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Human Rights Council holds panel discussion on enhancing capacity building in public health

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08 June 2017

MORNING
 
GENEVA (8 June 2017) - The Human Rights Council this morning held a panel discussion on realizing the right to health by enhancing capacity building in public health, hearing keynote statements by Kate Gilmore, Deputy High Commissioner for Human Rights, and Margaret Chan, Director-General of the World Health Organization.
 
The moderator of the panel was Nozipho Joyce Mxakato-Diseko, Representative of South Africa to the United Nations Office at Geneva.  The panellists were Tolbert Nyenswah, Deputy Minister of Health of Liberia and Director General of the National Public Health Institute of Liberia; Lorenzo Somarriba López, National Director of Public Health at the Ministry of Public Health of Cuba; Ren Minghui, Assistant Director-General for HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases at the World Health Organization; Gong Xiangguang, Deputy Director General of the Department of Law and Legislation at the National Health and Family Planning Commission of China; and Ilona Kickbusch, Director of the Global Health Centre and Adjunct Professor at the Graduate Institute of International and Development Studies.  
 
Kate Gilmore, Deputy High Commissioner for Human Rights, said that States were legally obliged by international law to enable people to realize their right to health, which was a prerequisite for the fulfilment of all other human rights.  The right to health did not stand alone, but was indivisible from other human rights.  Worldwide, the need to realize the right to health had never been more urgent.  Yet people’s ability to access quality health services was being continually undermined and threatened, through forces such as urbanisation and environmental degradation.
 
Margaret Chan, Director-General of the World Health Organization, said that governments’ ability to provide adequate health and social measures depended absolutely on having fundamental health capacities in place, which included surveillance systems that caught outbreaks quickly.  The right to health depended on regulatory authorities that kept water, air, food and medicines safe, and protected populations from exposure to harmful chemicals.  Legislation was one of the best ways to confer population-wide protection against threats to health.  Universal health coverage operated as a significant poverty reduction strategy and, thus, as a nation-building strategy; it was one of the most powerful social equalizers among all policy options.
 
Nozipho Joyce Mxakato-Diseko, Panel Moderator and Representative of South Africa to the United Nations Office at Geneva, said that the panel discussion would provide a platform for States and all relevant stakeholders to exchange experiences and practices on realizing the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. 
 
Tolbert Nyenswah, Deputy Minister of Health of Liberia and Director General of the National Public Health Institute of Liberia, spoke about the 2014-2015 Ebola epidemics in Western Africa, which had ravaged health systems, particularly in Guinea and Liberia.  In the post-Ebola era, there was still an urgent need to build a more resilient health system by providing adequate training for scientists. 
 
Lorenzo Somarriba López, National Director of Public Health at the Ministry of Public Health of Cuba, said that Cuba’s health care covered 100 per cent of the population, adding that one of the principles of Cuban public health was international cooperation; Cuba had medical brigades in 63 countries.

Ren Minghui, Assistant Director-General for HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases, World Health Organization, said there was global consensus that universal health coverage should not be viewed as a distant, aspirational goal but rather as a fundamental step in realizing the right to health.  Capacity building in public health was a core element of those efforts.
 
Gong Xiangguang, Deputy Director General, Department of Law and Legislation, National Health and Family Planning Commission of China, said that providing an efficient health system to all citizens was a key priority for the Government of China.  A five-year plan had been adopted, aimed at promoting a reasonable diet and physical fitness.
 
Ilona Kickbusch, Director of the Global Health Centre and Adjunct Professor at the Graduate Institute of International and Development Studies, said the international community could not see the health of people separate from the health of the planet.    Health literacy had to begin to be seen as integral to the right to health. 
 
During the ensuing discussion, speakers said all States had to take the primary responsibility to promote universal and equal access to health services, with some underscoring that developing countries should receive technical assistance and technology transfer to that end.  Many focused on the relation of the right to health vis-à-vis the Sustainable Development Goals, noting that health and well-being were essential for the achievement of those Goals.  Some developing countries lamented the effect of the brain drain of medical staff on their countries.  Several countries detailed their domestic efforts within the sphere of public health, outlining programmes and plans for various areas of health for their populations. 
 
Speaking were China on behalf of a group of States, European Union, Pakistan on behalf of the Organization of Islamic Cooperation, Portugal on behalf of the Community of Portuguese-speaking Countries, Tunisia on behalf of the African Group, Georgia, Paraguay, France, Qatar, Malaysia, El Salvador, Portugal, Botswana, United States, Venezuela, Iran, Haiti, Israel, Sierra Leone, Indonesia, Maldives, Ethiopia, Russian Federation and India.
 
The following non-governmental organizations also spoke: Swedish Society for Sexuality Education, Verein Sudwind Entwicklungspolitik, Amnesty International, International Human Rights Association of American Minorities, Tourner la Page, and Le Pont.
 
The Council is having a full day of meetings today.  At noon, it will continue its clustered interactive dialogue with the Special Rapporteur on internally displaced persons, and the Special Rapporteur on extreme poverty and human rights.
 
Opening Statement
 
JOAQUÍN ALEXANDER MAZA MARTELLI, President of the Human Rights Council, introducing the topic of the panel discussion, said that in its resolution 32/16, the Human Rights Council had decided to convene a panel discussion to exchange experiences and practices on realizing the right of everyone to the enjoyment of the highest attainable standard of physical and mental health by enhancing capacity-building in public health.  He introduced the panellists, before noting that the Secretariat had not managed to recruit sign-language interpreters for the occasion. 
 
Keynote Statements
 
KATE GILMORE, Deputy High Commissioner for Human Rights, noted that States were legally obliged by international law to enable people to realize their right to health, which was a prerequisite for the fulfilment of all other human rights.  The right to health did not stand alone, but was indivisible from other human rights.  Worldwide, the need to realize the right to health had never been more urgent.  It was a pathway to sustainable development, as well as a critical companion to education.  The health of women, children and adolescents was a crucial aspect of their development and the development of societies.  Sexual and reproductive health was an important topic.  Yet people’s ability to access quality health services was being continually undermined and threatened, through forces such as urbanisation and environmental degradation.  Conflict settings were challenging for the right to health, which was a core area for strategic investment.  Thanks to the Agenda 2030, the international community had an unprecedented opportunity to advance all individuals’ human rights.  A human rights-based approach could help States in several areas, such as better addressing the determinants of health, including gender inequality, discrimination, displacement, violence, dehumanizing urbanization, and other factors.
 
MARGARET CHAN, Director-General of the World Health Organization, welcomed the emphasis on the role of capacity-building in public health as a means of upholding the right to health.  Governments had a responsibility for the health of their peoples, which could be fulfilled only by the provision of adequate health and social measures.  The ability to perform that duty of care depended absolutely on having fundamental health capacities in place.  Examples of those capacities included the provision of essential preventive and curative health services and medicines, and sufficient numbers of appropriately trained and motivated health staff.  Countries also needed the statistical data from information systems that recorded births, deaths, and causes of death.  The provision of adequate health and social measures included surveillance systems that caught outbreaks quickly.  The right to health depended on regulatory authorities that kept water, air, food and medicines safe, and protected populations from exposure to harmful chemicals.  It also depended on legislation and its enforcement in multiple other ways.  Legislation could protect against discrimination and exclusion, and helped ensure that all people had an equal opportunity to enjoy the highest attainable level of health.
 
Legislation was one of the best ways to confer population-wide protection against threats to health.  Population-wide approaches provided an equal opportunity shield aimed at protecting everyone.  The World Health Organization had developed instruments and mechanisms that contributed to fair access to care and thus underpinned the right to health, most notably by making the prices of pharmaceutical products more affordable.  The health situation was marked by extremes.  The world had 800 million chronically hungry people, but it also had countries where more than 70 per cent of the adult population was overweight or obese.  That was a world where the price of some generic medicines had dropped so low that manufacturers had left the market, creating holes in the availability of essential medicines.  That was also a world in which the costs of some new medicines, especially for chronic conditions, were unaffordable, even for the richest countries in the world.  Despite remarkable recent progress, an estimated 5.9 million children had died before their fifth birthday in 2015.  The millions of young deaths that could have been prevented or cured by existing medical products would have been unthinkable in a fair and just world.  An estimated two billion people had no access to essential medicines. 
 
A respect for the right to health was a hallmark of good government.  Countries that had enshrined the right to health in their constitutions generally had the best human rights records.  Fragile States disrupted by armed conflict generally had the worst records, especially when political factions used the denial of international health assistance as a weapon of war.  A health system oriented towards universal health coverage left no one behind.  Universal health coverage operated as a significant poverty reduction strategy and, thus, as a nation-building strategy.  It was the ultimate expression of fairness.  It was one of the most powerful social equalizers among all policy options, Ms. Chan concluded.   
 
Statements by the Panel Moderator and the Panellists
 
NOZIPHO JOYCE MXAKATO-DISEKO, Panel moderator and Permanent Representative of South Africa to the United Nations Office at Geneva, recalled that on 1 July 2016, the Human Rights Council had adopted resolution 32/16 entitled “promoting the right of everyone to the enjoyment of the highest attainable standard of physical and mental health through enhancing capacity-building in public health”.  In the resolution, the Human Rights Council had decided to convene a panel discussion that would provide a platform for States and all relevant stakeholders to exchange experiences and practices on realizing the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
 
TOLBERT NYENSWAH, Deputy Minister of Health of Liberia and Director General of the National Health Institute of Liberia, recalled that the 2014-2015 Ebola epidemics in Western Africa had ravaged health systems, particularly in Guinea and Liberia.  The epidemics had affected over 100,000 persons, including medical and humanitarian staff, and provoked a death toll that killed over 5,000 Liberians.  The infection by Ebola had impacted the region largely, and reached geographical areas that were outside its original development zone, affecting for example Senegal and Mali.  In 2014, an incident management system had been established to lead the response to the epidemics by coordinating public health interventions to bring a lasting solution.  The international community had strongly supported this effort.  China, in particular, rose to assist Liberia, giving birth to a south-south collaboration initiative.  The Chinese had set up an Ebola treatment unit, providing technical assistance to Liberian health staff.  The World Health Organization had also brought technical assistance.  As a result, Ebola had been contained and fatal case rates minimized. 
 
Mr. Nyenswah recalled that the right to health for everyone was enshrined in article 25 of the Universal Declaration of Human Rights.   In order to fully implement this right, major efforts remained necessary in order to improve water and sanitation in developing countries.  In a post-Ebola world, there was still an urgent need to build a more resilient health system by providing adequate training for scientists, which could be delivered in the new public health institute that had recently been established in Liberia.  Finally, Mr. Nyenswah called on dependable partners like China to continue to support Liberia in its efforts to improve its health system.  
 
LORENZO SOMARRIBA LÓPEZ, National Director of Public Health at the Ministry of Public Health of Cuba, said that he would be setting out the experience of Cuba on the promotion of the right of everyone to the highest attainable standard of health.  Since 1959, Cuba had been applying health policies to change the panorama of the pre-Revolutionary period.  Cuba’s health care covered 100 per cent of the population, with multi-sectoral participation of Cuba’s communities.  That was anchored in law.  In Cuba, 99.9 per cent of births were in health institutions.  Cuba had an immunization programme that protected against 13 diseases, 8 vaccines of which were nationally produced.  Neonatal tetanus, measles, mumps, rubella and human rabies, among many other diseases, had been eradicated.  Cuba had been among the first to eliminate mother-to-child transmission of HIV.  One of the principles of Cuban public health was international cooperation.  Around 325,000 Cuban health professionals had over the years contributed to providing health care to populations around the world.  Cuba had medical brigades in 63 countries.  Human capital was the international community’s most valued richness. 
 
REN MINGHUI, Assistant Director-General for HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases at the World Health Organization, said that the World Health Organization was pleased that global momentum around universal health coverage, which had begun in 2010, had culminated in the embedding of that target in the Sustainable Development Goals.  There was global consensus that universal health coverage should not be viewed as a distant, aspirational goal but rather as a fundamental step in realizing the right to health.  There was also consensus that without increased investments in health system strengthening, moving towards universal health coverage would not be feasible.  Capacity building in public health was a core element of those efforts.  During the Ebola outbreak only one third of countries had had the core public health capacities that had been required to prevent, detect and respond to public health emergencies.   Much had been done to strengthen global preparedness for such emergencies and the World Health Organization had increased its own engagement and support for countries to build up core capacities that were required under the International Health Regulations.  Over the past year, there had been significant political momentum around health-in-all-policies, which was an important measure of the level of national and global commitment for capacity strengthening in public health.  The ninth World Health Organization Global Conference on Health Promotion, held in November 2016, had been a milestone in promoting health across all Sustainable Development Goals, and in generating commitments for increasing investments in health and well-being.  In many countries, the responses were inhibited by major financial, infrastructural and programmatic challenges.  Capacity building was, thus, critical for saving lives, expanding access to prevention, diagnostic testing and treatment, and shifting gears towards the ambitious goals set for 2030, Mr. Minghui underlined.
 
NOZIPHO JOYCE MXAKATO-DISEKO, Panel Moderator and Representative of South Africa to the United Nations Office at Geneva, emphasized the centrality of the Sustainable Development Goals in public health.  She reminded that the international community tended to forgot that each Sustainable Development Goal had a specific policy goal attached to it, such as for example the development of training for medical staff, in particular in developing countries, or the implementation of the World Health Organization’s Framework Convention on Tobacco Control.  The beauty of the panel was that it provided a comprehensive view of public health, rather than just a set of measures from which countries could pick and choose.    
 
GONG XIANGGUANG, Deputy Director General, Department of Law and Legislation, National Health and Family Planning Commission of China, stated that providing an efficient health system to all citizens was a key priority for the Government of China.   Important reforms had been undertaken in order to improve the public health service system.  In the last 10 years, life expectancy in China had consistently risen and mortality rates at birth had fallen.  The Chinese Government particularly stressed preventive measures and effective cure policies for all type of epidemics.  Another key goal was the improvement of legislation and regulations in the domain of public health emergencies.  In 2016, a five-year plan on “Healthy China” had been adopted, providing new tools to improve health system quality, enhance the accessibility to health for all citizens, and ensure equity in public health services.  Subsidies had also been raised to address a wide range of diseases and a public health project on combatting AIDS had been implemented.  The “Healthy China” plan also aimed at promoting reasonable diet, physical fitness, and prevention against the abuse of alcohol.  Health services for key groups, like aging people and persons with disabilities, had been enhanced
 
NOZIPHO JOYCE MXAKATO-DISEKO, Panel Moderator and Representative of South Africa to the United Nations Office at Geneva, recalled that the principle of equity in public health services, among countries but also between countries, was deeply enshrined in the  Sustainable Development Goals of the Agenda 2030.
 
ILONA KICKBUSCH, Director of the Global Health Centre and Adjunct Professor at the Graduate Institute of International and Development Studies, said the challenge at hand was summarized by a document from the World Health Organization, the Ottawa Charter for Health Promotion, which stated that “health was created and lived by people within the settings of their everyday life; where they learn, work, play and love.”  In the Sustainable Development Goals era, it was increasingly clear that the international community could not see the health of people separate from the health of the planet.  The Ottawa Charter had identified five action areas for health promotion, which included reorienting health care services toward the prevention of illness and the promotion of health.  The empowerment of people was one of the most critical components of capacity building in public health.  People needed to make a significant number of health decisions every day, but in most countries, they were not well equipped to do so.  Health literacy had to begin to be seen as integral to the right to health.  In a global consumer society, the right to health also included the need to address the commercial determinants of health, including the products, marketing and environments harmful to health.  Health was a political choice, and many political choices required strong commitment and courage.  People’s right to health, healthy lives, and increased well being at all ages, could only be achieved by promoting health through all the Sustainable Development Goals and by engaging the whole of society in the health development process.
 
NOZIPHO JOYCE MXAKATO-DISEKO, Permanent Representative of South Africa to the United Nations Office at Geneva and panel moderator, said heath was an integrated package, and noted the importance of health literacy as a basis for achieving health. 
 
Discussion
 
China, speaking on behalf of a group of countries, said that the right of everyone to the highest attainable standard of health was a fundamental right, noting that all States bore the primary responsibility to promote universal and equal access to health services.  Developing countries should receive technical assistance and technology transfer to that end.  European Union underlined that the cross-cutting nature of the right to health meant that it was essential for the realization of other rights.  Health and well-being were essential for the achievement of the Sustainable Development Goals.  The European Union asked how stigma and discrimination could be eliminated from public health.  Pakistan, speaking on behalf of the Organization of Islamic Cooperation, noted that achieving public health security was an arising challenge.  The Organization of Islamic Cooperation had developed a health plan of action, aimed at eliminating diseases and ensuring public health to the citizens of its countries.  Portugal, speaking on behalf of the Community of Portuguese Speaking Countries, reiterated the Community’s full commitment to build strong and resilient public health systems.  What was the potential of languages, which were not among the official United Nations languages, in promoting global public health?  Tunisia, speaking on behalf of the African Group, noted the Group’s strong commitment to improve public health systems on the African continent.  Although meaningful financing had been made available in many countries, they had been affected by the brain drain of medical staff.  Georgia stated that it had taken measures to improve its public health system, and it had created policies to implement the Sustainable Development Goals.  However, those goals could not be applied equally across all countries, particularly in those affected by conflict.   
 
Paraguay was convinced that health systems all over the world needed to follow international human rights standards in order to enhance their accessibility and efficiency.  Treaty Bodies, Special Procedures and the Universal Periodic Review formulated recommendations that were key to the realization of the right to health.  France recalled that achieving the Sustainable Development Goals would considerably help improve access to health.  There was an urgent need to strengthen health systems capacities in order to respond to sanitary emergency situations.  Qatar said it was committed to align its health system with international standards.  As a host country for the World Health Summit, Qatar called on all participating countries to take into account the best practices exchanged in this forum.  Malaysia focused on the need to enhance access for primary healthcare and affirmed that citizens needed to be involved in taking responsibility for their health through lifestyle choices.  El Salvador agreed that there was an urgent need to reinforce the capacities of national health systems, particularly primary health services.  Adequate reforms had led to the reduction of the levels of chronic malnutrition and mother mortality.  Portugal stressed the importance of adopting a human rights approach in order to reach world health coverage.  All forms of discrimination needed to be eliminated and access of migrants and refugees to healthcare must be provided.
 
Swedish Society for Sexuality Education said a vicious dynamic meant the most vulnerable were disproportionately affected by challenges, adding that States needed to take a human rights approach to health, including sexual health and reproductive rights.  Verein Sudwind Entwicklungspolitik said that access to reproductive health services and other access to health services had been affected in Iran, and asked the panellists for suggestions for coordinating the country’s health care with its international obligations.  Amnesty International said some groups were excluded from the right to health.  Health workers were not trained to respond to adolescents’ needs.  Investing in human rights training for health workers was one approach to mitigate the problem.
 
NOZIPHO JOYCE MXAKATO-DISEKO, Panel Moderator and Permanent Representative of South Africa to the United Nations Office at Geneva, said a rich variety of suggestions had been heard, and questions clustered into what progress had been made in ensuring access to medicines in developing countries, and that there had also been questions on the effect of the brain drain and how it could be addressed.  The challenges that countries faced were not the same, as different countries were affected by different circumstances.
 
TOLBERT NYENSWAH, Deputy Minister of Health of Liberia and Director General of the National Public Health Institute of Liberia, said that there was no one-size-fits-all solution, and people living with disabilities also needed to be included in policies.  Nobody knew where another refugee crisis would come from.  Brain drain was an issue which needed to be addressed, and one approach was for countries of the South to learn from each other, as had been suggested by Cuba’s example.
 
LORENZO SOMARRIBA LÓPEZ, National Director of Public Health at the Ministry of Public Health of Cuba, said that Cuba had defined a basic framework for medicines in order to guarantee its health service.  Some 531 medicines were produced by the national industry, while 318 items were imported.  Cuba had also developed so-called natural medicines.  It was the responsibility of the State to immediately import medicines if anything was missing.  
 
REN MINGHUI, Assistant Director-General for HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases at the World Health Organization, underlined the value of the human rights approach in public health.  In that respect, cooperation with the Human Rights Council was absolutely appreciated in the World Health Organization.  Many issues could not be tackled solely through a public health approach and required a wider political dimension because health was a political choice.  International cooperation was necessary to respond to various public health emergencies.  However, capacity building was a challenge not only for developing and poor countries, but also for richer countries.  Strong investment by countries in the production of medicines was absolutely necessary to ensure access to medicines.
 
GONG XIANGGUANG, Deputy Director General, Department of Law and Legislation, National Health and Family Planning Commission of China, wished to share the experience of China, stressing that over the last 16 years, the Chinese Government had considered health as a priority.  Mr. Xiangguang said that the lack of resources long suffered by the health system in China had been resolved.  Accessibility and equity in health was ensured, irrespectively of differences in income and gender.  A national mechanism had been set up to provide free medicine for all Chinese citizens.
 
ILONA KICKBUSCH, Director of the Global Health Centre and Adjunct Professor at the Graduate Institute of International and Development Studies, stressed that experience had shown that taxation of tobacco considerably reduced its use.  Every year, 5 per cent of global GDP was lost in tobacco use, money that could be invested in health.  A couple of weeks ago, a G20 meeting of Health Ministers was held in Berlin, allowing an exchange on good practices.  Such initiatives needed to be repeated to further foster discussions on health topics at the international level.
 
Discussion
 
Botswana said its Ministry of Health had adopted a plan that emphasized the need for inter-sectoral cooperation, adding that good governance was a crucial factor in the success of such plans.  United States said it was working to ensure its own citizens’ access to health care domestically, and also noted that internationally, the United States partnered with others to build and strengthen capacities.  Venezuela recognized the right to health as a key human right, and said challenges and viable solutions needed to be identified in order for that right to be implemented.  Iran expressed its commitment to capacity building in public health, and said public health was regarded as a priority in Iran, where reforms in that field had ensured that all necessary medicines were provided.  Haiti said that the Government was making efforts in providing universal health coverage, and the Health Ministry had been implementing a plan for dental health, adding that a single health care information system had been established, as well as a national ambulance centre.  Israel said capacity building in public health was a priority for Israel, adding that the Ministry of Health had an elaborate public health unit.
 
Sierra Leone stated that following the Ebola outbreak, it had taken measures to be better prepared to fight public health emergencies.  Capacity building had to be strengthened through international cooperation, especially through technical assistance to developing countries.  Indonesia said that despite efforts to increase access to comprehensive public healthcare services, it still faced challenges.  To that end, Indonesia had implemented programmes to ensure the availability of health personnel in remote areas.  Maldives noted that as a small island State, it had faced numerous challenges in providing quality health service to all, due to the dispersion of the islands.   It looked toward to the exchange of good practices and called for more technical assistance.  Ethiopia stressed that the availability and demand for health resources remained a big challenge for many developing countries, including the least developed countries.  Was the response of the international community up to the expectation of the call of the Council resolution 32/16?  Russian Federation hailed the inclusion of physical and mental health in the Sustainable Development Goals.  Access to high-technology health treatment was one of the priorities of the Russian Government.  India voiced its resolve to achieve universal health coverage.  Strengthening of health systems and capacity building in public health were at the core of its new health policy.  International cooperation was key to achieving health for all.     
 
International Human Rights Association of American Minorities raised the issue of the lack of access to health services faced by citizens in Yemen because of the current political crisis.  What type of assistance could the United Nations provide in Yemen where non-state actors were preventing people from accessing health services and medicines?  Tourner la page outlined that the Sri-Lankan Government had implemented a blockade on medicines during the war against Eelam Tamils in the north and east regions of the country.  Women and children had been particularly affected and had faced mental stress.  On the same topic, Le Pont outlined that nine years after the end of the war, ex Tamil freedom fighters were still suffering from trauma.  How could the United Nations help to improve the mental health of those individuals?
 
Concluding Remarks
 
In her concluding remarks, NOZIPHO JOYCE MXAKATO-DISEKO, Panel moderator and Permanent Representative of South Africa to the United Nations Office at Geneva, noted that each Sustainable Development Goal bore a package of objectives and means of implementations of those objectives that could be considered as useful entry points for countries to improve their health system and implement the right to health.  She recalled a number of questions and issues that had been raised during the discussion.  How could United Nations funds and programmes be used to improve the quality and accessibility of national health systems?  How could the United Nations help States overcome the challenges they faced in their implementation of the right of health?  How could qualitative and quantitative results be measured?
  
ILONA KICKBUSCH, Director of the Global Health Centre and Adjunct Professor at the Graduate Institute of International and Development Studies, noted that a good point was made during the discussion about the concept of good governance for health.  This notion was fully enshrined in Sustainable Development Goal number 16 on institution building.  Building resilient and high-quality institutions in the domain of health was indeed critical to improve access to health.  In addition, countries needed to initiate accountable policies that included prevention and health security aspects.  There was no room for separate agendas.  Links and close relations needed to be established between different sectors.  Health professionals had to be prepared for intersectional actions.  Finally, it was important to bear in mind that the right to health and other social rights, which all bore individual and collective components, were closely interlinked.
 
GONG XIANGGUANG, Deputy Director General of the Department of Law and Legislation at the National Health and Family Planning Commission of China, said that in the 1980s, China had lacked resources so there had been a bottleneck.  The central budgets had increased input in less developed areas in the country.  In the 1950s, it was realized that public health required the involvement of all sectors.  It was not possible to rely only on the Government.  There was a focus on vulnerable groups, such as women and children.  With ageing, that focus became more pronounced.
 
REN MINGHUI, Assistant Director-General for HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases at the World Health Organization, underlined the importance of information sharing with Member States.  The World Health Organization could not create good practices; they should come from the ground.  Health was relevant to economic and social development, which was why all United Nations agencies should work together to develop countries’ public health systems.  When it came to prioritization, it should come from country analyses and political decisions.
 
LORENZO SOMARRIBA LÓPEZ, National Director of Public Health at the Ministry of Public Health of Cuba, thanked all participants for the instructive comments on the daily implementation of health policies and measures.   As for Cuba’s experience in trilateral cooperation to increase quality health access, Cuban medical brigades had been deployed in West Africa during the Ebola outbreak.  Cuban medical training and education had a very important international cooperation component, based on ethical and humanitarian values.  Cuba and Norway had managed to forge very good cooperation in Haiti in the post-earthquake period. 
 
TOLBERT NYENSWAH, Deputy Minister of Health of Liberia and Director General of the National Public Health Institute of Liberia, noted that the parity between low-income, middle-income countries and high-income countries was an important element to consider in the provision of quality healthcare.  Developing countries faced major challenges to health, human rights and development.  The experience from the Ebola outbreak was used for vaccine trials in Liberia, epidemiological programmes, training of medical personnel, and capacity building.  Working together in health, South-South collaboration, and North-South collaboration were essential in addressing health emergencies. 
 
NOZIPHO JOYCE MXAKATO-DISEKO, Panel Moderator and Representative of South Africa to the United Nations Office at Geneva, said that when correctly implemented, international cooperation worked towards mutual respect among countries.  The country in need decided for itself what it needed and the country with resources promoted solidarity, monitoring in a collaborative way.  Those types of collaborations were valuable.  Each Sustainable Development Goal had a set of things that had to be done by 2030.   She reminded that developing countries were not at the starting point, which was why a reasonable burden of reporting should be applied to developing countries.  The Sustainable Development Goals were integrated and it was not possible to meet one without the other.  It was not possible to talk about good governance without the means that implementation required.

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Panel on enhancing capacity building in public health
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