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Final wrap on UN Week and the ‘historic’ global health confab

Someone important going to the UN

A news analysis:

As I head home from the Big Apple, the big news here today is that Palestine formally requested membership at the United Nations as a step toward becoming an independent nation. The actual vote comes later but the UN isn’t really a democracy. The U.S. has vowed to kill it with a veto in the UN Security Council.

Iranian President Ahmadinejad’s antics at the UN are already old news. Other top stories today include a satellite coming down and some Swiss nerds claiming they sent subatomic particles faster than Einstein said they can go.

An earlier meeting by the UN General Assembly was repeatedly hailed by those who care about poverty, health and social justice as “historic.” But it seemed to come and go with little notice.

I reported earlier this week on this much lower-profile UN High-Level Meeting on Non-Communicable Diseases (NCDs), admitting the entire time that I wasn’t quite sure what happened at this global health confab, or if it will matter much.

I couldn’t tell in part because of the byzantine manner which the UN does things, beginning with the apparently common UN practice of deciding on the outcome of a meeting before you have the meeting. I also couldn’t tell because the media is highly constrained and can only talk to participants at about the same level of engagement as someone jailed in solitary confinement.

That said, the UN meeting on NCDs does have the potential for something great … to emerge from this fog of sound-bites, press briefings and celebrity appearances. This could actually turn out to be historic, an expansion and re-ordering of the global health agenda.

It isn’t yet, however. As several of us who follow global health closely (obsessively, sometimes angrily) have noted, the UN didn’t really accomplish much of substance this week. As Laurie Garrett, perhaps the top global health journalist (or former journalist?) now with the Council on Foreign Relations, wrote on her blog:

After months of haggling, millions of dollars’ worth of meetings and travel costs and a prodigious mountain of studies and documents prepared in anticipation, the final Declaration of the UN High Level Meeting  is little more than a wishy-washy rendition of problems and vague solutions that are obvious to even casual observers….

Laurie, who is a friend, goes on to cite my earlier reports saying much the same thing and then calls me “super-insightful.” Wow, and I only paid her $20. Others just call me cranky. But I think we all want this thing to move forward, to expand the reach of the fight against the diseases of poverty.

The UN meeting, as goofy as it was, is still significant if only because it indicates the global health community is at a critical crossroads — where it appears to need to make some strategic, focused and tough choices or get sunk by failing to prioritize.

At the conclusion of the meeting, I talked to Ann Keeling, chair of the NCD Alliance — one of the leading organizations trying to get the UN to set hard targets on things like trans-fats in food, tobacco, sodium and corn syrup. The NCDs, or chronic diseases, are partly fueled by some powerful industries which had a lot of say in the talks leading up to the UN meeting.

(NOTE: Jamie Love, of Knowledge Ecology International, contended after I posted here that the NCD Alliance is itself fueled by some powerful commercial interests, disease advocacy groups supported by the pharmaceutical industry. So maybe what we have here is one segment of industry, drug makers, pushing against another, the food and beverage industry.)

“We wanted a much more defined strategy,” said Keeling. Here’s her group’s response to what they felt was a watered-down declaration by the UN. Keeling noted that the UN drafted its strategy prior to the meeting and only voted to approve it, as opposed to the routine of discussing it first and then drafting a declaration.

“It was a very difficult document to negotiate,” she noted.

This was likely because the declaration didn’t just threaten to put the onus on many in the food and beverage industries to stop selling disease-causing foodstuffs. Some also wanted the drug industry to relax its patent protections on drugs for treating chronic diseases — a proposal that didn’t get very far.

No wonder the media wasn’t to venture far into these meetings.

“We wanted clear, defined targets and the ability to monitor progress,” said Keeling. They wanted regulations, she said, while some in industry preferred voluntary commitments.

Now, she says, it’s up to the World Health Organization, governments and donors to work toward putting teeth in this vague declaration. Transparency will be critical, Keeling says, because of all the competing interests involved and the power they have had already to influence the nature and direction of the discussion.


About Author

Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at] or follow him on Twitter @tompaulson.