Comments
As noted in the discussion of the priority measures in this chapter, in order to promote, protect and guarantee health and sexual and reproductive rights, these must be made an integral part of primary health care, which in turn must be strengthened. Only in the context of primary health care is it possible to guarantee sufficient financial, human and technological resources to provide universal access to sexual and reproductive health for all persons.
In the context of the 2030 Agenda for Sustainable Development and the Sustainable Development Goals, work is now underway on:
(a) Strengthening primary health care. The 53rd Directing Council of PAHO, held in Washington D.C. from 29 September to 3 October 2014, approved the Strategy for Universal Access to Health and Universal Health Coverage, which (i) calls on Member States to establish formal mechanisms for participation and dialogue, establish national targets and goals, and define plans of action for universal access to health and universal health coverage, to strengthen governance and stewardship in the health sector, to improve the organization and management of health services, to improve human resource capacities at the first level of care, to increase the efficiency and public financing of health, to advance toward eliminating direct payment, and to facilitate the empowerment of people and communities; and (ii) requests the Director of PAHO to facilitate the leadership of the health authorities, to prioritize technical cooperation that supports countries in advancing toward universal access to health and universal health coverage, to develop measures to implement the strategy and to monitor it, to promote innovation and to strengthen the mechanisms of interagency coordination.
(b) The Report of the Open Working Group of the General Assembly on Sustainable Development Goals, presented to the United Nations General Assembly in August 2014 declares, in paragraph 12 of the proposal, that “each country has primary responsibility for its own economic and social development and the role of national policies, domestic resources and development strategies cannot be overemphasized. Developing countries need additional resources for sustainable development. There is a need for significant mobilization of resources from a variety of sources and the effective use of financing, in order to promote sustainable development. In the outcome document, the commitment to reinvigorating the global partnership for sustainable development and to mobilizing the resources necessary for its implementation was affirmed. The report of the Intergovernmental Committee of Experts on Sustainable Development Financing will propose options for a sustainable development financing strategy. The substantive outcome of the third International Conference on Financing for Development, in July 2015, will assess the progress made in the implementation of the Monterrey Consensus and the Doha Declaration. Good governance and the rule of law at the national and international levels are essential for sustained, inclusive and equitable economic growth, sustainable development and the eradication of poverty and hunger.”(c) As part of the preparatory work for the Third Conference on Financing for Development, held in Addis Ababa in July 2015, ECLAC hosted the Latin American and Caribbean Regional Consultation on Financing for Development in March 2015. The working document presented by ECLAC, Financing for Development in Latin America and the Caribbean: a strategic analysis from a middle-income country perspective, mentions, among its conclusions, that the 2030 Agenda for Sustainable Development will bring a profound transformation in sustainable development and will require a vast mobilization of resources, along with a change in their funding, organization and allocation, that meeting the goals will entail mobilizing both public and private resources, that the capabilities for accessing private financing vary among the Latin American and Caribbean countries, that the changes in the financial landscape increase the complexity of combining the various financing options, that greater access to external resources must be complemented and balanced with improved domestic resource mobilization, that mobilizing domestic resources means more than mobilizing fiscal resources alone, and that the mobilization of domestic resources through fiscal means should be complemented by strengthening the role of development banks. Countries of the European Union are now examining and taking steps to optimize their health care and pharmaceutical models and, in particular, pharmaceutical spending and its weight in health spending, and measures in this area will need to be addressed in light of that experience. Follow up to this priority measure also requires spending on sexual and reproductive health to be analysed as a percentage of health spending and of social public spending.
Related instruments, forums and mechanisms
This measure is associated with target 3c of the Sustainable Development Goals (“Increase substantially health financing and the recruitment, development and training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States”).
