HISTORIC HEALTH EVENT AT THE UNITED NATIONS

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Photo Caption: The First Lady of Sierra Leone HE Fatima Maada Bio; Dr. Judy Kuriansky, United Nations NGO representative International Association of Applied Psychology and Columbia University Teachers College; Deputy Executive Director of the WHO UN New York Office Werner Obermeyer. (Back row): Dr. Christine Roland-Levy, President, International Association of Applied Psychology

     History was made in healthcare recently when the governments at the United Nations adopted a Political Declaration on Universal Health Coverage (UHC) asserting that all people should have access to quality essential health and mental health services without risk of financial hardship. 

     The same week, during the prestigious United Nations General Assembly (UNGA), an impressive event was held on September 27 entitled, “Achieving SDG 3 And Universal Health Coverage: Innovative Projects, Policies and Financing Models To Reach Those Left Furthest Behind.”

     Impressive speakers from all fields presented innovative programs, policies and financing.

     Sierra Leone was front and center, by main sponsorship of the Mission of Sierra Leone at the UN with support of the Office of the First Lady of Sierra Leone H.E. Fatima Maada Bio, and presentations by the Ambassador of Sierra Leone to the United State HE Sidique Wai, Ministers of Health and Sanitation and of Education of Sierra Leone, the Youth Envoy of Sierra Leone, and the Disability Coordinator at the Washington DC Embassy.  Also present were Mission staff Deputy Permanent Representative HE Victoria Sulimani and Counsellor Finda Senesi; H.E. Francis Mustapha Kaikai, Minister of Planning and Economic Development, Sierra Leone and co-chair of the International Dialogue on Peacebuilding and Statebuilding; and other Sierra Leoneans; and parliamentarian Rosemarie Bangura.

     The event was a spectacular show of support for health in two major ways.

     Firstly, all important angles of the topic were covered, with innovative approaches in three crucial areas: programs, policy and financing.  Summaries of these important points are elaborated later in this article.

     Secondly, sponsors and speakers represented all stakeholder groups, a combination highly desirable at UN events: governments, civil society, the private sector, academia and youth.

     Government co-sponsors with Sierra Leone, included UN Missions from all regions of the world, namely, the United Arab Emirates, Canada, Cuba, and the People’s Republic of China, as well as high-level speakers from Japan, Trinidad and Tobago, and Portugal. The UAE’s SDGs in Action co-sponsored, and Ministers of Health and Education spoke.

      Agencies were represented, with the primary health agency, WHO, as a co-sponsor, and speakers from UNAIDS and USAID, and the International Federation of Red Cross and Red Crescent Societies (IRFC).  The private sector included co-sponsor Mission & Co, and speakers from the Islamic Development Bank and Pfizer.     

     The University of Queensland represented academia.  

     NGO co-sponsors included the International Association of Applied Psychology, the United African Congress and the Psychology Coalition of NGOs accredited at the UN.

     Luminary attendees included Dr. Nata Menabde, Executive Director of WHO’s Office at the UN and Tamara Tchelizde, who played a major role as Counselor in the Mission of Georgia to the UN, in the negotiations and drafting of the UHC Political Declarations; program co-sponsor the International Association of Applied Psychology’s President, Dr. Christine Roland-Levy; and program sponsor the United African Congress’ President, Gordon Tapper.

Introduction by moderator and main organizer

       The moderator and major organizer was internationally acclaimed clinical psychologist Dr. Judy Kuriansky, whose advocacy helped successfully ensure mental health being included both in the UHC Political Declaration and the UN Agenda 2030 Sustainable Development’s Goal #3 on “Health and Well-being for All.”  Introducing the event, she noted major advances in health and mental health and even during this week’s UNGA, when the UHC Political Declaration was adopted at a major summit the previous Monday whenthe UN Secretary General stated that health is at the core of the achievement of the UN Agenda 2030. The very first paragraph ensured health and mental health for all.  The Climate Summit on the same day suggests the integration of health for the people and the planet. 

     She outlined the comprehensive program; highlighted the special presentation of the First Lady of Sierra Leone, and played a music video of an original song, “Honor Our Girls,” co-written with international musician Russell Daisey, in honor of the First Lady’s projects presented at the event.

Part I. Welcoming remarks

      Setting the stage, WHO Deputy Executive Director of the UN NY Office, Werner Obermeyer, confirmed WHO’s support of countries to revise their mental health policies and plans and the need for training caregivers and personnel, especially for child and adolescent mental health and community health services. Giving shocking statistics that 80% of people in low-and middle-income countries suffer without health quality or affordable mental health care, he affirmed, “There is no health without mental health.”

Part II. The First Lady of Sierra Leone, Her Excellency Fatima Maada Bio and her medical partners

    The First Lady passionately described current health challenges in her country and appealed for support for two projects.

     A hospital center is being planned to serve Sierra Leone and the neighboring Mano River countries of Liberia, Guinea and the Ivory Coast. 

      Her campaign #HandsOffOurGirls targets child marriage, teen pregnancy, violence against girls, and rape (horrifically as common as “buying chewing gum”).  

      Encouraging cooperation, the First Lady invited partners to visit her country, ensuring “a free VISA any time to come into Sierra Leone because we need it desperately.”

    Attendees were riveted by her speech and touted her eloquence.

     Presentations were made by the co-chairs of the First Lady of Sierra Leone H.E. Fatima Maada Bio Medical Center and Research Group, USA, and Medical Center Project for the Mano River Union, a partnership arranged by Ms. Mine Anlar from World of Travel, Inc. Dr. Alper Tunga Demirarslan, Assistant Professor, Istanbul Okan University, Turkey, described the logistics and financing, targeting an initial $300 million.  Four hospitals are planned, to address priorities of needs of women and children, infectious diseases, cardiology and oncology. The focus is on public health issues of infant mortality, HIV/AIDS, clean water, malaria, immunizations, teen pregnancy, Ebola, and mental health.

    Dr. Mark Johnson, Chair of the Howard University School of Medicine Department of Community and Family Medicine, described plans for training and staffing including thousands of community health workers.

Part III. Statements from government co-sponsors

     The Mission of Canada to the United Nations, represented by HE Marc-André Blanchard, Permanent Representative of Canada to the UN, is a long-time supporter of mental health. The Canada statement affirmed that the Prime Minister has made mental health a national priority, with the government investing 11Billion in mental health and home care. In further proof of commitment, Canada launched the Alliance of Champions for Mental Health and Wellbeing with the United Kingdom and Australia, and also serves as co-chair of the UN Group of Friends of Mental Health and Well-being with Bahrain, Belgium and Ecuador.

     The Deputy Permanent Representative of the Mission of the People's Republic of China to the United Nations, WU Haitao, reported that China already provides basic medical insurance for all. He also urged that, “Developed countries should increase support to developing countries for health capacity building.” He added that “China and Africa are good brothers, good friends, and good partners,” citing (1) the headquarters of the African Center for Disease Control and Prevention and China-Africa Friendship Hospitals to open soon in Addis Ababa, Ethiopia; (2) the China-Africa Brightness Action charitable initiative for eye care, and (3) aid was sent by China for the Ebola outbreaks to West Africa in 2014 and currently to DRC and neighboring countries.  “China is ready to work with the UN, WHO, the international community and African friends to promote UHC and realize the mission of health for all,” he pledged.

     The United Arab Emirates, an event co-sponsor, was represented by the Minister of Community Development, Hessa Bint Essa Buhamaid. She outlined considerable health improvements in the UAE, including eliminating deadly communicable diseases like polio and preventing malaria and river blindness. Also, His Highness Sheik Mohammed bin Zayed Al Nahyan, Crown Prince of the Emirate of Abu Dhabi, has launched US$100 million for The Reaching the Last Mile Fund (RLMF) to end devastating neglected tropical diseases -- river blindness and elephantiasis -- in partnership with Bill Gates, the ALIMA philanthropies and others.      

     Co-sponsor Cuba was represented by the Deputy Minister of Foreign Affairs Anayansi Rodriquez Camejo, who was Ambassador to the UN. In achievement of UHC and SDG3, she reported that healthcare in Cuba is universal and free.  “Health is a human right that fully has to be implemented and respected,” she said, in contrast to “a world driven by selfish interest in which military expenditure is so high.” Notably, the Cuban health care force has been deployed to many countries around the world in crises. 

Part IV. Statements from other Mission and Embassy high-level officials

     Trinidad and Tobago, an island country in the Caribbean, was represented by H.E. Pennelope Beckles, Ambassador to the United Nations, who shared her moving personal story of a cancer diagnosis 17 years ago, to emphasize the importance of Universal Health Coverage, and the urgency for expertise, technology and research for small countries (given that she had to go to the United States for care of her health crisis, that fortunately was caught early). In that context, she said, “The wealth of a country to me is related to the health of a country”.  As the current President of the Executive Board of UN Women, Ambassador Beckles is also focused on the health of women and girls, including equity in physical and mental health and sports.

     Japan was represented by Ambassador Toshiya Hoshino, Deputy Permanent Representative of the Mission of Japan to the United Nations.  HE Hoshino noted that Japan introduced a national health insurance system as early as 1961.  He also emphasized the importance to Japan of mental health with physical health, nutrition and water sanitation.  Japan’s commitment to health is evident in having (1) chaired the Group of Friends of Universal Health Coverage, missions that supported the (successful) passage of the Declaration on Universal Health Coverage; (2) hosted a recent International Conference on Africa's Development, that the First Lady of Sierra Leone attended; and (3) took over the Presidency from the country of Georgia of Innovative Financing for Development at the United Nations.

     Portugal has also been a big supporter of health and mental health.  Representing the Mission of Portugal to the UN, Counsellor Jorge Castel Branco Soares elaborated Portugal’s commitment by (1) leading the UN resolution about mental health and human rights; (2) promoting the right to health, even extended to migrants and refugees on equal footing to nationals; and (3) supporting investment in mental health services as well as sexual and reproductive health and rights as core pillars to UHC.

     The Ambassador of Sierra Leone to the United States, HE Sidique Wai, expressed deep appreciation for all the innovative and compelling presentations, and called for follow-up to advance the important ideas and to continue and create partnerships. His call was echoed enthusiastically by many of the other presenters. 

Part V.  Policy

     * The Sierra Leone Health Minister Hon. Alpha Tejan-Wurie was interviewed by UNAIDS Director of Innovation Pradeep Kakkattil. The first question was: “Suppose that I am a young pregnant woman in rural Sierra Leone about to deliver a baby. What does UHC mean to me and how are you delivering to the needs that I have so that I’m safe, and my child is born safe? What are you doing? What are your plans?” The Minister responded that rural pregnant woman would traditionally use a birth attendant or midwife without skilled personnel to help, but plans are underway for more training of all health providers to ensure trusted care, reversing the “brain drain” of medical experts, and implementing the new national action plan for health emergencies and ambulances.

    The second question: “What can the international community do better to support your needs other than money?” The Minister requested help with building the hospitals and providing specialists.

     * The Sierra Leone Minister of Education Minister Alpha Osman Timbo remarked that education is integrally connected to health, referring to his country’s “Free Education for All” plan in President Julius Maada Bio’s “New Direction” agenda. “You cannot read when you are not healthy,” he said. “That is why health is an integral part of the human capital development program of the President of Sierra Leone.”

Part VI.  Innovative Health financing Models

     In this section, three presentations were made of innovative ways to finance health coverage.

      * The Utkrishst Development Impact Bond (the Hindi word for excellence) is an innovative partnership between the USAID and partners aimed at reducing maternal and new-born mortality in Rajasthan, India. USAID’s Irene Koek, Acting Assistant Administrator in the Bureau for Global Health, described how the UBS bank provides upfront capital for health providers, repaid by USAID and partner Merke Pharmaceuticals if certain targets are met.  Such “impact bonds” are increasingly popular to finance development.

     * The WASH Fund is an innovative partnership of the International Federation of Red Cross and Red Crescent Societies (IFRC) represented by IFRC Under-Secretary-General for Partnerships, Dr. Jemilah Mahmood, together with the Islamic Development Bank Group represented by the Lead of Alternative Development Finance, Amine Hillal. The project provides funding for clean water and sanitation, given shocking statistics that 844 million people still lack basic drinking water and 2.3 billion people lack basic sanitation, leading to millions of deaths that could be preventable. The model involves blended finance with Sukuk [the Arabic for financial certificates] that helps stem cholera and acute watery diarrheal diseases, whereby sufferers are forced to use undignified ways to use the toilet, in very unsafe areas.  Dr. Mahmood emphasized that such bonds need to go to low and middle-income countries rather than only to high-income countries.

     * The country of Georgia, a leader in Universal Health Coverage, co-chaired with Thailand the successful inter-governmental negotiations of the UHC Political Declaration.  Mariam Jashi, Chairperson of the Education, Science, and Cultural Committee of the Parliament of Georgia, described how Georgia had launched its flagship UHC program already in 2013, investing 3.0% of GDP, proving that “even with limited resources, any country can make a difference if you maximize financial investment in the health sector.” Also, Georgia significantly eliminated Hepatitis C (with support of the US government and GILEAD providing $80,000 worth of free drugs) and made significant advances in immunization of HIV, TB and malaria. Georgia also served as President of the Leading Group on Innovative Financing (passed on to Japan), with a forum last year in Tbilisi.

     Jashi described interesting Innovative financing projects including: (1) UNITAAID that integrates contributions to health into airline tickets; (2)  UNICEF’s “Checkout for Children” with Starwood Hotels, that adds $1 donation to each hotel checkout bill; (3) Product (Red), co-conceived in 2006 by rock star U2 frontman and activist Bono, as “ethical consumerism” whereby a portion of purchases for participating products by Nike, Starbucks, Gap, Hallmark and others, goes to fight AIDS, tuberculosis and malaria; (4) Georgia’s National Solidarity Fund where donations from civil servant’s monthly salaries and ticket purchases (for theater, movies or festivals) covered high costs for pediatric cancer. 

    *  Personal funds have been invested by doctors in the Ethio-American Doctors Group (EADG) for their Healthcare City Centre, described by Dr. Mohammed Nurhussein.  150,000 square meters of land has been purchased and ground was broken, aiming for operation in 2021. The for-profit Healthcare City Centre center, in Addis Ababa, Ethiopia, will include hospitals focusing on six disciplines: neurology, cardiology, orthopedics, oncology; trauma services, and maternal and child services, also providing in-patient and out-patient services and extended community health services. The buildings will meet standards of Leadership in Energy and Environmental Design. Other land is allocated for hotels and allied businesses.

Part VII.  Innovative Health Programs and Partnerships

     * Numerous innovative health programs of the United Arab Emirates were described by Dr. Radheya AlHashimi, Director of Policy Impact Department in the Strategy and Innovation Sector of the United Arab Emirates. These include (1) hosting the World Government Summit bringing together world leaders to share solutions for the future; (2) the “SDGs in Action” campaign with Global Councils to devise innovations to accomplish the UN Agenda’s Sustainable Development Goals, praising the “Health in Your Hands” initiative founded by Dr. Judy Kuriansky and Dr. Shariha Khalid Erichsen to reach those at the last mile of health; (3) the upcoming Dubai Expo 2020; and (4) the UAE “Government Accelerators” initiative whereby teams devise solutions to long-standing problems within a limit of 100 days, e.g., the 15-day paperwork period after a baby’s birth was reduced to one visit, and breast cancer screening for women in remote areas was facilitated by collating all health records.

     * The “Health in Your Hands” initiative was described by Dr. Shariha Khalid Erichsen, Managing Partner of Mission & Co and member of the UAE’s “SDGs in Action” Global Council 3 on health. The initiative was co-founded with Dr. Judy Kuriansky as a innovation solution to achieving SDG3 on health.The platformfeatures health innovations reaching the last mile and those let furthest behind that have documented impact and sustainable financial support. This innovation is significant, given staggering statistics that over half of the world’s population, including a billion people in remote rural communities, and given the lack of access to essential health services and an estimated shortage of 18 million health care workers. See: Healthinyourhands.co.

     One of the innovations, Living Goods in Kenya, was presented by the Deputy Country Director Dr. RuthNgech. The project supports community health workers in Kenya, Uganda, and starting in Sierra Leone, by providing live data to workers to follow their assignments through their cell phone, and tablets to supervisors to track workers and accurate diagnoses in the field.

     * The Ebola Coalition, a group of experts from the DRC and USA, described plans for innovative and comprehensive training workshops in the Democratic Republic of the Congo to address three aspects of the outbreak: psychosocial support (to build resilience); risk communication (to combat myths that Ebola is not real); and community engagement (to eradicate stigma).  Presentations were made by Gordon Tapper and Judy Kuriansky of the United African Congress, pastor Dr. Kaserika Kasmo of HaltEbola, Jacques Vithi, and BibiNdala of Friends of Congo. The team has been invited by the faith community in the worst-affected region. The intervention builds on the team’s previous successful help and awareness-raising during the 2014 Ebola outbreak in West Africa.

Part VIII. Commentary: Voices of the Private Sector, Academia, Disability Rights and Youth

     * Private sector representative Chris Grey, Senior Director of Global Health and Patient Access team at Pfizer, New York, read the statement from the UHC Private Sector Constituency, outlining seven contributions to UHC from the for-profit health-related private sector and businesses. These included to offer quality products, help strengthen the health workforce, and fundraise.

     * Representing academia, Dr. Claire Brolan, from the Center for Policy Futures, University of Queensland, Australia, and member of Finance Cluster of the UAE’s “SDGS in Action” initiative, outlined three key messages when it comes to financing the SDGs and SDG 3: (1) Shift wording from talking about financing SDG 3 or UHC, to talking about investing in the health and wellbeing of the invisible men, women, and children being left behind; (2) Provide seed funding for wonderful ideas in low, middle, and high-income countries, since small amounts of money can go a long way; and (3) Partner with universities that can do research to provide data and evidence, and can write grants.

     * As a voice of youth, Lucy Fagan, Global Focal Point for the United Nations Major Group for Children and Youth and Chair of the Commonwealth Youth Health Network, described the successful journey towards UHC from the UN Agenda2030 negotiations in New York in 2015, to the Astana Declaration last year about primary health care, and integrating mental health, to being back to New York now for adoption of the UHC Political Declaration.  Action is now needed, she urged, that requires political will, innovation, and partnerships. Young people can play a major role in technology and digital innovations, and also in policy.

     * Another voice of youth, Sierra Leone’s Youth Delegate Isaac Bayoh, urged taking advantage of the resources of young people as partners in global discussions, who have passion to transform society.

    *  Disability Coordinator at the Sierra Leone Embassy in Washington DC, Joseph Fofanah, described the needs of disabled persons in Sierra Leone after years of civil war, the Ebola epidemic, and the tragic mudslide, including equipment like wheelchairs, and mental health counseling to deal with the traumas. 

Conclusion

     In concluding, Dr. Kuriansky reaffirmed the historic nature of the advances in health and mental health and confirmed commitments made by the participants to heed Ambassador Wai’s call for ongoing cooperation and collaboration.

 

 Acknowledgments: The hard-working organizing team led by IAAP’s Dr. Judy Kuriansky included WHO’s Eva Kiegele, United African Congress’ Gordon Tapper, Mission & Co’s Dr. Shariha Khalid Ericshen, graduate students in Kuriansky’s class on “Psychology and the United Nations” at Columbia University Teachers College led by Sitara Maria and Bibi Ndala, with support of the Sierra Leone Mission to the UN.

 Note: Coincident events focused on Sierra Leone during UNGA week included a gala luncheon hosted by the First Lady of Sierra Leone on 25 September at the prestigious St. Regis Hotel, presenting her #HandsOffOurGirls project.  Luminaries from all fields attended, including the Sierra Leone President, WHO Director-General Dr. Tedrose Adhanom Ghebreyesus, many other First Lady’s of Africa and the First Lady of Turkey, who pledged her country’s support.

      A gala fundraising dinner was also held, in New Jersey, honoring the First Lady and the President of Sierra Leone, and supporters of her projects.  Musician Russell Daisey performed live the tribute song “Honor Our Girls” co-written with Dr. Kuriansky. The Frist Lady made a rousing appreciative address and danced with the enthusiastic attendees.

 

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