Cry for help. Seeking a high-pitched shout out for public health, at UNGA

Will the “health for all” global campaign get a high-level political booster from the United Nations General Assembly (UNGA) meeting, in New York, this week?

The 78th UNGA has the healthcare ecosystem buzzing, with civil society, big pharma and political representatives sending out missives on what this meeting should achieve. Coming at a time when the world witnesses multiple humanitarian and climate-related crises that threatens lives and livelihoods, the World Health Organization (WHO) called for an “unprecedented” focus on global public health, where the learnings from the Covid-19 pandemic would be applied.

But the learnings from the pandemic have been uncomfortable, say public health experts, pointing to the unequal distribution of Covid-19 vaccines across the world, for instance. Or the call for a waiver on Intellectual Property (IP) on Covid-19 products for the pandemic period — a proposal that did not fructify.

Professor and health economist, Indranil, with the OP Jindal Global Univeristy, outlines the contradictions in statements from different quarters, and the expectations from UNGA.

The recently-concluded G20 summit in India saw major statements pushing for, among other things, health emergency preparedness and cooperation in the pharmaceutical sector.

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But during the pandemic, some of these developed countries did not support initiatives like the IP waiver proposal from India and South Africa. Presently, several of these countries are negotiating FTAs (Free trade agreements) with developing nations, and this would involve greater IP protection features, he explains. The lesson from the pandemic was of “technology apartheid”, he says, where countries did not trust the developing countries to hand over technology, and that cost lives. “No one is raising these contradictions,” he says.

As showcased at the G20, India needs to be the voice for developing and deprived countries, especially so on health, he says, echoing an observation made by local public health experts who did not want to be named.

On the agenda

Pandemic prevention, preparedness and response is one of three major health issues seeking greater political commitment and investment at the UNGA. The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), a trade body representing innovative pharmaceutical companies, warns that pandemic preparedness plans “should not undermine” what worked in response to Covid-19 and must support both “innovation and equity.”

Thomas Cueni, Director General, IFPMA, said, “When the next pandemic hits, the success of our response will depend on how well we prepared and worked together in this moment between pandemics.”

The collective challenge is to deliver “innovation and equity”, he says, on how to incentivise research needed to develop vaccines and treatments, and how to ensure that there is equitable access to these medical countermeasures across the globe. Other issues on the agenda are universal health coverage (UHC) and ending TB. On the latter, Médecins Sans Frontières/Doctors Without Borders (MSF) called on US corporations Johnson & Johnson and Cepheid to announce that they would act to improve access to lifesaving TB drug bedaquiline and GeneXpert tests, respectively.

Phumeza Tisile, a TB activist from South Africa, points out, “What good is it to have medical advances if they’re not reaching the people who need them most?” Tisile along with India’s Nandita Venkatesan have survived drug resistant-TB, but could not access bedaquiline and had to take older drugs which made them go deaf, MSF said. They both have successfully challenged a patent on bedaquiline in India.

Everything at risk

“If Covid-19 taught us nothing else, it’s that when health is at risk, everything is at risk,” says WHO chief Dr Tedros Adhanom Ghebreyesus.

“The pandemic caused enormous economic, social and political upheaval, and stalled or reversed progress towards the health-related targets in the Sustainable Development Goals,” he said, calling on world leaders to take concrete steps towards “a healthier, safer and fairer world for all.”

Progress in reducing infant and maternal mortality has stagnated (in some regions, rates have even increased) and progress in tackling infectious diseases like HIV/AIDS, TB and malaria have faltered, the WHO said. “Access to life-saving tools is uneven across the world, with millions unable to obtain needed care. Non-communicable diseases and mental disorders, which account for over 70 per cent of deaths globally, threaten social and economic development everywhere,” it added.

Dr Tedros will lead the WHO’s delegation to UNGA, in what is the WHO’s 75th year. Also following these developments are international public health representatives, besides pharmaceutical industry top-brass — as negotiations there define how the world will navigate present and future health crises.

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