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March 23, 2023

The United Nations and global health

By Ioan Voicu


According to Chinese wisdom, “Health is preferable to wealth”. This truth could not fail to have an inspirational impact on  multilateral diplomacy.

A successful worldwide lobby led to the inscription on the agenda of the United Nations General Assembly (UNGA) of the item “Global health and foreign policy.”

Since 2008, as a result of fruitful negotiations, this item was permanently on the UNGA agenda and was considered on the basis of professional reports prepared by the World Health Organization (WHO). The reports, discussions and resolutions resulting from the consideration of this item revealed the existence of different areas of collaboration between health and foreign policy, helped to formulate specific recommendations, and thus contributed to a better understanding of the importance of health in international policy and developmental discussions.

On 11 December 2019 in a comprehensive resolution (11 pages41 operative paragraphs) adopted by consensus and circulated worldwide  under the title Global health and foreign policy: an inclusive approach to strengthening health systems  the UN offered persuasive warnings and recommendations which deserved universal attention.

Unfortunately, this resolution was not taken into account by the decision-makers at the national level  and today, as estimated at the highest political and scientific levels , the world faces its gravest health crisis  since the founding of the UN in 1945. Indeed, the novel coronavirus (officially named COVID-19) is now an obvious global danger, as  this virus has resulted in more than 255 million infections and more than 5.1 million deaths.

So being the case, in his well-received report entitled Our Common Agenda, the UN Secretary-General Antonio Guterres had to pay primordial attention to global health. In this programmatic document there are 47 direct references to health. According to this report ,COVID-19 pandemic has been a challenge like no other since the Second World War, revealing our shared vulnerability and interconnectedness. It has exposed human rights concerns and exacerbated deep fragilities and inequalities in our societies. It has amplified disenchantment with institutions and political leadership as the virus has lingered. We have also seen many examples of vaccine nationalism. Moreover, with less than a decade to go, the Sustainable Development Goals in 2030 Agenda have been thrown even further off track.

Under these circumstances,  the report  concludes that ” The world needs to unite to produce and distribute sufficient vaccines for everyone. We have been reminded of the vital role of the State in solving problems, but also the need for networks of actors stretching well beyond States to cities, corporations, scientists, health professionals, researchers, civil society, the media, faith-based groups and individuals. When we all face the same threat, cooperation and solidarity are the only solutions, within societies and between nations”.

Fighting COVID-19 is not an easy task .The document explains the causes : public distrust of governments and government distrust of publics made it harder to maintain consensus behind public health restrictions on COVID-19. Conversely, countries with higher levels of trust in public institutions (along with higher levels of interpersonal trust) did better at managing the pandemic.

In order to change the current situation, the report asserts that  a key lesson from COVID-19 is  to recognize the importance of the State as a provider of trustworthy information, goods and services, especially in times of crisis. Institutions can analyze and reduce administrative burdens that make it hard for people to gain access to their services. A total of $78 billion would be needed for low-income countries to establish social protection floors, including health care, covering their combined population of 711 million people.

The report offers lucid practical warnings. While dealing with global public health, countries must be persuaded that the costs of their failure to heed the warnings of a possible pandemic and work together more effectively once the virus took hold will reverberate for generations to come. Therefore, States  must ensure this never happens again. Mechanisms to manage health as a global public good effectively and proactively are essential for the very sustainability and safety of human life.

In this context, it is reminded that the greatest near-term test of multilateralism is the effort to end the COVID-19 pandemic, notably by winning the race between vaccines and variants.  Over 11 billion doses are needed for the global population to cross the 70 per cent vaccination threshold that might end the acute phase of COVID-19 pandemic. This will involve the largest public health effort in history. As for the future, longer-term governance of global health must focus more on prevention, preparedness and equity.

In the last section of the report  dealing with global health under the title Moving forward Antonio Guterres finds it necessary to emphasize the fact that it is imperative to ensure sustainable financing; to boost partnerships; to listen to and work with youth; and to be prepared for future crises, including but not limited to public health crises. The UN should be at the center of the efforts to deliver on these commitments, as there is no other organization with its legitimacy, convening power and normative impact.

A separate report of the UN Secretary-General has been circulated under the title Global health and foreign policy: strengthening health system resilience through affordable health care for all as well as improving international coordination and cooperation to address the health needs of all States during health emergencies . The final  conclusion of this report reads : “The world’s worst global health crisis in generations presents an opportunity: this is not the time for small changes and temporary solutions, but for bold ideas, bold commitment and bold leadership. There is an urgent imperative and opportunity to strengthen each country’s health system and reinvigorate international cooperation so that current and future generations are protected from health emergencies and have universal health coverage to ensure health and well-being at all ages and in all situations”.

This  report will be considered by the UNGA in the near future.

Meanwhile ,the report Our Common Agenda has been endorsed by  the UNGA through a resolution adopted by consensus,  after being introduced by a large group of States, including Romania. The UNGA  welcomed  the Secretary‑General’ s vision on the future of global cooperation and reinvigorating inclusive, networked, and effective multilateralism over the next 25 years, as requested by Member States.

The resolution  asked the Secretary‑General to inform and engage in consultations with Member States on his proposals in the report for follow‑up action to expedite full implementation of agreed frameworks, including the 2030 Agenda for Sustainable Development and the Paris Agreement on climate change.


*Dr Ioan Voicu was a Visiting Professor at Assumption University in Bangkok (2000-2019).


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