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 • > 100 global initiatives • Advocacies by problems, isolated funding gap analysis (consolidated > 40 b, "extrapolated" > 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

12. The EU and global health • The EU’s 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