Policy Updates

From September 18-19, 2023, during the high-level week of the 78^th UN General Assembly in New York, the Norwegian delegation emphasized global health and disease control as a development priority and underlined the importance of cooperation to secure better health for all.

One of the main global health messages from Norway was emphasizing UHC as a cornerstone of robust health systems. Norwegian Minister of Health Ingvild Kjerkol stated the need to accelerate work on UHC to achieve SDG #3 during the meeting. Norwegian Minister of International Development Anne Beathe Tvinnereim emphasized the need to harmonize health investments following the COVID-19 pandemic. She noted that robust UHC forms the foundation of good PPR.

Combating non-communicable diseases was also a health priority for Norway during the General Assembly. Kjerkol noted at a meeting led by the WHO that non-communicable diseases account for a predominantly large share of the global disease burden, disproportionately affect the most vulnerable, and are worsened by climate change.

Tvinnereim also participated at ICPD30, where several countries expressed a concern about SRHR being under increasing pressure. Tvinnereim underlined a need for broad consultations ahead of the ICPD's 30^th anniversary to build a vision for the future of the ICPD beyond 2024.

During the high-level meeting on tuberculosis, Kjerkol emphasized that solid and accessible health systems are necessary for access to basic services and the fight against tuberculosis.

On September 22, 2023, Canadian Prime Minister Justin Trudeau announced CAD692 million (US$510 million) in new military, economic, peace and security, and development assistance investments for Ukraine.

The announcement was made during a visit to Canada by Ukrainian President Volodymyr Zelenskyy. Trudeau reaffirmed Canada’s ongoing solidarity and unwavering support for Ukraine as it defends itself against Russia’s war of aggression.

The funding from Canada included:

• CAD650 million (US$479 million) in military assistance to supply Ukraine with 50 armored vehicles;
• CAD8 million (US$6 million) in peace and security assistance to strengthen nuclear security measures, enhance resilience against cyberattacks, and promote recovery and stabilization initiatives; and
• CAD34 million (US$25 million) in development assistance for four multi-year initiatives supporting mental health, agriculture, infrastructure, and technical assistance for an inclusive recovery process.

Trudeau and Zelenskyy also signed a modernized Canada-Ukraine Free Trade Agreement, which supports long-term security, stability, and economic development in Ukraine while ensuring high-quality market access terms for Canadian businesses participating in Ukraine’s economic recovery.

The commitment brought Canada’s total to more than CAD9.5 billion (US$7 billion) in assistance to Ukraine since the beginning of 2022.

On September 22, 2023, Dutch Minister for Foreign Trade and Development Cooperation Liesje Schreinemacher reaffirmed the Netherlands’ commitment to ensuring UHC at the high-level meeting on UHC at the 78^th UN General Assembly.

Schreinemacher stated that UHC is key to ensuring accessible health services to all, including providing safe abortion and preventing of unwanted pregnancies, and that achieving UHC requires strong health systems and flexible financing. This commitment to strengthening primary healthcare systems aligns with the Netherlands’ Global Health Strategy 2023-2030, originally published in October 2022.

A key outcome of the event was the approval of a new Political Declaration on UHC. The WHO noted that the declaration acted as a catalyst for world leaders to take bold action to mobilize the necessary political commitments and financial investments to achieve SDG #3 by 2030. The declaration, once adopted by the General Assembly, will be regularly monitored and discussed at the next UN High-Level Meeting in 2027.

The WHO estimated that an additional US$200-328 billion in financing is needed to scale up primary health care in low-and middle-income countries to fulfill SDG #3. SDG #3 aims to deliver 90% of essential health services, save 60 million lives, and increase average life expectancy by 3.7 years by 2030.

Healthcare NGOs responded with a joint statement highlighting the contrasts between the 2023 declaration and a healthcare declaration from 2019. They commended the new text’s increased focus on person-centered care, coordination of healthcare processes, HIV/AIDS, and community emphasis. However, the NGOs expressed concern that the declaration failed to explicitly mention criminalized and marginalized communities, did not strengthen essential aspects of healthcare delivery and equity, and lacked funding commitments for multilateral organizations and community-led responses.

On September 22, 2023, USAID announced that it will provide an additional US$23 million to USAID's Global Accelerator to End TB Plus funding package, where USAID has planned to spend a total of US$394 million in FY2023.

The funding will help reach the global targets that were agreed upon during the 78^th UN General Assembly. The effort is slated to focus on a number of countries, including conflict settings such as Ukraine, Afghanistan, and Myanmar. It intends to deliver on new prevention and treatments efforts, reduce drug prices, and invest in innovations.

USAID also pledged to commit 60% of TB funding to go directly to local partners by 2027.

On September 21, 2023, Canadian Prime Minister Justin Trudeau concluded his participation in the 78^th UN General Assembly and announced CAD427 million (US$314 million) to support the SDG 2030 Agenda.

The funding from Canada included:

• CAD125 million (US$92 million) to support projects in line that advance quality education, health care, and gender equality, including SRHR;
• CAD78 million (US$57 million) to UN programs including UNICEF, UN Women, UNFPA, and UNDP;
• CAD169 million (US$125 million) to promote global climate adaptation and leadership, with a focus on women and girls;
• CAD7 million (US$5 million) to combat illegal, unregulated, and unreported fishing and support ocean governance and protection; and
• CAD48 million (US$35 million) to promote stability and sustainable development in Haiti, with a focus on child nutrition and enhancing the justice system.

During the High-Level Dialogue on Financing for Development, Trudeau announced Canada’s intent to allocate an additional 700 million in SDRs, representing approximately CAD1.3 billion (US$958 million), to the IMF's Poverty Reduction and Growth Trust. The trust will provide concessional loans to LICs.

On September 21, 2023, Japanese Prime Minister Fumio Kishida and other global leaders convened at the UN General Assembly High-Level Meeting on UHC to reaffirm their commitment to UHC, where Japan outlined the results of the G7 Hiroshima Summit and emphasized the urgent need for global cooperative action.

During the G7 Hiroshima Summit, leaders pledged their commitment to bolstering UHC by enhancing healthcare systems to make them more resilient, equitable, and sustainable. Specific measures included the proposal for a Pandemic Treaty to improve preparedness and response to future health crises.

The G7 nations demonstrated their dedication to UHC by committing over US$480 billion, with Japan's contribution totaling US$7.5 billion. The G7 approved the Global Health Impact Investment Initiative to encourage private investment in healthcare.

To address challenges exposed by the pandemic, leaders announced the G7 Hiroshima Vision for Equitable Access to MCMs, with a focus on ensuring fair access to critical medical countermeasures during infectious disease crises. Initiatives including the MCDP were launched to coordinate efforts among relevant countries and organizations.

These collective efforts were consolidated under the G7 UHC Global Plan, demonstrating Japan’s and other global leaders’ commitment to working together to achieve UHC worldwide. Japan noted a goal of achieving UHC by 2030.

During the 78^th UN General Assembly from September 5 to 19, the US pledged a total of US$558 million in humanitarian assistance to countries around the world.

Secretary of State Anthony Blinken announced US$116 million in humanitarian assistance to Myanmar, Bangladesh, and the surrounding area to help Rohingya refugees fleeing Myanmar. The funding brought total US assistance to the region to US$2.2 billion since the beginning of the Rohingya crisis in 2017.

USAID announced that it will provide an additional US$130 million to assist in the humanitarian crisis in Sudan, providing emergency food assistance, health, WASH, protective services, and other relief. USAID also announced an additional US$247 million of humanitarian assistance to countries across Africa to address protracted humanitarian crises and natural disasters. The assistance will be provided to the Central Sahel region along with Burkina Faso, Cameroon, the Central African Republic, Chad, Djibouti, Mozambique, Niger, Nigeria, Togo, and Zimbabwe.

USAID also announced US$53 million for Angola, Kenya, and Madagascar in humanitarian aid to help respond to drought impacts exacerbated by climate change. The support will include emergency WASH services and other emergency aid, as well as assistance to help build resilience against climate shocks.

Finally, the US began airlifting US$11 million in humanitarian assistance to help those in Libya devastated by the floods from Storm Daniel. The funding is in addition to the initial US$1 million provided by the US directly after the floods. The US will work with the World Food Program, the UN High Commission on Refugees, and other international and local entities to provide medical, food, shelter, psychosocial support, and other assistance to help the thousands of people affected in the flood areas.

On September 20, 2023, Norwegian Minister of International Development Anne Beathe Tvinnereim and Norwegian Minister of Health Ingvild Kjerkol participated at the UN High-Level Meeting on PPR at the 78^th UN General Assembly.

The session was the first high-level meeting on PPR. Tvinnereim underlined the importance of learning from the COVID-19 pandemic to prevent, detect, and respond to new infectious diseases to limit the negative effects of future pandemics.

Kjerkol contributed to a discussion on capacity building and financing for global pandemic preparedness. She conversed with colleagues, including representatives from France and Estonia, about sustainability challenges in the health sector and Norwegian participation in the EU's health union.

Kjerkol also participated in a discussion about promoting the commitment to One Health alongside the WHO, the US, Indonesia and Canada. One Health is an integrated approach to drive the health system transformation required to mitigate the impact of health challenges at the global, regional, and national level.

On September 20, 2023, Japanese Prime Minister Fumio Kishida was awarded the Global Goalkeepers Award 2023 and expressed his deep gratitude to the Bill & Melinda Gates Foundation for their commitment to global health.

The award ceremony marked a significant meeting between the Prime Minister and Gates, emphasizing the importance of the foundation’s mission to ensure every person’s chance for a healthy and productive life. Kishida expressed gratitude for the award and acknowledged that it was a collective achievement, thanking the people of Japan and partners involved in this endeavor.

Kishida underscored the critical need to accelerate efforts to achieve the SDGs, especially in the wake of the COVID-19 pandemic. Discussions at the G7 Hiroshima Summit earlier in the year focused on strengthening global health architecture, achieving resilient, equitable, and sustainable UHC, and promoting health innovation. Japan pledged over US$7.5 billion in public-private financial contributions at the summit, while the G7 collectively committed more than US$48 billion.

Kishida emphasized the role of the private sector, including the Gates Foundation, in addressing global health challenges. He further called for continued collaboration between Japan and the foundation to achieve the SDGs by 2030.

On September 20, 2023, Australia announced it would provide AUD25 million (US$16 million) for the WHO's Health Emergencies Programme and AUD75 million (US$48 million) in voluntary core funding for the WHO until 2028.

Australia laid out plans to work with the WHO and other partners to improve the response to emerging pandemic disease threats, both globally and in the Indo-Pacific region. The funding is slated to assist the WHO to strengthen health systems and improve coordinated responses to outbreaks of disease.

Australian Foreign Minister Penny Wong spoke of the need for a capable and strong WHO, able to respond decisively and quickly to complex health situations.