Internetconsultation Global Health Strategy

Reactie

Naam	HealthNet TPO (Dr. Abdul Majeed Siddiqi)
Plaats	Amsterdam
Datum	22 augustus 2022

Vraag1

Session 1: Diplomacy and human rights-based

Question 1: How could we best include the input of marginalized groups in our diplomacy efforts?

Question 2: The Netherlands is often referred to as a donor with courage. If the Netherlands wants to continue being such a donor, which are the (health-related) themes we should focus on?

Question 3: How can the Netherlands best align the national and international efforts regarding Global Health?

Question 4: How can the Netherlands make more effective use of its diplomatic network abroad, including embassies, permanent representations and thematic experts (such as health attachés)?

Question 5: How can the Netherlands' position within the UN (and its reputation in the field of international (human) rights) be used to advance global health objectives?

Question 6: How can we systematically link diplomatic efforts in Brussels, Geneva and New York to the benefit of coherence and greater effectiveness?

HealthNet TPO Response:
Response to question 2: The Netherlands can continue to focus on specific thematic areas such as SRHR, Mental Health and Psychosocial support and prevention of communicable diseases. But importantly defining and supporting the primary healthcare concept and service delivery, specially in fragile, in chronic conflict and low income countries. This includes defining and enhancing community based and multisectoral approach at lowest level, to ensure availability and access to healthcare.

Response to question 3: Alignment and harmonization in funding health sector, requires a more robust and effective coordination. The gap in this ares is huge, and where lobbying is skewed towards specific issues and politicalized, although has good results but can be more effective, if there is a coordination mechanism and open discussions between all stakeholders (World Bank, WHO, UN agencies, donor countries, private donors). This maybe an important area that the Nethelands can take lead and play an important role.

Vraag2

Session 2: Health systems strengthening

Question 7: How can we reach everyone, especially the most marginalized people, to ensure their access to information and medical service?

Question 8: How can we make use of the specific knowledge and experience of all different sectors involved in global health? How can we also involve the private sector in meeting the people in greatest need?

Question 9: How can we promote green and sustainable health systems strengthening?

Question 10: How can we gear health systems strengthening most effectively towards better preparedness?

HealthNet TPO Response:
Response to question 7: The Netherlands should define clearly the approach for support in health sector considering categorization of the countries in broader term. The category of countries can be; a) where there is a prolong and complex conflict and will require a long term support through government or maybe other channels such non governmental organizations, b) where there is acute emergency and need urgent and short term support, c) the support to government and other institutes through technical and system enhancing in low or middle income countries. This will help to reach the marginalized population and ensure availability and access to healthcare in remote and to the last one.

Response to question 8: The Netherlands should develop the policy to seek engagement of the private sector in two specific areas. The hospitals in the cities as a center for the referral of specific cases and provision of subsidized support such as congenital heart diseases. But importantly to improve availability and access to vital preventive and curative services in remote areas, use of private practitioners through a public private partnership can play a pivotal role. HealthNet TPO throught the Dutch Consortium in Uruzgan started a very success similar approach, where results were promising and it is part of the national strategy and donor approach in the country. Thus private sector can play an important role, where public health is not able to deliver, for vaccination, reproductive health and nutrition activities.

Vraag3

Session 3: Pandemic prevention, preparedness and response

Question 11: Which lessons should we learn from our approach in earlier pandemics, and more specifically, what could we do better?

Question 12: What are the most pressing gaps in the current global health architecture regarding PPR, and how should/can they be addressed?

Question 13: How can we best ensure sustainable financing for PPR?

Question 14: To what extent should new international agreements be legally binding?

Question 15: To what extent should the Netherlands promote the sharing of IP, knowledge and data in the context of PPR?

Question 16: How could we best communicate to a global public audience in order to not only prevent but also respond better to a pandemic?

HealthNet TPO Response:
Pandemic control goes beyond virological and pure physical medical consideration from the very start of forming a response strategy. Taking economic, mental health and sociological aspect into account right from the start is vital for an effective/efficient control strategy. In addition, building a robust pandemic/epidemic preparedness strategy is vital in order to keep the health care system running.
Other countries such South Korea – which had built up its testing capabilities following the Middle East Respiratory Syndrome (MERS) outbreak in 2015.

There are Centres for Disease control all over the World – which have been not very much visible in the COVID-19 pandemic response. They were overshadowed by political discussions – which shouldn’t have been the case. There is need to highly de-policies outbreak control – and increase the mandate of the Disease control teams over the world. In addition, the outbreak management team has been very much arguing from a virological point of view – which is important – no doubt. However, effective outbreak control is a multidisciplinary matter and does more disciplines have to come in earlier in the response mechanism.

Vraag4

Session 4: Products and supply

Question 17: What is necessary to improve local research and production medical supplies, medicines and vaccines?

Question 18: How can the private sector contribute to the production and distributions of medical supplies, medicines and vaccines?

Question 19: How can we facilitate local production?

HNTPO feedback:
Response to question 17: In order to improve local research and production one has to carefully look into the protection of intellectual property rights. This means that there is a great need to work towards a better understanding of the implications of intellectual property rules for access to health technologies and medicines/vaccines. The global COVID - 19 pandemic response has demonstrated – how the private sector can effectively deny access to vaccines to less wealthy countries in the world – which poses a great threat to human lives and to the global community as such. Profit was put above the moral duty to safe lives and the international standard to work towards universal access. It is well appreciated that the private sector has to make investments for which it ought to be compensated – not doubt. But the role of profit making within the context of public health emergency should be greatly regulated.

Respone to question 18: The transparency and information on vaccine price should be available for all countries. For example, GAVI Alliance is able to purchase vaccine with a remarkably low price but countries not eligible does not have access to this facility. They have to purchase vaccines in a very high price, where it is a vital comodaty and thus lack of transparency of private sector and disclosure of GAVI Alliance, effects the countries and general population.

Vraag5

Session 5: One health multisectoral approach

Question 20: There are noticeable links between global public health and other themes, including climate, food security and nutrition, clean leaving environment (e.g. WASH/clean water and air), animal health, economy, school health (e.g. CSE, ASRHR) and sustainability (social, economic and environment). Which should be the priorities that are also practically feasible for the Netherlands in this regard?

Question 21: How do we best engage in this intersectional approach of global health?

Vraag6

Session 6: Sustainable financing

Question 22: How do we establish sustainable and innovative health financing with the strategy?

Question 23: How do we ensure best the blending of public and private funding for the Global Health Strategy?

Question 24: How do we ensure sustainable financing for the WHO and the global health architecture at large?

HealthNet TPO Response:
Response to question 22: Firstly the Netherlands government should focus the support in health sector with a long term strategy. It means any support to a country, should be have a long term vision, sustainability as key element from day one. Secondly, it will require a very coordinated efford from all donors and stakeholders. The pool fund and other approaches led by World Bank or OCHA, may be few examples the Netherlands can explore and lobby for it. Thirdly, the authorities, where possible, should be actively engaged and contribute to the process. Finaly, the non governmental organization, in fragile and low income can provide technical support and mobilize the resources to provide services, can be utilized.

Vraag7

Miscellaneous

Question 25: Do you have any other thoughts, ideas or comments you would like to share regarding the Global Health Strategy?

HealthNet TPO Response:
The third recommendation from the AIV (6 April 2022) states the importance from being able to move from emergency response to building up health infrastructure – also in times of an emergency. Hereby with think that the actual way the DRA is working has to be revised as it impedes the actually step to supporting the existing infrastructure in a country. This was seen in the case of Afghanistan where HealthNet TPO as the main Dutch health NGO in the country was denied access to funding – even though the needs could be articulated very precisely for the supporting the existing health infrastructures. In such cases it would have been very helpful besside DRA funding (access to be broadened) not only for emergency response as such but also to be able to sustain/and support the already existing health system, to avoid the collapse, in which the Netherlands has invested. An effective abd active plateform to enage NGOs and other stakeholders is required to ensure efficient use of resources and wider engagement.