On 14 April 2014, France organized with Japan and in collaboration with Thailand, Benin and Chile a public debate on the implementation and the evaluation of the universal health coverage (UHC).
During their interventions, the Permanent Representatives of France and of Japan supported the importance and the viability of the UHC. They underlined the importance of a sustainable development model based on the UHC by taking their national systems as an example.
The Permanent Representative of France underlined the role of the international community in the support of the implementation of the UHC to developing countries. He reminded France’s active participation in several bilateral and multinational funds such as the World Fund against aids, tuberculosis and malaria, as well as the West African Economic and Monetary Union initiative. He called for a consolidation of the efforts already conducted by France and other for access to health services without financial risk.
On 11 December 2013, the General Assembly adopted the resolution on "Global health and Foreign Policy". The Resolution was supported by France and co-sponsored by 75 other states. It was adopted by consensus.
The text reinforces the importance of universal health coverage to ensure access to health services to all. In addition, it calls for enhanced partnerships in research, capacities and production and calls for the involvement of multiple actors: governments and international organizations but also local authorities and stakeholders from the public and private sectors.
On 12 December 2012, resolution (A/RES/67/81) on Universal health coverage was adopted at the initiative of France on behalf of the “Foreign Policy and Global Health” group, composed of the Brasilian, French, Indonesian, Norwegian, Senegalese, South-African and Thai Ministers of Foreign Affairs. Co-sponsored by more than 90 countries, the resolution shows the commitment of the international community to extend social protection systems to health issues. By doing so, France helps strengthening the social dimension of globalization. This resolution recommends that consideration be given to including universal health coverage in the discussions on the post-2015 development agenda in the context of global health challenges.
A high-level meeting on non-communicable diseases took place during the General Assembly Ministerial Week, on 19 and 20 September 2011. Non-communicable diseases are responsible for 36 million deaths every year. A Political declaration on the Prevention and Control of Non-communicable Diseases has been adopted.
From 8 to 10 June 2011, thirty years after the first cases of AIDS, a high-level meeting on HIV/AIDS took place at the UN General Assembly. On this occasion, a political declaration was adopted by the General Assembly.
By this declaration, the international community committed itself to provide by 2015 antiretroviral therapy to15 million people living with HIV in countries with low or middle income, which will more than double the 6.6 million people treated today. It also pledged to eliminate transmission of HIV from mother to child.
The political declaration reiterates the importance of preventive policies and the need to better target vulnerable populations. For the first time, a text adopted at the UN explicitly mentions those populations (men who have sex with men, people who inject drugs and sex workers). Another first, the text acknowledges the importance of condom use as a responsible sexual behaviour.
The Security Council met on June 7, 2011 for a discussion on the theme: "Responsibility for the maintenance of peace and international security incumbent on the Security Council: HIV / AIDS and international peacekeeping to peace " and adopted a resolution reasserting the United Nations’ commitment in the fight against HIV / AIDS and stressing the important role of the UN peacekeeping operations in response to the epidemic.
The debate was chaired by the President of Gabon, Mr. Ali Bongo, as part of the Gabonese presidency of the Security Council. M. Alain Juppé, Minister of Foreign and European Affairs participated in the debate. In his speech, he mentioned the joint mobilization to fight against AIDS, which over the past 10 years has enabled to lower the number of deaths and the number of new infections by 20%. He noted that although these results are positive, 34 million people are still living with the disease and he urged the international community to redouble efforts. In this spirit, France as the world’s second largest contributor, has increased its contribution to the Global Fund by 20%, representing a commitment of more than 1 billion euros.
Most of the discussions relating to health take place at the World Health Assembly in Geneva, where the WHO is based. However, health is the subject of an increasing number of resolutions and meetings in New York, at the General Assembly, at the Security Council or the ECOSOC (see the 2009 Ministerial Declaration).
Health is in fact of fundamental importance to the development process. Three of the eight Millennium Development Goals (MDGs) (see our file on the MDGs) are therefore devoted to improving health throughout the world. In 2006, the General Assembly during a new high-level meeting adopted the political statement in which the international community set the goal of achieving universal access to prevention, treatment, care and support.
> MDG 4: Reduce the under-five mortality rate;
> MDG 5: Improve maternal health;
> MDG 6: Combat HIV/AIDS, malaria and other diseases
The special session of the UN General Assembly on HIV/AIDS in 2001 was an important landmark in the international community’s fight against this epidemic. This session was convened on the occasion of the 20th anniversary of the first medical recognition of AIDS and led to the adoption of a Declaration of Commitment on HIV/AIDS putting the fight against the virus at the forefront of international concerns.
In addition to its bilateral fundings, France is a major multilateral contributor to the Global Fund to Fight AIDS, Tuberculosis and Malaria, to UNITAID, to the Global Alliance for Vaccines and Immunization (GAVI Alliance). Over the last 12 years, France contributed more than 3,2 billion dollars to Health (within the Development framework). This financial support covered more than 150 countries.
- The Global Fund to Fight AIDS, Tuberculosis and Malaria
Faced with these epidemics, France decided to promote international multilateral cooperation by participating in the Global Fund to Fight AIDS, Tuberculosis and Malaria, to which it is devoting an important level of funding.
This public/ private partnership, which aims to raise, and then allocate, additional funding in order to prevent and treat these pandemics, benefited from a very active financial and political support by France since its creation in 2002.
France’s contribution amounted to 900 million Euros for 2008-2010. It has been increased then to 1,08 billion Euros (1,4 billion dollars) for 2011-2013. Like in 2011 and 2012, France contributed this year (2013) to 360 million Euros.
Having provided €2.905 billion to the Global Fund since its creation in 2002, France is the second leading donor after the United States. France’s financial support allowed 570 000 people to get treated against AIDS; 1,3 million to get treatments against Malaria and 42 billion impregnated mosquito nets to be distributed.
In addition and since 2011, 5% of France’s contributions to the Global Fund (23 million USD) are dedicated to bilateral actions. The 5% initiative, by providing a technical assistance to French speaking countries benefiting from IMF funding, strengthens their efficiency as well as their health impact.
France is also the leading contributor to the UNITAID initiative which, in close collaboration with the WHO, plays a vital role in ensuring access to treatment.
Established in September 2006, UNITAID is an international drug purchasing facility, responsible for centralizing the purchase of medications in order to achieve the best possible prices, in particular for developing countries. The initiative is aimed at fighting the most deadly pandemics (AIDS, tuberculosis and malaria) which lead to more than 6 million deaths every year throughout the world.
70% of UNITAID funds come from the International Solidarity Levy (tax on airline tickets) originally proposed by French President Jacques Chirac and Brazilian President Luiz Inácio Lula da Silva.
In the framework of the International Solidarity Levy, France contributed 1,1 billion USD between 2006 and 2012. This contribution helped developing medicines adapted to HIV and AIDS infected children (less than 10 000 children were under anti-retroviral treatment in 2010 but today they are more than 560 000); to drastically reduce the prices of second-line anti-retroviral medicines and of multi-drugs resistant tuberculosis treatments; or to generalize the use of more adapted anti-malaria treatments.
- UNAIDS and WHO
France has provided financial support (600 million Euros in 2013) to UNAIDS, the Joint United Nations Programme on AIDS in charge of coordinating UN agencies on HIV/AIDS and provided experts (2 for the headquarters and 2 in regional offices).
Finally, France is providing 30 million Euros to support WHO, with 10 million Euros being voluntary contributions, focusing on maternal and child health (4,5 million Euros), health safety (2,3 million Euros), social safety in the field of healthcare (in average 500 000 Euros each year from 2009 to 2012). France also contributes to expertise-funding at the head quarters (9 experts) and in regional offices (4 experts). In addition, the French Ministry for Health and its agencies provide more specific funding (health-environment, non-communicable disease, etc.)
In 2000, HIV/AIDS has become the first health issue discussed by the UN Security Council, because of the potential threat that this disease represents to the maintenance of peace and international security.
Resolution 1308 of the Security Council (adopted in July 2000) officially acknowledged HIV/AIDS as a security issue, and urged Member States and the international community to develop long term strategies for training and prevention. It states that AIDS has the potential to reduce the capacity of peacekeeping forces troops and thus prevent the Security Council from carrying out its primary task of maintaining peace and security.
The Security Council met again on this theme in 2005 and adopted a presidential statement reiterating the conclusions presented in resolution 1308.
A discussion on the theme: "Responsibility for the maintenance of peace and international security incumbent on the Security Council: HIV / AIDS and international peacekeeping to peace " was held by the Security Council on June 7, 2011. A resolution reasserting the United Nations’ commitment to the fight against HIV / AIDS and stressing the important role of the UN peacekeeping operations in response to the epidemic. The resolution calls on the Secretary General to pursue a "zero-tolerance" policy towards all forms of sexual abuse in UN missions. It also stresses the importance of prevention, treatment, care and support policies for the UN staff, at a time when health problems have become the main cause of death in the peacekeeping missions.
The debate was chaired by the President of Gabon, Mr. Ali Bongo, as part of the Gabonese presidency of the Security Council. M. Alain Juppé, Minister of Foreign and European Affairs participated in the debate. In his speech, he mentioned the joint mobilization to fight against AIDS, which over the past 10 years has enabled to lower the number of deaths and the number of new infections by 20%. He noted that although these results are positive, 34 million people are still living with the disease and he urged the international community to redouble efforts. In this spirit, France as the world’s second largest contributor, has increased its contribution to the Global Fund by 20%, representing a commitment of more than 1 billion Euros.
- Muskoka Initiative
President Sarkozy pledged at the G8 in Muskoka (Canada) in June 2010 to contribute up to 500 million Euros to the Muskoka Initiative for the period 2011-2015. The members of the G8 and their partners pledged at this summit to provide an additional 5 billion USD in funding to fight infant and maternal mortality. According to WHO estimates, the Muskoka Initiative will enable developing countries to prevent the death of 1.3 million children under five years old and 64,000 maternal deaths and provide access to modern methods of family planning to 12 million couples.
France contributes to the Global Alliance for Vaccines and Immunization (GAVI), a non-governmental organization established in 2000. This public/ private partnership aims to save the lives of children and to protect the health of populations by expanding access to vaccinations in the poorest countries in the world. GAVI provides vaccines against diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenza type b, or Hib, by making good use of state-of-the-art technology, such as the pentavalent vaccine, which combines all of the vaccines.
France provided contributions of 15 million Euros between 2003 and 2006 to the Global Alliance for Vaccines and Immunization.
The cumulative contributions since the creation of the Alliance in 2000 reach 254 million dollars (France is the 5th contributing country). France has thus helped vaccinating more than 350 million children in the 72 poorest countries in the world, which includes 28 French- speaking countries. WHO estimates that GAVI helped avoiding 3.8 premature deaths of children.
France is also engaged alongside the United Nations Population Fund (UNFPA) in promoting sexual and reproductive health through an annual voluntary contribution. It provided 400 000 Euros for 2013. In addition, it provides funding to health projects fighting maternal mortality and ending obstetric fistula in Africa.
Pregnant woman in East Timor where the UNFPA has sent medical equipment to reduce maternal mortality - 10 February 2010 (UN Photo/Martine Perret)
France devotes a major share of its Official Development Assistance to improving health in developing countries and has real experience in this area. Health is one of the 5 priority areas for French development assistance.
The “Foreign Policy and Global Health” initiative was launched by France and Norway in 2006 in collaboration with Brazil, Thailand, Indonesia, South Africa and Senegal.
The goal of this group is to make foreign policies more responsive to health issues, to take action with respect to the foreign policy dimension of health issues and thus help achieve the MDGs. A resolution on this issue is adopted every year at the General Assembly on the proposal of the seven members of the initiative.
Every year, a resolution on health is adopted at the UN General Assembly, as a result of a Draft proposed by the seven members of the Initiative, on a topic pre-identified by the Group within the Oslo Declaration of March 2007. These ten themes are:
1. Preparedness and foreign policy
2. Control of emerging infectious diseases and foreign policy
3. Human resources for health and foreign policy
5. Natural disasters and other crises
6. Response to HIV/AIDS
7. Health and the environment
8. Health and development
9. Trade policies
10. Governance for global health security
To date, five resolutions have been adopted at the initiative of group by the UN General Assembly under the “Foreign Policy and Global Health” agenda item:
— Resolution A/RES/63/33, 26 November 2008
— Resolution A/RES/64/108, 10 December 2009
— Resolution A/RES/65/95, 9 December 2010
— Resolution A/RES/66/115, 12 December 2011
— Resolution A/RES/67/81, 12 December 2012
Today, one billion people are denied access to the health services they need. The World Health Organization estimates that 100 million people are falling under the poverty line each year because of expenses for health.
Universal health coverage will help reducing poverty and achieving equality and social cohesion, which are at the core of the international discussions aiming at providing the post-2015 development agenda.
Resolution A/67/81 has been presented by France on behalf of the “Foreign Policy and Global Health” group. This resolution demonstrates the commitment of the international community to expand to health the social protection systems. France contributes to strengthening the social dimension of globalization.
The resolution has been co-sponsored by more than 90 States, and embodies therefore the wide, inter-regional support for Universal health coverage.
7 June 2011 - Security Council - Impact of HIV/AIDS epidemic on international peace and security - Statement by Mr Alain Juppé, Ministre d’Etat, Minister of Foreign and European Affairs
20 September 2010 - General Assembly - MDGs Summit - Speech delivered by M. Nicolas Sarkozy, President of the French Republic
11 December 2013 - General Assembly - Resolution on "Global health and Foreign Policy"
12 December 2012 - Resolution A/RES/67/81
12 December 2011 - Resolution A/RES/66/115
7 June 2011 - Resolution 1983
9 December 2010 - Resolution A/RES/65/95
10 December 2009 - Resolution A/RES/64/108
26 November 2008 - Resolution A/RES/63/33
17 July 2000 - Resolution 1308 - "HIV/AIDS and peacekeeping operations"
Consult the Millennium Development Goals (MDGs) website
Consult the UNITAID website
Consult the WHO website
Consult the United Nations Population Fund (UNFPA) website