Transcript IHR Revision Process and health diplomacy: The Brazilian Experience PAHO / WHO

PAHO / WHO
World Health Day
The Role of Health Diplomacy:
Building a Safer Future
IHR Revision Process and health diplomacy:
The Brazilian Experience
DANIEL LINS MENUCCI
Health Surveillance Secretariat
Health Ministry of Brazil
Health Policy and Foreign Affairs in Brazil
HISTORICAL BACKGROUND
The first public health measures in Brazil were also related
to TRADE : to protect the country against international
dissemination of disease at ports, following the same
direction of international practice of quarantine measures in
Europe:
1809
-was created the first health bureau, one year after opening
Brazil’s ports for commerce with friendly nations
- imported diseases like cholera and plague.
Historical participation of Brazil in Regional Agreements
and Europeans health forums:
1887,
Sanitary Convention between Brazil, Argentina and Uruguay
(sanitary measures for cholera, plaque and y. fever)
1902, First Americas Sanitary Conference
1903, International Sanitary Conference and the
subsequent Rome
Agreement
1924, Pan American Sanitary Code
1946, WHO Constitution I International Sanitary Conference
1951, 1969, 1973, 1981, 2005 - International Health Regulations
Health Policy and Foreign Affairs
Globalization process in the XX Century
Investments in Health as fundamental for
economic growth and development
X
Threats to health may compromise a country’s
stability and security
X
Health measures may compromise trade
Health Policy and Foreign Affairs
Globalization process in the XX Century
International
Increase
Health
of global communication and transportation
impact of international traffic and trade
Sharing
The
agreements and its impact on national laws
global solutions and international responsibilities
role of intergovernmental organizations: PAHO/WHO
International
actions: life and health as fundamental rights
The Brazilian Participation at
IHR (2005) Revision Process
• Different Global scenarios of
health epidemics situation and
foreign affairs (trade, security,
etc.).
• Two different approaches for
the IHR revision process.
The Brazilian Participation at
IHR (2005) Revision Process
• First phase – Surveillance of Syndromes
Resolution WHA48.7,1995-1999
– emerging and re-emerging infectious diseases,
exemplified by outbreaks of pest (India 1984),
cholera (South America, 1990 and 1995) and
Ebola (Africa, 1994) and its impact on
international trade and global health.
– The need to work with a global notification and
response system, able to deal with infectious
diseases and not restricted only to the existing 3
diseases list.
The Brazilian Participation at
IHR (2005) Revision Process
First phase – 1999-2000
Surveillance of Syndromes
– Restricted participation of Member States
– MOH Legal Expert as focal point for IHR
– Infectious diseases & health measures at points
of entry major concern
– MOH of Brazil participation on IHR syndromes
surveillance proposal validation process
– MERCOSUR Health WG first meetings
– Restricted to technical and legal MOH meetings
and no interference of Brazilian Foreign Affairs
Ministry
The Brazilian Participation at
IHR (2005) Revision Process
• second phase – 2000- 2005
Public Health Events of International Concern
(irrespective its origin or source)
– 10 January 2000, WHO circulate a document with
political guidance, in which no more is mentioned any
list of diseases or surveillance for signs and
symptoms, instead, appears a notification proposal for
events of
importance.
urgent
international
public
health
– New global public health risks and treats to security:
Sept.11th, Anthrax, Chemicals weapons, SARS, etc.
– Pandemics, global security matters, trade and health
impact and the need of a different IHR approach
beyond infectious diseases.
The Brazilian Participation at
IHR (2005) Revision Process
Second phase – 2000- 2005
Public Health Events of International Concern
– Increased participation of Member States
– Pub. Health Events irrespective its origin or source
– Special IHR Commission at MERCOSUR Health
Minister Meetings
– Brazil and MERCOSUR Member States participation
on several IHR informal consultations and
Intergovernmental WG
– National inter-ministries meetings coordinated by
Brazilian Foreign Affairs Ministry
– Concerns about animal and plants, sovereignty,
national security, health and human rights and
respect to other international agreements
The Brazilian Participation at IHR
(2005) Revision Process
WHA 58TH – IHR (2005) DRAFT ON THE FLOOR
Americas and Intergovernmental WG meetings
– MERCOSUR sub-regional health advocacy approach
for IHR(2005): negotiating a consensus integrated
with foreign affairs
– Brazil- Rio de Janeiro Sub Regional meeting: new
actors on the floor (foreign affairs, agriculture, etc)
– Canada regional meeting: living with differences and
getting to know sub-regional approaches
– Geneva Intergovernmental Working Group meetings:
South Americas contributions (Montevideo and
Buenos Aires documents)
The Brazilian Participation at IHR
(2005) Revision Process
LESSONS LEARNED
– When countries shares common health policies
and confidence building, it makes international
negotiation and cooperation easier (B.Aires and
Montevideo documents).
– Regional agreements plays an important role on
developing, strengthening and maintain national
health systems and supporting harmonized health
actions of preparedness and response.
– Health International agreements which considers
both national health policy and foreign affairs
policy during negotiation process has better
chance
during
negotiation
and
in
its
implementation.
The Brazilian Participation at IHR
(2005) Revision Process
LESSONS LEARNED (cont.)
– Developing national health policy should take into
consideration global health, like pandemics treats.
– The IHR(2005) represents a great effort to
strength global health and its implementation
relies in the international cooperation in health
and other foreign affairs actors.
– Intergovernmental organizations, like PAHO/WHO,
plays an important role, regarding harmonization
of rules and procedures, support countries to
develop, strengthen and maintain core capacities
and sharing information.
GLOBAL HEALTH AND DIPLOMACY
Challenges
Principles
Protect health
Save lives
Improve Live
quality
Live and health as
fundamental rights
Instruments
Health policy
Health diplomacy
Challenges
To deal with
differences,
share
responsibilities
and solutions
to build a
healthier
and safer future
‘impact on health’
POINT OF DEPARTURE
FOR HEALTH DIPLOMACY
“how to make ‘impact on health’ a point of
departure and a defining lens that each of our
countries will use to examine key elements of
foreign policy and development strategies, and
to engage in a dialogue on how to deal with
policy options from this perspective” [1].
[1] “OSLO MINISTERIAL DECLARATION – Global health – a pressing foreign policy
issue of our time”. Statement issued in Oslo on 20 March 2007, by Ministers of
Foreign Affairs of Brazil, France, Indonesia, Norway, Senegal, South Africa and
Thailand, under their initiative on Global Health and Foreign Policy, launched in
September 2006.
THANK YOU!
GRACIAS!
MERCI!
Obrigado !
[email protected]
www.saude.gov.br/svs