Internetconsultation Global Health Strategy

Reactie

Naam	Anoniem
Plaats	Geneva - Switzerland
Datum	19 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?

Question 1.
The Dutch government should build governance structures that ensures adequate consultation of such groups as it designs or implements its own policies and practices. It should also ensure that, where possible, it provides funding to such groups to strengthen accountability and ensure an effective voice for marginalized groups.

Question 2.
One means to be a donor with courage is to invest in those areas of global health which are not just reactive and responsive, but which seek to address long-term problems for which there is no immediate solution. While antimicrobial resistance is now an urgent crisis, with a recent study estimating at least 1.27 million deaths worldwide from drug-resistant infections in 2019, the consequences will only worsen over time if there is no planning and investment in a response. Such investments now will pay off in the long-term.

Question 3.
First, it should ensure not all international efforts related to global health are fully focused on what is also of concern in the Netherlands. For example, while certain priority pathogens may be of greater import in the Netherlands than around the world, it must make sure its international efforts to combat AMR are not always going to be the current priorities in the Netherlands (even though such pathogens will eventually become of greater import in the Netherlands).
Second, the Dutch government should assure that investments in research and development, a core pillar of global health, are implemented in a manner to benefit relevant populations in the Netherlands and around the world, by ensuring that the outputs of such investments in R&D are affordable, accessible, and backed by rigorous evidence to inform use in the Netherlands and other countries.

Question 4.
This diplomatic network should seek to be more engaged with and consult with Ministries of Health, civil society, and the private sector in other countries so as to build a more comprehensive understanding of the challenges other countries face.

Question 5.
The Netherlands has been an early and outspoken champion of efforts to address antimicrobial resistance through a whole of government approach. The Netherlands can use its position in the UN, both as a champion of human rights, but also as a champion of addressing drug-resistant infections, to ensure that a comprehensive, global response is undertaken by the UN and Member States.

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?

Question 7.
One key measure is to ensure that clinical research and evidence generated for new medicines, diagnostics, and vaccines is also developed on behalf of populations, including children, in low- and middle-income countries. Without such evidence or clinical trial data, such technologies cannot be used effectively or appropriately in those countries. Secondly, such technologies must be registered and made available for use. Third, there must be specific efforts to work with leading countries to build models of care that can be scaled up in health systems worldwide to ensure effective use of new tests and treatments, including to address drug-resistant infections.

Question 8.
The Global Antibiotic Research and Development Partnership is built on the notion that strong partnerships between all sectors – including governments, the private sector, civil society, academia, and research institutions, is critical for the timely development of and access to new treatments to address drug-resistant infections. We believe such partnerships, if constructed in the spirit of serving the public interest, and assuring those new technologies are used for the benefit of people in low- and middle-income countries, can assure that all sectors are contributing to common objectives to advance the public good.

Question 10.
One key component of both stronger health systems and improved preparedness is a robust pipeline of antibiotics as well as wide availability alongside effective stewardship of existing antibiotics. For more than a century, antibiotics have been the foundation of modern medicine. They prove indispensable to countless routine interventions, such as surgeries, chemotherapy, organ transplantations and other invasive procedures.
But antibiotics have a time limit. For decades, we have known that their power had an expiration date. Bacteria develop resistance against antibiotics and become “superbugs”. Untreatable infections reduce the value of these procedures and thereby lower their value to patients. We need constant innovation to keep up against this natural evolution.

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?

Question 12.
1. We believe that there must be greater recognition and inclusion of antimicrobial resistance in future pandemic preparedness and response, and sufficient investment in public, not-for-profit, and private entities seeking to prepare and respond to AMR.
2. There must be greater investment in the development of medical countermeasures as a critical element of pandemic preparedness.
3. We must ensure that access to diagnostics, treatments, and vaccines for all is a cornerstone of pandemic preparedness and response.
4. There must be greater global cooperation across geographies and sectors and within a One Health framework. This could include the development of one or more international agreements to facilitate such global cooperation.
5. There must be measures to ensure low- and middle-income countries are equal partners in a comprehensive global response. Solutions that have been pioneered by countries should be recognized and integrated into PPR.

Question 13.
It ultimately requires much greater recognition by governments (and the private sector) of the consequences of inaction and a lack of sustainable financing. With respect to AMR, the long-term costs of inadequate preparedness will accumulate and multiply over time. In 2017, the World Bank has warned that AMR could be as damaging to the global economy as the 2008 financial crisis, with a global increase in health care costs between US$ 300 billion to US $ 1 trillion per year.

Question 15.
We believe the sharing of IP, knowledge and data can be highly beneficial in the context of PPR to: (a) ensure adequate and affordable supply of countermeasures for all countries; (b) to encourage development of follow on versions of specific countermeasures, including adapted formulations for resource-poor settings or to benefit specific populations, such as children, and (c) to encourage the sharing of all relevant IP, knowledge, and data for the benefit of all countries, with each country using such IP and knowledge for the purposes it deems most appropriate to address its own needs.

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?

Question 17.
There must be appropriate sharing of intellectual property, data, and knowledge, as well as technology transfer where required. There should be adequate financing to support the development and manufacturing of such technologies and supplies. There should be clear commitments to purchase such technologies by governments and other third parties to sustain development and production of such technologies.

Question 18.
The private sector plays a critical role in the development of new medicines, supplies, and vaccines both to respond to pandemics and for other health needs. Several measures that companies can take are:
a) Ensuring that research priorities are well aligned with public health needs, such as the WHO Priority Pathogen List for drug-resistant infections.
b) Form partnerships with the public and not for profit sector to develop new products that respond to unmet needs, while ensuring broad affordability and availability of such products.
c) Ensure that there is adequate and affordable supply of novel products that have broad public health impact, whether through its own investments or through appropriate licensing agreements with other manufacturers that can assure production and distribution at affordable prices in relevant geographies.
d) Ensure that new products are tested in populations that otherwise may be neglected during research and development (as well as in all relevant geographies), and to also assure that follow on versions of relevant technologies are adapted to all populations such as children and neonates.

Question 19.
Local production is increasingly critical to assure security of supply and improve equitable access to medical technologies during and even outside of pandemics. Some measures to improve local production can include – (a) the sharing of intellectual property, data, and knowledge on a non-exclusive basis, (b) government to government or private-sector led technology transfer to relevant manufacturers in the public and private sector; (c) sustained financing including preferential procurement of local production to sustain investment and production.

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?

Question 20.
One key priority for the Netherlands should be antimicrobial resistance, which requires appropriate linkages between human health, animal health, and the environment. This requires measures that cut across food and agriculture, clean living environment and appropriate water and sanitation, appropriate investments in human health and health systems, education and awareness, including in schools and the general public, and appropriate environmental management, including the production of antibiotics and other medicines.

Question 21.
AMR is one area of global health that, even prior to the pandemic, required and has featured an intersectional approach to global health. This includes collaboration amongst major UN agencies, and at the national level, similar cooperation amongst government agencies and departments. The Netherlands can play a key role continuing to strengthen such investment amongst major UN agencies as well as supporting the implementation of National Action Plans that seek to bring together such intersectional approaches to 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?

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Vraag7

Miscellaneous

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

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