20 June 2016: The UN General Assembly (UNGA) held a briefing on strengthening the global health architecture, hearing updates on multilateral responses to global health crises such as Ebola and other pandemics. UNGA President Mogens Lykketoft told delegates that implementation of Sustainable Development Goal (SDG) 3 (Ensure healthy lives and promote well-being for all at all ages) will require a shift from addressing single issues to taking a systems approach.

The UN Secretary-General’s report of 8 April 2016, titled ‘Strengthening the global health architecture: implementation of the recommendations of the High-level Panel on the Global Response to Health Crises,’ addresses the Ebola outbreak in West Africa, where the UN established its first-ever emergency health mission, the UN Mission for Ebola Emergency Response (UNMEER). It notes that the crisis had highlighted the importance of a “whole of system” response to a health crisis. The report recommends that: countries should include health crises in their national disaster risk reduction (DRR) plans; regional and subregional organizations should develop their capacities to monitor, prevent and respond to health crises; and that the international community should ensure that affected governments have access to predictable, rapid funding when responding to health emergencies. The report also observes a serious shortfall in research and development of vaccines and therapeutics for neglected communicable diseases that pose an initial threat primarily to developing countries, but that could lead to a widespread outbreak. It calls on the World Health Organization (WHO) to lead in assisting developing countries in building research and manufacturing capacities, including through South-South cooperation.

Addressing the UNGA on 20 June, UN Secretary-General Ban Ki-moon updated delegates on actions taken on recommendations from the High-Level Panel. He noted that the Panel had been commissioned in April 2015, and had issued its report in February 2016, setting out 27 recommendations for national, regional and international action. Ban then established a Global Health Crises Task Force to monitor, coordinate and support implementation of the recommendations. UN Deputy Secretary-General Jan Eliasson, WHO Director-General Margaret Chan and World Bank President Jim Yong Kim are co-leading the task force. Eliasson is supported by David Nabarro, the UN Secretary-General’s Special Adviser on the 2030 Agenda for Sustainable Development and climate change. Ban also stressed the importance of strengthening UN system coordination during health crises, and the role of the Inter-Agency Standing Committee (IASC) in this endeavor. He reported that the WHO and the UN Office for the Coordination of Humanitarian Affairs (OCHA) are developing standard operating procedures for responding to infectious hazards.

Ban also highlighted WHO’s creation of a Health Emergencies Programme, which provides WHO with “an operational arm” to respond to disease outbreaks and other health emergencies. He said this changes the fundamental nature of WHO, which had primarily seen itself as technical and normative.

Also at the briefing, Ban welcomed the World Bank’s Pandemic Emergency Financing Facility (PEF), which was launched in Sendai, Japan, on 21 May 2016, ahead of the G7 Summit. Japan, which holds the G7 Presidency, committed the first US$50 million towards the new initiative.

The PEF is a fast-disbursing global financing mechanism that creates the world’s first insurance market for pandemic risk. Under the scheme, 77 of the world’s poorest countries can access insurance coverage of up to US$500 million for an initial period of three years, to use in fighting outbreaks of infectious diseases including influenza, respiratory diseases such as SARS and MERS, Ebola and zoonotic diseases such as Lassa fever. The funding will be triggered through publicly available data on the size, severity and spread of the outbreak. The PEF combines funding from insurance markets with the proceeds of World Bank-issued pandemic bonds, known as catastrophe or “Cat” bonds, with a complementary cash window for addressing emerging pathogens before they cause a pandemic. Launching the PEF, World Bank President Jim Yong Kim said the Ebola crisis has shown the need for greater vigilance about disease outbreaks. The World Bank noted that the annual global cost of serious pandemics is around US$570 billion, or 0.7% of global gross domestic product.

In May, Ban announced the establishment of the UN Zika Response Multi-Partner Trust Fund (MPTF), which will support a coordinated response from the UN system and partners against the spread of the Zika virus. The Zika virus is linked to severe fetal malformations and serious disorders of the central nervous system, and is spread through the Aedes mosquito.

Also in May, WHO released recommendations on a new treatment regimen for multidrug-resistant tuberculosis (TB), which is shorter and faster than traditional treatments. The treatment can be completed in 9 to 12 months, and is expected to reduce deaths and improve treatment outcomes, at a cost of less than US$1,000 per patient. Resistance to standard TB drugs exists in most countries worldwide, and resistance, fuelled by inadequate treatment, can spread from person to person through the air. [UNGA President’s Opening Remarks] [UN Press Release, Secretary-General’s Remarks] [Strengthening the global health architecture: implementation of the recommendations of the High-level Panel on the Global Response to Health Crises] [World Bank Press Release on PEF] [UN Press Release, Zika Response] [UN Press Release, Multidrug-Resistant TB Response] [IISD RS Story on Panel’s Report]