Economic and Social Council Examines United Nations Response to Economic Crisis, Deemed Pivotal to Cementing Growth, Attaining Millennium Development Goals
Economic and Social Council Examines United Nations Response to Economic Crisis, Deemed Pivotal to Cementing Growth, Attaining Millennium Development Goals
|Department of Public Information • News and Media Division • New York|
Economic and Social Council
2010 Substantive Session
23rd & 24th Meetings (AM & PM)
Economic and Social Council Examines United Nations Response to Economic Crisis,
Deemed Pivotal to Cementing Growth, Attaining Millennium Development Goals
South-South Cooperation Softening Impact of Crisis, but No Substitute
For Traditional North-South Cooperation, Council Hears in One of Two Panels
With the world economy still reeling from the profound repercussions of the global economic crisis, which had rocked financial markets in the North and threatened to reverse recent gains in developing countries, the Economic and Social Council today examined the United Nations short- and long-term response, which was seen as critical to the achievement of the Millennium Development Goals.
The first of two panel discussions today was moderated by Council Vice-President Morgen Wetland, and focused on the world body’s response to the economic and financial crisis, as well as progress on implementing two international social and economic initiatives: the Global Jobs Pact, a policy measure adopted by the International Labour Conference in June 2009; and the United Nations Social Protection Floor Initiative, a crisis plan put forward by the United Nations Chief Executives Board for Coordination undertaken in conjunction with the International Labour Organization (ILO) and the World Health Organization (WHO).
The social costs of the current crises were immense, said panellist Assane Diop, Assistant Director-General and Executive Director for the Social Protection Sector of the International Labour Organization, pointing to unemployment and poverty rates, which were increasing at an alarming pace. “We need a global solution to these crises, and all countries must play their role,” he stressed.
He underlined the link between economic growth and social progress, noting that policies were needed for both. The Global Jobs Pact, which aimed at creating jobs and stimulating economy recovery, was a “precious tool” in promoting decent work and social protection in line with the achievement of the Millennium Goals.
Panellist Carissa Etienne, Assistant Director-General of Health Systems of the World Health Organization (WHO), emphasized the importance of the Social Protection Initiative, noting that more than half of the world’s population lacked any type of formal social protection. Therefore, WHO focused on “reaching the unreached”, with special emphasis on vulnerable populations, the poor, women and children, migrants, ethnic minorities, and indigenous peoples.
Universal access to preventive, rehabilitative, and curative health services, however, could not be achieved without a strong health financing system, she stressed. A broader perspective was needed, as coordinated efforts to ensure and promote social security could only have a lasting impact if information flows about the Social Protection Initiative were strengthened among United Nations agencies and other partners at the country level.
In the afternoon, the Council turned its attention to South-South cooperation and financing for development during a panel moderated by Magded Abdelaziz of Egypt, who said such cooperation had gained significance given an economic power shift in favour of developing countries. While their economic influence had been witnessed in trade negotiations and efforts to mitigate and cope with climate change, he stressed that South-South cooperation was not a substitute, but rather a complement to traditional North-South cooperation.
Elaborating on that point, panellist Ajay Singh, Senior Director of Reddy Laboratories in India, said that both North and South had a role to play; however, North-South cooperation was not well understood. His company was a global pharmaceutical company, and while most innovation and drug creation was found in the North, pharmaceutical companies in the South were playing a growing role in increasing access to health care. They were focused on saving costs through new processes and scale that, in turn, drove down overall health-care costs.
In other business, the Council also began its general debate on coordination, with several speakers citing the General Assembly’s upcoming meeting to review the status of the Millennium Development Goals as a critical juncture for addressing remaining challenges. Progress had been slow or lacking with regard to all health-related targets, especially maternal and newborn health. The representative of Yemen, speaking on behalf of the “Group of 77” developing countries and China, noted that nearly 10 million women could be lost in a generation due to pregnancy or childbirth-related complications, 99 per cent of whom would live in developing countries.
Meeting the internationally agreed health-related goals required all Member States to bolster their commitment to strengthen health systems so they could deliver equitable outcomes, he continued, calling for donors to ramp up their efforts to honour commitments, including the fulfilment of official development assistance (ODA). Belgium’s representative, on behalf of the European Union, added that focus must be given to domestic resource mobilization in developing countries, with special emphasis on enhanced tax governance and adequate national budget allocation, to effectively support comprehensive health systems.
Also participating in the general debate were representatives China, Russian Federation, Brazil, Ethiopia, Indonesia and Peru.
Assistant Secretary-General for Policy Coordination and Inter-Agency Affairs of the Department of Economic and Social Affairs, Thomas Stelzer, introduced the report on the United Nations System Chief Executives Board for Coordination’s Annual Overview Report for 2009/2010.
The Economic and Social Council will reconvene at 10 a.m. on Thursday, 8 July, to conclude its coordination segment.
The Economic and Social Council continued its coordination segment today, which featured two panel discussions on, respectively: operationalizing the United Nations short- and long-term responses to the economic and financial crisis; and South-South cooperation and financing for development.
Introduction of Reports
THOMAS STELZER, Assistant Secretary-General for Policy Coordination and Inter-Agency Affairs of the Department of Economic and Social Affairs, introduced the report on the Annual Overview Report of the United Nations System Chief Executives Board for Coordination for 2009/2010 (document E/2010/09), saying that it provided an overview of the major developments in inter-agency cooperation. It showed how the Board’s three pillars — the High-Level Committee on Management (HLCM), the High-Level Committee on Programmes (HLCP) and the United Nations Development Group (UNDG) — had advanced coordination to promote a more effective United Nations system.
He said that the Board, asked to monitor the development and social effects of the financial crisis on the Millennium Development Goals, had held substantive dialogue with States on progress made under the Joint Crisis Initiatives, and expressed deep concern about the crises’ negative impacts. On climate change, another area where the United Nations had intensified efforts to “work better together”, the Board would contribute to processes leading up to the Conferences of the Parties (COP), supporting States in implementing international agreements, and contributing to implementation of the COP framework. As for operational activities, efforts continued to strengthen the management and accountability of the development and resident coordinator system.
The Board also continued to develop a more effective United Nations Security Management System to protect staff in insecure environments, he said. Taking the lead in efforts to simplify and harmonize business practices, the Board was working to enhance transparency in that process. It also was clear States would welcome more transparency in the Board’s decision-making and thus, it would ensure timely and open information sharing of its work and outcomes of its sessions. The Board also recently had launched a new website.
Next, ASSANE DIOP, Assistant Director-General and Executive Director of the Social Protection Sector of the International Labour Organization (ILO), introduced the Secretary-General’s report on Recovering from the crisis: a Global Jobs Pact (document E/2010/64). He said that the Pact presented “tried and tested” responses to the global financial crisis, aiming to provide a road map for improving investment, employment and social dialogue. It offered an internationally agreed policy framework to address the fallout from that crisis, reviewing international support for its implementation. The report’s second section considered the United Nations work to promote the Global Jobs Pact and highlighted that the nine Joint Crisis Initiatives offered examples of stronger inter-agency efforts, including assessments of social and labour markets and capacity-building in the design and implementation of employment programmes.
He said that the report also underscored the need for more coordination between the market economy and the employment agenda, among other things. Section three, which provided an overview of the crisis’ consequences, noted that even amid recovery in large emerging economies, overall growth was fragile. Rural and urban incomes featured declining wages and earnings. Aid budgets were also under threat, undermining efforts to achieve the Millennium Development Goals. Indeed, enhancing employment and decent work content of recovery programmes remained an urgent task. The report’s section four reviewed national policy responses and included a survey by the International Labour Organization of 50 nations, showing that Governments most frequently used policy measures to increase spending on infrastructure, training programmes and cash transfers, among other things. Some countries — including Argentina, Bulgaria, Mauritius, South Africa and Ukraine — had launched their own applications of the Pact, and the ILO was supporting those initiatives.
The report’s conclusions cautioned against the withdrawal of public support for programmes before private investment was strong again, he said. The section also called for new policy thinking and a combination of employment and social measures to stimulate demand and investment. It drew attention to the financial constraints hampering low- and middle-income countries from implementing the Pact. Finally, it highlighted the importance of coordinating international measures vis-à-vis trade expansion and environmental sustainability, among other things.
Panel Discussion on Operationalizing Short- and Long-term Responses
Moderated by MORGEN WETLAND (Norway), Economic and Social Council Vice-President, the panel included Assane Diop, Assistant Director-General and Executive Director, Social Protection Sector, ILO; Carissa Etienne, Assistant Director-General, Health Systems, World Health Organization (WHO); Norberto Ciaravino, Chef de Cabinet in the Ministry of Labour, Employment and Social Security, Argentina; and Carlos Acevedo Flores, President, Banco Central de Reserva, El Salvador.
Mr. WETLAND noted that the financial and economic crises had had a severe and devastating effect on the world economy, especially on the economies of developing countries, and threatened to erode the recent gains. How the United Nations system responded to that issue was critical if progress was to be made in achieving the Millennium Development Goals.
Kicking off the discussion, Mr. DIOP said the Global Jobs Pact was indivisible from the concept of social protection, and particularly the Social Protection Floor Initiative. The economic crisis had hit all countries hard. Global employment levels had dropped by 1 per cent since 2009, while unemployment numbers had risen dramatically, to nearly 210 million in 2010. The social costs of the current crises were immense, with poverty an increasingly worsening issue.
“We need a global solution to these crises, and all countries must play their role,” he said. Global economic growth was happening primarily in countries in the South, while countries with advanced economies struggled to make gains. In that regard, China, India, Brazil and South Africa would make significant contributions and stimulate employment at the global level, due to their ability to offer productive investments, he noted.
The ILO had proposed a global exit strategy to leaders of the “Group of 77” developing countries and China, which raised numerous questions about the link between economic growth and social progress. Rethinking that link was crucial, and policies were needed for both. With that in mind, he called the Pact a “precious tool” in promoting decent work and social protection in line with the achievement of the Millennium Goals. The Social Protection Floor Initiative, adopted by the Chief Executives Board in 2009, was founded on an innovative, holistic approach that would ensure the availability and continuity of access to social services, including housing, employment, and social transfers for children and the elderly, among others.
He stressed the need to extend knowledge bases with research, step up South-South cooperation, and urge for international support of launched initiatives. Since 2006, his organization had promoted a fair development model, which viewed access to health care and education as the foundation of social justice, fairness and sustainable development. Underscoring the need for more political will and a renewed vision, he added that more countries needed to prioritize the issue.
Ms. ETIENNE noted that the Social Protection Floor was a central part of both the United Nations and the WHO’s work over the long term. Financial crisis or not, most of the world’s population did not have access to necessary health services because they lacked the means. Some 150 million people suffered severe hardship each year, while about 100 million more were pushed below the poverty line, owing to health service payments. Furthermore, more than half of the world’s population lacked any type of formal social protection.
She said her organization focused on “reaching the unreached”, with special emphasis on vulnerable populations, the poor, women and children, migrants, ethnic minorities, and indigenous peoples. However, she stressed that universal access to services — preventive, rehabilitative, and curative — could not be achieved without a strong health financing system, an important component of broader efforts to ensure social protection in health.
WHO, therefore, was already working with countries to help develop their financing systems in ways that would allow more people to access needed services without suffering financial hardship, she said. Those efforts were done, in part, through partnerships with ILO, the World Bank, Germany and France, within the framework of the Providing for Health (P4H) Initiative, she added.
She recalled that her organization’s 2010 World Health Report entitled, “Health Systems Financing: the Path to Universal Coverage”, outlined ways in which countries could modify their financing systems towards universal health coverage. With that in mind, the international community should help interested parties to assess and implement those recommendations, in accordance with national health strategies and financing capacities. A broader perspective was needed, as coordinated efforts could only have a lasting impact if information flows about the Social Protection Floor Initiative were strengthened among United Nations agencies and other partners at the country level.
Next, Mr. CIARAVINO said that, in 2001-2002, Argentina had experienced an early version of the 2009 crisis, which had included two key problems of creating decent work and social protection. All decisions taken had been based on the need to create jobs, and many had seen positive results. By way of background, he said decent work — which covered health services, family allocations and pensions — had not covered the whole country, so it had been necessary to extend the social protection floor beyond the formal work sector. Social benefits were provided to those not part of the formal job market. Today, Argentina’s social system covered 18 million beneficiaries, or half of the total population.
He said that older persons were included in the pension system, as they had not been fully covered. The family benefit system was extended to cover all children, even those of informal sector employees. A $50 per month per child benefit covered vaccinations and basic medical care, among other things. Programmes also had been adopted to preserve jobs, rather than to protect the unemployed. Businesses received a subsidy on condition that they keep jobs, which allowed 200,000 workers to remain employed. Extension of pension and child benefit systems helped to prevent increased poverty and improve the overall economic picture, in part by increasing consumption. Indeed, salaries and social protection systems were drivers of the economy and they should be strengthened in crisis.
Rounding out the panel, Mr. ACEVEDO FLORES, noting that his country had been among the hardest hit of Latin American nations by the crisis, said gross domestic product (GDP) had fallen by 3.5 per cent in 2009, with growth expected to reach only 1 per cent in 2010. Moreover, El Salvador maintained close links with the United States, and remittances, which accounted for almost 18 per cent of GDP, had fallen by 10 per cent in 2009, while exports, almost half of which went to the United States, had dropped by 18 per cent. Forty thousand more jobs had been lost due to the crisis, or 2 percentage points of the total labour pool.
In response, the Government, which had taken office in June 2009, had initiated a new model for social and economic development, which was comprised of two main strategies, he said. For the short-term, an anti-crisis programme aimed to cushion against the crisis’ impacts on the most vulnerable. It sought to protect existing employment, initiate a universal social protection system and develop inclusive economic and social policies. For the medium term, a plan for the 2009-2014 period had been launched, which strove, among other things, to create a new financial system for promoting national development and a strategy to foster productive activities. It also included a new approach to build consensus.
As for international support, the United Nations was cooperating in many areas, he said, noting assistance from the United Nations Development Programme (UNDP) in the work of the Consejo Económico y Social, as well as a $50 million loan from the World Bank for income protection and employment generation. El Salvador sought complementarity between short-term responses and long-term actions. It confronted severe fiscal constraints, and although the debt-to-GDP ratio had increased, it was committed to maintaining fiscal sustainability in all its programmes. It was especially interested in the keeping permanent jobs created in the anti-crisis programme, as the country needed those jobs in productive activities, he added.
In the ensuing discussion, several speakers agreed that the financial and economic crises continued to adversely impact the economic and social sectors, welcoming the Global Jobs Pact and Social Protection Floor Initiative. The representative of Venezuela noted that the crises would enter into an even more severe phase given increases in public debt, and he called for States to correct their financial systems and their inequities. “Financing the real economy is the only option,” he stressed.
Many speakers highlighted the need to create decent jobs as an effective response to the crises, with the Republic of Korea’s representative calling for the private sector’s role to be strengthened for sustainable job creation. While the Global Jobs Pact could potentially be effective, it was unclear if it was being implemented on the ground. The representative of Bangladesh pointed out a perceived disconnect between the United Nations Headquarters and country-level operations, and urged the Organization, as well as the international community, to further intensify monitoring of the Pact’s implementation at the country level to ensure that benefits reached those in need.
Several speakers also called for medium- and long-term solutions that would protect the social system. In that regard, Argentina’s representative added that policy responses should be compatible with satisfying national employment and social security needs, while El Salvador’s representative underscored the need for a multidimensional approach to fill the gaps in existing policies.
Also participating in the discussion were representatives of Belgium (on behalf of the European Union), Benin, Cuba, and Brazil.
Responding to the query about whether global concepts had taken root at the local level, Ms. ETIENNE said that, in the area of primary health care and universal health-care coverage, countries were trying to address their financial systems and the issue of user fees. If countries responded, they would say they did take into consideration those concepts and, if supported by international organizations, implemented them.
As to whether the Global Jobs Pact had been sufficiently included in United Nations cooperation efforts, Mr. DIOP said there had indeed been cooperation. The ILO had incorporated the Pact into its country programmes on decent work, which were also supported by the United Nations.
To a question on the role of agriculture in developing countries, he said the sector was an important part of GDP for many countries. The impact of the social protection floor on agriculture was real, and cooperation between WHO and ILO must continue in that regard.
As for South-South cooperation, he highlighted China’s “excellent” cooperation with countries of the global South, and noted that Brazil had signed an agreement with the ILO and a third country in the global South to assist in development efforts. To the question about a lack of financing, he agreed that that situation must be rectified. As for youth employment, he cited Brazil’s bolsa familia programme and agreed that the private sector’s role generally must be strengthened.
Mr. CIARAVINO, describing Argentina’s “Recovery of Production” programme, under which companies had recourse to the State to retain jobs, said it did not run counter to general measures for job creation and had delivered good results. By way of example, he said that at a key moment of the crisis, when buyers in the United States and European Union had stopped buying leather exports, Argentina was able to keep those jobs from being lost.
On other issues, he said a youth programme, targeting youth aged 15 to 18 years old who were unemployed and marginalized, offered training and assistance in finding stable work. It covered 600,000 young people.
Wrapping up the panel, Mr CEVEDO said that agriculture was an important sector in many countries, as it was labour-intensive. It was also an area in which there was pervasive poverty. In El Salvador, agricultural workers were not covered by social security, and productivity was lower than that in other sectors. There was a need for sectoral policies to eliminate obstacles.
ABDULLAH M. ALSAIDI (Yemen), speaking on behalf of the Group of 77 developing countries and China, said the Secretary-General’s report on coordination had stressed that the dramatic sequence of global crises over the past two years had and would continue to affect the international community’s efforts to meet agreed health goals. Based on current trends, many developing countries were unlikely to achieve the health-related Millennium Development Goal targets by 2015, especially reducing child mortality and general and under-5 deaths in particular.
In addition, he said, there was deep concern that efforts to achieve the maternal health goals were seriously lagging. For example, every year, more than 350,000 women died from complications related to pregnancy and childbirth. That meant that 10 million women could be lost in a generation — 99 per cent of them would be in the developing world — even though such complications could be prevented through simple, cost-effective health care and treatment. He also highlighted the ongoing ravages of the HIV/AIDS virus and its “serious consequences” for socio-economic development in the developing world, especially in terms of the loss of productive human resources.
With all that in mind, the Group of 77 reiterated that meeting the internationally agreed health-related goals required all Member States to bolster their commitment to strengthen health systems so they could deliver equitable outcomes, he said. “There is a need to scale up global financing for capacity-building and ensuring the efficiency of health-care systems.” It was now also time to build a global movement for maternal and child health care that was similar to the movement launched to combat HIV. That movement had united countries, regions, the global community, civil society, donors and people living with that virus. The Group also urged donors to step up their efforts to honour their commitments, including the fulfilment of official development assistance (ODA), such as the 0.7 percent gross national index for ODA.
CHRISTOPHE DE BASSOMPIERRE (Belgium), speaking on behalf of the European Union, said that, while economic growth was an essential factor in improving health outcomes, it was not sufficient alone. Health was a basic human right, and economic and social conditions were crucial determinants of it. Therefore, a holistic and multisectoral approach, in terms of employment, education and gender equality, was imperative for sustainable physical and mental health. Furthermore, investment in health systems and policies aimed at equitable access to care was tantamount to an investment in human development and social well-being.
With only five years left before 2015, he emphasized the need to make progress on health-related Millennium Goals sustainable. However, the progress thus far had been uneven and insufficient, particularly with regard to Goals 4 (child mortality) and 5 (maternal health), and especially in sub-Saharan Africa and South Asia. “The Summit must be an opportunity to give a new impulse in this area,” he said, reaffirming the Union’s readiness to accelerate progress on global health challenges, including in the area of non-communicable diseases.
In that regard, the Union and its 27 member States would support partner countries’ efforts to strengthen comprehensive health systems through enhancing their capacities to develop, regulate, implement, and monitor effective national health policies and strategies. Particular attention would be paid to the four main health challenges, including sexual and reproductive health, child health, and communicable and non-communicable diseases. Non-communicable diseases were an increasing health threat, and he called for them to be mainstreamed into primary health care, through preventative measures.
In light of slow progress in achieving Goal 5, particularly in sub-Saharan Africa, he said health systems should pay special attention to gender equality, and women and youth’s needs and rights, among other issues. To effectively support comprehensive health systems, focus must be given to domestic resource mobilization in developing countries, with special emphasis on enhanced tax governance and adequate national budget allocation. In closing, he highlighted the importance of partnerships, including with civil society, in developing better-functioning and cost-efficient health systems.
ZHANG DAN ( China) said that over the past year, the United Nations system had worked vigorously to integrate resources and explore methods of cooperation in implementing projects in the field of public health, as well as in providing financial support and technical assistance at the national level to strengthen health-care systems and boost capacity in the field of global health. Global health now faced tough challenges, and the negative impact of interrelated global crises on public health-care systems in the developing world were threatening the developing countries’ ability to attain the Millennium Goals. The United Nations system, guided by the Council’s 2009 Ministerial Declaration, should strengthen coordination and advance global cooperation in the public health sphere.
She said China believed that the implementation of the aims of the Declaration should be focused on achievement of the Millennium Development Goals. To that end, the Assembly’s upcoming high-level meeting on the status of the Goals would provide an opportunity for all stakeholders to build consensus and take concerted and relevant action. Governments should pay close attention to the slow progress in realizing health objectives, especially for women and children, and, among other actions, should reinforce measures in family planning services, immunizations, and the prevention and treatment of infectious diseases.
She also called for implementation of the Declaration to focus on building national public health systems, saying: “A fully developed public health system provides the basis for the improvement of peoples’ health and is crucial to the response to natural disasters and public health contingencies.” The policy consensus contained in the Declaration could become truly country-owned and produce real results only when placed in the context of national public health systems. As for China’s efforts to bolster its national health-care system, the Government, since 2009, had deepened its reforms of the medical system, maintained the public welfare character of that system and built basic health-care systems for both urban and rural residents. In addition, China had, among other things, ensured that 25 provinces now provided subsidies to doctors in rural areas.
VASSILY NEBENZIA ( Russian Federation) fully supported the United Nations work to implement the health-related Millennium Development Goals, with WHO at the helm of that effort. Contributions also had been made by UNAIDS and the United Nations Population Fund (UNFPA), and his delegation had noted the importance of an appropriate division of labour among them. The global health-care system had seen a proliferation of vertical funds, among other things, which could regrettably weaken WHO’s role. Meanwhile, the General Assembly and ECOSOC should increase political attention and develop a coordinated process to address health care.
He said that the Council’s Ministerial Review, which marked the first time such a comprehensive discussion on health care had been held outside of the WHO, had clarified a political strategy to combat health threats. The General Assembly also had taken steps in combating non-communicable diseases and improving road safety. In that context, he recalled that the Russian Federation was the main sponsor of Assembly resolution 64/265 (2009). The Assembly also had adopted a resolution his country had submitted to improve global road safety, naming 2011-2020 as the Decade of Action for Road Safety. He called on all relevant agencies to prepare for the launch of that Decade in March 2011.
On other matters, he said his Government favoured strengthening the Council’s coordination segment, which provided coherence to work undertaken by United Nations agencies, and welcomed the President’s efforts to rationalize work for the segment. It was important to give more time to inter-agency units, including the Chief Executives Board. The Russian Federation had read with interest the Board’s annual overview and trusted there would be an opportunity to share views on that document. September’s summit on the Millennium Development Goals might require adjusting certain mandates, including that to outline clearer aims of the coordination segment.
GUILHERME DE AGUIAR PATRIOTA ( Brazil), aligning with the Group of 77 and China, said the Council was mandated to follow up on major summits and support coordinated implementation of agreed commitments. Only last year, it had reached consensus to adopt the Ministerial Declaration on implementing the internationally agreed goals and commitments on global health. States had noted that health-related Goals had characteristics that required targeted and focused attention, and reaffirmed their determination to boost collaboration to improve health. As such, no country should be allowed to fail to meet health-related Goals, owing to lack of resources, and Brazil supported a scaling up of funds. National capacities also must be enhanced to strengthen health systems and ensure access.
Moreover, he said, investment in pharmaceutical production was essential, as was access to low-cost. The United Nations Conference on Trade and Development (UNCTAD) and UNDP, among others, must help developing nations build capacity in such crucial areas. Specifically, the global community must help end unfair trade barriers that prevented developing nations from accessing low-cost drugs. Welcoming efforts to address issues related to the intergovernmental follow-up mechanism to the financing for development process, he supported the Council’s decision to establish a three-step mechanism, which would ensure ongoing consideration of financing for development. Indeed, the Monterrey Conference was the only such meeting that had not resulted in a formal intergovernmental body to oversee work.
With the prospect of a double-dip recession in developed countries, the Council must keep those issues on its agenda and adopt a specific resolution on those matters, he said. The economic situation still called for policies that stimulated jobs and social protection, which could, if integrated properly, sustain economic recovery. On the Chief Executives Board, he urged aligning substantive action with State mandates. The Board had worked to boost dialogue, notably about the global crisis, and a formal framework would surely improve the Board’s accountability to Member States.
DANIEL Y. WORKIE ( Ethiopia) said that in the aftermath of interrelated global crises over the past 18 months, and their impacts on health still unclear, “achieving [the internationally agreed goals in health] may be easier said than done”. In that context, the Secretary-General’s relevant report revealed that efforts to reduce maternal and newborn mortality by the 2015 deadline set by the Millennium Goals were most at risk. Indeed, his own country, which had made enormous strides in achieving the Goals overall, was still struggling to reach the target for improving maternal health.
He said that the major causes of maternal deaths in Ethiopia were obstructed labour, ruptured uterus, severe eclampsia and malaria. “This problem is closely related to the inability to expand access to and [ensure] the quality of health facilities and professionals,” he said, calling on the international community to urgently renew its commitment to prevent and eliminate child and maternal mortality and morbidity. Further, he urged international partners to scale up assistance for strengthening health systems as a key component of an integrated approach to achieving rapid and substantial reductions in mother and child deaths.
“We support the Secretary-General’s call to develop a joint action plan for accelerating progress on maternal and newborn health,” he said, adding that his delegation also commended the significant work under way to strengthen coordination among United Nations agencies to address the health-related Millennium Goal targets. The United Nations system should ensure that the Council’s 2009 Ministerial Declaration on global public health was carried out in ways that benefited programme countries and which were in accordance with their national development policies and priorities. Additional financial resources were also required for tackling health-related development challenges. While increased financial resources for the United Nations system were crucial and should be directed to core budgets, the quality and predictability of broader development assistance was a prerequisite for effectiveness.
ADE PETRANTO ( Indonesia) said the Council’s coordination segment was taking place at a critical juncture — a few months ahead of the General Assembly’s high-level assessment of the status of implementation of the Millennium Development Goals. The direction that summit would take to accelerate progress on the Goals depended, in some part, on the Organization’s work over the coming weeks, including in the Council. World leaders, when they arrived in New York in September, should have before them a clear indication of what had been achieved and what remained to be done so they could take the appropriate steps.
He said that poverty eradication was an urgent priority, infringing on all the Goals, including the theme of the Council’s 2009 Ministerial Declaration on global public health. Due to the turbulence in the global economy over the past 18 months, it was absolutely necessary to prevent the erosion of progress in the area of poverty eradication. Member States, and the Council itself, must use tools at their disposal to accelerate progress, “and coordination is one of those tools”. Indeed, it clarified roles; identified gaps; and helped map out the way forward. Strengthening broad cooperation remained crucial, and the United Nations should lead in that effort.
Indonesia believed that one of the Organization’s main tasks in that regard was in the health sphere, with a particular focus on the health-related Millennium Goals. Though there had been solid progress on general health targets, the sector was nevertheless characterized by vast inequities, especially regarding women’s and children’s health. The effort to bolster coordination, therefore, should be built around the Secretary-General’s global Joint Action Plan to improve child and maternal health. Coordination on its implementation should look ahead to 2015 and beyond, and should rally action around two vital needs: to increase the quantity and quality of health services worldwide; and to increase access to adequate health services. Discussions on improving coordination in the area should also tackle the need to scale up financing and improve the availability of affordable drugs and medical services.
GONZALO GUTIÉRREZ REINEZ (Peru), noting that health problems directly impacted a country’s human capital, said solutions must be linked to efforts to overcome poverty, improve education, promote gender equality and attain environmental sustainability. For its part, Peru had strengthened its primary health-care system. From 2007-2008, the proportion of those able to access health insurance had increased by 10 percentage points. Moreover, infant mortality had substantially dropped to one third from 1990s levels. At the same time, however, gaps linking newborn and maternal mortality, especially in rural areas, persisted. Having assessed the Secretary-General’s plan for the health of women and children, he expressed hope that it would incorporate the needs of low- and middle-income countries.
In the fight against HIV/AIDS, Peru had developed a strategic plan to improve coverage of antiretroviral treatment, among other things, he said. Middle-income countries should cooperate to maintain momentum in the fight against diseases such as AIDS and malaria. Regarding non-contagious diseases, such as stroke and diabetes, Peru, last year in Geneva, had called for the adoption of “Goals+”, which would include a plan to combat non-contagious diseases. He was pleased with the General Assembly’s adoption of resolution 64/265 (2009), as it was imperative to move towards specific goals in that area. To access medicine, Peru favoured Trade-Related Aspects of Intellectual Property Rights (TRIPs) and the proper use of the Doha Declaration on public health. Efforts also were needed to reach Millennium Development Goal 7 (environmental sustainability). In other areas, Peru had created a national sanitation plan, but it needed international cooperation to improve health information systems.
Panel Discussion on South-South Cooperation and Financing for Development
Chaired by Council Vice-President Morgen Wetland ( Norway) and moderated by Magded Abdelaziz of Egypt, the panel included Ajay Singh, Senior Director, Reddy Laboratories, India; and Heiner Flassbeck, Director of the Division on Globalization and Development Strategies, UNCTAD.
Mr. ABDELAZIZ noted that, while there were emerging signs of economic recovery, the crisis had had profound repercussions on developing countries, and while economic growth rates had improved, they were still far from pre-crisis levels. Much remained to be done in terms of trade liberalization, debt sustainability and fulfilment of official development assistance pledges.
In that context, he said South-South cooperation had gained significance in the last decade, due in part to a shift in economic power in favour of developing countries. Their increasing influence in the world economy had been seen in trade negotiations and climate change. Also in the last decade, the share of South-South exports to total exports had increased by 7 per cent in Africa and risen elsewhere. Against that backdrop, there was a need to address financing for development from a holistic approach. South-South cooperation was not a substitute but a complement to North-South cooperation.
Launching the discussion, Mr. SINGH said that between the North and South, “everyone has a role to play”. Explaining that his company was a global pharmaceutical company, he said that, while most innovation and drug creation was found in the North, pharmaceutical companies in the South were playing a growing role in increasing access to health care. They were focused on saving costs through new processes and scale that, in turn, drove down overall health-care costs.
Discussing a case study of “G-CSF”, a generic drug given to cancer sufferers to build white blood cell count, he said that, at its launch, the drug was priced 50 per cent lower than neupogen, the non-generic equivalent invented by Roche. After the launch, Roche lowered the price of neupogen to the level of its generic competitor. As a result, the number of units produced “completely exploded”. The market grew by 10 times, post-generic entry. The number of patients increased by 1,000 per cent, which showed the level of unmet need. Prices dropped even further when other companies entered the market.
In a broader context, he discussed the need to expand the discourse beyond HIV/AIDS and malaria, saying that antiretroviral drugs, invented in the North, had contributed immensely to increasing the life expectancy of HIV sufferers. Companies of the South, notably in Africa, also had made a large contribution, he said, citing the $1/day programme of the antiretroviral drug manufacturer — CIPLA. There also had been an epidemiological shift, with cancer and cardiovascular disease widely prevalent in low- and middle-income countries. In those countries, more patients died of cancer than HIV, malaria and tuberculosis together. Finally, South-North cooperation was not well understood. By example, he said that in the United States, pharmaceutical costs accounted for only 10 per cent of total health-care costs. One market-based approach to improving health care access in the South was through partnerships between non-governmental organizations and the private sector.
Next, Mr. FLASSBECK focused on the ways South-South cooperation could be used to offset the impact of the crisis. He called for more investment in the real economy and improving its productivity. There was a need to follow investment paths that focused, not on individual returns, but on social returns. That would require re-regulation of the entire world banking system to separate business investment activities from basic banking services. He was concerned that the financial sector was slipping back into a “business as usual mode” where corporations were handling capital as if they were “gambling in casinos”.
He also cautioned against viewing trade as the panacea for all ills. For developing countries following that path, he emphasized the need for coherence between financial and trading sectors as the way to avoid the types of shocks that had been witnessed during the crisis, for instance, when trade-dependent small economies had run into trouble when their larger trade partners had seen their incomes evaporate in a matter of months.
Turning to technology, he said there was too much focus on foreign investment. Indeed, he was worried that some developing countries seemed to mistrust their home-grown talent and technological expertise and simply waited for Western companies to swoop in and open up a plant. He urged those countries to develop their own ideas and innovation “so it’s not just a game of Monopoly from the North”.
“We are in danger that the industrialized countries might face a second wave of the crisis,” he said, and it was, therefore, important that developing countries prepared to “go their own way”. They must not stand idly by awaiting growth prospects in the North before making moves to secure sustainable development and social-economic growth. Among other suggestions, he said developing countries needed to keep interest rates low so that real domestic-level development was not hampered. Holding down prohibitive interest rates in Africa and elsewhere in the developing world would have immediate positive impacts on agricultural sectors in those regions. Finally, he said regional cooperation was a question of political will to drive change in macroeconomic and other spheres.
When delegations took the floor, many speakers stressed the importance of South-South and triangular cooperation, especially to promote economic integration and trade and investment between and among developing countries. Several delegations emphasized the need to follow such an approach to help developing countries cope with or mitigate the effects of climate change. Other speakers highlighted the difficulties facing developing countries, acting alone, when dealing with issues such as licensing, intellectual property and patent regulations.
A speaker also called for actively promoting technology transfer and exchange of ideas. Brazil’s representative was among those noting that, given the shortcomings in ODA, South-South and triangular cooperation could help developing countries blunt the impact of the economic and financial crisis. “We need a concept that makes room for South-South cooperation on its own merits,” he declared.
Responding to several of the comments and queries, FLASSBECK said UNCTAD was looking for ways to improve its own statistics and to help developing countries improve the way they collected data. “We can only ask countries to improve their national statistics bases because without that […] it’s basically just guess work for us,” he added.
On strengthening capacities in areas where all regional partners were relatively small, he said it was difficult to launch triangular cooperation without an “anchor” country. Indeed, there was no evidence that 6 or even 10 developing countries working together could counter the weight of or compete with the behemoths in the international marketplace. He noted that thus far, even small groups of regional actors sought to tie their cooperation initiatives to those of larger neighbouring countries.
Others taking part in the discussion included Belgium (speaking on behalf of the European Union), Bangladesh, Republic of Korea, Mongolia and India.
* *** *