Joint Action and Learning Initiative for National and Global Responsibilities for Health (JALI)
- Date submitted: 1 Nov 2011
- Stakeholder type: Major Group
- Submission Document: Download
- Additional Document:
Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI): Submission on Rio+20 Outcome Document
The Joint Action and Learning Initiative for National and Global Responsibilities for Health (JALI) is a global network of civil society and academics working towards a post-Millennium Development Goals global health agreement grounded in the human right to health. In particular, we are exploring the potential for a new treaty, a Framework Convention on Global Health. It has the potential to close unconscionable global health inequities and serve as a platform for linking, progressing, and creating greater accountability on a broad spectrum of issues, including climate change and nutrition, vital to protecting and improving the public?s health.
We encourage the Rio+20 Outcome Document to recognize the inextricable connection between health and sustainable development, and to support the development of a rights-based Framework Convention on Global Health, as described below.
Connections between health and sustainable development
The links between human health and sustainable development are manifold, with great synergy between the two. Concerns central to sustainable development, such as climate change and agriculture, have tremendous health implications. An effective response to climate change and food security will save lives and improve health. These responses must themselves take conscious steps to protect health, such as through climate change adaptation strategies. Air and water pollution harm both the environment and human health; indoor and outdoor air pollution contribute to more than 3 million deaths annually. The most authoritative interpretation of the right to health recognizes a healthy environment among the underlying determinants of health.
Another link between health and sustainable environment is through the imperative to preserve biodiversity. The richness of life on this planet ? planets, animals, and micro-organisms, both land and marine life ? is also the source of a large portion of medicines. Destroying habitats and species means destroying potential sources of new medicines. Similarly, biodiversity is the source of genes being used in bioengineering to make crops such as rice and maize more nutritious and resilient, protecting and promoting human health. A loss of biodiversity may degrade the nutritional quality of local diets. Furthermore, ecosystem services are critical to clean air and water and fertile soil, among other contributions to better health.
The connection between health and the environment extends to the importance of universally available quality health services. One of the greatest challenges to sustainable development is population growth. Enabling all people to access quality reproductive health services, while improving children?s health (which also requires improving the health of mothers) so that parents can be confident that their children will survive into adulthood will enable families to have fewer children, thus slowing population growth. Furthermore, ill health ? a major cause of impoverishment directly and through health-related spending, and of reduced economic growth ? is a significant impediment to development and poverty reduction, and to the resilient societies that are best positioned to develop sustainably.
Meanwhile, one of the most important modalities for securing adequate financing for health, a just, equitable tax system, is also a source of income that can fund the many forms of investment required for sustainable development. And in ways such as those described above, improved health services that a just tax system can help secure will also contribute to sustainable development.
In short, one of the fundamental building blocks of sustainable development is human health. And any overarching effort to improve human health must include steps to improve the health of the planet.
A Framework Convention on Global Health
A Framework Convention on Global Health (FCGH) could be just such a comprehensive endeavor to improve human health. It could be the basis of the post-2015, post-MDG global health framework. It would aim to close today?s gross health inequities, both among and within countries; ensure universal coverage; create accountability among governments and other global health actors; create and catalyze more inclusive, participatory local, national, and global health processes; achieve adequate funding, and; improve coordination and collaboration based on inclusive country ownership. The treaty would enable health to take its rightful position of priority in other legal regimes that affect health, such as trade and investment.
The FCGH could institutionalize the norms, structures, and processes ? the global governance ? required to realize the potential of these initiatives and to enable all people to enjoy the right to health. For instance, it could:
? include ambitious yet achievable global targets, with processes to adapt them to local circumstances and ensure national and community ownership;
? require comprehensive public health strategies addressing both health services and social determinants of health;
? move towards clarifying what are the ?key? health services that universal coverage should encompass and all people should enjoy, while still enabling adaptation to local circumstances and priorities;
? develop a financing framework with clear funding benchmarks for governments? domestic health spending and for international health funding commitments, including non-health sectors central to the underlying determinants of health;
? establish targets on and develop mechanisms to dramatically reduce domestic health inequities and ensure the accountability of health services to the communities they serve;
? support civil society and community participation in planning, implementation, and evaluation of local, national, and international partner-supported health plans, policies, and programs;
? establish commitments and monitoring mechanisms to ensure that health plans, policies, and programs emphasize the health needs of traditionally discriminated against and underserved populations, including women, people who are poor, and marginalized groups; and
? offer specific measures that countries should take in trade, environment, finance, and other realms to protect and promote health, including mechanisms to evaluate the adoption and effective implementation of these measures.
States can take immediate steps to achieve an FCGH, such as by:
? lending support to civil society, governmental, and other efforts to develop the targets and indicators, rights and responsibilities, and other aspects of the framework, including innovative incentives and sanctions to promote compliance; and
? supporting consultations on the FCGH, including and especially among disadvantaged populations and communities who stand to be most impacted by the treaty.
States could work with civil society and international institutions such as the World Health Organization and UN Office of the High Commissioner for Human Rights to take steps now to advance the goals of and lay the groundwork for successfully implementing an FCGH, including:
? supporting and sharing information on initiatives to educate communities on health and human rights;
? supporting and sharing information on community accountability mechanisms, such as village health committees and community scorecards; and
? developing indicators and disaggregating data in order to develop and monitor policies to better secure the health needs of marginalized populations.
The UN Secretary-General has endorsed an FCGH, aptly placing it in the context of human rights: ?Let the AIDS response be a beacon of global solidarity for health as a human right and set the stage for a future United Nations framework convention on global health.? By also endorsing and calling for an FCGH through its Outcome Document, Rio+20 has the potential to help ensure that an FCGH will give due weight to climate change, food security, and other health issues most directly linked to sustainable development. And an endorsement will build momentum towards achieving a global health agreement that has the potential to transform the global health landscape and serve as a major step towards securing for everyone the human right to health.
Momentum is growing to holistically address health ? ensuring universal coverage of equitable, quality health systems and of fundamental human needs such as clean water, sanitation, and nutritious food, while prioritizing the determinants of health and the needs of the world?s least healthy and most marginalized people. The Rio Political Declaration on Social Determinants of Health has reaffirmed and deepened a global commitment to an inclusive approach to health. As improving global health will powerfully contribute to sustainable development and closing global inequities, the Rio+20 Outcome Document should also advance a holistic approach to health, including by supporting an FCGH. The time has come for a Framework Convention on Global Health that would extend, elevate, and realize global commitments to human rights, health equity, and health for all.