EU — Council conclusions on the EU role in Global Health

3011th FOREIGN AFFAIRS Coun­cil meet­ing — Brus­sels, 10 May 2010
The Coun­cil adopt­ed the fol­low­ing con­clu­sions:
1. The Coun­cil wel­comes the Com­mis­sion Com­mu­ni­ca­tion on the EU Role in Glob­al Health which high­lights the need to take action to improve health, reduce inequal­i­ties and increase pro­tec­tion against glob­al health threats. Health is cen­tral in people’s lives, includ­ing as a human right, and a key ele­ment for equi­table and sus­tain­able growth and devel­op­ment, includ­ing pover­ty reduc­tion.

2. Eco­nom­ic and social con­di­tions are cru­cial deter­mi­nants of health. Efforts to address social exclu­sion, pow­er struc­tures that impede equi­ty, and gen­der equal­i­ty are of key impor­tance, as well as a strong focus on pol­i­cy coher­ence for devel­op­ment in par­tic­u­lar the “Equi­ty and Health in All Poli­cies” approach.

3. The Coun­cil con­sid­ers these con­clu­sions also as part of the over­all process of estab­lish­ing the EU posi­tion for the MDG High Lev­el Ple­nary Meet­ing to be held in New York, which will fur­ther define the EU response to the most off-track sit­u­a­tions. Progress towards achiev­ing the health-relat­ed MDGs has been uneven and insuf­fi­cient, par­tic­u­lar­ly for MDGs 4 and 5 and espe­cial­ly in Sub-Saha­ran Africa.

4. The EU has a cen­tral role to play in accel­er­at­ing progress on glob­al health chal­lenges, includ­ing the health MDGs and non-com­mu­ni­ca­ble dis­eases, through its com­mit­ment to pro­tect and pro­mote the right of every­one to enjoy the high­est attain­able stan­dard of phys­i­cal and men­tal health. The Coun­cil empha­sis­es the com­mon agreed EU val­ues of sol­i­dar­i­ty towards equi­table and uni­ver­sal cov­er­age of qual­i­ty health ser­vices as a basis for the EU poli­cies in this area.

5. The Coun­cil calls on the EU and its Mem­ber States to act togeth­er in all rel­e­vant inter­nal and exter­nal poli­cies and actions by pri­or­i­tiz­ing their sup­port on strength­en­ing com­pre­hen­sive health sys­tems in part­ner coun­tries, which are cen­tral to all glob­al health chal­lenges. Since part­ner coun­tries and their gov­ern­ments hold pri­ma­ry respon­si­bil­i­ty in this regard, this would require strength­en­ing their capac­i­ties to devel­op, reg­u­late, imple­ment and mon­i­tor effec­tive nation­al health poli­cies and strate­gies. This process should ensure full par­tic­i­pa­tion of the rep­re­sen­ta­tives of civ­il soci­ety and oth­er rel­e­vant stake­hold­ers, includ­ing the pri­vate sec­tor.

6. This sup­port shall ensure that the main com­po­nents of health sys­tems – health work­force, access to med­i­cines, infra­struc­ture and logis­tics, financ­ing and man­age­ment — are effec­tive enough to deliv­er uni­ver­sal cov­er­age of basic qual­i­ty care, through a holis­tic and rights based approach. In this regard, par­tic­u­lar atten­tion will be devot­ed to the four main health chal­lenges (sex­u­al and repro­duc­tive health, child health, com­mu­ni­ca­ble and non­com­mu­ni­ca­ble dis­eases) and to the mul­ti­di­men­sion­al nature of health, with close links to gen­der, food secu­ri­ty and nutri­tion, water and san­i­ta­tion, edu­ca­tion, and pover­ty.

7. The EU remains con­cerned with slow progress in MDG 5, par­tic­u­lar­ly in Sub-Saha­ran Africa. Health sys­tems should pay spe­cial atten­tion to gen­der equal­i­ty, women’s needs and rights, includ­ing com­bat­ing gen­der-based vio­lence. Recall­ing rel­e­vant inter­na­tion­al instru­ments, the Coun­cil rec­og­nizes women’s rights to have con­trol over, and decide freely and respon­si­bly on mat­ters relat­ed to their sex­u­al and repro­duc­tive health. The Coun­cil, while strong­ly reaf­firm­ing the link­age between HIV/AIDS poli­cies and pro­grammes and sex­u­al and repro­duc­tive health and rights (SRHR) poli­cies and ser­vices, under­lines that full imple­men­ta­tion of and access to these poli­cies and ser­vices as set out in the ICPD/Cairo Dec­la­ra­tion and Pro­gramme for Action, the Bei­jing Dec­la­ra­tion and Plat­form for Action and oth­er rel­e­vant inter­na­tion­al instru­ments as well as inter­na­tion­al­ly-agreed devel­op­ment goals, includ­ing the MDGs, is cru­cial for women’s rights, gen­der equal­i­ty and women’s empow­er­ment.1

1 Cf. Coun­cil Con­clu­sions of May 2007 on “Gen­der Equal­i­ty and Women’s Empow­er­ment in Devel­op­ment”, para­graph 21.

8. In order to effec­tive­ly sup­port com­pre­hen­sive health sys­tems, atten­tion must be giv­en to the mobi­liza­tion of devel­op­ing coun­tries’ domes­tic resources, in par­tic­u­lar through enhanced tax gov­er­nance and ade­quate and effi­cient nation­al bud­get allo­ca­tion to health. The EU should sup­port coun­tries to put in place fair financ­ing health schemes with­in social health pro­tec­tion mod­els and mech­a­nisms which pool resources, avoid direct pay­ments at the point of ser­vice deliv­ery, par­tic­u­lar­ly for vul­ner­a­ble groups, such as chil­dren and preg­nant women, and aim at achiev­ing uni­ver­sal and equi­table cov­er­age of essen­tial health ser­vices.

9. In line with the Paris and Accra com­mit­ments on aid effec­tive­ness, the EU and its Mem­ber States should, where cir­cum­stances per­mit, endeav­our to chan­nel two thirds of health CPA through pro­gramme based approach­es, at least 50% using coun­try sys­tems, includ­ing through bud­get sup­port. They will strive to achieve the nec­es­sary medi­um-term pre­dictabil­i­ty to enable the design and imple­men­ta­tion of nation­al health strate­gies.

10. The Coun­cil insists on the need to fore­cast and mon­i­tor the EU dis­tri­b­u­tion of direct and indi­rect (includ­ing through bud­get sup­port) health aid, in order to bet­ter sup­port coun­tries in great­est need. Using exist­ing data col­lec­tion mech­a­nisms as much as pos­si­ble, the EU will reg­u­lar­ly map planned three year sup­port in health pol­i­cy by the EU and its Mem­ber States, to accel­er­ate progress on aid effec­tive­ness com­mit­ments and on the EU divi­sion of labour.

11. The EU stress­es the impor­tance of fur­ther devel­op­ing, includ­ing through broad­er par­tic­i­pa­tion, and imple­ment­ing inno­v­a­tive mech­a­nisms for mobil­is­ing addi­tion­al resources in the health sec­tor, and of their poten­tial to con­tribute to the achieve­ment of the health MDGs, tak­ing into account the aid effec­tive­ness prin­ci­ples2.

12. The Coun­cil calls on EU Mem­ber States and the Com­mis­sion to sup­port an increased lead­er­ship of the WHO at glob­al, region­al and coun­try lev­el, in its nor­ma­tive and guid­ance func­tions address­ing glob­al health chal­lenges as well as in tech­ni­cal sup­port to health sys­tems gov­er­nance and health pol­i­cy, giv­en its glob­al man­date. Accord­ing­ly, the Coun­cil requests Mem­ber States to grad­u­al­ly move away from ear­marked WHO fund­ing towards fund­ing its gen­er­al bud­get. With­out prej­u­dice to respec­tive com­pe­ten­cies, the EU and its Mem­ber States will endeav­our to speak with a stronger and coher­ent voice at the glob­al lev­el and in dia­logue with third coun­tries and glob­al health ini­tia­tives.

2 Cf. Coun­cil Con­clu­sions of May 2009.

13. The Coun­cil acknowl­edges the Inter­na­tion­al Health Part­ner­ship (IHP+) prin­ci­ples (sup­port one nation­al health strat­e­gy, through one bud­get process and fol­low up through one mon­i­tor­ing frame­work) as the pre­ferred frame­work to apply the aid effec­tive­ness com­mit­ments to health and strength­en health sys­tems.

14. The EU also recog­nis­es results achieved so far by glob­al health ini­tia­tives and funds (notably the Glob­al fund to fight HIV/AIDS, tuber­cu­lo­sis and malar­ia and the GAVI) in the health sec­tor as well as their role in broad fund­ing mobi­liza­tion. The EU should active­ly sup­port them to enhance their focus on strength­en­ing com­pre­hen­sive health sys­tems, on meet­ing the chal­lenges of glob­al health3 through cost-effec­tive inter­ven­tions and stress­ing their com­pli­ance with aid effec­tive­ness prin­ci­ples.

15. In line with the com­mit­ments made on pol­i­cy coher­ence for devel­op­ment (PCD) and in the frame­work of the PCD Work Pro­gramme, the Coun­cil calls on the Com­mis­sion and the Mem­ber States to address the major aspects that influ­ence glob­al health in the five pri­or­i­ty areas of trade and financ­ing, migra­tion, secu­ri­ty, food secu­ri­ty and cli­mate change.

16. In this regard the EU should :

  • sup­port third coun­tries, in par­tic­u­lar LDCs, in the effec­tive imple­men­ta­tion of flex­i­bil­i­ties for the pro­tec­tion of pub­lic health pro­vid­ed for in TRIPs agree­ments, in order to pro­mote access to med­i­cines for all, and ensure that EU bilat­er­al trade agree­ments are ful­ly sup­port­ive of this objec­tive;

  • on migra­tion; encour­age progress towards com­pli­ance with the agreed com­mit­ments of the EU Strat­e­gy for Action on the Cri­sis in Human Resources for Health in Devel­op­ing Coun­tries, and con­tribute to the WHA Code of prac­tice on the inter­na­tion­al recruit­ment of health per­son­nel;

  • seek to ensure opti­mal access to health ser­vices for pop­u­la­tions in frag­ile con­texts, emer­gency and/or human­i­tar­i­an sit­u­a­tions and in peace and sta­bi­liza­tion process­es;

  • . strength­en the links between food secu­ri­ty, nutri­tion and health, with par­tic­u­lar sup­port to the most vul­ner­a­ble groups, inter alia chil­dren under five and women in preg­nan­cy and lac­tat­ing peri­od;

  • include con­sid­er­a­tion of health issues in the adap­ta­tion and mit­i­ga­tion strate­gies in devel­op­ing coun­tries in envi­ron­men­tal and cli­mate change poli­cies and actions.

17. The Coun­cil under­lines the impor­tance of build­ing EU and its Mem­ber States col­lec­tive exper­tise on glob­al health and strength­en­ing its capac­i­ty to engage in health analy­sis and pol­i­cy dia­logue with devel­op­ing coun­tries. The map­ping of exist­ing EU exper­tise should be the foun­da­tion for action in this area.

3 2009 EU Coun­cil Con­clu­sions on the Progress Review of the Pro­gramme for Action on HIV/AIDS, malar­ia and tuber­cu­lo­sis through the exter­nal action (2007–2011).

18. As regards to research and evi­dence based dia­logue and action, the Coun­cil calls on the EU and its Mem­ber States to pro­mote effec­tive and fair financ­ing of research that ben­e­fits the health of all. Towards that aim the EU will ensure that inno­va­tions and inter­ven­tions pro­duce prod­ucts and ser­vices that are acces­si­ble and afford­able. This should be achieved by the EU and its Mem­ber States through:

  • work­ing towards a glob­al frame­work for research and devel­op­ment that address­es the pri­or­i­ty health needs of devel­op­ing coun­tries and pri­ori­tis­es per­ti­nent research actions to tack­le glob­al health chal­lenges in accor­dance with the WHO Glob­al Research Strat­e­gy.

  • increas­ing research capac­i­ties in pub­lic health and health sys­tems in part­ner coun­tries and strength­en­ing coop­er­a­tion between the EU and part­ner coun­tries in this respect.

  • explor­ing mod­els that dis­so­ci­ate the cost of Research and Devel­op­ment and the prices of med­i­cines in rela­tion to the Glob­al Strat­e­gy and Plan of Action on Pub­lic Health, inno­va­tion and intel­lec­tu­al prop­er­ty, includ­ing the oppor­tu­ni­ties for EU tech­nol­o­gy trans­fer to devel­op­ing coun­tries.

  • ensur­ing that EU pub­lic invest­ments in health research secure access to the knowl­edge and tools gen­er­at­ed as a glob­al pub­lic good and help gen­er­ate social­ly essen­tial med­ical prod­ucts at afford­able prices, to be used through ratio­nal use.

  • strength­en­ing and bal­anc­ing the com­plete health research process of inno­va­tion, imple­men­ta­tion, access, mon­i­tor­ing and eval­u­a­tion. Inter­na­tion­al coop­er­a­tion, com­mon plat­forms of knowl­edge shar­ing and exchange of good prac­tices are essen­tial in this field.

  • improv­ing health infor­ma­tion sys­tems of part­ner coun­tries and the col­lec­tion of qual­i­ty and com­pa­ra­ble data and sta­tis­tics to enable bench­mark­ing and inform on the impacts of glob­al and nation­al poli­cies on social deter­mi­nants in health includ­ing the adop­tion of equi­ty indi­ca­tors.

  • respect­ing the prin­ci­ple of evi­dence-based approach when set­ting nor­ma­tive action of food, feed, prod­ucts, phar­ma­ceu­ti­cals and med­ical devices, while tak­ing into account the pre­cau­tion­ary prin­ci­ple con­sid­ered on a case by case basis.

19. The EU shall pro­mote dia­logue and joint action with key glob­al play­ers and stake­hold­ers, includ­ing UN agen­cies con­cerned with glob­al health, Inter­na­tion­al Financ­ing Insti­tu­tions, region­al organ­i­sa­tions, region­al health net­works, and coun­tries, in order to iden­ti­fy syn­er­gies, coor­di­nate actions, advance in the achieve­ment of com­mit­ments, and avoid dupli­ca­tion and frag­men­ta­tion to increase effec­tive­ness.”

Coun­cil of the Euro­pean Union