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March 4, 2015

Challenges of Global Health Toward ‘Accelerating Equity’ – Prince Mahidol Award Conference 2015

The Prince Mahidol Award Conference 2015 was held Jan. 26 to 31, in Bangkok, to discuss issues in the health sectors around the world.

Since the Prince Mahidol Award Foundation was established in 1992 in commemoration of the hundredth anniversary of the birth of Prince Mahidol, who is known as “the father of modern medicine and public health in Thailand,” the Prince Mahidol Awards have been given every January to individuals and organizations for their contributions toward medical science and public health. The conference is held immediately after the award ceremony, and the Japan International Cooperation Agency has been participating since 2011 as a co-host (1).

Discussion among a wide range of stakeholders has moved forward with regard to setting new targets for the post 2015 development agenda because the Millennium Development Goals (MDGs) sets 2015 as the year to be achieved(2). This year, the theme was “Global Health Post 2015 – Accelerating Equity,” and a lively discussion was held on health issues that need to be tackled globally, and on how to find improvements and solutions. Members from JICA, including delegation leader, Vice President Kiyoshi Kodera, were actively involved in the discussions. Kodera sent a message about efforts related to universal health coverage (UHC) (3) aimed toward reducing inequity.

Discussions on global health 'Post 2015'

photoA side event organized by the the World Bank

From Jan. 26 to 28, before the opening of the main conference, the World Bank held a side event entitled “Universal Health Coverage: Sharing Lessons and Developing Country Strategies.” JICA participated in this event together with representatives from the governments of Indonesia, the Philippines, Viet Nam and Myanmar, and the participants advanced the debate on challenges in achieving UHC and future efforts by each country. Kodera delivered the closing remarks.

The main conference was held Jan. 29 to 31, and it consisted of four plenary sessions and 21 parallel sessions, with 610 people attending from 58 countries. From Japan, on Jan. 29, Keizo Takemi, a member of the House of Councilors and a former vice minister of Health, Labor and Welfare, gave a keynote speech at the plenary session entitled “Priority Global Health Issues and Health Related Post-2015 Development Goals/Targets/Indicators.” On Jan. 30, Kiyoshi Kurokawa, professor, National Graduate Institute for Policy Studies, joined as a panelist in the plenary session entitled “Global Health Financing – What Lies Ahead?” From JICA, Naoyuki Kobayashi, deputy director-general, Human Development Department, and Tomohiko Sugishita, JICA senior advisor for health, participated as the moderator.

Through the conference, the following seven points were proposed toward “accelerating equity in health”: 1) Increased fiscal space for health, 2) progressive universalism (4), 3) Functioning, responsive and resilient PHC (5), 4) Governments ensure financial risk protection, especially for the poor & vulnerable (6), 5) Address political origins of health inequity: national and transnational, 6) Accountability of other sectors for health impacts, and 7) Effective accountability framework: empowering local communities.

Moderators of three parallel sessions

photoNaoyuki Kobayashi, deputy director-general, Human Development Department, JICA, explains about the Post 2015 Agenda.

During the parallel session entitled “Health-related Post-2015 Development Goals and Targets” on Jan. 29, Kobayashi acted as a moderator and talked about the state of achievement of the MDGs and “Post-2015 Agenda” with consideration for equity.

Reporting on the outcome, he talked about the need to take measures against such new threats as Ebola and non-communicable diseases while dealing with remaining MDG issues such as maternal and child health and infectious disease control. “When we deal with these problems, so that health services are offered equitably to all people, it is important to measure with attention paid to incorporating the point of view of equality in the indicators targeted by UHC, and to pursue quality in health services as well as accountability on the part of diverse stakeholders (nations, peoples and civil society)," said Kobayashi.

On Jan. 30, he also moderated a parallel session entitled “Universal Health Coverage Political Commitment and Financing for Complex Public Health Needs in the Next Two Decades.” In the session, efforts in the Philippines and Kenya toward UHC were mentioned. Also, some discussed to contain escalation of medical costs as a result of introduction of health technology assessment and population aging, which got the audience's attention.

On the same day, Sugishita moderated a parallel session entitled “Health Systems Responsiveness: Health Service Delivery Ensures Dignity, Confidentiality, Autonomy and Promptness in Empowering the Poor and Marginalized.” The session focused on responsiveness by participating in the health system from point of view of communities and consumers. African country gave presentations about efforts toward community health services, Thailand gave presentations on the participation of civil society in the annual health meeting and consideration of methods of measurement to accelerate equity, and Vietnam gave presentations on an analysis of the influence of the health care system on accelerating equity. Broad discussion followed the presentations.

Future Trends Around Global Health

photoJICA Vice President Kiyoshi Kodera hands a trophy to an award winner.

Through the conference, as discussion of UHC moved forward with relation to achieving equity, it was reaffirmed in particular that the provision of high-quality health services is an important element and that it is important to appropriately carry out training and placement of human resources for health.

Also, future trends around global health are drawing attention, such as the problem of health security that came up from the Ebola epidemic in West Africa and the state of fund-raising with the post-2015 development agenda in mind. Next year, the conference will be entitled “Priority Setting for Universal Health Coverage” and further discussion is planned.

On last day of the six day event, Kodera took the podium as a presenter at the “Prince Mahidol Award Conference 2015 World Art & Photo Contest” and handed trophies to the winners.

Notes:
1. Co–hosted by The Prince Mahidol Award Foundation, JICA, the World Health Organization, the World Bank, the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United States Agency for International Development (USAID), the Rockefeller Foundation, the China Medical Board and Chatham House.
2. International development targets adopted based on the United Nations Millennium Declaration in 2000. There are targets dealing with eight issues, including education, gender equality, maternal health, disease, the environment and eradicating poverty.
3. Universal health coverage refers to "the ability of all people to receive appropriate services related to health promotion, prevention, medical treatment and functional recovery at a cost they can pay." (definition by WHO)
4. Progressive universalism refers to extending medical insurance and health services in stages to create a framework for all people to obtain the health services.
5. This was adopted at the joint conference by WHO and UNICEF in 1978, with the goal of “attaining health for all by 2000.”
6. People who live in rural area or can’t access health service. And also they include women, children, the elderly and people who have disability.

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