Partners in Population and Development
Inter-Ministerial Conference
November 2012, Dhaka, Bangladesh
Overview
 What is the Framework Convention on Global Health
(FCGH)?
 Why an FCGH?
 Benefiting the Global South
 Towards an FCGH
 Legal pathways towards a global health treaty
Background to the FCGH: Persisting
Health Inequities and Challenges
 Health inequities
 Life expectancy in Sub-Saharan Africa (2011): 54 years
 Life expectancy in high-income countries (2008): 80
years
 Continued and emerging global health challenges
 AIDS, TB, hunger, maternal and child deaths, lack of
access to sanitation, etc., persist
 Rapidly growing NCDs, injuries in the South
Background to the FCGH: Global
Response Required and Possible
 Pressures requiring global response
 Growing but insufficient funding
 Health worker migration
 Population growth
 Trade and intellectual property (access to medicines)
 Global industry (e.g., tobacco, “big food”)
 Power of law
 Framework Convention on Tobacco Control
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176 countries party to FCTC
Action: more than 60% of 72 long-term state parties have increased
tobacco taxes and expanded smoke-free public places
Proposed Response: The FCGH
 Proposal for a new global health treaty
 Core elements defined
 Framework convention – global framework and
commitments with protocols on specific issues (e.g.,
R&D, health worker migration)
 UN Secretary-General Ban Ki-moon (2011): “Let the
AIDS response be a beacon of global solidarity for
health as a human right and set the stage for a future
United Nations framework convention on global
health.”
 UNAIDS has strongly endorsed the need for an FCGH
Central FCGH Elements
 Universal health coverage
 Standards for health systems, public health interventions,
underlying determinants of health
 Financing framework covering domestic and global health
financing
 Right to health grounding, including accountability,
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participation, equity
Elevate health in other regimes (e.g., trade, financing,
agriculture)
Alignment with national health strategies and systems
Innovative financing mechanisms
Strong mechanisms of monitoring, evaluation, and
compliance
Health and Equity
 Legal framework for policies and funding to
significantly close health inequities and benefit health
especially of least healthy populations
 Health equity
 Country-specific equity targets and strategies
 Prioritize and support policies and processes to meet
health needs of marginalized populations
 Women’s rights
 Address violence against women (e.g., legal capacitybuilding, norm change)
 Maternal and child mortality audits
Population and Sustainable
Development
 Wealth from health
 Productivity increase from better health
 Improved child health > improved education >
increased wealth
 Sustainable development and population
 Universal health coverage to include comprehensive
reproductive health services
 Reduce child mortality > reduced fertility
Access to Medicines and Health
Workers
 Protect access to medicines
 Require bilateral and multilateral trade agreements to protect
access to medicine
 R&D
 Protocol based on WHO’s Consultative Working Expert
Group
 Targets on public financing for R&D to address health needs
in the South
 Research outcomes as global public goods
 Health worker migration
 Build on WHO Global Code of Practice on the International
Recruitment of Health Personnel
Accountable Health Systems
 Accountability > increased confidence and legitimacy
of state
 Strengthen government efforts to improve population
health
 State and development partners ultimately all
accountable to the public, especially those suffering
most from health inequities
 Mechanisms
 Transparency
 Remedies to health rights violations
 Corrective measures where shortcomings
Country-led Processes
 Establish legal norm and mechanisms to increase
development partner alignment with national health plans
developed through inclusive, participatory processes
 Framework for sufficient, predictable, long-term financing
 Benefiting the people: Strengthen capacities and policies to
ensure community and civil society input in local, national,
and international/development partner policies and to
advance the right to health
 Inclusive and participatory processes for translating FCGH
norms to national targets and policies
Possible Pathways Towards the
FCGH
 UN General Assembly
 Establish committee to explore possibility (and begin
drafting?) an FCGH
 Request member states to submit to Secretariat views on an
FCGH
 World Health Assembly
 Request Director-General initiate process towards an FCGH
 Establish working group to negotiate and draft an FCGH
 UN Human Rights Council
 Human Rights Council Advisory Committee to explore or
negotiate an FCGH
PPD Actions
 Advance the FCGH
 Briefing of PPD member state UN ambassadors
 UN or WHA resolution to support and initiative process
towards an FCGH
 PPD permanent representative to UN and PPD ambassador
send diplomatic correspondence to UN Secretary-General
 Support FCGH principles in post-2015 development goals
 The FCGH and the post-2015 development agenda
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FCGH and Post-2015 Incorporation, available at
http://jalihealth.org/publications.html
Involving Civil Society and
Communities
 Ensure FCGH meets the needs of poorest and most
marginalized populations
 Support Southern civil society and communities in
input into FCGH
 Civil society and communities as crucial allies towards
a transformative FCGH
Joint Action and Learning Initiative on National
and Global Responsibilities for Health (JALI)
 What is JALI?
 A global civil-society led coalition advocating for and
supporting development of an FCGH
 Committed to an ambitious treaty that will truly be
grounded in the right to health
 Initiating broad and inclusive process to develop FCGH
contents
JALI
 Who is JALI?
 Steering Committee and Secretariat members
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Center for Human Rights and Development (Uganda)
Communications for Development Centre (Nigeria)
Centre for Excellence for Universal Health Coverage (Bangladesh)
Medico International (Germany)
O’Neill Institute, Georgetown University Law Center (USA)
Hélène De Beir Foundation (Belgium)
Individual members from Brazil, India, Kenya, Nigeria, Norway,
United Kingdom
 Advisory Panel being formed
 Who supports JALI?
 Rockefeller Foundation
For Further Information…
 JALI developing a “framework of a framework” to give
more detail on the proposed FCGH
 Draft planned for end of 2012
 www.jalihealth.org
 Contacts
 Sameera Hussain (sameera@bracu.ac.bd), School of
Public Health, BRAC University, Bangladesh
 Moses Mulumba (mulumbam@gmail.com), Center for
Human Rights and Development, Uganda
 Eric Friedman (eaf74@law.georgetown.edu),
Georgetown University Law Center, USA