Explanation of Position on the High-Level Health Meetings

Ambassador Lisa Carty
U.S. Permanent Representative to the Economic and Social Council
New York, New York
October 5, 2023


The United States is pleased to join consensus on the Political Declarations of the United Nations General Assembly High-Level Meetings on Tuberculosis, Universal Health Coverage, and Pandemic Prevention, Preparedness, and Response. We appreciate the constructive approach of all three sets of co-facilitators, Poland and Uzbekistan; Guyana and Thailand; and Israel and Morocco; and thank General Assembly Presidents Csaba Kőrösi and Dennis Francis for their leadership in helping us reach consensus. 

The United States is a proud leader and the largest donor in global health, with over $10 billion of assistance provided annually. Since his first day in office, President Biden has made a strong commitment to ensure our country is better prepared for future pandemics. The United States has repeatedly reaffirmed its longstanding commitment to strengthen global health security and its recognition of the need to do more to ensure that our partners around the world are better prepared to address future health threats.

Promoting and protecting the human rights of all persons in all their diversity is fundamental to achieving UHC, creating a strong pandemic prevention, preparedness, and response architecture, and ending TB. This includes implementing laws, policies and programs that eliminate stigma and discrimination, and provide for the full inclusion of all persons.

To this end, we must include the voices of all women, girls, adolescents, LGBTQIA+ persons, persons with disabilities, Indigenous peoples, and other marginalized and under-represented populations in our decision-making. And we must meaningfully include all persons in every aspect of planning, implementation, monitoring and accountability.  We must reject policies that hinder their access to care because of bias, discrimination, or stigma. These actions are essential to meeting the Sustainable Development Goals, and to building a more resilient world in the face of threats such as climate change, future pandemics, and conflicts and crises.

On Universal Health Coverage, the United States applauds continued efforts to advance this priority – an essential building block toward achieving global health equity and strengthening global health security, including preventing, preparing for, and responding to future pandemics. We join the global community in urging action to get back on track in all critical UHC areas and in restoring essential health services to levels that are better than before the pandemic, ideally by 2025. This year’s UHC declaration made some important progress on these elements since 2019, including strong language on health care workers and access to UHC for members of marginalized populations.  The declaration also highlights the shortfalls of achieving UHC on a global level by 2030, including where SDG3 implementation has failed to progress since 2019.

The world has been profoundly impacted by the COVID-19 pandemic, with nearly a billion people infected and over seven million lives lost, along with devastating effects on economies, livelihoods, and health systems. The pandemic demonstrated that as a global community we were underprepared. We need to address the gaps exposed by COVID-19 and prepare for the future. The United States is incorporating the lessons learned from COVID-19 on an ongoing basis and will continue to do our part to prepare for, and respond to, the next health emergency. This year’s political declaration, the first of its kind in the General Assembly, laid down an important marker and reaffirmed at the head of state level the importance of further enhancing political momentum and commitment towards pandemic prevention, preparedness, and response, while remaining aligned with the Geneva-based processes on the Intergovernmental Negotiating Body and the International Health Regulations.  

The High-Level meeting on fighting tuberculosis comes at a critical time. While the world continues to take steps towards universal health coverage, and works to improve pandemic prevention, preparedness and response, the age-old scourge of tuberculosis takes more than 1.6 million lives each year. The United States remains the largest bilateral donor to the global effort to end TB, which has saved over 75 million lives to date. For over two decades, we have worked with partners to end TB through surveillance, programs, and research efforts. We will continue these collaborations, including through our contributions to the Global Fund to Fight AIDS, TB, and Malaria. This year’s political declaration on TB makes important progress on updating the language on targets, references to the Global Fund and Stop TB partnership, and incorporates important additional language on human rights, including a reference to the Universal Declaration of Human Rights.

We regret that we missed the opportunity to strengthen prior commitments on some critical cross cutting issues. For example, advancing and respecting Sexual and Reproductive Health and Rights for all remains foundational to promoting gender equality and global health, and also protects the human rights of all persons in all their diversity. The United States is disappointed we could not reach agreement to go beyond previously agreed language.

In addition, we regret that the phrase “multiple and intersecting forms of discrimination” as well as the fully inclusive listing of those most marginalized, including LGBTQIA+ persons, does not appear in the final versions of all three documents. We do however applaud the inclusion of strong language on the importance of and challenges faced by the global shortage of health workers in all three documents.

As we adopt the three Political Declarations in the General Assembly plenary today, the United States wishes to reiterate our outstanding concerns with the paragraphs on trade and technology transfer, and terminology around equal pay for equal work.

Thank you, Mr. President.