High-Level Dialogue on Health in the Post-2015 Development Agenda concludes in Botswana

IFMSA Interventions at the Global Thematic Consultation on Health in the Post-2015 Development Agenda, delivered by IFMSA President Roopa Dhatt

March 3-5, 2013 in Botswana

Intervention #1—Importance of YP in the Development Agenda, Health in All Policies, and Getting to the Root Cause

Young people are a large population. Health issues (such as mental health, violence, injuries, child marriages, unprotected sex, early pregnancy and childbirth, sexual coercion, HIV) and social issues (such as employment, environment, education) continue to challenge their ability to meaningfully participate in achieving their future. We urge the post MDG framework to increase young people’s analysis, perspective and participation. We also urge the post MDG to consider forgotten voices of marginalized and vulnerable groups regardless of political, religion, social, racial, national, sexual, gender, national, sexual or any discrimination.   Not only are young people the future, but also they will be responsible for sustaining the efforts that are set now. We should engage with young people early on about healthy lifestyles, sexual reproductive health, and career planning and use them as a vehicle for social change, specifically in increasing the shortage in human resources for health.

We also feel that health should be placed in other policy agendas beyond the development agenda and the sustainable development. We urge the creation of more health indicators that are context specific, age-specific, and population specific in evaluating policies.

We encourage the global community to seek and address the root cause of inequity and the determinants that challenge health and well-being, especially in empowering young people early on.

Intervention #2—Political Language and Health in all Policies

1. We need a political language that is universal–understood and useful across sectors, so we can have more meaningful dialogue on setting the development agenda, especially if we are aiming for a more integrated approach.

We have heard a great deal about Human Security as potential framework that is emerging in some other non-health settings. It is a framework that focuses on development, human rights and state security. It is focused on the needs of people, multi-sectorial, integrated, and focused on both protections and empowerment.  It is a tool for both design and evaluation.  We need to consider such frameworks.

2. We need to keep our approach multi-sectorial, focused on sustainable efforts, addressing root determinants of health, bridging gaps, and integrating at the local level.

3. The how still needs to be answered, as we focus on these efforts.                                                       

Intervention #3—Human Resources for Health/Health Workers

 

When we talk about setting the health priorities for post-2015, we have to ask ourselves several questions.

• Who are the targets of these priorities?
• Who will be central to responding to the health priorities? Human resources for health or Human resources for development.
• If these are health workers or similar groups, how do we plan to engage with them and include them in setting in the post-2015 agenda?
• What will be their health literacy?
  • Will this include?
    • Multi-sectorial approach
    • Social Determinant of Health/ Determinants of Well-being
    • Sustainable development
    • Global heath
    • E-Health
    • Addressing the needs of target, marginalized and vulnerable groups
• How do we plan to build their capacities and make sure quality is

 

As a future health care provider, answering these questions are essential to setting the future development agenda and insuring that health priorities that are set are achieved.

 

Intervention #4—Specific Target Groups and An overarching goal on adolescents and young people

 

While we support universality of the goals that are set in the next development agenda, we want to highlight the importance of outreach to specific target group, like marginalized and vulnerable populations, especially adolescents.  While we do support the notion of age-specific, life cycle or other similar groupings for an over arching goal, we want to make sure that specific target groups are emphasized.

 Moreover, we would like to propose to the health community, about considering another additional overarching goal. We have heard in the room these past days a lot of mention of young people and their engagement, involvement, and access to health services, especially sexual reproductive health services. We also have been hearing at the UN level, at the WHO, the Rio+20 and other thematic consultations the importance of investing in young people as an emerging theme.

 

We have been discussing about the future…

The many health issues we discussed are most pertinent to young people, especially adolescents…(topics such as sexual reproductive health, mental health, violence, child brides, even health lifestyles and NCDs apply)

Young People are the future…

So why don’t we put adolescent health on the global development agenda, as an overarching goal?

Such a goal would be universal, sellable, and compelling.

Such a goal appeals to sustainable development (green economies, future generation)

Such a goal has the potential to be multi-sectorial (job employment, education, environment, nutrition)

Social determinants of health are a reality for young people, especially adolescents’ future.

Young people are innovators of social media, new technologies, tools and approaches.

Young people are already in some cases acting as human resources for health. 

Young people are engaging already on claiming their future and investing into it.

 

Discussion Points on Round Table during the meeting

 

GOAL: Universal Health Coverage

• The goal as is comprehendible, sellable, and universal.
•  The message should be more universal health access versus universal health coverage.
• We should make sure that such a goal, also has a specific mention for target groups, especially vulnerable and marginalized groups like migrant, rural, indigenous, young people.
• We should take the time to incorporate more sustainable development concepts in the goal, including sustainable practices.
• The goal should prepare health systems for a dynamic environment and not only the health issues of now, but for the future.
• Human resources for health (health workers) are an essential aspect of achieving this goal, so greater emphasis should be placed on targets for this workforce in the development agenda.
• When we talk about prevention, we should talk about health literacy and what competencies are we aiming for in UHC.
• There also needs to be emphasis on quality and therefore, quality indicators created, no only indicators on service coverage and protection.

 

 

 

GOAL: Maximizing Health Life Expectancy

• The goal is hard to understand and is not very sellable, but universal.
• We recommended changing the language to promoting a more understandable message and one beyond health, as a larger over arching goal (either well-being, healthy planet, maximizing human potential).

• We recommended age-specific targets, but making sure that there is a special mention of target groups, especially adolescents, marginalized and vulnerable populations.
• We should avoid in this setting creating silos and emphasize the multi-sectorial possibilities with other sectors such as education, green economies, environment, and nutrition.
• Additionally, there is potential to make this a larger goal.
• The possibility exists to keep the healthy life expectancy as an indicator.
• We should also integrate more sustainable development concepts and language into this goal—include education, green economies and the environment.

Written by Roopa Dhatt, IFMSA President 2012/13

IFMSAs Road to Rio+20 (Summary of the 3rd UNCSD intersessional)

At the end of last month IFMSA attended for the second time in the Rio+20
preparations in UN Headquarters, New York. Fancily called the 3rd UNCSD
Intersessionals. Think Global Initiative Coordinator Mike Eliasz and Liaison
Officer to WHO Usman Mushtaq represented IFMSA in this meeting. This was the
second time Mike attended the Rio+20 intersessionals and a lot of progress have
been made in the negotiations since last time, from not being in the text at all
health probably has its in own chapter. Before we arrived there had been a week
of informal – informal negotiations where civil society groups had been unable
to share the text which required some quick catch up. The negotiations have
also got a bit stuck, the relatively short zero draft has been transformed into a
monstrosity of a text with all the interesting stuff in brackets. From previous
experience with UN negotiations, we can tell you that this is not unusual.

It was frankly sickening to hear governments of certain developed nations trying
to argue there was no such thing as a right to development for other countries
and more scarily a human right to water and sanitation (despite this right being
politically acknowledge already). There are also concerns about efforts address
population growth not being undertaken in the context of a reproductive rights
agenda. If your more interested in this check out this great petition from children
and youth ensuring the human rights are incorporated into the Sustainable
Development agenda insert link

At the meeting what was most interesting was getting to chat informally with
various UN officials about what was going to happen at Rio and where it fitted
into the post 2015 Millennium Development Goals (MDGs) agenda. As one
official put it ‘Rio is now just posturing for post 2015’ all the UN agencies are
trying to make sure there area of interest is on the Agenda and also they have a
specifically defined area of work. While Usman tried to get hold of the negotiators
from EU, Switzerland and Norway who mainly proposed the health language in the text,
Mike noticed that all countries positions on things were based purely on self-interest;
“I was hearing about Mexico and the Philippines pushing social protection for migrants.
The naïve and idealistic person that I am loved this idea, but the reason for Mexico and
the Philippines pushing this is that their economies are entirely dependent on
remittances from expatriates overseas, therefore the more protection migrants
have the more remittances they can send home. It is a self-interested policy
but also worthwhile in its own right, I came to the realisation all things in
International Relations need framing in individual countries self-interest.”

In the blog from last meeting, Mike wrote stated that one of the most likely
outcomes of the summit was Sustainable Development Goals but as with all
UN meetings we probably now have a roadmap to agreeing to Sustainable
Development Goals. (SDGs) This also will occur under the General Assembly,
many countries were annoyed by the work of certain UN agencies to prepare
goals to be fostered on countries at the end of the conference. (I should probably
add that the Millienium Development Goals were developed by technocrats and
introduced late in the night at negotiations so governments had no say in their
development).

With the SDGs there are a number of opinions on these from Governments as to
what form they should take. You can see some of the ideas below:
• We have stand alone SDGs before 2015
• The SDGs are released at the same time as the replacement to the MDGs
post 2015 and they are complementary to each other
• The MDGs are replaced by SDGs altogether.

As the IFMSA we fit somewhere in between two major groupings in the Rio
process the Major Group on Children and Youth and the NGO group(Health
cluster). Whilst we predominantly work on health issues we have also been
involved in supporting wider youth participation and engagement. It was in this
context Mike got to deliver a speech on behalf of the Children and Youth group
to the Bureau on youth participation, human rights and youth employment.
The group on Children and Youth are doing some amazing work and are by
far the most organised grouping at Rio. In particular check out the work on an
ombudsperson for future generations really inspiring stuff, will hope that there
is an element of accountability for future generations within the UN system.
Insert Link

The day after the intersessional, we took the bus to Washington DC for a
meeting with the Pan American Health Organizations (PAHO). PAHO is the WHO
regional office for America We introduced our work and discussed around were
IFMSA and PAHO could best collaborate. The regional office has long focused
on Sustainable Development and Health interlinkages, they released a tool kit
with a website specifically on the Rio process. PAHO is going to be one of the
biggest actors from the health community in Rio this June, and they are very
willing to support and include IFMSA in their activities. We have been even
offered to collaborate on a joint side event. The 5 hour bus trip from New York to
Washington, paid well off and IFMSA gained another strategic partner.

In terms of next steps for IFMSA:
• Launch our campaign toolkit which will facilitate the capacity building
efforts in our own federation and also ensure an advocacy campaign.
• Try to set an example and make our commitments on behalf of IFMSA and
the health sector to sustainable development
• Continue to advocate our stance in the ongoing negotiations, with the 4th
and final intersessional coming up next week.
• Position ourselves for post Rio+20 process

We have come a long way since IFMSA first started to work on Sustainable
Development through the Climate Change negotiations, only this time we are
ahead the process and not behind!

Kind regards
Mike Eliasz and Usman Mushtaq