one of the greatest challenges is to create a system for monitoring and evaluating progress toward achieving sustainable development goals for guidance when necessary and for reporting on progress.
Chile: Addressing the social determinants in the health system
Chile's delegate told the Assembly that the country is making strides toward achieving universal coverage and is including a new approach to the social determinants of health, such as the environment and the economy.
Efforts are being made to improve the position of health on the political agenda, with a view to achieving across-the-board reforms in all the sectors—including education and transportation, for example. The goal is to institutionalize these joint initiatives so they will be more effective.
In this context, the delegate added, it is important for countries to work together on priority problems like the high cost of medicines. He pointed out that cooperation has been strengthened through joint purchases of medicines through the PAHO Strategic Fund.
Peru: Eliminate restrictions that keep people from accessing health care
Aníbal Velásquez, Minister of Health of Peru, cited measures that his country has used in recent years to reduce poverty, extreme child malnutrition, and infant mortality, as well as with other diseases.
Velásquez reported on a health sector reform that got under way in 2013. It has focused on key actions to "eliminate the restrictions that keep people from exercising their right to health." This reform has made it possible "to extend health insurance to the Peruvian population," a move that has increased access to services that were not available before. He also mentioned response to emergencies and disasters, as well as actions to respond to outbreaks of dengue, chikungunya, and more recently, Zika.
The minister commended PAHO Director Carissa F. Etienne for undertaking a hemisphere-wide effort to analyze inequities in health in the Region. "This initiative," he said, "will make it possible to build more just societies."
Uruguay: Establish clear health-related objectives and promote an intersectoral approach to achieving sustainable development
Jorge Basso, Minister of Public Health of Uruguay, told the World Health Assembly that working together toward achieving health-related objectives and promoting an intersectoral approach to sustainable development are key in the 2030 Agenda. He pointed out that the challenge for all the governments is "to leave no one behind."
Basso emphasized that understanding health as a human right means assuming that health also means having a healthy life. This assumption becomes the basis for actions on the environment, education, health information, and all areas where life goes on.
"While Uruguay "does not have low indicators, we still need to identify problems and take concrete actions to remedy them," the minister said. Thus, Uruguay undertook a reform in its health system that proposes objectives for assuring quality in the delivery of care and sustainable development on the part of the system. A total of 15 critical problems were identified, and actions and objectives were established for addressing them. The areas include: teen pregnancy, high rates of cesarean section delivery, mother-to-child transmission of syphilis and HIV, nutritional problems in early childhood, and noncommunicable diseases, to mention a few examples. Working on those health objectives, he added, will make it possible to ensure sustainable development.
Costa Rica: Universal health coverage is the path to sustainable development
Fernando Llorca, Minister of Health of Costa Rica, told the Assembly that for his country universal health coverage is the best strategy for moving closer to achieving sustainable development. Admitting that current efforts could be improved upon, he declared that it will be essential to turn talk into action. He emphasized the importance of intersectoral, interinstitutional, and international strategies to address such problems as obesity.
Llorca issued a call to promote health in all policies, coupled with actions and strategies to accompany its incorporation. He emphasized that poverty and inequity continue to be the most violent assaults against the population. Costa Rica is working in a partnership with the health industry to ensure better access to health care.
