1. health and fitness

GROUP OF FIFTEEN
The Summit Level Group of Developing Countries
Distribution: General
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G-15 Joint Statement
to the Sixty-Eighth World Health Assembly
Geneva, 18th -26th May 2015
1. I have the honour to deliver this statement on behalf of the Group of Fifteen (G-15), a
Summit Level Group of Developing Countries comprising 17 member states1, aimed for
mutually beneficial cooperation and collaboration for realizing sustainable development
and economic progress.
2. The emergence of the deadly Ebola outbreak in 2014 rang an ‘alarm bell’ for the global
community, on the need to have a comprehensive and resilient preparedness, response
and recovery mechanisms within global health systems, to address existing as well as
emerging crises. The Ebola crisis demonstrated that health emergencies transcend man
made borders and divisions on ‘developing’ and ‘developed’, and highlights the
importance of coordinated global efforts to improve health systems at all levels. In this
context, we hope that the ongoing work on the reform program within the World Health
Organization (WHO) would facilitate in identifying and rectifying the existing
implementation gaps to rapidly respond to any future challenges. As part of this process,
we highlight the need of an effective and efficient coordination between all three levels
of the organization, in order to ensure timely response, which will help in saving many
lives.
3. The Group welcomes the timely discussion in this august assembly, on the theme
“Building Resilient Health Systems”, and wishes to re-iterate its call for a coordinated
and collaborative multistakeholder action, encompassing national, regional as well as
global efforts. This would include sharing of experiences and expertise for capacity
development and technology transfer in risk reduction, response and recovery; reducing
health inequalities; to improve mitigation and management capacities, preparedness and
timely response; ultimately accounting for a resilient health system.
4. While our primary focus should be in building the resilience in national health systems,
efforts towards global preparedness for emergencies and disasters are critical. In this
regard, we note the current discussions on the global health emergency workforce and
the contingency fund, as agreed in the resolution adopted at the Special Session on
Ebola. The Group believes this would facilitate the WHO and the international partners
to better respond to health crises in a more timely manner, and looks forward for a
consensus on the modalities of these processes. The Group is of the view that other
possible outbreak emergence should also be given proper attention, in particular the reemergence of Polio threat. In this regard, the Group believes that the international
community should continue its concerted efforts in addressing Polio, including by
guaranteeing the availability of the affordable Polio vaccines for developing countries.
1 Algeria, Argentina, Brazil, Chile, Egypt, India, Indonesia, Iran, Jamaica, Kenya, Malaysia, Mexico, Nigeria, Senegal, Sri
Lanka, Venezuela and Zimbabwe.
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5. The model for a strong resilient system should be focused on the integrated health needs
of the people at all levels and throughout their life-cycle, young and old, men and women,
rural and urban, national and regional etc. In this approach, we note the importance of
building effective and inclusive domestic health care systems in the first place, to
facilitate the vital initial responses, including through robust dissemination of information
on prevention as well as detection and treatment capabilities. The Group also emphasizes
the importance of enhancing effectiveness of existing national health systems, particularly
by ensuring adequate number of trained health workers, improved infrastructure,
availability of quality, safe and affordable medicines and vaccines, reliable health
information systems, investment in research and development and most importantly,
sound health policies, as a primary responsibility of the States.
6. Fulfilling these key elements of a resilient health system cannot only be fully
accomplished by the national efforts, as rightly noted in the UNGA resolution 69/132
‘Global Health and Foreign Policy’, but requires global engagement, rooted in global
solidarity and shared responsibility. In this regard, the Group underscores the
importance of North-South, South-South and triangular cooperation as non-exclusive and
complementary processes, that are founded on the exchange of best practices, as well as
capacity-building and the transfer of technology on mutually agreed terms, to address the
health inequities.
7. The Group notes with concern that the global health research and development (R&D)
is currently not able to address and fulfill the priority health requirements of developing
countries. This risks the health, wellbeing and development of many in the Global South.
In order to implement the global commitments for an inclusive and equitable health care
system for all, it is essential to overcome the failures of market dynamics in the
production of life-saving medical products for diseases, which are disproportionately
affecting the poor. In this regard, the Group wishes to highlight the importance of having
globally agreed priorities in health related R&Ds, in line with the global health
requirements, particularly for the poor and other vulnerable groups. We call the
international community to consider new and innovative mechanisms to put in place for
Global R&D that incorporate principles enunciated in the Consultative Expert Working
Group (CEWG) report – (i) innovations systems that are based on open sharing of
knowledge; and (ii) de-linkage of the cost of R&D from the price of final product. We
also call the international community to collaborate in building developing countries
capacities in order to carry out their own R&D and meet the specific local health needs of
these countries.
8. Despite the significant advances in research and development of new potentially lifesaving medicines, the Group is deeply concerned on the increasing prices of some of
these products that are critical to public health priorities. These reach markets at
unaffordable levels for the majority in need, depriving access to quality medicines to the
people in the Global South as well as, vulnerable segments within the developed
countries, as recently demonstrated by new medicines for hepatitis C and cancer. In this
context, the Group reiterates the need for urgent international policy space to facilitate
equitable access to affordable, quality, safe and efficacious medicines, including
generics, immunization services, safe vaccines and advanced medical technologies for
combating diseases. In order to make access to medicines more equitable, reduce
inefficiencies and curtail inappropriate and irrational use, medicines must be included and
better integrated into public health systems.
9. The Group underscores that the public health needs of the developing countries will be
best served if full use of the flexibilities available under the WTO TRIPS Agreement,
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including the Doha Declaration on the TRIPS Agreement and Public Health are
respected, made available and implemented. This would ease the cost of national
governments in affording health care including medicines and vaccines, and for better
implementation of the principle of universal health coverage.
10. The Group also expresses concern on the threats posed by increasing resistance to
Antimicrobial drugs including multi-drug resistant Malaria, HIV and Tuberculosis, which
are accelerated by excessive use of antimicrobials in animal feeds, inappropriate human
use, and the lack of new and approved antimicrobial drugs and recalls that the challenge
of combating antimicrobial resistance cannot be addressed by any country, or even region
of the world, alone. There is an urgent need for collective action to ensure responsible use
of antimicrobials in both human and animal husbandry and to reduce the burden of
antimicrobial resistance in the environment. In this context, the Group recognizes that the
countries with limited resources and vulnerable healthcare systems need particular help
and attention from the international Community in strengthening antimicrobial
stewardship and infection prevention and control, as well as in reinforcing cooperation in
research & development investments.
11. The Group also wishes to underscore the importance of strengthening public health
systems as both a health and a development goal, in order to address the health related
priorities in an inclusive, people–centric, transparent and sustainable manner based on the
principles of equity, and social justice, which will build on the progress achieved by
States in realizing the MDGs. In this regard, the Group closely follows the ongoing
negotiation on the post – 2015 development agenda, and believes that health and
development must remain core principles of the agenda, as also underlined by the Open
Working Group on Sustainable Development Goals in their proposals.
12. The Group is also concerned on the emerging and critical challenges of noncommunicable diseases (NCDs), which are closely linked to an array of socio-economic
issues that are being disproportionately felt by developing countries. The Group
underscores the importance of comprehensive multistakeholder strategies to address the
NCD challenges, including policies and strategies to access affordable and equitable
prevention, treatment and care. Regarding neglected tropical diseases, we underscore
the term ‘neglected’ as these diseases disproportionately affect the poor, but have been
long underserved. We therefore encourage the continued prioritization of these diseases in
national as well as global health agendas, in order to prevent any conceivable
catastrophes.
13. Finally the Group wishes to reiterate its firm recognition of WHO’s leading role in
shaping global health policies and in engaging and coordinating global health partners. In
this regard, we appreciate the efforts of the Director General Dr. Margaret Chan in
leading the organization, and also notes the commitments as outlined in the ‘WHO
Statement on the Ebola Response and WHO Reforms’ undertaken by the Director General
and the Staff of the WHO, on the lessons learnt and the path defined for a stronger WHO.
We hope that these commitments will be transpired in to action, enabling the WHO to
emerge more effectively and stronger to be able to fulfill its mandate as the leading global
health authority, for improved health outcomes.
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