The Platform for a Framework Convention on Global Health: Realizing the Universal Right to Health June 2014 Overview Why a global health treaty based in the right to health? The Framework Convention on Global Health (FCGH) The Platform for an FCGH The FCGH and the Sustainable Development Goals Get involved: Join the Platform for an FCGH Why a global health treaty based on the right to health? Global and national health inequity • Health inequities • Life expectancy in high-income countries (2012): 79 years Japan: 84 years • Life expectancy in low-income countries (2012): 62 years • Sierra Leone: 46 years • Domestic inequities Life expectancy in the United States (2012): 79 years Life expectancy of Native Americans on the Pine Ridge Reservation in South Dakota: upper 40s Under-5 mortality in India – top wealth quintile: 39/1,000 Under-5 mortality in India – bottom wealth quintile: 117/1,000 Under-5 mortality, global median – top wealth quintile: 50/1,000 Under 5 mortality, global median – bottom wealth quintile: 102/1,000 International law outside the health sector: Undermining the right to health? Intellectual property regime impedes access to medicine Added danger of TRIPS-plus bilateral and regional agreements Investment treaties enable corporations to challenge public health regulations Trade treaties open foreign markets to cheap, unhealthy food displacing local, healthier produce International narcotic regime impedes access to medicines necessary to control pain The voluntary nature of the WHO Global Code of Practice on the International Recruitment of Health Personnel may not prevent recruitment from countries experiencing critical health worker shortages Accountability and claiming the right to health Despite international right to health commitments of all countries, implementation remains poor in many countries Populations, particularly those marginalized, are often unable to participate in policy decisions affecting their health Local health accountability mechanisms are frequently non-existent or poorly functioning Discrimination against women, people with disabilities, sexual minorities, and others, in and out of the health sector, remains common, violating their right to health Accountability and health financing Most higher-income countries do not adhere to global commitment to international development assistance International health financing is often insufficiently aligned with country strategies and systems Few African countries meet their 2001 Abuja Declaration pledge of at least 15% of national budgets being allocated to the health sector Further benefits Establish model for equitable, accountable global governance Respond to growing demands of societies t0 reduce inequality Contribute to economic productivity and growth Build national public health capacities contributing to global health security A Framework Convention on Global Health Overview of the Framework Convention on Global Health Proposed global treaty based on the right to health and aimed at national and global health equity Legally binding As framework convention, the initial treaty would be followed by protocols (separately ratified) with greater detail on certain issues or responding to unaddressed or emerging issues Financing, research and development, health worker migration? Could be adopted by the United Nations or World Health Organization Would set forth a right to health for the 21st century Address right to health in a globalized world requiring international responsibilities Respond to implementation shortcomings Key elements of the FCGH Robust universal health coverage Include universal coverage for public health (such as clean water, adequate sanitation, healthy environments, nutritious food) Could set global standards with national adaption through inclusive process Move towards system where level of coverage does not depend on wealth or other status Truly universal Domestic and international financing framework Align with national health strategies and systems Address social determinants of health Ensure other legal regimes (e.g., trade, investment, intellectual property, migration) respect and promote right to health Ensure other sectors respect and promote right to health (Health in All Policies) Enforceable norms on transparency, participation, and other aspects of accountability to empower people and civil society to assert and secure the right to health and related rights Clarify responsibilities for ensuring transnational corporations respect right to health Strong mechanisms for monitoring compliance, including rigorous monitoring and reporting and innovative incentives and sanctions More FCGH features Right to health impact assessments to determine compliance with right for health in health and non-health sector policies and projects Principles to enhance collaboration between health and other sectors to advance the social determinants of health Health accountability strategies addressing community to global levels Standards on equitable financing and other measures to ensure equal access to health care and public health interventions, including to overcome barriers for disadvantaged populations Non-discrimination, including outside health sector in ways that undermine right to health Requirements on transparency, public participation (including marginalized communities), and effective accountability policies and mechanisms Ensure justiciability of right to health (can use courts to realize right to health) Right to health education for public, media, government, lawyers, judges, health workers and other measures to enable people to claim their right to health Empower WHO for global health leadership More FCGH possibilities Right to health capacity-building funding mechanism to support NGOs, government institutions, and others building public understanding of and advocating for the right to health, and incorporating it into policies and institutions Multi-sector forum with strong civil society participation to help integrate the right to health into various international legal regimes National health equity strategies with action plans for equity for each marginalized community Global Fund for Health for health care and public health interventions New accountability mechanisms such as increased number of regional human rights special rapporteurs focused on equity, participation, and accountability Establish clearer standards for key elements of right to health “maximum of…available resources,” progressive realization, “highest attainable standard of physical and mental health” Make binding key elements (such as participation and emphasis on marginalized populations) in authoritative General Comment 14 of Committee on Economic, Social and Cultural Rights The Platform for a Framework Convention on Global Health Overview of the Platform for an FCGH Global steering committee directs overall strategy and serves the needs of regions and national platforms Present interim steering committee (http://www.globalhealthtreaty.org/about-us/who-we-are/) Developing more democratic structure for future Possibility of future global advisory board National FCGH platforms Regional coordination National FCGH platforms and regional coordination National FCGH platforms Raise awareness about and advocacy for the FCGH at national level Organize contributions to FCGH content at national level Regional coordination Ensure national platform content contributions feed into global content development Coordinate national advocacy possibilities and actions with global advocacy strategy Develop and work with national platforms to execute regional FCGH activities and actions The Framework Convention on Global Health and the Sustainable Development Goals The FCGH and the Sustainable Development Goals Sustainable Development Goals (SDGs) will set health and development agenda 2015-2030 FCGH addresses multiple expected SDGs Health, clean water, adequate sanitation, nutritious food Themes of equity, participation, accountability, human rights FCGH Platform seeking UN SDG declaration expected in September 2015 to include process to launch an FCGH Calling for UN Secretary-General and WHO Director-General to form a multi-stakeholder working group to evaluate the value and benefits of, and propose the key principles, core content, and scope of, the FCGH Need for an FCGH in the context of the SDGs: Governance and accountability Legally binding agreement with treaty compliance and national accountability measures would provide stronger accountability in healthrelated areas than SDGs Capacity building measures for the right to health that empower people to claim the right and governments to implement the right would advance health aspects of the SDGs FCGH would fill in gaps in GGH governance in addition to accountability Intellectual property law and access to medicine and other medical innovations Trade, such as in cheap and unhealthy foods that can displace healthier, local alternatives Health worker migration Research and development Investment treaties and protecting national health regulations Right to health assessments and other measures would protect and promote health outside health sector Need for an FCGH in the context of the SDGs: Equity and financing Equity Ensuring universal health coverage is non-discriminatory with respect to all populations, including frequently excluded (e.g., irregular migrants) Population-specific health equity strategies, participatory requirements, and more to enhance health equity Universal health coverage that does not depend on level of a person’s wealth Ensure equitable approach and special concern for marginalized groups through health and related SDGs Financing Develop binding domestic and international financing framework, ensuring funds to support health-related SDGs Ensure equitable distribution of health financing Taxation, capital flight measures, innovative financing, capacity building to increase resources for health and development Get involved: Join the Platform for a Framework Convention on Global Health Take action www.globalhealthtreaty.org Endorse the FCGH Platform statement http://www.globalhealthtreaty.org/actions/ Offer your views on the FCGH and the platform statement Join or initiate your national FCGH platform Circulate national sign-on letter on SDGs and FCGH For more information: info@globalhealthtreaty.org “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health….” Thank You