Global talks at UN to focus on pandemic preparedness, universal health coverage, and TB

Pandemic preparedness, universal health coverage, and tuberculosis (TB) will be at the centre of global talks at the United Nations this week, with the health sector ramping up pressure on leaders to make good on commitments towards the health SDGs.

The three global health meetings at the UN General Assembly in New York come at the mid-way point for the Sustainable Development Goals (SGDs), many of which are severely off-track for meeting their 2030 targets.

The first of the meetings, on Wednesday (20 September), will see heads of state and government convene to adopt a declaration on pandemic prevention, preparedness, and response, led by president of the UN General Assembly Dennis Francis and the World Health Organization (WHO).

"If COVID-19 told us nothing else, it's that, if health is at risk, everything is at risk," WHO director-general Tedros Adhanom Ghebreyesus told a press briefing on Thursday (14 September).

"The pandemic showed that health is essential for development, social and economic prosperity, and national security."

He said the declaration would support ongoing member state negotiations on a pandemic agreement and amendment of the International Health Regulations, a set of binding rules on disease outbreaks that have the potential to cross international borders, agreed by countries in 2005.

On Thursday (21 September), talks will centre on Sustainable Development Goal 3 - achieving universal health coverage. It follows a progress report, jointly published Monday by the WHO and the World Bank.

Ending TB

The following day (22 September), global policymakers will discuss how to give people equitable access to TB prevention, testing, and treatment by focusing on advancing science, finance and innovation.

Eliud Wandwalo, head of TB at the Global Fund to Fight AIDS, Tuberculosis and Malaria, said he hoped it would lead to innovations being deployed equitably and rapidly where they are most needed.

"Investing in innovation alone will not help us end TB," he told SciDev.Net. "We must simultaneously fight the inequities that fuel the disease."

But some global health experts are not so optimistic about what might be achieved through the meeting.

"Unfortunately, it is hard to envisage tuberculosis being high on the agenda of world leaders more concerned with war, food insecurity, and … economic climate," said an editorial published 16 September in the Lancet.

Cutbacks

Madhukar Pai, associate director of the McGill International TB Centre, and a member of the Lancet Commission on Tuberculosis, told SciDev.Net: "My anxiety is that TB, this time again, will garner little political interest.

"Countries are already cutting back on health after COVID, and TB is a small portion of health expenditure."

He believes getting TB included in the universal health and pandemic response agendas could be a more effective strategy for making progress on the disease.

A report by the Lancet Commission published last week pointed out that while many African countries have seen declines in TB mortality rates since the last UN high-level meeting on TB in 2018, more than 7 million people have since died from the disease.

It said none of the ten countries with the highest TB burden had reached the targets set in that meeting, citing COVID-19 as a major setback to progress. The WHO has said the pandemic had set global goals on TB back a decade.

In 2020, global TB deaths stopped declining for the first time in two decades, the Commission said. However, it pointed to a range of new diagnostic tools and treatments which, if scaled up, mean that "ending tuberculosis within a generation is still plausible".

On 19 September, the Stop TB Partnership will launch the "Coalition of Leaders to End TB" advocacy initiative, bringing together heads of state and delegations from ten countries together with heads of multilateral and UN organisations to collaborate towards ending TB. It will also host a TB Innovation Summit the same day in New York.

SDGs, climate summits

Ahead of the meetings on health, the UN General Assembly kicks off with a two-day SDG summit (18-19 September) to assess progress on the 17 global goals. The UN says it will result in a political declaration with the aim of resetting progress to achieve the goals by 2030.

This will be followed on 20 September by a high-level dialogue on financing for development, to provide guidance on the implementation of the Addis Ababa Action Agenda, a UN framework for financing the SDGs.

Another key focus of the UN meeting will be the Climate Ambition Summit on 20 September, led by UN secretary-general Antonio Guterres. He will urge all sectors to come up with an ambitious course of action to respond to the climate crisis.

Pete Ogden, vice president for climate and environment at the United Nations Foundation, told SciDev.Net that the summit would "feature the ways in which a wide range of actors—from governments, to the private sector to sub-national leaders and international financial institutions—are stepping up and doing what it takes to be 1.5 degrees C-aligned," referring to the 2015 agreement reached in Paris to limit global temperature increases to 1.5 degrees Celsius above pre-industrial levels.

"And in so doing, it will build pressure on others to join what the secretary-general calls the 'first movers and doers' in the critical run up to COP 28, when we need to see their ranks swell."

Climate action and governance are also a recurring theme at the annual Science Summit, hosted on the sidelines of the Assembly by the International Science Council and partners.

The summit is looking at the role of science in attaining the SDGs and aims to foster collaborations to that end. It is also being used to prepare input for the UN Summit of the Future, which will take place during next year's UN General Assembly.