Statement by Mr. Sha Zukang, Under-Secretary-General for Economic and Social Affairs to the ECOSOC Annual Ministerial Review
Geneva, 7 July 2009

Introduction to the Report of the Secretary-General on “Implementing the internationally agreed goals and commitments in regard to global public health” (E/2009/81)

Madame President,
Distinguished delegates,
Ladies and gentlemen,

I have the honour to introduce the report of the Secretary-General (E/2009/81) on the theme of the AMR “Implementing the internationally agreed goals and commitments in regard to global public health”. I would like to thank the World Health Organization in particular and other UN agencies for their collaboration in the preparation of this report.

The MDGs are the most prominent expression of our development aspirations. They reflect the recognition that development requires an integrated and comprehensive approach. Our goals in poverty eradication, alleviation of hunger, health, environment and global partnership are intertwined. Ignoring any one at the expense of another would have serious consequences.

This cannot be stressed enough now, as the world confronts food, energy and the climate crises, joined by the H1N1 pandemic. We have to address these issues coherently, in collaboration with all our partners. Most importantly, we cannot afford to turn to short-term answers, for a temporary respite from the difficult circumstances we face. We must move urgently toward sustainable, long-term resolutions.

This report looks at the trends in achieving the MDGs, particularly in the area of public health. Overall, we have made progress, but visible gaps remain. Let me highlight six key messages.

First, the global financial and economic crisis is exacerbating these gaps. The crisis affects all countries, with a serious and disproportionate impact on the poor and most vulnerable. Livelihoods of rural and urban poor families are already deteriorating rapidly. Jobs are being lost in most regions at a quick pace, with women in developing countries being disproportionately affected. Government expenditures and social protection systems will be negatively impacted. There is a grave risk of reversing progress towards the MDGs. This would mean negative consequences not only for human well-being, development and economic growth, but also for peace and stability. An entire generation could be put at risk in many countries.

Second, in the area of health, we should recognize the progress made in the past decade. Success stories can be found in the global response to HIV/AIDS, malaria and tuberculosis. In contrast, we have seen less forward movement in the prevention, treatment and control of neglected tropical diseases and non-communicable diseases. Tragically, the least progress has been made toward MDG5 on improving maternal mortality and newborn health.

It is quite clear to me that the biggest failing in public health is our inability to make a dent in maternal mortality. The Secretary-General has often emphasized the need to change the grim statistics on maternal deaths. The issues and remedies are clear. We need to maintain maternal health and women’s health high on the political and financial priority agenda. As part of this effort, we should put in place plans and policies to train, retain and deploy skilled health workers where they are needed. And we must make sure that these health workers have the infrastructure, medicine and equipment they need to provide people with quality services.

DESA will work with member states and donors, to support the scope of the work of the four agencies – WHO, UNFPA, UNICEF and World Bank – which have come together to accelerate progress in maternal and newborn health, including in addressing the human resources crisis. We will report next year on the progress made by the UN system in this area, particularly on how successfully we have worked with civil society organizations, health workforce professional associations and academia to accelerate their efforts and collaboration with the UN partners in their efforts. At the time of the Coordination segment next year, we can report to ECOSOC on the progress made in building up this collaboration, as a follow-up to this year's high-level segment, which has focused on public health.

Third, the nexus between health and development is evident. Good health is a pre-requisite for advancement toward most of the MDGs. Yet, inequities in health outcomes persist within and among countries. Most of the difference is attributable to the conditions in which people are born, grow, live, work and age – including underlying problems of gender inequality. Unacceptably, health outcomes for women and girls often lag far behind those for men and boys.

Improving health outcomes is linked not only to the provision of health services, but also to interventions outside the health sector, both national and international. The challenge is to ensure that policy making engages all the relevant sectors and actors, and responds to local needs and demands. It must also be accountable and oriented towards health equity.

Fourth, aid to the health sector has been increasing. Contributions from the private sector, and the various health initiatives in collaboration with civil society, private sector and governments, have shown remarkable results. However, the global economic downturn may lead to a drop in aid flows, even if existing commitments are met. We must not let this happen, as it would be devastating for most developing countries, particularly the least developed ones. At the same time, governments and their development partners must strive to invest resources wisely. While we need “more money for health”, we should also aim to achieve “more health for the money”.

Fifth, to make the most of strong donor support and private sector engagement will require strengthening health systems in many countries – through better planning, investment and coordination of aid. The issues of human resource development and brain drain also need to be addressed. This would require global and regional solutions, including through South-South cooperation.

Finally, leaders have shown, thus far, a strong commitment to the health-related MDGs. But this commitment and resolve has yet to be fully transformed into urgent, collective and multilateral action. With its unique convening power, its subsidiary bodies and functional commissions, ECOSOC can spearhead the response needed to advance the global public health agenda.

I now look forward to the national perspectives of the countries which have volunteered to make presentations.

Thank you.