Our world is like a vast, interconnected family where all beings rely on one another and on the elements of nature. Understanding and accepting this interconnectedness should reshape our approach to health. It calls for equitable access to nutritious food, clean water, and fresh air for all. Providing shelter to shield against the forces of nature should be a universal right. Furthermore, every individual should enjoy equal opportunities for a dignified livelihood and have access to essential healthcare. In this way, we can aspire that everyone has the gift of a healthy and fulfilling life.
Nations have come together to protect themselves from hunger, poverty, illiteracy, illness, natural disasters, and wars, among other challenges. The United Nations and its agencies emerged to work towards these shared objectives. However, the governance architecture to steer the member nations has been flawed in its design since its inception. Given that it took birth in the age of colonialism, it was molded in the colonial mindset. In addition, the state actors wielding the power of governance excluded the other two players of the triangle of governance, namely the private sector and the civil society. There is a need for all the actors to agree on the universal truths stated in the beginning and adopt the above-listed fundamental objectives as their collective purpose. In fact, sustainable development goals (SDGs) came into being as a result of this thought process.
As the world faces a confluence of global crises, there is a growing urgency to transform the current governance architecture. Institutional mechanisms should be agreed upon to encourage participatory governance involving governments and non-government actors (for-profits and non-profits) such as the private sector, civil society representatives, academia, religious bodies, etc. Each should agree on their rights, responsibilities, and accountability in governance.
Decisions should be arrived at based on objective evidence and experiential wisdom. The information related to every decision should be communicated down to the local level in a way that is understood correctly by the frontline implementers. Given that multiple stakeholders are involved horizontally at a given level and across levels – global to local- there should be institutional mechanisms to build relations between all the stakeholders for better coordination and collaboration. Hence, information, communication, and relations management systems should be given as much importance as other functions of governance, namely policymaking and financing.
Our world has enough resources – financial, human, material, technological, and knowledge, to secure the health of people, animals, plants, and the planet. The world can collectively mobilize and pool these resources according to each nation’s capacity. Similar to progressive taxation followed by many nations, nations can agree on global and national priorities and allocate these resources to each nation as per an agreed framework. This way they can support each other in the effective use of allocated resources.
Ensuring access to healthy food, safe drinking water, clean air, protective shelter, and essential healthcare during normal and crisis times sits on top of the priority list. Except for clean air, all others can be easily met if there is a collective effort. UN can mobilize and pool finances, food, medicines, public health emergency health workforce, technology know-how, etc. Such nascent efforts in the form of global funds, GAVI, CEPI, Pandemic Fund, COVAX, etc., are in the right direction. However, these are still operating on the principle of voluntary contributions, and not on the principle of global public investments. The frameworks to allocate these need to adopt the principles of equity, inclusivity, transparency, efficiency, etc.
Existing trade agreements, intellectual property rights regimes and waivers, international health regulations, international labor laws, multilateral lending bodies, etc., have to be reevaluated in the context of the emerging principle of “one world, one family, one future” or “Vasudhaiva Kutumbakam” as enunciated in the recent G20 deliberations and its final communique. All nations should crystallize what they all agree upon as a starting point while keeping their differences on the sidelines.
There is a near-uniform consensus that the future of humanity is in danger. The world is interconnected and interdependent. No one is safe until everyone is safe. Global collaboration evidenced in the unprecedented development of the COVID-19 vaccine can be replicated to find global solutions. We must act fast and with a shared purpose of strengthening global health systems to secure the health of people, animals, plants, and the planet.
Dr. N Krishna Reddy
President (Asia), ACCESS Health International
Photo Credits: Brown University