10 October 2019
Seventy-fourth Session, 14th Meeting (AM)

General Assembly Adopts Political Declarations on Realizing Universal Health Coverage, Helping Small Island Developing States Tackle Climate Change

The General Assembly today adopted three resolutions including two containing political declarations on realizing universal health coverage by 2030 and addressing the priorities of small island developing States amid the rising threat of climate change.

By the terms of the text on health coverage, Member States — agreeing to scale up action to ensure healthy lives and promote well-being for all — committed to progressively cover 1 billion more people by 2023 with quality essential health services, as well as safe, affordable vaccines, with a view towards universal coverage by 2030.  Also by that date, Member States committed to stop the rise and reverse catastrophic out-of-pocket health expenditures through measures that ensure financial risk protection and end poverty due to health-related expenses.

Expressing concern about the global shortfall of health workers, primarily in low- and middle-income countries, Member States further committed to take immediate steps to address the demand for 40 million new health worker jobs by 2030, taking into account local and community health needs.  Among other pronouncements in the wide-ranging text, they pledged to strengthen efforts to deal with both communicable and non-communicable diseases, increase services for all persons with disabilities and mobilize resources for health-related Sustainable Development Goals in developing countries, noting that an additional $3.9 trillion by 2030 could prevent 97 million premature deaths, according to the World Health Organization (WHO).

Several delegations including Guatemala, Libya and the United States, said that while they had joined consensus on the text, they wished to disassociate themselves from paragraph 68, which states that the Declaration ensures by 2030 “universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes”.

The representative for Libya said that language runs counter to the religious and social specificities of some countries, while the speaker for the United States said it is deplorable that some countries politicized the text by using language to promote abortion.  “There is no international right to abortion,” she said, adding that rather than pursuing divisive policies that undermine the family unit, the United States supports a positive vision for advancing gender equality.  For its part, Guatemala’s representative emphasized that article 13 of her country’s Constitution guarantees the right to and protection of life from the moment of conception.

Adopting another draft titled “Political declaration of the high-level meeting to review progress made in addressing the priorities of small island developing States through the implementation of the SIDS Accelerated Modalities of Action (SAMOA) Pathway”, Member States renewed their solidarity with such States, reaffirming that they remain a special case for sustainable development.  Member States remained especially concerned about the devastating impacts of climate change on small island nations and noted with concern the scientific findings in the Intergovernmental Panel on Climate Change’s “Global Warming of 1.5 degrees Celsius” special report.

They called for urgent and ambitious global action in line with the Paris Agreement and pledged to remain committed to helping small island developing States further explore innovative financial instruments and mechanisms — such as debt-for-development and debt-for-climate adaptation swaps, and blue or green bonds — while remaining mindful of the need to ease debt burdens with a view to improving their access to finance.

The representative from Belize, speaking on behalf of small island developing States, stressed that it is incumbent upon all States to translate these words into actions, as the window for critical early steps to mitigate the impact of climate change is closing.

Andrei Dapkiunas, Deputy Minister for Foreign Affairs of Belarus, speaking on the item regarding strengthening the United Nations system — which the Assembly also considered today — welcomed the Organization’s reform initiatives.  Expressing concern about the issue of overlap, he stressed that the time has come for the Assembly to excise redundant items.

In other matters, the Assembly adopted without a vote a resolution submitted by its Fifth Committee (Administrative and Budgetary) titled “Scale of assessments for the apportionment of the expenses of the United Nations: requests under Article 19 of the Charter”, and contained in an eponymous report (document A/74/483).  By its terms, the Assembly agreed that the failure of the Comoros, Sao Tome and Principe and Somalia to pay the full minimum amount necessary to avoid the application of Article 19 of the United Nations Charter was due to conditions beyond their control, and thus decided to permit these States to vote in the Assembly until the end of its seventy-fourth session.

Turning to the Fifth Committee report titled “Appointment of members of the Advisory Committee on Administrative and Budgetary Questions” (document A/74/482), the Assembly decided to appoint Donna-Marie Chiurazzi-Maxfield of the United States as a member of the Advisory Committee for a term of office beginning on 14 October 2019 and ending on 31 December 2020.  The Assembly also took note that on 7 October 2019, Andreas Mavroyiannis of Cyprus was elected Chair of the Fifth Committee.

Also speaking today were representatives of Japan, Hungary and Switzerland, as well as European Union and the Holy See.

The General Assembly will meet again at 10 a.m. on Tuesday, 15 October, to consider the outcomes of the World Summit on Sustainable Development and other major conferences.

Strengthening of the United Nations System

ANDREI DAPKIUNAS, Deputy Minister for Foreign Affairs of Belarus, said that reforming the development system should be the impetus for the achievement of the Sustainable Development Goals.  Belarus welcomes United Nations reform initiatives that will help the world overcome crises and prevent international conflict.  There is broad support among States in giving new life to peacekeeping.  However, Belarus has repeatedly raised the issue of redundant and overlapping efforts, he said, stressing that the time has come to revise the General Assembly to excise redundant items.  For example, the Operational segment duplicates the work of the Second Committee (Economic and Financial).  Strengthening the United Nations is impossible without a well-functioning Security Council and related subsidiary bodies.  Some subsidiary bodies are reaching conclusions on sanctions that are based on an arbitrary use of facts.  Reform must not be undertaken for reform’s sake alone.

Action on Draft Resolution: Global Health and Foreign Policy

Turning to its agenda item on global health and foreign policy, the Assembly adopted a resolution titled “Political declaration of the high-level meeting on universal health coverage” (document A/74/L.4) without a vote.

The representative of Guatemala, explaining her country’s position after adoption, said Guatemala’s Constitution underscores the fundamental right to health.  Reiterating Guatemala’s commitment to ensuring the physical, mental and social well-being of its people, she expressed reservations about paragraph 68 and its references to universal access to sexual and reproductive health care.  Under article 13 of the Constitution, the State guarantees the right to and the protection of life from the moment of conception.

The representative of Japan said that the Declaration represents the highest commitment of world leaders to achieve universal health care by 2030, including to cover all people with quality essential health services.  These commitments cut across all health challenges, including both communicable and non-communicable diseases, and go even beyond health to include human rights and financing.  Now it is time for Member States to deliver on commitments.

The representative of Hungary said that the Declaration on health care is welcome and the goal of universal health care is worthy.  However, Hungary laments that this well-intentioned initiative has been overtaken by the Global Compact for Migration, which has not been accepted by one-fifth of States.  Political declarations should respect national sovereignty, as each State has the right to formulate and decide its own national health policy.  Hungary does not agree that everyone is entitled to the same level of health care, as this discriminates against citizens, she said.  Hungary remains dedicated to its human-rights commitments, including on women’s rights and equality.  However, it notes that the issues of sexual and reproductive health and contraception, among others, lack consensual definitions in the European Union and at other international levels.

The representative of Libya said the Declaration includes important objectives and goals.  International cooperation is critical to ensuring solidarity with health-care sectors in poor countries and countries in conflict.  Libya joined consensus on the Declaration in the hope that the other delegations would not include any controversial topics in the text.  Sexual and reproductive health and rights are not clearly defined and run counter to the religious and social specificities of some countries.  While joining in on the consensus, Libya disassociates itself from any language that runs counter to its Constitution.

The representative of the United States stressed the need to engage all sectors to deliver high-quality care to all patients.  The United States is the largest bilateral funder of global health programmes and remains committed to improving its engagement to advance global health.  “We can do more for people by coming together,” she said.  Rather than pursuing divisive policies that promote abortion and undermine the family unit, the United States supports a positive vision for advancing gender equality and the empowerment of women and girls.  It is deplorable that some countries politicized the text by using language to promote abortion and diminish the role of the family.  She firmly disassociated her delegation from paragraph 68 of the Declaration.  “There is no international right to abortion,” she stressed.  Expressing solidarity with Hungary on the issue of migration, she emphasized that not all migrants can be considered vulnerable.

The representative of the European Union, in a statement after adoption, said that his delegation is committed to the Sustainable Development Goals and the right of everyone to obtain high-quality mental and physical health care.  The European Union follows a rights-based approach to health care, which includes support for all individuals’ sexual and reproductive health.  He reaffirmed the European Union’s commitment to securing the right of each person to decide his or her sexual and reproductive health care, including sex education, free from discrimination and violence.

The representative of the Russian Federation supported the text and is pleased that the Declaration notes the value of combating the spread of infectious diseases, such as tuberculosis and HIV/AIDS, and non-communicable diseases.

The Permanent Observer for the Holy See called for greater attention to the health-care needs of the poorest and those at risk of being left behind.  He commended the emphasis placed on policies to respond to the food and nutrition needs of all people.  Nutrition in the first 1,000 days provides the foundation for lifelong health for both mothers and their children.  As such, investing in cost-effective nutrition interventions can lead to lower child and maternal mortality and healthier mothers and babies.  He welcomed the recognition of the engagement of families and communities as one of the core components of health-system governance.  The phrase “reproductive health” and related terms apply to a holistic concept of health, which embraces the entire person — mind, body and personality.  The Holy See rejects the interpretation that all aspects of abortion — including sex selection, aborting fetuses diagnosed with health challenges, maternal surrogacy and sterilization — are dimensions of reproductive health and universal health coverage.

The representative of Switzerland welcomed the international community’s efforts to meet the health needs of individuals without difficulties.  Health services should be high quality and part of a system that puts patients first.  Universal health care must be made financially viable in the long term, he said.  Switzerland supports the emphasis on reproductive health care.

Follow-up to and Implementation of SAMOA Pathway/Mauritius Strategy

The Assembly then adopted without a vote a draft resolution titled “Political declaration of the high-level meeting to review progress made in addressing the priorities of small island developing States through the implementation of the SIDS Accelerated Modalities of Action (SAMOA) Pathway” (document A/74/L.3).

The representative of Guatemala supported the efforts to combat climate change.  Family remittances can transform communities.  Guatemala supports debt-relief plans that consider the unique needs of Caribbean nations and expresses its solidarity with and support for small island developing States, which are among the primary victims of climate change.  Guatemala is not an island State, but like Caribbean countries is located in an area at high risk for the detrimental effects of climate change.  The United Nations must have a holistic approach for sustainable development that includes appropriate categories of countries beyond just their per capita income, she said.

The representative from the United States said her country understands the unique circumstances facing small island developing States.  The country gave $34 million in immediate relief to the Bahamas in the wake of Hurricane Dorian.  It also is providing $3.2 billion in bilateral assistance to small island developing States, she said.  The United States recently announced more than $100 million in assistance to the Pacific Islands, in addition to the $350 million it currently provides.

She also said that the Declaration is non-binding and does not create rights or obligations under international law.  Paragraph 18 must be implemented consistent with the rights of States under international law.  Paragraph 58 of the 2030 Agenda for Sustainable Development must respect the independent mandates of other processes, including negotiations.  The United States also reaffirms its intention to withdraw from the Paris Agreement on Climate Change at the earliest opportunity.  Regarding Paragraphs 22 and 30 of the Declaration, she stressed the importance of banks acting against money-laundering and the financing of terrorism.

The representative of the European Union said his delegation joined the consensus on the adoption of the Declaration.  However, it would have preferred stronger language concerning abortion, gender equality, climate change and the environmental determinants of health, he said, noting the growing number of disasters afflicting small islands because of climate change.

The representative from Belize, speaking on behalf of small island developing States, welcomed the Declaration’s more targeted approach.  It is incumbent upon all States to translate these words into actions.  The first step in this process is for the Secretary-General to transmit this document beyond the United Nations so that urgent and effective follow-up can begin.  The window for small island developing States to take critical early steps to mitigate the adverse impacts of climate change is closing, she said.

For information media. Not an official record.