Tracking the Political Declaration on UHC

What is a political declaration?

The output from the High-Level Meeting on UHC will be a concise Political Declaration. Its aim will be to provide a framework for agreed action, to support the global goal of achieving UHC contained in Sustainable Development Goal (SDG) 3.8. As part the SDGs, also known as Agenda 2030, all countries have committed to work towards achieving UHC by 2030 and the Political Declaration aims to provide a foundation for better global cooperation and consensus in order to make progress.

Why is this important?

The UN High-Level Meeting on the 23rd September 2019 will be the most politically significant meeting on UHC to date. The Political Declaration is being negotiated by UN Member States in New York and this negotiation period has been important in identifying where there is global consensus, as well as sticking points which are likely to shape the implementation of UHC moving forwards.

One important aspect of these negotiations will be reaffirming the primary responsibility of Governments to urgently and significantly scale up efforts to deliver UHC, with a particular focus on ensuring the financial sustainability of investment in resilient and patient-centred health systems.

What does it include?

The majority of the text in the latest draft of the political declaration (Rev.4) has been agreed, with only a few outstanding issues (highlighted in yellow). The introductory text (paras 1 to 23) helps to set out the political context for the document, some key aspects for cancer control are the recognition of:

• The essential links between health, social and economic development and the need to invest in health as a driver for improvements nationally. It also highlights the current shortfalls and inequities in global health spending.
• The need for a clear and sustained focus on the poor, vulnerable and marginalised and recognises the need to build services around women and girls in order to empower them to access services and as health workers.
• It emphasises that UHC should include services from across the cancer control spectrum; from health promotion and disease prevention, to early diagnosis, treatment and palliative care, founded on strong primary health care systems.

The key commitments are contained in para 24 onwards and include some useful language for cancer control including commitments to:

• Strengthen public health surveillance and data systems and improve the disaggregation of data
• Improve routine immunisation, including for non-communicable diseases
• Prioritise health promotion and disease prevention, including addressing malnutrition in all its forms, increasing physical activity and implementing fiscal measures to reduce NCD risk factors
• Improve access to essential medicines, technologies, vaccines and other health products
• Implement measures to improve mental health and well-being
• Address the global shortfall of health workers, including international recruitment practices
• Improve the integration of services, particularly between HIV/AIDs, TB, malaria and NCDs.

At the end of the document Member States have set out two commitments (still to be confirmed) to have established national UHC targets by no later than 2021 and for a follow-up HLM on UHC in 2023 to track progress.

The next step for Member States is to reach consensus on outstanding areas and language. These paragraphs touch on some controversial issues including access to medicines, and in particularly how to reduce the high costs of these medicines and other products. Following on from discussions at the World Health Assembly in May, negotiators have been discussing how to improve the transparency in pricing of medicines and other health products, and the move to use alternative financing mechanisms for research and development to separate the costs of investment from the price and volume of sales.

What happens next?

If Member States can reach consensus, the political declaration will enter into a ‘silence procedure’. This provides Member States with some time to raise any objections to the current text, however if no objections are raised it is taken that everyone is in agreement and the political declaration moves forward for adoption at the HLM on the 23rd September. 

From this point, the Political Declaration should provide a useful tool to support your advocacy nationally and regionally. To support UICC members, the Knowledge, Advocacy and Policy team will develop a short summary document on the political declaration and what it means for the cancer community (see an example for the 2018 political declaration here). We would warmly welcome thoughts from UICC members on the current draft to help shape this.