World leaders on Thursday agreed to boost efforts to provide universal health coverage for all by 2030. By approving a new political declaration at UN Headquarters during the high level meeting, Member States also pledged to take concrete action and provide the necessary funding to reach the ambitious goal. The declaration – Universal Health Coverage: expanding our ambition for health and well-being in a post-COVID world – also saw governments promise to invest political capital in the push to expand universal care.  A political choice Ultimately, achieving health coverage for all is a political choice, said Tedros Adhanom Ghebreyesus, Director-General of the UN World Health Organization (WHO). “But the choice is not just made on paper. It is made in budget decisions and policy decisions. Most of all, it is made by investing in primary healthcare, which is the most inclusive, equitable, and efficient path to universal health coverage,” he emphasized. The declaration was adopted during the second of the three health summits taking place during this year’s General Assembly High Level Week. The summit on pandemic preparedness took place on Wednesday and there will be another on ending the scourge of tuberculosis scheduled for Friday. Staggering statistics The urgency of the declaration is evident in the staggering statistics. At least 4.5 billion people – more than half the world’s population – are not fully covered by essential health services, according to 2021 data. Access to basis healthcare caused financial hardship for nearly two billion people, while over 1.3 billion were pushed back or pushed deeper into poverty just trying to access basic services and medicines – a stark reality of widening health inequities, according to WHO. A fundamental right Speaking on behalf of UN chief António Guterres, Deputy Secretary-General Amina Mohammed emphasized that universal health coverage will correct a “human rights tragedy on a massive scale”, with billions currently unable to access essential health services. She called on countries to ensure universal access to sexual and reproductive health services for girls and women, while focusing on the most vulnerable populations, including children, refugees, migrants, and those living through humanitarian crises. “[Countries] must invest in a well-trained, well-paid health workforce capable of delivering safe, effective quality care to all who need it,” she said. The deputy UN chief highlighted the need to increase the presence and voices of women – who already make up the majority of health workers – in decisions that concern health. Extra support Ms. Mohammed also urged massive scale-up in investments, stressing additional support is crucial for developing countries. “I call on countries to generously support the SDG Stimulus to increase financing for sustainable development to reach at least $500 billion per year, including investments in health systems,” she said. She also argued for effective debt-relief mechanisms and multilateral development bank reform.

The President of the UN General Assembly told foreign ministers gathered in New York on Thursday that forecasts predicting the death of effective diplomacy are premature.  “Your strong engagement during our deliberations today reaffirms that multilateralism is neither dead nor obsolete,” said Dennis Francis in his opening remarks to a preparatory meeting for next year’s Summit of the Future. Scheduled for September 2024, it is billed as a once-in-a-generation opportunity to reinvigorate multilateralism, address gaps in global governance, and reaffirm existing commitments, including to the Sustainable Development Goals (SDGs) and the UN Charter.  Recent global shocks – including the COVID-19 pandemic, the war in Ukraine, and the climate emergency – have tested international institutions, underlining the critical need for unity around shared principles and common goals. ‘A unique opportunity’  “The Summit of the Future is a unique opportunity to help rebuild trust and bring outdated multilateral institutions and frameworks into line with today’s world, based on equity and solidarity,” said UN Secretary-General António Guterres.   “But it is more than an opportunity,” he added. “It is an essential means of reducing risks and creating a safer and more peaceful world.”  The Summit has its origins in Our Common Agenda, the Secretary-General’s 2021 report outlining his vision for the future of international cooperation “through an inclusive, networked, and effective multilateralism.”   The report aims to “turbocharge” the push towards the 17 SDGs – the global promise to deliver a more just, equitable and greener future for all people and the planet by 2030.  Although progress has been derailed by the pandemic and other crises, a “rescue plan” agreed this week aims to get them back on track. Pact for the Future  At the Summit, countries are expected to adopt a Pact for the Future that covers five areas: sustainable development and related financing; international peace and security; science, technology, innovation and digital cooperation; youth and future generations; and transforming global governance.  Mr. Guterres commended their pledge to advance human rights, the empowerment of women and girls, and acceleration towards achieving the SDGs.  To support the negotiations, he has published 11 policy briefs that build on proposals contained in Our Common Agenda.  “The Pact for the Future will be your contract with each other and with your people,” he said.  “It represents your pledge to use all the tools at your disposal at the global level to solve problems – before those problems overwhelm us.”   ‘Start talking to us’: Youth advocate Varaidzo Kathivu, a girls’ education activist and youth advocate from Zimbabwe, welcomed the Pact’s focus on future generations.  Over half of the world's population is under 30, representing the largest generation of young people in history. They need a real seat at the table when it comes to decision-making she declared, sitting next to the UN chief.  “Please stop talking about us and start talking to us. And not only talking to us but working with us,” she said.  “We want to be recognized as true and equal partners who have a stake in this just as much as you. We want to help get these Sustainable Development Goals back on track. And we are more than talented, willing and capable.” 

Applause rang out in one of the main conference rooms at UN headquarters on Friday as world leaders, civil society representatives and other stakeholders approved a declaration to advance efforts to end tuberculosis (TB) by 2030.  The document lays out ambitious new targets for the next five years that include reaching 90 per cent of people with TB prevention and care services, providing social benefit packages to those who have the disease, and licensing at least one new vaccine. TB is the second leading infectious killer worldwide after COVID-19, with some 1.6 million deaths in 2021 alone, according to the World Health Organization (WHO). The only available vaccine  is more than a century old. Defeating a killer “Why, after all the progress we have made – from sending man to the moon, to bringing the world to our fingertips – have we been unable to defeat a preventable and curable disease that kills over 4,400 people a day?” said the President of the UN General Assembly, Dennis Francis. TB has afflicted humanity for millennia, going by several names including the white plague and consumption.   It is caused by bacteria and mainly affects the lungs, and treatment is with antibiotics.  A WHO council established to facilitate the development and equitable use of new vaccines met for the first time this week. A personal commitment Stamping out the TB epidemic is among the health targets of the Sustainable Development Goals (SDGs), the roadmap for a more just and green global future by the end of the decade. Five years ago, countries set the target of delivering TB treatment to 40 million people, reaching 34 million. They also aimed to provide 30 million with preventive treatment but fell short by half. UN Deputy Secretary-General Amina Mohammed called for action to tackle the main drivers of TB - poverty, undernutrition, lack of access to healthcare, the prevalence of HIV infections, diabetes, mental health, and smoking. Stigma surrounding the disease also needs to be reduced so that people can get help without fear of discrimination, she added, while governments must ensure universal health coverage that includes TB screening, prevention and treatment.   Ms. Mohammed also shared her own reason for supporting the global fight. "My commitment is my personal story: losing my father to TB at 50, 37 years ago this week,” she said.  “Today we have the tools to diagnose, treat, and what we need right now is a vaccine. Let's end TB now. It is possible. Stigma fuels death Mongolian author Handaa Rea, who has survived the disease, urged world leaders to “treat TB not only medically but also socially.” She has written about her own experience of TB-related stigma, discrimination that she said is prevalent in many developing countries, resulting in “hundreds of thousands of people” delaying seeking treatment. The consequences of stigma are “more enhanced” for women and girls who are held to higher standards of health, well-being and beauty, she added. “When society says things like ‘she's too skinny, because she has TB, she's unworthy of marriage because she has or had TB, or she continues to have TB because she's irresponsible,’ we as a society are bullying TB patients one step closer to death - a death that is fully preventable. And this has to stop,” she said. The ‘final chapter’ WHO chief Tedros Adhanom Ghebreyesus commended the “amazing” energy in the room, where participants frequently chanted “End TB, yes we can!” He welcomed the political declaration, which was agreed by consensus ahead of the meeting.  It will be presented to the General Assembly, the UN’s most representative organ, comprising all 193 Member States. “For millennia, our ancestors have suffered and died with tuberculosis, without knowing what it was, what caused it, or how to stop it,” he said. “Today, we have knowledge and tools they could only have dreamed of.  We have political commitment.  And we have an opportunity that no generation in the history of humanity has had: the opportunity to write the final chapter in the story of TB.” 

“Horrendous heat is having horrendous effects”, the UN chief declared on Wednesday, as a broad global coalition of “movers and doers” politicians, business and civil society gathered in New York for the first ever Climate Ambition Summit. Front and centre was an urgent call to action, to prevent cascading climate disasters through a just and equitable energy transition – before it’s too late. In his impassioned address on the sidelines of the UN General Assembly to politicians, business, activists and civil society leaders, Secretary-General António Guterres issued a stark warning about the dire consequences of inaction. With extreme weather events accelerating, “humanity has opened the gates to hell,” said the Secretary-General, describing distressing scenes of farmers helplessly watching crops washed away by floods, the emergence of virulent disease due to rising temperatures, and the mass exodus of people fleeing historic wildfires. Race for solutions “Our focus here is on climate solutions – and our task is urgent”, he said. He warned that climate action was being “dwarfed by the scale of the challenge”, with humanity heading towards a 2.8°C temperature rise, increasing danger and instability. But “the future is not fixed” he added and the Paris Agreement target of limiting temperature rise as close as possible to 1.5°C is still attainable. “We can still build a world of clear air, green jobs, and affordable clean power for all,” he said, addressing the high-level gathering of “first movers and doers”. Driving force for change Activists are refusing to be silenced, Indigenous Peoples are rallying to defend their ancestral land, and corporate executives are transforming how they do business. The UN chief is calling for a Climate Solidarity Pact that will hold major emitters more to account, and calling on wealthy countries to support emerging economies so they can weather the crisis. The Acceleration Agenda calls on governments “to hit fast forward”, he added. Anger rising The Secretary-General spoke of the need for more climate justice, recognizing the anger felt by many of the world's poorest nations disproportionately affected by a crisis they did not cause. “Many of the poorest nations have every right to be angry,” he added, explaining that promised finance had not materialized while the costs of borrowing remain sky-high. “All parties must operationalize the Loss and Damage Fund at COP28,” he urged and reminded the developed countries must meet the $100 billion commitment, replenish the Green Climate Fund, and double adaptation funding. Creating early warning systems for everyone by 2027 is a must, too. Rebuilding trust The Acceleration Agenda also calls for businesses and financial institutions to embark on true net zero pathways, with a focus on transparency and credibility in emission reduction plans. “Every company that truly means business, must create just transition plans that credibly cut emissions and deliver climate justice,” the Secretary-General said. He called for action beyond the meeting rooms of New York. “We can – and we must turn up the tempo,” he concluded, to loud applause around the room. Responding to the call, Kenyan President William Ruto, which recently hosted the Africa Climate Summit, spoke about the continent’s huge potential. With about 30 per cent of the world’s mineral resources and vast biodiversity, it is capable of “green global manufacturing” at scale, given the necessary financial support. “Unlike other regions, Africa does not have to choose between satisfying new demand and decarbonizing existing capacities, because our existing capacity is very low,” he explained, adding that the continent can “leapfrog into fully green industrial paradigm”. Climate justice Financing and environmental justice were themes running throughout the discussions. Lidy Nacpil is Coordinator of the Asian Peoples' Movement on Debt and Development, an NGO advocating for the transition to renewable energy. New agreements are needed to make the shift “without loopholes or excuses”, she said. An international treaty on the non-proliferation of fossil fuels and a global phase-out plan are needed to reach “real zero” by 2050. “We, the people of the Global South are not asking for aid or assistance. Climate finance is an obligation and a part of reparations for historical and continuing harms and injustices,” she asserted the right “not just to survive, but to build a better home and future for our children.” No buy out Developed countries at the Summit said they were prepared to contribute their fair share. President of Austria Alexander Van der Bellen, for example, announced an additional €220 million for tackling climate change between 2023 to 2026. “€50 million will be used to support programmes and projects related to loss and damage,” he assured. The country will also increase its contribution to the Green Climate Fund by a quarter, for a total of €160 million. However, the Austrian president said, “we cannot buy ourselves out of the climate crisis. We must curb emissions at home.” His country aims to achieve the ‘net zero’ target by 2040. Summit goers later held a special session to discuss the thorny but crucial issue of loss and damage.