At an event at the the United Nations General Assembly last week, the President of the Swiss Confederation, Alain Berset, issued a call to action for achieving universal health coverage in emergencies. This call to action came out of a side event and report at the World Health Assembly in Geneva in May. It was confirmed and supported by Peter Maurer of the International Committee of the Red Cross; the Director-General of the World Health Organization, Dr Tedros; Gavi, The Vaccine Alliance; the Netherlands; Poland; the Central African Republic; Sweden; Italy;and Afghanistan.
Alain Berset, President of the Swiss Confederation
Alain Berset highlighted the devastating effects that attacks on health facilities and health workers have on health systems as a whole. He urged the protection of health through a multisectoral and global approach, to ensure that national health systems are strengthened and supported. Berset highlighted that the international frameworks for the safeguarding of health are already in existence, with the UN Security Council’s resolution 2286, but that efforts need to go further: attacks must be stopped and perpetrators held to account. He outlined a threefold commitment to achieve universal health coverage in emergency settings:
- We, the international community, must aim to strengthen health systems and support the basic functions of public health.
- We must commit to full implementation of international humanitarian law, human rights, implementation of UN resolutions, the 2030 agenda, and recommendations from the ICRC.
- Acknowledge the importance of continuity in health systems and access to services.
Peter Maurer, President of the International Committee of the Red Cross
Peter Maurer of the ICRC urged states to use this platform to protect health workers and facilities, stating “the pathway is not rocket science,” any single attack on health is an attack too many. Maurer outlined seven key areas for action:
- The international community should do more to prevent the collapse of health systems, flexible mechanisms for rapid response are needed.
- We must make the invisible visible, with specific approaches for working with the most vulnerable groups such as the survivors of sexual violence.
- We must stop the blocking of humanitarian access in order to achieve global health care.
- In the context of heightening counter terror laws, we must safeguard health worker’s ability to provide impartial treatment.
- Health in humanitarian settings is an ongoing problem.
- The international community must recognize the importance of protecting mental health and noncommunicable diseases in conflict settings.
- We must urge all parties to protect civilians, limit the use of wide impact explosives and the destruction of health facilities.
Dr. Tedros Adhanom, Director-General of the World Health Organization
Dr. Tedros highlighted that more than 1.6 billion people are currently living in fragile contexts with weak health systems and praised the “powerful statement of political commitment” that led to this call to action. Dr. Tedros was clear that “UHC is not just for countries that enjoy peace and prosperity… strong health systems can mitigate suffering and save lives,” stating that health can be a bridge for peace. Highlighting the work of the WHO in humanitarian settings to alleviate suffering, Dr. Tedros concluded with: “Let me be clear, health workers and health facilities are not a target… it is a violation of international law and an outrage.”
Sigrid Kaag, Minister for Foreign Trade the Netherlands
Sigrid Kaag urged the community to look at this issue from a holistic perspective: seeing it as the nexus between humanitarian work and development and ensuring that, while focusing on speed, continuity and quality also be emphasized. Supporting the WHO surveillance system for documenting attacks on health, Kaag reminded the community that evidence is necessary for the accountability and full implementation of resolutions and recommendations. Kaag also raised concern that sexual and reproductive health rights become forgotten in conflict settings and urged that victims of gender-based violence be supported. The delegation from the Netherlands concluded by urging a focus on mental health and psychological support, insisting that this should not be viewed as a “luxury add on” but as essential to creating effective and holistic support structures.
Dr. Pierre Somse, Minister of Health and Population, the Central African Republic
Pierre Somse represented the Central African Republic and highlighted some of the challenges to achieving universal health coverage in his country, such as the poor nature of the road networks, poor access to health facilities, lack of medicine, corruption, issues of mismanagement, and the lack of accountability. Somse recognized the importance of viewing health not as a cost, but as an investment and praised that health workers’ capacity is built through working with international humanitarian actors.
The Safeguarding Health in Conflict Coalition support these recommendations and eagerly anticipate the establishment of concrete steps towards implementing the 2030 agenda, resolution 2286, and the recommendations of the ICRC.
By Jessica Turner