Internetconsultation Global Health Strategy

Reactie

Naam	SRGR platform (SRHR advocacy officer T Vanacker)
Plaats	Amsterdam
Datum	21 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?

The Netherlands has a strong reputation as an international donor with courage for SRHR and LGBTIQ+ issues. The Netherlands should uphold this reputation by continuing diplomatic efforts on these topics in international spaces, and funding for SRHR and queer programming. The Dutch Global Health Strategy can take into account important lessons from the decades of track record in SRHR:

Adopt a human rights-based, gender-transformative and intersectional approach in all health programmes and investments;

Promote the destigmatization, anti-discrimination and decriminalization of people with diverse sexual orientation, gender identity and sex characteristics as a necessary condition to improve health outcomes for marginalized groups;

Give special attention to the most marginalized groups who receive least aid from other donors, such as key populations and adolescent girls and young women.

Promote the full integration of comprehensive SRHR into UHC, as well as linkages across different health programmes with other relevant issues (poverty reduction, gender equality, WASH etc.);

Recognise communities and civil society as mobilisers, service providers, watchdog agents and advocates across the health agenda;

Ensure meaningful civil society participation through the promotion of inclusive governance structures for multilateral (health) organizations

Invest in meaningful youth participation, with young people as a key target group for health policies and important drivers of change;

Take an active role in the various UN mechanisms and working groups, to have a strong presence in conversations that matter and divide the tasks with other like-minded countries.

Build an international coalition of such a like-minded countries to more effectively push back against the conservative pushback concerning SRHR

Work with CSOs and CBOs to reach marginalized groups, and ensuring their participation throughout the policy cycle (policy development, implementation and evaluation). Organise a yearly roundtable so representatives from marginalized groups can give feedback on the strategy implementation, and the policy can be adapted.

In the appendix you can find the full position paper of the SRHR platform on Global Health.

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?

In order to reach everyone, the strategy should provide political and financial support aimed at strengthening community health interventions and community-based primary care embedded in strong health systems. This requires strong and effective public financing to reduce (catastrophic) out of pocket health expenditure.

The strategy should leverage digital tools to reach and train key community mobilisers and service providers, while taking additional measures for people in those areas where digital tools don't work in order not to enhance the divide. The Netherlands should actively engage with other donors and governments to ensure adequate investments in community-led interventions.

In the dichotomy between health systems strengthening and disease specific interventions, it is important to understand that these are not two contradicting efforts, but rather interventions that need each other and feed into each other. When specific diseases overburden health systems it reduces their capacity to handle other diseases and when health systems are weak it harms their ability to fight specific diseases. To make the two complementary, it is important to ensure that disease specific investments are done wisely so that they simultaneously contribute to stronger health systems.

Finally, it is important to have clear, realistic targets at different levels and a monitoring framework on HSS including (proxy) SRHR targets and indicators, and with a focus on reaching marginalised groups.

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?

Over the last decade, African countries have been more affected by e.g. Ebola and HIV than the European continent and the Netherlands. The Netherlands can learn from their response by promoting South-to-North learning. In terms of lessons from past pandemics the following examples come to mind:

Lessons learned from the recent Covid-19 pandemic are:

Invest in a global response and promote solutions that are based in equality, diversity and inclusion;

Promote the full integration of SRHR services into UHC and into emergency response plans to avoid disruption of services;

Set up quick support systems for prevention of and response to SGBV (sexual and gender-based violence) including IPV (intimate partner violence);

Invest in strong health systems and particularly in community-health interventions and community preparedness.

Lessons learned from the hiv-pandemic are:

Pandemics can only be effictively fought if the voices and needs of the people most affected by diseases are heard.

Inequality is a main driver of pandemics and serious reduction in deaths and infections can only be made possible once treatment and prevention tools are made accessible globally.

Overprotecting intellectual property of pharmaceutical companies can seriously harm health outcomes in lower and middle income countries. Exempting them from international rules concerning patents on its turn greatly advances such outcomes.

In order to create sustainable financing for PPR duplications within the existing global health landscape need to be avoided and non-ODA funding for PPR needs to be safeguarded. Financing pandemic prepardness of other countries should be regarded as a matter of investment rather than development cooperation, since pandemic prepardness in the Netherlands can only be achieved once domestic strategies concerning PPR are not seen apart from global strategies.

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?

Ensure efficacy by focusing the One Health priorities around the key priorities of the Dutch international development policy, mainly WASH, SRHR including LGBTIQ+ and food security. Create more flexible funding and promote intersectional and integrated approaches in development programmes.

The climate crisis is leading to more extreme weather events, such as prolonged drought or severe flooding. Poverty and economic setbacks lead to an increase in harmful practices such as FGM and CEFM. The Netherlands should support adaptation to the ongoing effects of climate change, water management (diseases, sanitation, draught) and ensure the indispensable role of the most impacted by the climate crisis (girls, young women and communities in a marginalized position) in decision-making on climate adaptation.

Vraag7

Miscellaneous

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

Good data on marginalised groups are still scarce, as well as thorough analyses of what result certain measures bring for marginalised groups. Often we don't exactly know where the barriers lie for access to information and services. This is combined with a lack of clarity of who marginalised people really are, and the problems they face. Therefore it is important to invest in good research and contribution to the knowledge base, with these issues in mind.

Bijlage