Speech by Ambassodor by Thomas Greminger
How can Switzerland meet responsibilities in a changing environment?
Von Thomas Greminger / Direktion für Entwicklung und Zusammenarbeit DEZA
The population worldwide is living longer and increasingly in urban areas. Non-communicable diseases grow rapidly in low and middle income countries and are the leading cause of death worldwide. Climate change as well as water, air and soil pollution are generating global health hazards. Armed conflicts, organized crime and domestic violence are widespread. This violence produces trauma and impairs mental health. The globalization of trade and the increasing mobility have raised the risk of rapidly spreading epidemics.
Unsere Welt verändert sich in einem Masse wie nie zuvor. Klimawandel, Flüchtlingsströme, gewaltsame Konflikte, aber auch die älter werdende Bevölkerung und der Anstieg von chronischen Erkrankungen als häufigste Todesursache weltweit sind Herausforderungen, die einer globalen Antwort und vor allem einer vermehrten Investition in die Gesundheitssysteme bedürfen.
Trotz der Erfolge, die auch auf der Grundlage der Millenniumsentwicklungsziele in den letzten Jahren erzielt werden konnten, ist das Recht auf Gesundheit für alle noch lange nicht erreicht. Aus diesem Grund hat die Schweiz mit Nachdruck ein Gesundheitsziel innerhalb der Sustainable Development Goals SDGs gefordert. Universal Health Coverage ist nicht ausreichend, um die Gesundheit der Menschen zu verbessern, ebenso essentiell sind Faktoren wie Wasser, Ernährung, Geschlechtergleichheit und Ausbildung, Handelsregulie-rungen, Umweltbedingungen etc.
Die neue Schweizer Botschaft 2017-2020 berücksichtigt all diese Faktoren und gegenseitigen Abhängigkeiten und verfolgt die Vision einer friedlichen Welt ohne Armut. Neben der Stärkung der Humanitären Hilfe innerhalb der Botschaft, soll die wirtschaftliche Entwicklung in unseren Partnerländern und vor allem die Stärkung der Menschenrechte und die Beseitigung von Ungleichheiten (auch der Geschlechter) in Schwarzafrika forciert angegangen werden. Zur Verbesserung von Gesundheit setzt die Botschaft drei Schwerpunkte: 1. Stärkung der Gesundheitssysteme, insbesondere der Basisgesundheitsversorgung. 2. Verringerung der doppelten Last der Krankheitsgefährdung unter den armen Bevölkerungsschichten. 3. Verbesserung der Mutter-Kind-Gesundheit und der sexuellen und reproduktiven Gesundheit und Rechte bei Frauen und bei Heranwachsenden.
Die neue Botschaft wird im Februar 2016 verabschiedet und Medicus Mundi hat wertvolle Inputs dazu geliefert. Die Kernaussagen der neuen Botschaft: Die bilaterale Gesundheitszusammenarbeit wird gemäss den genannten Schwerpunkten mit ausgewählten Ländern fortbestehen. Die Zusammenarbeit mit multilateralen und internationalen Partnern wird intensiviert. Das Rahmenprogramm Globale Gesundheit verlangt mehr Kohärenz in unserem Engagement für die globale Gesundheit und die vermehrte Entwicklung von globalen Initiativen. Die Zivilgesellschaft und die Mitgliedorganisationen von MMS bleiben weiterhin wichtige Partner für die DEZA und werden durch Programmbeiträge unterstützt. Die SDGs implizieren, diese Zusammenarbeit in den nächsten Jahren noch zu verstärken.×
Thomas Greminger at the MMS Symposium (Photo: Christoph Engeli/MMS)
Dear President of MMS Board, Dear Partners,
Ladies and gentlemen,
It’s a pleasure for me to address this year’s Medicus Mundi Symposium, because 2015 is such a crucial year for our common future. Our world is changing at a pace never seen before, and so is the global public health landscape with many new challenges.
All these challenges require a global response that combines effective emergency measures and more long-term investments to build stronger health systems.
Some improvements have been achieved
Yes, the challenges are many, but, thanks to a tremendous mobilization of resources and coordinated interventions, progress achieved during the last decade has been impressive.
The mortality of children under 5 years has been cut by half. New HIV infections have declined by 38%. The MDG target on access to safe drinking-water has been achieved...
The MDGs have contributed to raise a lot of additional resources for health and to guide investments into targeted areas.
However, ladies and gentlemen, this global progress remains uneven and fragile.
Some countries and regions have improved rapidly, while others are lagging behind. Many countries are not equipped to consolidate and sustain the gains. Health inequality is still widespread and realizing the right to health remains a dream for many.
The Medicus Mundi Health Cooperation Symposium 2015 at the Pullmann Hotel Basel (Foto: Christoph Engeli / MMS)
Major challenges still remain
For this reason, Switzerland had proposed a Health SDG which looked actually quite similar to the SDG 3 that has eventually been adopted by the international community last month in New York (pdf). We acknowledge that Universal Health Coverage is a necessary, but not sufficient condition to improve the health of populations. Water and nutrition, gender equality and education, trade rules and environment, employment and housing conditions, are all crucial factors for the full realization of the right to health.
The SDG agenda requires that we all move beyond our silos and sectors, in order to implement genuine multi-sectoral approaches or health in all policies
Ambitous new Message 2017-2020
In line with the SDGs, the new Message to the Parliament on international cooperation for the period 2017-2020 builds on the observation that the challenges of poverty, conflicts and global hazards are interconnected and that we have to respond in an integrated manner. That is why we have decided to agree on a new common strategy integrating the cooperation instruments operated by the SDC, the State Secretariat for Economic Affairs and the Human Security Division of the Political Directorate.
The message presents an ambitious vision: a world without poverty and in peace, for sustainable development. It is strongly anchored in the framework of the Sustainable Development Goals, and features a clear commitment to more political coherence for sustainable development.
The message proposes to reinforce the focus on fragile contexts. These countries and regions where one third of the World’s poor live are also characterized by appalling health situations. Sierra Leone, Chad, Somalia, RDC, Central African Republic… It is these countries that have the worst under-five mortality indicators worldwide.
The work in these contexts entails many operational challenges and security risks, as we have just recently witnessed with the tragic bombing of a Médecins sans frontières hospital. I would like to take this opportunity to commend all the women and men of SDC, NGOs and other partners, who work in these difficult contexts. They do represent in an exemplary way Switzerland's solidarity towards the world
The message 2017-2020 also proposes to contribute to economic progress, with a clear emphasis on the role of the private sector and on job creation. We therefore have to respond to the rapidly rising demand from our partner countries, in order to better support the development of basic education and vocational training systems.
The message also calls for allocating up to 55% of our resources to sub-Saharan Africa for increased efforts to reduce inequalities (including gender) and for promoting human rights.
Health in the new message
As for health, there are three priorities, that the message is proposing:
- First to strengthen Health systems with a focus on primary health care. SDC will continue to promote mechanisms to ensure access to services by the poor, as well as community approaches to improve accountability and demand for quality services.
- A second priority is to reduce the burden of diseases that disproportionately affect poor populations in low and lower-middle income countries. This includes the support for prevention, treatment as well as research and development notably for malaria and neglected tropical diseases.
- And a third priority is to improve maternal, newborn and child health as well as sexual and reproductive health and rights, with a focus on the needs of women and adolescent girls and boys.
This new message is in the making. Medicus Mundi Schweiz has sent valuable inputs on a first draft, notably on the definition of vulnerable groups, on the necessity to promote quality health services and on the crucial role of health Professionals.
The draft message is now in a fairly consolidated state. The final version of the message should be adopted by the Federal Council in February 2016 and then be submitted to parliamentary approval and about to be sent to the consultation of offices.
The topic of the MMS Symposium is for the actors of the Swiss development cooperation of particular relevance. (Foto: Christoph Engeli / MMS)
Impact of the new message on SDC
Ladies and Gentlemen, what will the new message imply for SDC?
The bilateral health cooperation programs will continue to be implemented in selected African, Asian and Eastern European countries and regions. SDC will focus its activities along the three stated priorities of the message, and play an active role in the policy dialogue with Governmental and Non-State actors. SDC will also foster inter-sectoral approaches to address health challenges.
As global health issues require global responses, SDC will intensify its cooperation with multilateral and international actors. SDC provides funding and expertise to specialized multilateral institutions (Global Fund, WHO, UNAIDS…to cite a few), to global NGO networks (like International Planned Parenthood Federation), and to public-private partnerships (like Drugs for Neglected Disease Initiative)
In 2015, the strategic framework for the Global Program Health has been approved. This Global Program intends to make the Swiss engagement in global health more coherent and effective, and aims at developing initiatives in line with the “Swiss Health Foreign Policy”.
The five core components of this Global Program are very similar to the priorities of SDC’s bilateral work. But the Global Program engages in policy shaping and supports global initiatives to develop innovations.
SDC will continue to offer direct humanitarian aid, partly implemented directly by the Swiss Humanitarian Aid Branch, partly supported by specialized humanitarian organizations (like ICRC, MSF, Red Cross).
Swiss civil society organizations remain key partners for SDC. MMS Member Organizations play an important role in the development of health services in low income countries, but also in raising public awareness in Switzerland on global health issues, like equity and the right to health.
Both your experience from your own fieldwork and the results of your operational research are extremely valuable for SDC. A case in point is the impact study done by the Swiss Red Cross on ”Equitable access to quality health care for the most vulnerable”.
Acknowledging this important role, SDC will continue to support Swiss NGOs with program contributions, and, as you have certainly heard, has just approved a new phase of support to MMS.
Outlook for the coming 15 years
Let me conclude:
Since the beginning of this century, the investment of the international community in health has been unprecedented, with significant progress on the MDGs.
But a lot remains to be done. We have to end the epidemics of HIV, malaria and tuberculosis; we have to strengthen weak health and community systems, we have to respond to the rise of non-communicable diseases and of emerging diseases; we need to have new diagnostic and treatment products to respond to neglected tropical diseases; we have to ensure that people enjoy healthy living conditions and that no one is left behind.
The SDGs represent a very ambitious programme for the next 15 years. This will require a lot of energy, innovation and resources. We, the Swiss international cooperation actors, will need to cooperate very closely to reach these ambitious objectives.
You are all engaged in one form or another in international health cooperation. Your role is paramount. You are at the heart of our action to improve the lives of the poorest.
Your professionalism and commitment make up the quality of Swiss development cooperation.
We must live up to our vision of a world without poverty and in peace, to our commitment for sustainable development, and to our engagement for the right to health and an equitable share of resources to live a healthy life.
Thank you for your attention.
Thomas Greminger, Ambassador
Deputy Director-General of the Swiss Agency for Development and Cooperation