Unasur will have three countries at the WHO Executive Board

Rio de Janeiro, june 2013

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Unasur will have three countries at the WHO Executive Board South American Health Council presented joint positions during the 66th Session of the World Health Assembly

defined. The 67th WHA is expected to take place late May next year.

In addition to electing their representatives, Unasur Health Council also managed to show joint positions on important issues of the global agenda discussed during a series of parallel meetings conducted by CSS Coordinating Committee - forum that brings together the bloc national coordinators. Among the highlighted issues, one can mention health in the Post-2015 Development Agenda (read more on page 2), Universal Health Coverage, social determinants of health, policies for people with disabilities, WHO budget, international health regulations, and research and development funding.

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International Health Regulations and Research Funding As for the discussions on International Health Regulations (IHR), Unasur and Mercosur presented a joint position emphasizing the importance of the reports forwarded by countries-members to WHO and requiring answers to queries about IHR implementation or interpretation. The two regional blocs requested to be informed about the support offered by WHO regarding a better definition of the yellow fever risk map.

The South American Health Council took a position also on the Consultative Expert Working

Group on Research and Development (CEWG) report, evaluating the creation of a world observatory on research and development as priority action. Unasur affirmed that the incentive generating system based on patents is insufficient to meet the needs of developing countries and, therefore, stressed the importance of CEWG proposals about alternative models, in a report forwarded to the 65th WHA. During the debate on policies for people with disabilities, CSS thanked for the inclusion of the theme as a topic for discussion, adding that the matter has been dealt with by the bloc by means of public policies so to ensure inclusion and access to health services. The bloc encouraged WHA to adopt a resolution draft and discuss an action plan for full approach of the subject.

READ MORE • 66th World Health Assembly ends highlighting Post 2015 Development Agenda - Page 2 • Unasur holds first South American Conference on Natural Resources, in Caracas - Page 3 • Interview: Oscar Varas talks about the first National Health Conference in Bolivia - Page 4

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Argentina, Brazil and Suriname will take charge of three out of the six seats of the Americas’ Region

In the 66th WHA opening, Peru Health Minister and CSS Pro Tempore President, Midori de Habich, spoke on behalf of the other countries of the bloc and advocated the inclusion in health policies of the agreements signed at the World Conference on Social Determinants of Health and in Rio+20 UN Conference on Sustainable Development - both held in Rio de Janeiro in 2011 and 2012, respectively.

Midori also exposed her standpoints on the concept of universal coverage, stating that it should not be based on a paternalistic perspective and financial risk protection, but on elements of prevention and health promotion, rehabilitation, access to medicines and social determinants of health. The Minister reinforced the concern about the reduction of WHO resources allocation for Pan American Health Organization (PAHO).

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The 66th World Health Assembly (WHA), taken place last May 20-28, in Geneva (Switzerland), elected three countries-members of the Union of South American Nations (Unasur) to integrate the new Executive Board of the World Health Organization (WHO). The choice of representatives rewarded the joint efforts carried out during WHA by the South American Health Council (CSS), also resulting in the adoption of decisions on a variety of topics of interest to countries that compose the bloc.

After the election, Argentina, Brazil and Suriname – next country to take charge of CSS Pro Tempore Presidency (PPT), currently held by Peru – will take charge, until 2016, of three positions out of the six seats destined to the Americas’ Region. WHO Executive Board is composed of 34 seats and responsible for advising WHA and carrying out its resolutions.

In the previous board composition, only Ecuador was the representative to South American countries. Cuba, Mexico and Panama complete the new Americas’ Region representation in the organism.

The first meeting of the new Executive Board which usually holds two annual meetings – took place after the 66th World Health Assembly closing, on May 29-30. The next meeting of the organism is scheduled to be held in January 2014, when the 67th WHA priorities are to be

Representatives of Brazil, Argentina and Surinam at the 66th Session of WHA and the Director of PAHO, Carissa Etienne (center)

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66th Session of the World Health Assembly was held between May 20th and 28th at WHO headquarters, in Geneva (Switzerland)

World Health Assembly ends emphasizing health in Post-2015 Development Agenda The 66th WHA ended last May 28 after nine days of discussions on global health The 66th World Health Assembly (WHA) ended last May 28 defining 24 resolutions and five decisions on topics such as a new milestone for research and development (R&D), the definition of Universal Health Coverage, and health insertion in the Post2015 Development Agenda. During those nine days, high representatives of the 194 countries that compose the World Health Organization (WHO) met in Geneva (Switzerland) to discuss the main topics of the global health agenda during WHA annual meeting.

In her opening speech, WHO DirectorGeneral, Margaret Chan, affirmed that “efforts in health lead to the success of all other development policies” and advocated that health be included in a prominent position in the Millennium Development Goals (MDGs), whose topics are under discussion (read more next side). After an exposition on the progress of countries in attaining Millennium Development Goals, WHA approved a draft resolution that urges States-Members also to maintain as to rush efforts to ensure health to occupy a prominent place in the Post-2015 Development Agenda.

“Efforts in health lead to the success of all other development policies” Some members expressed the hope that Universal Health Coverage be one of health representatives in Post-2015. In addition, a resolution draft on the importance of training health staff to apply the universal coverage was submitted and approved.

Another issue raising expectations before 66th WHA was the appraisal of the report and resolution draft issued by the Consultative Experts Work Group (CEWG) in Research and Development. Both were approved, and

the resolution recognizes the urgency to address health needs of developing countries, inequalities related to the current research scenario, and the need to increase R&D investments on health. It was also required to create a R&D world observatory on health with the aim to monitoring and analyzing information on that matter.

WHO 2014-2019 General Working Programme and Budget The World Health Assembly also approved its 2014-2019 General Working Programme and Budget, and, for the first time in its history, WHO becomes almost completely financed.

However, the high amount of specific voluntary contributions is a concern, since it creates a funding imbalance between programs. Following the Secretary-General recommendation, the conversations on funding starting this June will include discussions about the need for more flexible financing by non-State actors.

In addition, countries’ delegates approved the resolution draft concerning the World Landmark of Integral Surveillance and Targets for Prevention and Control of Noncommunicable Diseases, on which WHO world action plan for 2013-2020 is based.

The latter is an action plan comprising a set of actions among States-Members, United Nations organizations, and other international partners to achieve the nine goals worldwide agreed. The reduction of 25% in premature mortality by non-communicable diseases until 2025 is one of them.

The resolution on policies for persons with disabilities was approved with amendments, urging States-Members to apply the Convention on the Rights of Persons with Disabilities and to develop action plans. In her closing speech, Chan showed concern with the new coronavirus, “of which we hardly know and is a threat that cannot be solved by one country alone”.

UN Secretary-General, Ban Ki-moon received on May 30 the official report of the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda, offering suggestions for the definition of the Sustainable Development Goals (SDGs), i.e., the conjoint of goals that will replace the Millennium Development Goals (MDGs). By the occasion of the document handing, Ban Ki-moon declared that the world is living the historic opportunity to eradicate extreme poverty and promote sustainable development.

Titled “A New Global Partnership: Eradicate Poverty and Transform Economies through Sustainable Development”, the report presents an agenda for the eradication of poverty by 2030 and defines five main lines to accomplish that goal: universalize the advances in poverty reduction; promote sustainable development; encourage job generation and comprising growth; ensure peace and reliable institutions; and establish a new global partnership.

The role of health in Post-2015 Development Agenda was prominent theme in the 66th World Health Assembly (read more next side) and motivated a joint manifesto from Unasur Health Council. According to the bloc, new SDGs definition should be useful to include in public policies the dimension of social determinants of health, which play an important role in the construction of inclusive, equal and healthy societies.

Created last year after the UN Rio+20 Conference on Sustainable Development, the High-Level Panel is composed of 27 representatives of countries from all regions of the world and coordinated by the leaders of United Kingdom (David Cameron), Indonesia (Susilo Yudhoyono) and Liberia (Ellen Sirleaf).

The report will serve as input to the report the Secretary-General himself should submit in September, at the 68th UN General Assembly.

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World Health Organization

High-level Panel hands report on MDGs to the UN Secretary General

UN Secretary General (right) receives the High Level Panel

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Leaders advocate regional agenda during the first Unasur Conference on Natural Resources

Conexion Health

The first Unasur Conference on Natural Resources and Integral Development of the Region ended last May 30 with an emphatic defense of a continental strategy on the topic and the definition of a schedule of meetings in the coming months to continue the discussions held at the event. For four days, the Conference brought together, in Caracas (Venezuela), heads of States, academics, experts and regional leaders to discuss South American development as from the exploitation of its wealth.

In the closing session, Unasur SecretaryGeneral, Alí Rodríguez Araque, affirmed that the region “must advance towards common policy and plans, [and] we can say that this was the core conclusion of this event in defense of the States’ property rights over natural resources”. He announced a meetings schedule that includes: a conference on water resources and watersheds, in Bolivia; an event on forests and biodiversity, in Brazil; an activity on science, technology and innovation, in Venezuela; a meeting of geological institutes, in Ecuador; and an event on defense and natural resources, in Argentina.

of South America’s countries”.

On the first day of the conference, it was discussed the proposal of establishing a Center for Advanced Studies of Unasur engaged in preparing a map of the natural wealth of South America. Monica Bruckman, adviser of the General Secreariat, told TeleSUR that this initiative “will aim to deepen the study and information production in a transversal perspective, which means the sovereign use of natural resources for economic and social development of people in a sustainable manner”.

Bruckmann coordinates the Research Group on Natural Resources of the General Secretariat, which operates since May in ISAGS headquarters in Rio de Janeiro. Earlier this month, in an interview with ISAGS Report, Bruckmann said that “natural resources are a fortress of South America” ​​and talked about the definition of a strategy that overcomes the “extractive” model.

Unasur will organize five meetings on natural resources the next 12 months

On Tuesday (28), the second day of the conference, the Deputy Executive Secretary of ECLAC, Antonio Prado, presented the Report “Natural Resources in Unasur: Status and Trends for a Regional Development Agenda”.

On Wednesday, the third day of the event, it was held a table with the participation of the Chief of Office of ISAGS, Mariana Faria, and of the Director of the Center for Strategic Studies in Defense (CEED), Alfredo Forti, the two centers of strategic thinking of Unasur.

The Conference was determined during the VI Unasur Heads of State and Government Council Ordinary Meeting, which took place in November 2012. About 100 people attended the event organized in five working tables economic and social exploitation; biodiversity and environment; sovereignty; scientific and technological development; and South American strategy - three conferences and a closing appraisal session.

The President of Venezuela, Nicolás Maduro, opened the Conference by proposing a “joint agenda based on natural resources reserves

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Event discussed continental strategy on the subject on May 27-30 in Caracas (Venezuela)

Minister Susana Muñiz and Temporão, ISAGS Director

URUGUAYAN MINISTER HOSTS ISAGS

ISAGS Executive Director, José Gomes Temporão, met Health Minister of Uruguay, Susana Muñiz, during the second day of the 66th World Health Assembly (WHA). At the meeting, the Minister reiterated that the country has as priority in its health care reform the training of human resources for primary health care, aiming at universalizing the service addressed to the user rendering. Uruguay plans to create a Government School in Public Health.

DIRECTOR DISCUSSES REFORMS IN PERU

Health Ministry of Peru invited ISAGS Executive Director to participate in the Health Sector International Seminar, convened for the reform process of the Peruvian health system started this year. During the event, planned to take place in Lima on June 6-7, Temporão will make a presentation on the reform processes of other South American countries, mainly to the Ministry employees.

In April, ISAGS Director received Peruvian Minister and Pro Tempore President of the South American Health Council (CSS), Midori de Habich, at the Institute headquarters, in Rio de Janeiro. At the time, regional integration issues were also discussed, and the Minister highlighted the importance of regional policies on human resources and medicines.

ECLAC: Situation and Trends for Development

ISAGS SUPPORTS CREATION OF CCI

ISAGS is providing advice to the Unasur General Secretariat in Quito (Ecuador), for the implementation of its Center for Communication and Information (CCI), and the development of a methodology for document management for the regional bloc. The advising occurs through the area of Information and Knowledge Management of the Institute, which sent one person to the headquarters of the General Secretariat in May. There is also a representative of the Centre for Strategic Studies in Defense of Unasur (CEED) in the advising team.

Read more about the Unasur Conference on Natural Resources and Integral Development of the Region and see the ECLAC Report in bit.ly/UnasurNaturalResources

Government of Venezuela

EDUCATION AND DEFENSE IN UNASUR

The Unasur Education Council held last May 31st its first meeting in Lima, during which it were agreed the 2013-2017 Five-Year Strategic Plan, an agreement for the exchange of students and one for the revalidation of diplomas, among other measures. Also at the end of May, representatives of Unasur ratified the creation of the first South American Defense College (Esude), in order to form military of the bloc’s 12 countries to contribute to peace in the region.

The information was confirmed by the Director of CEED, Alfredo Forti.

The first Unasur Conference on Natural Resources and Integral Development of the Region was held between May 27th and 30th

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“It’s a political decision of Bolivia’s Government to work towards a Unified Health System”

What were the topics discussed at departmental meetings in preparation for the national event?

Five thematic central lines were proposed and spun off into topics and sub-topics, following each line characteristic. The five central lines are: To ensure that Bolivia be a healthy State and adopt the philosophy of well living; Public Health Organization of Bolivia’ Plurinational State; Participatory Management in Public Health System; Economics and Financing of Public Health Model; and Human Resources Policy for Public Health System.

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Oscar Varas, Bolivian Health Promotion Director, talks about National Health Conference

Oscar Varas Catoira, Director of Health Promotion of the Ministry of Health and Sports of Bolivia, in his office

In an interview to ISAGS Report, Oscar Varas Catoira, Health Promotion Director at Bolivia’ Ministry of Health, talked about the National Conference for Free and Public Health Revolution. The meeting, which has no date set to be held, would happen between June 4th and 7th, but was postponed after disputes between the Government and the Central Obrera Boliviana. The Director pointed out, however, the importance of the Conference to discuss the basis for action to ensure to all bolivians universal, free and qualified access to health services.

Health was regarded as a right in Bolivia in 2009. What improved in these four years?

The need to reverse health negative indicators of mothers and children, which impact maternal mortality and child malnutrition, was and still remains one of the main Government effort activities. The Government created and implemented the programme Bono Juana Azurduy de Padilla, based on economic support to mothers.

Mothers receive five money transfers during pregnancy, which are further extended to comprise the child up to the age of two. In addition to the subsidy, the program also includes nutritional support with invigorated food and micronutrients.

In another stream, for attention and benefit of the entire population, a health system reform is being developed, for which the Intercultural Community Family Health Policy (SAFCI) was created and has been carried out since the 2009 management.

Health institutionalization in Bolivia occurred shortly after Unasur creation.

Interaction with other countries is being important for the Bolivian health system changes?

All these years, Bolivian health system is being a major problem for State and society.

Unattended needs by the system were raised, also, through social mobilization demanding efficient care with quality and responsiveness.

Today, we move towards solutions and, some way, it is undeniable that also relations with neighboring countries as interactive and crosscutting communication guide and provide new ideas to implement necessary solutions.

“It’s undeniable that the relations with neighboring countries as interactive and cross-cutting communication guide to solutions” Public health coverage in Bolivia is focused on children up to four years and on adults older than 60 years. The Conference is one of the targets to transform this scenario?

Yes. Definitely, this is a political decision of the Government and Health Ministry. We must work for a Unified Health System, whose basic and essential content be the universal attention from birth till death.

ISAGS-UNASUL Executive Director: José Gomes Temporão Head of Office: Mariana Faria Coordinator: Henri Jouval INFORMATION AND KNOWLEDGE MANAGEMENT Coordinator: Camilla Ibiapina ISAGS Report Editor: Amaro Grassi Team: Flávia Bueno, Manoel Giffoni and Mariana Moreno

How delegations were composed of?

By Supreme Decree, it was determined that four institutions organized the Conference for Free and Universal Public Health Revolution: Bolivian Working Syndicate (COB), Bolivia’ Physicians College, Bolivian University System, and Ministry of Health and Sports main representatives. Concurrently, the society participates through social movements and of those arising in municipal and departmental governments.

How will be the work after the Conference?

Health Ministry will organize departmental conferences resolutions as a system so to prepare a final document of collective social acceptance with shared responsibilities.

What are the expected results in short and medium terms?

The results will be assessed shortly after the implementation of the new Health Care System in its different areas, taking into account the five main themes dealt in the national summit and its resolutions.

How will be the role of Bolivian Government and departments?

According to our political constitution, the Plurinational State Government has the power to apply health policies at the national level.

For this action to be effective, each department will be delegated the corresponding skills for enacting and completion.

SCHEDULE • 06-07/06 - International Seminar on Health Sector Reform - Lima (Peru) • 10-14/06 - 8th Global Conference on Health Promotion - Helsinki (Finland) • 17-21/06 - 152nd Session of the Executive Committee of PAHO/WHO - US

This is the report from the South American Institute of Government in Health (ISAGS), the think tank on health of the Union of South American Nations (UNASUR) that aims to contribute to improving South America government quality in health by means of leadership training, knowledge management and technical support to health systems.

Contact: comunicacao@isags-unasur.org Phone: +55 21 2215 1858

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