NEXT week, the UN is convening three high-level meetings on universal health coverage (UHC), tuberculosis (TB) and pandemic prevention, preparedness and response (PPPR) at its 78th General Assembly session.

These meetings are set to review the progress made on these intersecting global hea­lth challenges as they are tied to the Sustain­able Development Goals (SDGs) and the cha­nged global pandemic architecture. They give heads of states and governments a chance to revisit the post-Covid global health landscape and recommit themselves to sustained action on the commitments en­­shrined in the political declarations on TB and UHC made in 2018 and 2019 respectively.

The 2019 declarations on UHC-SDG 3.8 set a target of reaching an additional one billion people by 2023 and reversing trends in medical impoverishment caused by out-of-pocket expenses. Yet the latest UHC commitment review’s key findings suggest that progress on UHC has stalled and in some cases reversed. This state of play on the follow-up underscores the need for expedited action on delivering on political commitments on TB-SDG 3.3 — which are way off track. Covid has blown these goals off track.

The theme of the 2023 high-level meeting on TB is “advancing science, finance and innovation, and their benefits, to urgently end the global tuberculosis epidemic, in particular, by ensuring equitable access to prevention, testing, treatment and care”. At the 2023 meeting, progress on the targets set and achieved so far will be reviewed and a future action plan framed.

Next week’s UN meetings are a chance to revisit health targets.

In the run-up to the 2023 high-level meeting, civil society groups voiced their expectations of the meeting in May in New York. The key policy asks which emerged out of the civil society consultation focused on reinforcing commitment to reaching all people affected by TB, accelerating research and development in new TB vaccine, drugs and diagnostic services, enhancing funding for TB programmes and prioritising TB across UHC, primary healthcare, pandemic prevention, preparedness and response and anti-microbial resistance.

The first UN high-level meeting on pandemic prevention, preparedness, and response has assumed special urgency against the backdrop of the devastating impact of Covid-19 on health systems, SDGs, and pre-existing health inequalities. PPPR is especially important in relation to serious threats which future pandemics pose to the realisation of the SDGs, UHC and TB as demonstrated by the Covid pandemic. The Pandemic Action Network of civil society groups has called on heads of states for vigorous international action on pandemic preparedness in health and beyond health sectors in whole-of-system approach, as well as increasing ownership and accountability of pandemic preparedness and response plans, while ensuring the widest possible participation of civil society and others in these efforts.

However, the draft of the political declaration has been described by health press and advocates as long on words and short on commitments and lacking in ambition. Specific actions have been kicked down the line to 2026 when the UN will convene another high-level meeting to further deliberate on the state of pandemic preparedness. Three years is too long a period when it comes to pandemics, particularly when existing pandemic preparedness and response mechanisms have been found wanting in the Covid response.

More importantly, the publicly released draft of the political declaration does not include any specific financing targets for global and domestic health spending on pandemic preparedness and respo­nse. An even earl­ier proposal re­­­la­­ted to the establishment of an independent monitoring body to assess member-state co­­m­­pliance with the pandemic treaty and spending commitment has been done away with in the draft declaration.

UHC, the elimination of TB and new pandemic preparedness and response mechanisms are key to achieving the SDG goals, intersecting and interlinked with nature as they are. Therefore, the convening of three high-level meetings on these global health issues is a rare opportunity for world leaders and member states to tackle global health challenges in a synchronised and integrated way. Pakistan’s caretaker government should show leadership and commitment to the broader idea of ensuring that no one is left behind in UHC drives and in accessing new TB vaccine and drugs and that the future pandemic response is robust, equitable and well financed.

All this will require careful preparation, nimble-footed health diplomacy and political will at these important high-level meetings in September. Like other member states, Pakistan too should step up.

The writer, a public health and development consultant, is the author of Patient Pakistan: Reforming and Fixing Healthcare for All in the 21st Century.
drarifazad@gmail.com
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Published in Dawn, September 14th, 2023