Reflections on the 73rd Session of the UN General Assembly

The UN General Assembly (UNGA) brings together 193 countries to deliberate on national and global policies.  This year the Sustainable Development Goals (SDGs) were discussed in every meeting I attended.  All sectors are beginning to use the SDGs as a measurement of progress.

Highlights from the Meetings:
A global anti-microbial Resistance (AMR) challenge led by the U.S. Centers for Disease Control and Prevention (CDC) was launched. This is aimed at committing action to deliver results and combat one of the greatest public health threats in the world. 

The UN meeting on Mental Health threw light on the inadequate services and infrastructure available to tackle this growing issue in all countries.  More than 300 million people suffer from depression globally, and suicide is the second highest cause of death for ages 15 to 29 years old. There is an onus on Employers to promote good mental health and well-being at work. Dr. Tedros, Director General of the World Health Organization, (WHO) stated that “Every country in the world can be considered as a developing country when it comes to mental health.”

2nd Ministerial High-level Meeting on Cervical Cancer: A world free of cancer
It was agreed that better coordination is required to achieve the global elimination of cervical cancer. Governments and organisations working on NCDs, Maternal Newborn and Child Health, Women and Girls and HIV came together to deliberate how best to collaborate. 

Food and Nutrition: The global crisis
There was a one-day conference on food and nutrition organised by the Barilla Center for Food and Nutrition, which addressed the need for improved agriculture, food security and the link to tackling NCDs through the availability of healthy and nutritious food.

 “What is good for us needs to taste better than what is bad for us.”
                                                                                   – Paul Newman, Chef’s Manifesto Initiative

UN High-level Meeting on Non-Communicable Diseases (NCDs)
H.E. Ms. Maria Garces, foreign minister of Ecuador and President of the General Assembly, opened the UN high-level meeting on NCDs. The meeting was attended by heads of state and governments, ministers of health, civil society, multilateral agencies and the private sector.

Currently, effects of NCDs lead to annual GDP losses of about 6 percent. UNGA adopted a political declaration titled "Time to Deliver: Accelerating our response to address NCDs for the health and well-being of present and future generations." It includes commitments to reduce premature mortality by one-third from NCDs by 2030, in line with the 2030 Agenda for Sustainable Development of the UN. While acknowledging the progress achieved by some countries in controlling four major NCDs—cardiovascular disease, diabetes, cancer and chronic respiratory diseases—the declaration stated that actions so far have been inadequate.

Heads of state and governments committed to 13 new steps to tackle NCDs, including, promoting greater policy coherence and coordination through whole-of-society approaches, as well as health–in-all-policies approaches.  They also committed to working with the private sector and promote public-private partnerships (PPPs) to scale up innovative solutions.

They further committed to implement a series of WHO recommended policies to prevent and control NCDs, such as public health education campaigns to promote healthier lifestyles, vaccinating against HPV virus to protect against cervical cancer and treating diabetes and hypertension. WHO estimates that implementing all these policies could generate US $350 billion in economic growth in low and lower-middle-income countries between now and 2030.

Dr. Tedros, WHO’s Director General, stated that NCDs kill 41 million people each year.  He noted that we can prevent 10 million NCD deaths by 2025 if we can adopt the WHO “best buys” and suggested a presidential coalition of six to 12 heads of state who would act as presidential champions of NCDs initiatives globally.

Dr. Tedros outlined three actions that governments must take for NCDs:

1. Political commitment – political intervention is a necessity;
2. Domestic investment – spending to build a healthy population is not a cost but an investment for human capital;
3. Focus on Universal Health Coverage: Next year there is a UN High-level meeting on UHC.

My Key Takeaways and Recommendations
The President of the UN General Assembly committed to mobilising international cooperation and support through the UN System, the private sector, research institutions, civil society and health groups, for countries to meet their goals.

The timely publication of the World Bank’s Human Capital Index, which for the first time ranks countries according to their investment in health and education, will demonstrate the need for investment. The Human Capital Index quantifies the contribution of health and education to the productivity of the next generation of workers and will now influence World Bank spending.

Canada stood out as one of the key countries that aims to tackle mental health from its root with a $5 billion commitment to mental health and addictive services.  Finland’s example of Health-in-All policies demonstrated the results that can be achieved through this approach. Tanzania is making great strides towards getting health insurance coverage for all their population. Several governments have started introducing National Physical Activity programmes with Singapore having great success in their National physical activity challenge.

There is the double burden of malnutrition on one hand and obesity on the other that needs to be tackled with different interventions.

A focus on preventative care and early diagnosis is required. NCDs need domestic financing and should be included in benefit packages. Quality of care and Integrated healthcare delivery is required in addition to the strengthening of primary care.

With so many health issues that need attention, an integrated health delivery approach and total prioritisation of health is critical for every government.

Six Recommendations to Governments

• Each country should set up an implementation task force team on NCDs that reports progress directly to the head of state.
• Daily physical education should be mandatory in every school for children ages 4-16 years old.
• Governments should prioritise the whole-of-government approach and “Health-in-All” government policies.
• Governments need to work with employers to create “healthy” workplaces – both mentally and physically.
• The role of investors and non-traditional financial institutions should be explored.
• Governments should prioritise tackling NCDs that have the highest economic burden and those that cause the most premature deaths and disabilities.

The time to act is now.