Keynote address by Regional Director at the Consultation on “Sustainable Development Goals and UHC: States’ perspectives”
11 November 2016, Chandigarh, India
H.E. Chief Minister of Punjab, Shri Prakash Singh Badal ji,
Distinguished participants, ladies and gentlemen,
A very good morning to you, and welcome to this important meeting on the opportunities Punjab has to leverage the SDGs and enhance public health and development across the state.
I think everyone in this room knows by now that the 2030 Agenda for the 17 Sustainable Development Goals – or SDGs – reflects a significant change in thinking about what should be achieved and how to go about it. This applies to development in general, as well as health more specifically. Indeed, the health goal – SDG3 – builds on the significant success of the health-related MDGs. But it is also much broader in scope, calling on us to ‘Ensure healthy lives and promote well-being for all at all ages’.
This breadth reflects the reality of people’s health needs today: Not only do the SDGs implicitly recognize the need to close-out the unfinished MDG agenda, but they also respond to new priorities such as non-communicable diseases, health security, and the health impact of migration and climate change. Achieving these goals is, obviously, of utmost importance to our Region.
In terms of how exactly to realize them, the SDG agenda recognizes that human health and wellbeing depend on the political, economic, social and natural environments within which people live. This more integrated approach marks a departure from the MDGs, and reflects the ambition of the SDG vision.
Though critics have argued that a lack of definition could inhibit progress, such a charge is mistaken. As with all policy initiatives, our ability to turn vision into reality depends on the praxis we use. With regards to the SDGs, our praxis is clear.
There are six universal instruments of change that must be employed.
The first instrument is leveraging intersectoral action by multiple stakeholders. Health must feature prominently in all sectors of policymaking, with the linkages between sectors clearly understood. To give an example from India, around 9% of the population today is over 60, though projections suggest it will rise to 20% by 2050. By linking pensions and employment policy, and breaking down the institutional barriers that too often exist between medical and social care, the heath needs of older persons can be addressed.
The second instrument is health system strengthening with the aim of achieving universal health coverage. The performance of health systems and their ability to provide services to all without risk of financial hardship must be a fundamental priority. By focusing on primary health care we can accelerate the gains made under the MDGs; expand health outcomes related to challenges such as NCDs and mental health; and promote practical ways of implementing other health interventions such as routine immunization.
The third instrument is an emphasis on health equity and human rights. As history demonstrates, the human rights discourse and its associated mechanisms are immensely powerful. The right to the highest attainable standard of health must inform everything that we do, and must intersect with other human rights concerns related to gender and non-discriminatory laws, for example. Leaving no one behind must be the mantra of a new progressive universalism in which the provision of high-quality public health care is non-negotiable.
The fourth instrument is securing adequate and dependable financing. With foreign aid unlikely to increase in coming years, health authorities in low- and middle-income countries must find novel ways to finance their public health initiatives, including by pursuing public-private and sustainable international partnerships. They must also find ways to maximize value. By investing in health system strengthening rather than vertical disease control programs, for example, health authorities can avoid the duplication of functions while advancing the reach and quality of services.
The fifth instrument is encouraging scientific research and innovation. Our narrative of change can only be realized by investing in the development of new technologies, new legal and financial instruments, and new ways of delivering health care services. This could be as simple as digitizing health services to enhance data collection or as ambitious as developing purpose built research facilities.
The final instrument – and one which informs all of the others – is implementing effective monitoring and evaluation systems. Without effective monitoring and evaluation we cannot gauge the effectiveness of interventions and adjust course if necessary. And we also cannot understand who is being left behind and why. Effective monitoring means paying attention to data – both its collection and analysis – and having the courage to revise policy as and where necessary.
Ladies and gentlemen,
It is not foreseen that the health-related SDGs will be achieved overnight. Rather, the process will be one of progressive realization. An important takeaway from this year’s ‘Regional Consultation on Health, the SDGs and role of Universal Health Coverage’ was that no country is starting from zero, and that each must therefore develop its own plan using the instruments I have just outlined.
In this regard, India’s own commitment to UHC and its determination to build on recent successes is most inspiring. Given that much depends on sub-national action, it is also inspiring to see the same commitment being echoed at the state level here today. Indeed, I note with pleasure the steps the state of Punjab has made towards achieving UHC in recent years.
This includes augmenting the health workforce through recruitment of staff nurses, lab technicians and specialist doctors. It includes actions to enhance the range of services offered, from increased numbers of ambulances on the roads to more readily available cancer screening and treatment services. And it also includes improved access to medicines and increased financial protection. I here note Punjab’s efforts to make essential drugs free of cost, including medications for chronic diseases like hypertension and diabetes. As I mentioned earlier, monitoring and evaluation will be crucial to ensuring implementation is moving in the right direction and that the intended groups are benefiting.
In commending Punjab’s efforts to move towards UHC in recent years, and in urging you to build on these achievements, I take this opportunity to reiterate WHO’s full support for your efforts. I also take this opportunity to reiterate the Organization’s ongoing role in facilitating the achievement of our shared agenda.
To this end, WHO is pleased to offer capacity building and technical support. This involves participating in consultations such as the one being held today, as well as helping health authorities fine-tune their policies and interventions, from expanding the health workforce to enhancing data collection.
WHO is energized to rally social and political will in support of the SDG agenda and the achievement of UHC. This includes through convening high-level advocacy and awareness initiatives, as well as engaging with the wider public via traditional and social media.
WHO is similarly looking forward to reporting to countries on a regular basis on global and regional progress. This requires informing countries of progress among their peers and facilitating opportunities to learn from their successes.
And WHO relishes the opportunity to represent public health interests in SDG-related deliberations at regional and international levels. This means connecting the concerns of national and sub-national health authorities to the wider agenda, as well as working to enhance cooperation and efficiency at the macro level.
Ladies and gentlemen,
I appreciate very much your commitment to harnessing the promise and power of UHC to drive health reform in the state of Punjab. Your dedication to leaving no one behind will not only advance the enjoyment of fundamental human rights, but will also drive social and economic development in your state and across India.
I wish you a productive and enlightening consultation, and many further successes in your quest to achieve the SDGs.
Thank you very much.