From now to the future: a world in which children will survive and thrive

COUNTLESS PRIORITIES BUT ONE OBJECTIVE: STRENGHTENING HEALTH SYSTEMS

The agenda of the week was rich, both in terms of official deliberations and events held on the sidelines of the Assembly, thanks in particular to civil society actors.

Member States have made strong commitments to WHO from the onset. They reappointed its Director General, Dr. Tedros Adhanom Ghebreyesus, for a new five-year term and pledged to gradually increase their mandatory contributions to the Organization to strengthen its financial sustainability and independence from donors.

Also at the top of the agenda was the question of preparedness and response to public health emergencies, a very dense subject that resonated beyond the Palais des Nations. One thing was stressed over and over again: strengthening health systems should be at the heart of all these discussions. Resilient systems are key for delivering essential health services for women and children – especially in times of emergencies. This was part and parcel of a side-event organized by Save the Children that brought together representatives from WHO, the Global Financing Facility, the Ministry of Health of Ethiopia, Amref Health Africa, USAID, Members of Parliament and many others.

Gwen Hines, Save the Children UK CEO, reminded us that “the reality is that children and women are among the ones suffering the most in fragile States and emergencies". Along with the other speakers, she stressed the need to focus interventions at community level, empowering communities and investing in a sustainable way in the health workforce, particularly in community health workers.

Beyond the COVID-19 pandemic, which is still well underway, mothers and children continue to live in emergency situations due to conflicts, droughts or epidemics. Our health systems must cope with multiple shocks and be resilient enough to continue delivering care while responding to emergencies.

UNFINISHED AGENDAS AND THE NEED TO STEP UP THE HEALTH WORKFORCE

During the pandemic, countries reported disruptions to a wide range of services, in particular on sexual and reproductive health, immunization and nutrition, but also HIV and hepatitis. Many of these major health issues were debated last week but sometimes with deeply concerning results. The long negotiations and final vote that resulted in the deletion of sexual health and rights terminology from the Global Health Sector Strategies on HIV, Viral Hepatitis and Sexually Transmitted Infections 2022-3030 goes against the evidence and poses the risk of leaving behind key populations.

While it did not come out strongly during the Assembly, access to immunization for all children must remain a top priority. The resurgence of measles and polio cases on the African continent shows how unfinished this agenda remains for so many countries, leaving millions of children vulnerable to diseases we can and must prevent. Another example is pneumonia, the largest infectious killer of children under five, for which a life-saving and effective vaccine exist but that countries still struggle to introduce or implement at scale. This was emphasised at a side event Save the Children co-hosted with partners on highlighting the lifesaving power of vaccines such as PCV for children in Africa. The moderator, Gitinji Gitahi from Amref raised “The bad news is we still have countries in Africa struggling with [PCV] introduction – Somalia, South Sudan, Chad, and Guinea. If we introduce PCV they could prevent deaths of about 92,000 children by 2030 in those four countries alone.”

Central to the delivery of health services is the health workforce. The shortage of health workers has been identified as a major cause of the disruption of essential health services. It is therefore essential to put in place programmes and policies to protect, remunerate, train and integrate the health workforce, including community health workers, into the health system. To that effect, the Assembly adopted a resolution calling on member states to implement a new Working for Health action plan for 2022–2030.

BACK TO ALMA ATA

More broadly, child survival is a priority that needs renewed commitment. Save the Children and its partners addressed this issue during a roundtable discussion on the margins of the Assembly. Health ministers from 7 countries raised the importance of a multi-sectoral approach to reach the communities most affected by inequality and discrimination, the ones we call "zero-dose". The COVID-19 pandemic, conflict and climate change pose a real challenge and invite us to rethink or rather return to the basic precept that health is a fundamental human right, the realization of which requires the participation of all actors in society.

Throughout the week, we heard our advocacy repeatedly echoed -  to build  robust primary healthcare systems at community level, equipped to deliver basic yet effective interventions to children and their families. By promoting primary health care, we can develop integrated approaches that will optimize costs and provide more services despite limited resources.

There is still a long way to go to reach Universal Health Coverage and achieve the Sustainable Development Goals, but we come out of this week of hard work with the certainty that we remain committed to a better world where children can thrive.