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At the 66th World Health Assembly, delegates also debate health in the post-2015 development agenda and noncommunicable diseases

Geneva, 23 May 2013 (PAHO/WHO) — Delegates from countries of the Americas at the 66th World Health Assembly have expressed strong support for the goal of universal health coverage and the inclusion of health as a central component of the post-2015 development agenda.

Representatives of 18 countries of the Americas addressed the Assembly's plenary session during the first three days of the meeting. Their remarks are summarized below (in chronological order):

United States: Universal health coverage is a regional and national priority

U.S. Secretary of Health and Human Services Kathleen Sebelius spoke on behalf of the countries of the Americas region, saying that universal health coverage is essential to health as well as to social and economic development. She said that achieving universal coverage requires special efforts to address the needs of the most vulnerable sectors of society.

"For our goal of universal health coverage to be truly universal, we must work tirelessly to remove those social and institutional barriers and to find new ways to reach out to those who are most vulnerable to health disparities," said Sebelius. "We need to ensure that all people, even those at the margins of our societies, have the full opportunity to access health coverage."

In addition to work at the national level, Sebelius said, "It is imperative that the international community fulfill its essential role as champions for universal coverage. That means continuing to set aggressive targets, and supporting member states in their efforts to put quality care and preventive services within the reach of all people." She acknowledged the work of the Pan American Health Organization (PAHO) and the World Health Organization (WHO) in fulfilling this role. The United States is committed at the national level to expanding access to health for all its population, she said. See video.

Brazil: Protecting health achievements and addressing new challenges

Vice Minister Jarbas Barbosa of Brazil said the post-2015 development agenda should seek to protect health achievements that have already been won while also reflecting new challenges, including that of achieving universal health coverage.

"In Brazil we are committed to putting health at the top of our priorities," he said, citing Brazil's free and public Unified Health System as an example of the country's commitment to health. He said a major challenge going forward—for Brazil as well as other countries—is to ensure sustainable financing for health systems, with increases in health spending needed to address health needs associated with higher life expectancy, the double burden of infectious and noncommunicable diseases, and the introduction of new medicines and health technologies.

He called for continued international cooperation in outbreak alert and response to deal with emerging threats, such as novel influenza viruses. "Brazil, which will host two major mass events—the World Cup in 2014 and the Olympic Games in 2016—is taking lessons from other countries that have organized these events and is working to ensure that they take place in a secure environment" for health, he said.

Mexico: Health at the center of public policies

Mexico's secretary of health, Mercedes Juan, urged fellow delegates to work hard to ensure that health remains at the core of the development agenda. "Placing health at the center of public policies will put us in a better position for advancing our countries' development," she said.

Juan also noted the rising burden of noncommunicable diseases and their high costs for health systems as well as for society, productivity and countries' competitiveness.

She said the next generation of global development goals should include overcoming the gaps in equity. She said Mexico is advancing in this regard, with initiatives such as the National Crusade against Hunger, which addresses malnutrition. She added that the countries supports proposals to include universal health coverage as a post-2015 development goal.

Canada: Concerns for noncommunicable diseases and mental health

Canada's minister of health, Leona Aglukkaq, said that despite progress toward the MDGs, maternal and child mortality remain problems and mental health is a complex, growing concern. "This means that the agenda has to change. We need strong leadership on these issues," she said. Echoing other health leaders, she said health needs to remain at the center of the international development agenda.

Aglukkaq said mental health is one of her chief concerns as Canada's health minister. She cited teen suicide, particularly in northern Canada, as a major problem, one that her country is trying hard to address not only domestically but in other arctic countries.

Peru: Law on healthy nutrition and UNASUR proposal

Peru's Law to Promote Healthy Eating for children and adolescents was the focus of remarks by Minister of Health Midori de Habich. She said the law is "a pioneering mechanism aimed essentially at ensuring health school meals and fully informing consumers about the contents of processed foods."

She also said her government is working with all sectors to achieve universal health protection, which is a basic human right, and said that the future international development agenda must take into account the interdependence of health, human welfare and economic development.

"UNASUR also believes that universal coverage is not sufficient if it is only in the context of assistance and that structural changes are also needed," she said.

Guatemala: Child malnutrition and primary health care

Addressing child malnutrition is one of Guatemala's top priorities under its current administration, said Minister of Health Alejandro Villavicencio on the second day of the Assembly. Guatemala is implementing a national program called Zero Hunger, which seeks to eradicate hunger by the year 2033. A strategy known as "The 1,000-day Window" targets children during their first three years of life, when good nutrition is most critical for their cognitive and physical development.

Villavicencio urged WHO to advocate for strengthening of primary health care systems as a post-2015 development goal. He also called for more studies and analysis of drug abuse and the international drug trade to inform debate about the dangers of drugs to health and citizen security.

Chile: Keep working to achieve pending MDGs by 2015

Chile's undersecretary of health, José Díaz, said countries should keep working to achieve the unfulfilled MDGs during the two remaining years before the 2015 target date, even as they begin to shape the post-2015 development agenda.

"We believe that the improvements we have seen have not occurred at the pace we expected," said Díaz, adding that the last MDG progress report shows that two-thirds of the goals have not yet been reached. He said Chile was working to identify persisting gaps to be able to close them. He added that preventive measures are indispensable for addressing the rise in noncommunicable diseases.

Jamaica: NCDs are the newest challenge

Fenton Ferguson, minister of health of Jamaica, cited noncommunicable diseases and maternal and child mortality as major health challenges and said the achievement of universal health coverage is "the most powerful social equalizer and the ultimate expression of justice." He also said that the post-2015 development agenda must take into consideration the social determinants of health.

Argentina: Health in all policies and NCDs

Argentina's undersecretary for social determinants and health relations, Eduardo Bustos Villar, acknowledged WHO's work in the area of "health in all policies" and called on fellow health authorities to promote this approach. He also urged action to advance the goals established by the United Nations High Level Meeting on NCDs and that these goals be included in the post-2105 agenda.

He said Argentina is working to achieve universal health coverage through intersectoral policies that promote equity, including health promotion. He cited examples including the primary health care model and community health centers. See video.

Haiti: Health system still needs international support

Minister of Health Florence Guillaume of Haiti described the many problems her country has faced as a result of the 2010 earthquake and the cholera epidemic that began later the same year.

"But Haiti is not just this," said Guillaume. "It is a country of dignified citizens who find the courage to smile and who now want to advance decisively on the road to real change." But real change cannot occur, she said, without universal health coverage.

Despite all its difficulties, Haiti has worked to fulfil the MDGs and "progress toward universal health coverage through community agents,"" said Guillaume.

"Now and after 2015, we must take account of the country's socioeconomic development," she said. "We have learned our lessons, and we will achieve success if we have external assistance and if it is used more effectively, keeping the population in mind." She thanks WHO and other partners and governments that have supported Haiti's health system. "We hope they continue their support to achieve a better world."

Note: Spanish summaries of the remarks of delegates from Uruguay, Colombia, Cuba, Costa Rica, Nicaragua, Ecuador, Honduras, and Venezuela are available here.