Pacific Small Island Developoing States (PSIDS)
Cook Islands, Federated State of Micronesia, Fiji, Kiribati, Nauru, Niue, Palau, Papua New Guinea, Marshall Islands, Samoa, Solomon Islands, Tonga, Tuvalu,
Vanuatu
PACIFIC SMALL ISLAND DEVELOPING STATES
United Nations Member States
Phone: 212-557-5001
Fax: 212-557-5009
E-mail: pngmission@pngun.org
Permanent Mission of the Independent State of
Papua New Guinea to the United Nations
201 East 42nd Street, Suite 2411, New York, N.Y. 10017
Statement
by
H.E. Mr Robert G. Aisi
Permanent Representative of Papua New Guinea
to the United Nations
at the
Fourth Session of the Open Working Group (OWG) on
Sustainable Development (SDGs) on Health and Population Dynamics
19 June 2013, New York
“Check against delivery”
-------------------------------------------------------------------------------------------------------------------------------
Co-Chair,
1. I speak for the Pacific Troika in the OWG on SDGs, namely Nauru, Palau and my own country
Papua New Guinea. I am also speaking on behalf of the 11 Pacific Small Island Developing
States (PSIDS) represented at the UN, namely, Federated States of Micronesia, Fiji, Republic
of Marshall Islands, Nauru, Palau, Papua New Guinea, Samoa, Solomon Islands, Tonga,
Tuvalu and Vanuatu. We align ourselves with the Statement just made by Benin on behalf of
the Least Developed Countries, of whom some of our members are part of and likewise
with the AOSIS Chair’s Statement delivered by one of our member, Nauru.
2. I also thank the Panelist for their valued commentaries on health and population dynamics
yesterday.
3. By global standards, our region has one of the highest rates of non-communicable disease
related ill-health and premature deaths as a result of obesity, diabetes, cancer, chronic
respiratory diseases, heart disease including hypertension and stroke. These are
increasingly due to changes in our traditional way of life and modern consumption patterns.
This is compounded by increasing incidences of communicable disease such as diarrhoeal
diseases, leptospirosis, typhoid fever, cholera, dengue, sexually transmitted infections, HIV
and AIDS.
4. Weak governance and institutional structures, capacity constraints and dysfunctional health
care and service delivery remain a serious concern and impediment to sustainable
development. Efforts are being made by respective governments to address these issues
with measured success but more remains to be done.
Cook Islands, Federated State of Micronesia, Fiji, Kiribati, Nauru, Niue, Palau, Papua New Guinea, Marshall Islands, Samoa, Solomon Islands, Tonga, Tuvalu,
Vanuatu
2
5. We agree with the TST and the Secretary-General’s High-Level Panel of Eminent Persons on
the Post-2015 development agenda for a stand-alone Health Goal. This is because a healthy
and productive population is a long-term investment and key driver to achieving any
sustainable development goals we set for the world and for our communities, families and
personally.
6. The progressive but unfinished work on health-related MDGs will need to be expanded and
scaled-up under any new global Health SDG, as many UN member States, including from our
region, are unlikely to meet the health-related MDGs by 2015. We simply cannot afford to
let our guard down in this critical area.
Co-Chair,
7. The key target areas that a goalable Health SDG should prioritise include: Prevention and
control of non-communicable diseases (NCDs) and communicable diseases; Strengthening
of national health systems; Maternal, child and adolescent health; Social determinants of
health; Sexual and reproductive health issues, including human rights; Food security;
Mental health; Climate change and health; Primary health care; and Disaster Risk
Management.
8. Special focused attention must be accorded to the marginalized and most vulnerable
population such as the poor, disabled persons, children, women and girls, elderly and those
stigmatized for various reasons.
9. Other important cross-cutting issues of population dynamics that a universal Health SDG
must address are urbanisation and overcrowding, increasing population pressure,
inadequate nutrition and housing, lack of education, unhygienic physical environment,
water and sanitation challenges, and deprived socio-cultural environments, including
human rights based sexual and reproductive health, which are factors impacting on global
health challenges.
10. Equally important issues that a future Health SDG must address holistically include ensuring
national governments taking ownership to overcome the inability of health systems to
deliver adequate and quality services, address inherent lack of human and financial
resources, improve poor infrastructure, invest in and strengthen inefficient health care and
delivery services and reinforce transparency and accountability for a transformative health
agenda.
Cook Islands, Federated State of Micronesia, Fiji, Kiribati, Nauru, Niue, Palau, Papua New Guinea, Marshall Islands, Samoa, Solomon Islands, Tonga, Tuvalu,
Vanuatu
3
Co-Chair,
11. Comprehensive and effective multi-stakeholder coordination and strategic partnerships at
all levels that will result in improved health outcomes in the areas of Non-Communicable
and Communicable Diseases as well as other major drivers of poor health need to be
prioritized and implemented. The challenge is to maximise opportunities for positive
synergies between sectors. For the major development partners and regional agencies
working with governments, more needs to be done in terms of effectively addressing these
challenges than the current efforts and resources being mobilised.
12. Investment in strengthening national health systems is a critical need for all countries.
However, such investment should not be focused solely on hospital based care at the
expense of prevention or primary health care. We cannot afford to neglect the importance
of strengthening preventive methods of health care which are the key to sustainable
development. Hospital care is not only expensive but will continue to take away a sizeable
proportion of the national health budget from other cost-effective measures in prevention.
Having an effective health information system is also important for providing evidence
bases for policy formulation and prioritising needs, strategic planning, budget allocation,
monitoring trends and reporting progress on international commitments.
13. It is critical to develop appropriate national health strategies and policies aligned to national
development priorities. These health sector strategies should be developed, owned and led
by countries in line with the Paris Declaration. Unless national Health Strategies reflect the
needs of the countries, based on evidence, and appropriate human resources, financial, and
structural adjustments are made, with appropriate financing mechanisms applied and
appropriate regulatory environment is created, systems will continue to have major
challenges in the short and long term.
Co-Chair,
14. There is an urgent need to develop capacity and capability of national and regional
agencies in the creation of relevant scientific information and evidence on key public health
priorities. This includes adapting and adopting evidence-based interventions and good
practice which are appropriately applied to context. Well-funded multidisciplinary research
teams are needed to translate research advances into practical management solutions. Of
critical importance is undertaking regular cost-benefit analyses to inform and guide national
decisions on investment in health interventions and that the knowledge and information
generated is utilised to guide policy and strategic directions.
15. This must also be supported by legislative and regulatory frameworks that protect and
promote health that also need to be implemented, monitored and evaluated. Legislative
and regulatory interventions (including taxation) are among the most effective
interventions for public health.
Cook Islands, Federated State of Micronesia, Fiji, Kiribati, Nauru, Niue, Palau, Papua New Guinea, Marshall Islands, Samoa, Solomon Islands, Tonga, Tuvalu,
Vanuatu
4
16. Health financing, including under the Paris Declaration must be prioritized and
predictable. This is to avert short-term measures that fail to build long-term sustainable
capacity, especially in the presence of rising health care costs and growing populations. This
has resulted in less predictability and inflexibility of development assistance to many
developing countries, including ours.
Co-Chair,
17. Specialist technical skills and expertise in strategic health communication/social and
behaviour change communication are lacking across many developing countries, including
in our region. The strong verbal commitment to health promotion and disease prevention is
not reflected in the human and financial resources made available for health
promotion/strategic health communication. Our own experiences inform us that efforts to
encourage individuals and communities to adopt and maintain healthy behaviour take a
narrow health education or “awareness-raising” approach, believing if people know the
dangers/consequences, they will change behaviours. This should also include restriction of
unhealthy food exports and imports. Such approaches need to change to address the
complex, sophisticated, challenging and difficult nature of social and behaviour change.
18. Much of the health sector related activities delivered by national governments are
through their health systems which comprise human resources, financing, essential drugs
and medicines, disease surveillance, health information and service delivery. Even in the
best of assistance from regional development partners and national commitment of
sizeable contribution of their GDPs, many of the health systems still lack behind in providing
services for unmet needs – family planning commodities, essential medicines, vaccines for
children and diagnostic procedures for primary care. The impact of such weakened health
systems could be reflected in their slow progress towards achieving the health-related
MDGs.
19. Weak health systems impede universal access to essential primary health care services
and negatively impact health equity and the exercise of human rights to health. Frequent
changes in health leadership affects good governance, accountability and policy direction
for moving health forward.
20. Severe human resource constraints are a major long-standing problem across SIDS. This
includes an inadequate number of trained health professionals, exacerbated by their
migration to other countries. Furthermore, the distribution of the available human
resources is often inequitable, with outer island populations underserved.
Cook Islands, Federated State of Micronesia, Fiji, Kiribati, Nauru, Niue, Palau, Papua New Guinea, Marshall Islands, Samoa, Solomon Islands, Tonga, Tuvalu,
Vanuatu
5
21. The neglect of human settlements and inadequate waste disposal contribute to the
prevalence of infectious diseases such as dengue fever, malaria, tuberculosis, cholera, and
typhoid fever. Recent reported literature on health status of populations in the Pacific
region have stated that the Infant Mortality (IMR) and Under 5 Mortality Rates (U5MR)
remain a problem with the majority of the disease burden due to acute respiratory
infections and diarrheal diseases and thus some countries are unlikely to meet the MDGs by
2015i.
Co-Chair,
22. Environmental changes brought about by climate change are likely to compound existing
environmental health concerns and a resurgence of endemic diseases such as typhoid fever.
Many countries would need to give more priority to the environment than is currently done
in order to improve not only the standard of living but also reverse the poor health
indicators related to child morbidity and mortality. This is an emerging issue which is of
increasing concern to us and therefore needs requisite attention in the long-term under a
Health SDG.
23. In conclusion, as we go into recess, the work of the post-2015 development agenda of the
OWG is not put on a backburner but rather we would encourage the continuation of the
positive momentum we have built through a regularized informal consultations, where
feasible.
I thank you.
Vanuatu
PACIFIC SMALL ISLAND DEVELOPING STATES
United Nations Member States
Phone: 212-557-5001
Fax: 212-557-5009
E-mail: pngmission@pngun.org
Permanent Mission of the Independent State of
Papua New Guinea to the United Nations
201 East 42nd Street, Suite 2411, New York, N.Y. 10017
Statement
by
H.E. Mr Robert G. Aisi
Permanent Representative of Papua New Guinea
to the United Nations
at the
Fourth Session of the Open Working Group (OWG) on
Sustainable Development (SDGs) on Health and Population Dynamics
19 June 2013, New York
“Check against delivery”
-------------------------------------------------------------------------------------------------------------------------------
Co-Chair,
1. I speak for the Pacific Troika in the OWG on SDGs, namely Nauru, Palau and my own country
Papua New Guinea. I am also speaking on behalf of the 11 Pacific Small Island Developing
States (PSIDS) represented at the UN, namely, Federated States of Micronesia, Fiji, Republic
of Marshall Islands, Nauru, Palau, Papua New Guinea, Samoa, Solomon Islands, Tonga,
Tuvalu and Vanuatu. We align ourselves with the Statement just made by Benin on behalf of
the Least Developed Countries, of whom some of our members are part of and likewise
with the AOSIS Chair’s Statement delivered by one of our member, Nauru.
2. I also thank the Panelist for their valued commentaries on health and population dynamics
yesterday.
3. By global standards, our region has one of the highest rates of non-communicable disease
related ill-health and premature deaths as a result of obesity, diabetes, cancer, chronic
respiratory diseases, heart disease including hypertension and stroke. These are
increasingly due to changes in our traditional way of life and modern consumption patterns.
This is compounded by increasing incidences of communicable disease such as diarrhoeal
diseases, leptospirosis, typhoid fever, cholera, dengue, sexually transmitted infections, HIV
and AIDS.
4. Weak governance and institutional structures, capacity constraints and dysfunctional health
care and service delivery remain a serious concern and impediment to sustainable
development. Efforts are being made by respective governments to address these issues
with measured success but more remains to be done.
Cook Islands, Federated State of Micronesia, Fiji, Kiribati, Nauru, Niue, Palau, Papua New Guinea, Marshall Islands, Samoa, Solomon Islands, Tonga, Tuvalu,
Vanuatu
2
5. We agree with the TST and the Secretary-General’s High-Level Panel of Eminent Persons on
the Post-2015 development agenda for a stand-alone Health Goal. This is because a healthy
and productive population is a long-term investment and key driver to achieving any
sustainable development goals we set for the world and for our communities, families and
personally.
6. The progressive but unfinished work on health-related MDGs will need to be expanded and
scaled-up under any new global Health SDG, as many UN member States, including from our
region, are unlikely to meet the health-related MDGs by 2015. We simply cannot afford to
let our guard down in this critical area.
Co-Chair,
7. The key target areas that a goalable Health SDG should prioritise include: Prevention and
control of non-communicable diseases (NCDs) and communicable diseases; Strengthening
of national health systems; Maternal, child and adolescent health; Social determinants of
health; Sexual and reproductive health issues, including human rights; Food security;
Mental health; Climate change and health; Primary health care; and Disaster Risk
Management.
8. Special focused attention must be accorded to the marginalized and most vulnerable
population such as the poor, disabled persons, children, women and girls, elderly and those
stigmatized for various reasons.
9. Other important cross-cutting issues of population dynamics that a universal Health SDG
must address are urbanisation and overcrowding, increasing population pressure,
inadequate nutrition and housing, lack of education, unhygienic physical environment,
water and sanitation challenges, and deprived socio-cultural environments, including
human rights based sexual and reproductive health, which are factors impacting on global
health challenges.
10. Equally important issues that a future Health SDG must address holistically include ensuring
national governments taking ownership to overcome the inability of health systems to
deliver adequate and quality services, address inherent lack of human and financial
resources, improve poor infrastructure, invest in and strengthen inefficient health care and
delivery services and reinforce transparency and accountability for a transformative health
agenda.
Cook Islands, Federated State of Micronesia, Fiji, Kiribati, Nauru, Niue, Palau, Papua New Guinea, Marshall Islands, Samoa, Solomon Islands, Tonga, Tuvalu,
Vanuatu
3
Co-Chair,
11. Comprehensive and effective multi-stakeholder coordination and strategic partnerships at
all levels that will result in improved health outcomes in the areas of Non-Communicable
and Communicable Diseases as well as other major drivers of poor health need to be
prioritized and implemented. The challenge is to maximise opportunities for positive
synergies between sectors. For the major development partners and regional agencies
working with governments, more needs to be done in terms of effectively addressing these
challenges than the current efforts and resources being mobilised.
12. Investment in strengthening national health systems is a critical need for all countries.
However, such investment should not be focused solely on hospital based care at the
expense of prevention or primary health care. We cannot afford to neglect the importance
of strengthening preventive methods of health care which are the key to sustainable
development. Hospital care is not only expensive but will continue to take away a sizeable
proportion of the national health budget from other cost-effective measures in prevention.
Having an effective health information system is also important for providing evidence
bases for policy formulation and prioritising needs, strategic planning, budget allocation,
monitoring trends and reporting progress on international commitments.
13. It is critical to develop appropriate national health strategies and policies aligned to national
development priorities. These health sector strategies should be developed, owned and led
by countries in line with the Paris Declaration. Unless national Health Strategies reflect the
needs of the countries, based on evidence, and appropriate human resources, financial, and
structural adjustments are made, with appropriate financing mechanisms applied and
appropriate regulatory environment is created, systems will continue to have major
challenges in the short and long term.
Co-Chair,
14. There is an urgent need to develop capacity and capability of national and regional
agencies in the creation of relevant scientific information and evidence on key public health
priorities. This includes adapting and adopting evidence-based interventions and good
practice which are appropriately applied to context. Well-funded multidisciplinary research
teams are needed to translate research advances into practical management solutions. Of
critical importance is undertaking regular cost-benefit analyses to inform and guide national
decisions on investment in health interventions and that the knowledge and information
generated is utilised to guide policy and strategic directions.
15. This must also be supported by legislative and regulatory frameworks that protect and
promote health that also need to be implemented, monitored and evaluated. Legislative
and regulatory interventions (including taxation) are among the most effective
interventions for public health.
Cook Islands, Federated State of Micronesia, Fiji, Kiribati, Nauru, Niue, Palau, Papua New Guinea, Marshall Islands, Samoa, Solomon Islands, Tonga, Tuvalu,
Vanuatu
4
16. Health financing, including under the Paris Declaration must be prioritized and
predictable. This is to avert short-term measures that fail to build long-term sustainable
capacity, especially in the presence of rising health care costs and growing populations. This
has resulted in less predictability and inflexibility of development assistance to many
developing countries, including ours.
Co-Chair,
17. Specialist technical skills and expertise in strategic health communication/social and
behaviour change communication are lacking across many developing countries, including
in our region. The strong verbal commitment to health promotion and disease prevention is
not reflected in the human and financial resources made available for health
promotion/strategic health communication. Our own experiences inform us that efforts to
encourage individuals and communities to adopt and maintain healthy behaviour take a
narrow health education or “awareness-raising” approach, believing if people know the
dangers/consequences, they will change behaviours. This should also include restriction of
unhealthy food exports and imports. Such approaches need to change to address the
complex, sophisticated, challenging and difficult nature of social and behaviour change.
18. Much of the health sector related activities delivered by national governments are
through their health systems which comprise human resources, financing, essential drugs
and medicines, disease surveillance, health information and service delivery. Even in the
best of assistance from regional development partners and national commitment of
sizeable contribution of their GDPs, many of the health systems still lack behind in providing
services for unmet needs – family planning commodities, essential medicines, vaccines for
children and diagnostic procedures for primary care. The impact of such weakened health
systems could be reflected in their slow progress towards achieving the health-related
MDGs.
19. Weak health systems impede universal access to essential primary health care services
and negatively impact health equity and the exercise of human rights to health. Frequent
changes in health leadership affects good governance, accountability and policy direction
for moving health forward.
20. Severe human resource constraints are a major long-standing problem across SIDS. This
includes an inadequate number of trained health professionals, exacerbated by their
migration to other countries. Furthermore, the distribution of the available human
resources is often inequitable, with outer island populations underserved.
Cook Islands, Federated State of Micronesia, Fiji, Kiribati, Nauru, Niue, Palau, Papua New Guinea, Marshall Islands, Samoa, Solomon Islands, Tonga, Tuvalu,
Vanuatu
5
21. The neglect of human settlements and inadequate waste disposal contribute to the
prevalence of infectious diseases such as dengue fever, malaria, tuberculosis, cholera, and
typhoid fever. Recent reported literature on health status of populations in the Pacific
region have stated that the Infant Mortality (IMR) and Under 5 Mortality Rates (U5MR)
remain a problem with the majority of the disease burden due to acute respiratory
infections and diarrheal diseases and thus some countries are unlikely to meet the MDGs by
2015i.
Co-Chair,
22. Environmental changes brought about by climate change are likely to compound existing
environmental health concerns and a resurgence of endemic diseases such as typhoid fever.
Many countries would need to give more priority to the environment than is currently done
in order to improve not only the standard of living but also reverse the poor health
indicators related to child morbidity and mortality. This is an emerging issue which is of
increasing concern to us and therefore needs requisite attention in the long-term under a
Health SDG.
23. In conclusion, as we go into recess, the work of the post-2015 development agenda of the
OWG is not put on a backburner but rather we would encourage the continuation of the
positive momentum we have built through a regularized informal consultations, where
feasible.
I thank you.
Stakeholders