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Ministerial Communique Foreign Policy and Global Health Initiative

Last updated: 22.05.2014 // Geneva, 20 May 2014

The Ministers of Health of the Foreign Policy and Global Health (FPGH) Initiative, comprising Brazil, France, Indonesia, Norway, Senegal, South Africa, and Thailand or their representatives, met today on the sidelines of the 67th Session of the World Health Assembly in Geneva.

They reaffirmed their commitment to the role of the Initiative in promoting synergy between foreign policy and global health, as well as the contribution of the Oslo Ministerial Declaration entitled “Global Health: a pressing foreign policy issue of our time” in placing health as a foreign policy issue on the international agenda.

They also recognized the leading role of the World Health Organization as the primary specialized agency for health.

The Ministers reaffirmed their commitment to make every effort to accelerate the achievement of the health-related Millennium Development Goals (MDGs) and address the remaining gaps. In this regard, they emphasized the importance of implementing the recommended actions by the UN Commission on Life-Saving Commodities for Women and Children. They also recognized that efforts to achieve progress towards the realization of health-related MDGs shall continue beyond 2015, and that greater efforts should be made to address health system gaps.

They noted that challenges in global health, including major inequities and vulnerabilities among and within countries and regions, still remain and demand persistent attention. In this regard, they underlined the importance of a renewed Global Partnership for development that enables an inclusive and people-centered development agenda, to reinforce the commitments of the international community to poverty eradication and sustainable development, as outlined in the 2013 UN General Assembly Resolution on Global Health and Foreign Policy (A/RES/68/98).

The ministers agreed that UHC is based on equity and the right to health, which must also be the principles for building health systems that guarantee universal access, ensuring that all people have access to the health services they need (promotion, prevention, treatment, rehabilitation and palliative care). In line with this, they reaffirm their commitment to give due consideration to including this theme in the discussion on the post 2015 development agenda, as stated in the 2012 UN General Assembly Resolution on Global Health and Foreign Policy which addressed UHC (A/67/81). They recognized the importance of universal access to quality health services while ensuring that the use of these services does not expose the users to financial hardship. The Ministers further recognized universal health coverage as a key contribution to enhancing health, social cohesion and sustainable human and economic development (Rio +20) and as an important element of the future we want.

The Ministers acknowledged that health is both a driver and a beneficiary of economic growth and development, and in this regard they stressed the importance of building health systems to guarantee universal access. They also noted that health has a strong relationship with the core values that should be at the heart of advancing the UN Development Agenda beyond 2015, with particular focus on: universality, Poverty eradication, sustainable development, human rights, inclusion, participation and equality as well as realizing unmet Millennium Development Goals.

The Ministers agreed that the future health goal or goals should be accompanied by a set of ambitious, yet realistic, achievable, measurable and easily understandable targets, as well as health indicators which could also serve to measure progress towards sustainable development in other sectors. They appreciated the work of WHO and other agencies and countries to develop targets and indicators for universal health coverage, child and maternal health, sexual and reproductive health and the promotion and protection of all human rights in this context , and communicable as well as non-communicable diseases. The Ministers agreed that ambitious post 2015 targets on health would require stronger action in and co-operation with non-health sectors, notably finance, labour and social welfare, as well as an emphasis on innovative research and development. 

In this regard, the Ministers expressed their appreciation of WHO’s efforts to address the link between climate and health, noting with particular concern that according to the newest estimates, 7 million premature deaths annually result from air pollution. They agreed that addressing the health effects of environmental challenges requires effective multi-sectoral action that also has a foreign policy dimension, and that both national health authorities and WHO has an important role to play in key multilateral processes such as the United Nations Convention on Climate Change, including the ongoing discussions for the 21st conference of Parties scheduled to take place in Paris in 2015.

The Ministers further emphasized the need to prioritize public health, including social protection mechanisms, and strengthen national health systems, especially through health promotion, prevention, primary health-care, and a strengthened health work force. The ministers expressed their concerns on the possible cost escalation due to the excessive use of expensive new drugs and health technologies, ageing populations and NCDs, and the need for continued efforts to address this problem, in particular through the use of health innovation and technology assessment and policies relating to demographic transition.

The Ministers underscored the necessity to address the emerging threats posed by the growing burden of non-communicable diseases, and expressed their continued strong support to the 9 voluntary global targets and 25 indicators which will drive action in this area. Production, trade and marketing of addictive substances and unhealthy food, together with urban lifestyles that hamper physical activity as well as environmental hazards contribute significantly to the growing burden of non-communicable diseases. At the same time, they encouraged strengthening the fight against communicable diseases, including neglected tropical diseases.

The Ministers stressed the importance of the implementation of the Framework on Pandemic Influenza Preparedness for Sharing of Influenza Viruses and Access to Vaccines and Other Benefits and noted that its implementation should be in line with the International Health Regulations. They reiterated their expectation that the Framework will contribute to a more coordinated, comprehensive and equitable response to future pandemics.

The Ministers expressed their concern on the recent outbreak of polio and the persistent problem of accessing areas stricken by polio. There is an urgent need for the international community to continue supporting and assisting efforts of affected countries in addressing this threat, including by ensuring the availability of effective and affordable vaccine as well as safe access to preventive vaccination campaign and programs.

The Ministers are deeply concerned about the threats posed by increasing resistance to Antimicrobial drugs including multi-drug resistant Malaria, HIV and Tuberculosis, which are accelerated by excessive use of antimicrobials in animal feeds, inappropriate human use, and the lack of new and approved antimicrobial drugs. There is an urgent need for collective action to ensure responsible use of antimicrobials in both human and animal husbandry and to reduce the burden of antimicrobial resistance in the environment. The Ministers support the call for the development of a global action plan to combat antimicrobial resistance and are ready to collaborate with WHO and other international partners on these efforts.

The Ministers expressed concerned about the heavy burden of viral hepatitis, especially hepatitis B and C, and encouraged Member States to improve surveillance and diagnosis programmes. They reaffirmed the importance of comprehensive prevention policies, including through HBV immunization, safe blood transfusions as well as harm-reduction programs, especially among vulnerable groups.  They welcomed the recent development of new therapeutic options and the publication of new WHO guidelines for screening, care and treatment of persons with hepatitis C infection. They further welcomed the recent decision of the International Drug Purchase Facility (UNITAID) to tackle market barriers for hepatitis-related commodities and encouraged all stakeholders to also contribute to improved access to hepatitis treatment.

The Ministers reaffirmed their commitment to the Doha Declaration on TRIPS and Public Health and underlined the need for the full implementation of the TRIPS flexibilities.  In this regard, they welcomed the work of the Member State Mechanism on SSFFC .

With regard to the reform process of the WHO, the Ministers recognized the magnitude of the task and the useful steps already taken, while urging an increased emphasis on implementation. The Ministers also underscored that the reform process and its implementation should be Member-State driven, based on clear and agreed priorities, fully transparent and inclusive. They stressed the necessity of continued measures in strengthening the Organization at its three levels (global, regional and national) in order to provide evidence-based guidance for decision-making and to fulfill its constitutional mandate in the interest of all Member States. They welcomed the contribution made by the Financing Dialogue. They welcomed the opportunity to expand dialogue on health issues with other actors and reiterated the intergovernmental nature of WHO and the decision-making prerogative of member states. Clear and well-defined rules of engagement with non- state actors are essential to protect the organization from any potential, real or perceived conflict of interests.

They expressed concern over increasing violence and attacks against health facilities and health workers, and its consequences in terms of access to health services.  The group will address this issue at the 69th United Nations General Assembly, under the item “Global Health and Foreign Policy”. 

The Ministers reaffirmed their commitment to continue advancing global health issues in the broader United Nations framework and beyond, in particular by maintaining and utilizing the agenda item “Global Health and Foreign Policy” on the agenda of the United Nations General Assembly.


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