Explanation of Position on Agenda Item 127: Global Health and Foreign Policy

Laurie Shestack Phipps
Adviser for Economic and Social Affairs

December 12, 2017


Mr. President, Excellencies, distinguished colleagues, I would like to start by thanking Nathita Premabhuti for leading the negotiation of the Global Health and Foreign Policy resolution so skillfully and for bringing consensus to many difficult, but important, issues contained in this resolution. She has ably guided the negotiation schedule over the last several weeks, and we are appreciative that the text was concluded in a timely manner.

We take this opportunity first to welcome the focus in the resolution on the health of the most vulnerable. We also wish to make important points of clarification on some of the language we see reflected.

Regarding all references to universal health coverage, in both L.27 and L.28, the United States emphasizes that Member States should choose their best path towards universal health coverage in line with their national contexts and priorities. We applaud efforts to encourage universal health access, understanding that efforts to expand access do not imply primarily government-centric solutions or mandates, which we do not support.

We further underscore that the resolutions, and many of the outcome documents referenced therein, including the 2030 Agenda for Sustainable Development and the Addis Ababa Action Agenda, are non-binding documents which do not create rights or obligations under international law.

Regarding the reaffirmation of the 2030 Agenda, the United States recognizes the Agenda as a global framework for sustainable development that can help countries work toward global peace and prosperity. We applaud the call for shared responsibility in the Agenda and emphasize that all countries have a role to play in achieving its vision. We also strongly support national responsibility stressed in the Agenda. However, each country has its own development priorities, and we emphasize that countries should work towards implementation in accordance with their own national policies and priorities.

We also highlight our mutual recognition, in the 2030 Agenda paragraph 58, that implementation of this Agenda respect, and be without prejudice to, the independent mandates of other processes and institutions, including negotiations, and does not prejudge or serve as precedent for decisions and actions underway in other fora. For example, this Agenda does not represent a commitment to provide new market access for goods or services. This Agenda also does not interpret or alter any WTO agreement or decision, including the Agreement on Trade-Related Aspects of Intellectual Property, TRIPS Agreement.

Regarding the reaffirmation of the Addis Ababa Action Agenda. Specifically, we note that much of the trade-related language in this outcome document has been overtaken by events since July 2015 and is immaterial. Our reaffirmation of the outcome document has no standing for ongoing work and negotiations involving trade. Indeed, some of the intervening events happened just months after the release of the outcome document.

The United States recognizes the importance of access to affordable, safe, and effective medicines and the critical role that intellectual property plays in incentivizing the development of new and improved medicines. We regret, however, the inclusion of unacceptable language on the WTO TRIPS Agreement and Doha Declaration on the TRIPS Agreement and Public Health in preambular paragraph 28. It is unacceptable to the United States that the UN and some member states have used non-WTO multilateral forums to attempt to characterize WTO rules and agreements. This could lead to misinterpretation of international trade obligations in a manner which may negatively affect countries’ abilities to incentivize new drug development and expand access to medicines.

The United States reaffirms in this context that the strong protection and enforcement of intellectual property rights incentivizes the creation and distribution of lifesaving medicines and other useful consumer products around the world that address the health, environmental, and development challenges of today and tomorrow through a carefully negotiated, balanced set of TRIPS member rights and obligations. We continue to oppose language that we believe attempts to characterize trade commitments. We do not believe that UN resolutions are the appropriate vehicle for such pronouncements and we are concerned that inclusion of this language may be an attempt to prejudice negotiations underway or anticipated in other, more appropriate, fora.

Regarding OP 14, the United States believes that women should have equal access to reproductive health care. We remain committed to the principles laid out in the Beijing Declaration and the ICPD Program of Action. As has been made clear over many years, there was international consensus that these documents do not create new international rights, including any “right” to abortion. The United States fully supports the principle of voluntary choice regarding maternal and child health and family planning. We do not recognize abortion as a method of family planning, nor do we support abortion in our reproductive health assistance. Let me reiterate that the U.S. is the largest donor of bilateral reproductive health and family planning assistance.

In response to the United States’ position on the Global Compact on Migration, we do not support its inclusion in OP15 or reference to the development of the Global Compact on Migration.

Lastly, we interpret this resolution’s references to obligations as applicable only to the extent that States have assumed such obligations, and with respect to States Parties to the International Covenant on Economic, Social, and Cultural Rights, in light of its Article 2(1). The United States is neither a party to that Covenant nor to its Optional Protocol, and the rights contained therein, including the right to the enjoyment of the highest attainable standard of health, are not justiciable as such in U.S. courts. We read this resolution to urge States to comply with their applicable international obligations.

We request that this statement be made part of the official record of the meeting. Thank you.