Explanation of Vote on a UN General Assembly Plenary Resolution on Global Health and Foreign Policy: Healthier World Through Better Nutrition

Courtney Nemroff
Deputy U.S. Representative to ECOSOC
U.S. Mission to the United Nations
New York City
December 13, 2018


The United States regrets that we find it necessary to vote against this resolution today. No nation makes greater contributions in terms of resources and actions to promote global health than our country. And we appreciate the intent of the originators of the Global Health and Foreign Policy resolution to address this topic through an annual process, as a way of showing our long-term commitment to the issue. We also appreciate the importance of the general theme of this year’s resolution focusing on nutrition.

Therefore, we find it unfortunate that this well-intentioned idea seems to have degenerated into an exercise in negotiating a resolution for the sake of negotiating a resolution. While the topic of nutrition is indeed an important one, this resolution seems little more than a collection of general platitudes along with many paragraphs on extraneous topics, composed of previously agreed text that adds the phrase “and nutrition” to make them appear on topic. This year’s resolution has become a metaphor for the problem of the over-consumption of foods that have little nutritional value but are high in empty calories.

As delegates here know, when resolutions really matter, the sponsors go to lengths to defend the texts from extraneous or controversial language in order to defend the parts that are important. In this instance, the opposite has happened — there is almost nothing in the text worth defending, so it has become a freight train in which the goal seems to be to load it with as much extraneous text and unfinished business as possible. And no delegation dares oppose the text because we all believe health is so important.

So this year our delegation has decided to vote against this resolution. We do so not out of disrespect for this body, but in fact because we respect the need to focus on resolutions that are actionable and have real-world implications.

In future, when these types of resolutions are brought up annually, we would urge the sponsors to take a different approach — keep the resolutions as concise as possible; minimize or eliminate entirely preambular text; and resolve to keep operative text to a minimum, with an emphasis on text that is truly new. Sponsors should seek to defend these resolutions against regurgitations of previously agreed text that we’ve passed countless times.

The resolution before us today does not respect the results of the High-Level Meetings held by our leaders in these halls just two months ago. On the contrary, this resolution diminishes and distorts the declaration by our leaders.

With regard to preambular paragraph 7, 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. We also note that the U.S. is the largest bilateral donor of reproductive health and family planning assistance.

Moreover, with respect to PP8, the United States strongly supports the dignity and values of all human life and rejects any attempt by others to construe the term “health services” or “health-care services” to include abortion.

It is our view that the United Nations must respect the independent mandates of other processes and institutions, including trade negotiations, and must not involve itself in decisions and actions in other forums, including at the World Trade Organization.

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 33. 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. Furthermore, this paragraph distorts and distracts from the treatment of this issue by our political leaders reached less than three months ago during the NCD High-Level declaration.

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.

Nor does this resolution prefigure or in any way influence the preparations for or outcome of the Fall 2019 High-Level Event on Universal Health Coverage.

And, finally, Mr. President, regarding the reference to the Global Compact for Safe, Orderly and Regular Migration, we believe the Compact and the process that led to its adoption, including the New York Declaration, represent an effort by the United Nations to advance global governance at the expense of the sovereign rights of States to manage their immigration systems in accordance with their national laws and interests. While the United States honors the contributions of the many immigrants who helped build our nation, we cannot support a “Compact” or process that imposes or has the potential to impose international guidelines, standards, expectations, or commitments that might constrain our ability to make decisions in the best interests of our nation and citizens.

With regard to references to the 2030 Agenda for sustainable development, we addressed our concerns in our statement on December 3 under agenda item 12.

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