by Gavin Wayne, Vuong Phan, Isabelle Nehme, Zoe Byrne and Natalie Ward
In preparation for the UN General Assembly high-level meeting on Universal Health Coverage, talking place on 23rd September 2019, an interactive multi-stakeholder hearing was convened at the United Nations in New York, on 29th April 2019. AMSA’s presence consisted of a delegation of five (from left): Natalie Ward, Vuong Phan, Zoe Byrne, Isabelle Nehme and Gavin Wayne (not pictured).
Deciding on how best to represent AMSA, position the organisation at the meeting, and advocate for our continued involvement at high-level meetings, the team met at the stunning New York Public Library to discuss the approach at the next day’s meeting. With the hearing featuring delegates with expertise on many facets of UHC, but very few youth or student organisations represented, we decided to focus on highlighting the unique perspective that AMSA can bring to the discussion. With that in mind, we developed a policy brief particularly focusing on the importance of youth representation, active engagement in decision-making processes and representing Indigenous and Rural populations.
- Youth and students play a pivotal role in the future workforce and delivering UHC, and should thereby be supported in their capacity to contribute to relevant processes;
- In realising UHC, policies should strive to be truly ‘universal’ – all peoples should have equitable access to a high-quality system:
- In particular, Indigenous and underserved populations should be empowered in their autonomy to cater healthcare to their individual needs.
- Healthcare professionals have a professional responsibility in advocating for the realisation of UHC.
With our position sorted, we set out to explore New York and prepare ourselves for an early start and a full day at the UN.
Before the meeting started, the team came across Batool Wahdani, the current President of the International Federation of Medical Students’ Associations (IFMSA), who was due to be a panelist in Session 2 of the meeting. It was wonderful to see that youth and medical student representation was given a prominent international presence.
The meeting ran in three sessions, “UHC as a driver for inclusive development and prosperity”, “Leave No One Behind – UHC as a commitment to equity”, and “Multi-sectoral and Multi-stakeholder Action and investments for UHC”, with the first session moderated by journalist Femi Oke, and the next two by journalist Zain Verjee. During each session, diverse panellists were invited to discuss issues related to UHC, from a personal or professional perspective, as well as to answer questions submitted by members of the audience, and a selection of the statements submitted by non-state actors were also read.
UHC as a driver for inclusive development and prosperity
The first session highlighted the importance of UHC for not only achieving health targets, but also advancing social justice, economic growth and human rights. Discussions between panelists highlighted that, in order to realise this mission, there must be a strategic roadmap for action, which includes evidence-based policy, resource mobilisation, oversight, accountability and regulation. It is imperative that governments increase public investments – particularly in primary prevention of disease – and involve all disciplines of healthcare, including community health workers, nurses and allied health practitioners, utilising technology to accelerate progress in all measures. Further, it is important that governments capitalise on investments made in UHC, ensuring that progress made in this space continually points forward towards its realisation.
Particularly well-received in the speaker segment of this session was the call for a ‘7th Ask’ to the existing UHC 6 Asks. Ann Keeling, on behalf of Women in Global Health, called for commitment on gender equality and women’s rights as a foundational principles of UHC. Here, she highlighted the role of women as 70% of the health workforce, and their significant contribute to unpaid care work, the impact that gender as a determinant of health has for all genders, and the need for diverse involvement on women, in equal number to men, in UHC.
Leave No One Behind – UHC as a commitment to equity
This second session was closely related to the action points developed in the AMSA policy brief, as the importance of youth involvement and reaching underserved populations were key discussion points. Batool featured as a panelist, and she championed the importance of youth involvement in delivering UHC, and the need for incorporating UHC into the medical curriculum to address the 65% of medical students who currently have not heard of UHC.
In addition to the focus on youth in delivering UHC, this session saw a focus on ensuring that UHC truly does reach everyone, and ensuring that marginalised groups not only receive health care, but also have a voice in shaping the UHC agenda. Benilda Batzin, Expert on Health Citizenship, brought her perspective on the situation of health coverage in Guatemala, and called for the involvement of citizens in breaking-down cultural barriers to health, and the need to involve indigenous peoples in the public policy in all countries. Monthian Buntan, Chairperson of the Division of International Relations and Special Affairs, Disabilities, Thailand, echoed the appeal for involvement of all citizens in UHC, encouraging greater accessibility of health to reach all people, and calling for empowerment of communities to take part in shaping UHC.
Powerful words from Batool closed this session, as she again : “We’ve heard a lot that UHC needs grassroots involvement, bold action and innovative solutions…these are synonyms to the word ‘youth’. We need to invest in the power of the younger generation.”
Multi-sectoral and Multi-stakeholder Action and investments for UHC
The final session of the day explored the usage of multi-sectoral and multi-stakeholder partnerships to ensure that everyone is represented by UHC. Encouragingly, Australian Dr Justin Koonin, President ACON, was featured as a panelist, and discussed Australia’s promising progress towards ending HIV transmission. Discussing this as an example of the positive impact of the inclusion of community and community organisations, Dr Koonin spoke of the importance of including those affected by healthcare and health conditions in determining their needs, and guiding the response of systems.
Dr Koonin is a great example of using people from different backgrounds to think laterally and assist in creating solutions, he is a Mathematical Doctorate who has worked in financial modelling that is now working with ACON. Ultimately this works to highlight, that we must integrate people from a multitude of perspectives and connect stakeholders from multiple platforms in order to create pragmatic and realistic solutions.
A Toast to the UHC Movement, a reception following the UN Multi-Stakeholder Hearing on UHC
Following an insightful day of discussion, our team made our way to the reception at Japan Society co-hosted by the Japanese Mission, WHO and UNDP, for food, drinks, music and meeting the other Member States. This was a perfect opportunity to have in-depth conversation with individuals who had spoken throughout the day. We quickly became acquainted with our Australian counterparts, some of whom were representing organisations such as ACON and the Fred Hollows Foundation. It instantly became evident that each person you spoke to had taken a wildly unique trajectory to end up in front of you that day. What struck us the most, was the genuine excitement these leaders expressed to see young people like ourselves at events of this level. This sincere atmosphere allowed many of us to develop partnerships internationally and find long-term mentors in the stakeholders present.
Upon reflection, the variety of countries and organisations represented emphasised the great lengths and personal horrors many had endured, resulting in their passion for Universal Health Coverage and equity. It became apparent, however, that one of the major barriers taking this movement forward will be unifying each party’s vision and goals without siloing their story.
Prior to attending the UN, we felt that we had to be 65-year-old CEOs with a wealth of experience before we could even contemplate making a significant impact on our healthcare system. Via this opportunity, our delegation realised that so many individuals are making great strides in this field, yet we struggle to find an all-inclusive, global system for tackling health status discrepancies. This empowered us to truly believe that there is a space for youth in the conversation about Universal Health Coverage, and that there is nothing stopping a young person from uniting all partners to walk together.