United States Explanation of Position on Agenda Item 126: Global Health and Foreign Policy

Courtney R. Nemroff
Acting U.S. Representative to the Economic and Social Affairs Council
U.S. Mission to the United Nations
New York, New York
December 11, 2019


The United States takes the floor to speak to the Global Health and Foreign Policy resolution and its theme this year of “An inclusive approach to strengthening health systems.” We appreciate a number of concepts in the resolution on which governments, at whatever level of development, can act in concert with partners to advance the health of their populations.

To achieve better health, we must expand access to high-quality care that centers on patients and target those vulnerable and at risk. We must draw on the strengths and resources of both the public and private sectors by promoting partnerships that include government, private sector, civil society and non-governmental organizations (NGO), including faith- and community-based groups. These and other stakeholders are critical in achieving our goals in the health space.

Promoting and protecting human rights is also a key component of strengthening health systems. Human rights violations and abuses lead to further marginalization and enhanced barriers to accessing health care, and also fundamentally weaken health systems in countries. We are pleased to see positive language that calls on states to uphold their human rights obligations. We were disappointed, however, by the last-minute weakening of the text on this topic. It is regrettable that while other topics for which delegations broke silence were not changed, the co-sponsors decided to remove important human rights language.

We also want to draw attention to the need to seriously consider the timing of this resolution in the future. Informal consultations began during the busiest times in Second and Third Committees and today’s deadline for action left us with several technical inaccuracies and a text that did not feel final to many delegations. We would encourage next year’s chair and the group of seven countries to consider adopting this text either later in December or in January and, at a minimum, begin informal consultations after the conclusion of the Second and Third Committees.

The United States remains firmly committed to improving health around the world and advancing the health-related Sustainable Development Goals. In 2019, the U.S. Government invested $19 billion in global health programs. Through our investments, we collaborate with UN Member States, the United Nations, the World Health Organization, and other organizations to achieve our shared goals in global health.

The United States believes that women should have equal access to health care. In fact, the United States is the largest bilateral donor of global health and family planning assistance. However, it is unacceptable to interject controversial terms such as “sexual and reproductive health” and “sexual and reproductive health-care services” into this document. We remain committed to principles laid out in the Beijing Declaration and the ICPD Program of Action but, as written, preambular paragraph 13 misstates international consensus. The United States therefore called for a vote on preambular paragraph 13 and voted no.

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 global health assistance. The United States strongly supports the dignity and value of all human life, and rejects any attempt by others to construe the term “health services” or “health-care services” to include abortion.

The United States has joined with countries in recent fora to support a positive, consensus-based vision for access to universal health coverage that promotes better health and the preservation of human life and dignity. Our vision includes strong support for equality between men and women and the empowerment of women and girls, accelerating programs to end maternal mortality, improving girls’ education opportunities, and ensuring the health sector is responding effectively to gender-based violence.

Mr. Chair, 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, high-quality and effective medicines and the critical role intellectual property plays in incentivizing the development of new and improved medicines. It is unacceptable to the United States that the UN and some Member States have used non-WTO multilateral forums to attempt to characterize the WTO’s 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 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 set of rights and obligations under the WTO Agreement on Trade Related Aspects of Intellectual Property Rights. We continue to oppose language that we believe attempts to characterize trade commitments.

With these concerns in view, the United States strongly opposes the inclusion of operative paragraph 29 in the resolution and we called for a paragraph vote and voted no. There is recent consensus language from the outcome of the High-Level Event on Universal Health Coverage held during the General Assembly’s High-level week in September that should have been the only TRIPS reference; Preambular Paragraph 22 is more current than the language in Operative Paragraph 29. Furthermore, the OP 29 language has no precedent as an operative paragraph and it was moved from the preambular section to the operative section in the final text of the resolution – after negotiations were concluded and with no substantive or procedural justification. Such capricious manipulation of the text undermines consensus on the entire resolution.

Regarding our position with respect to the 2030 Agenda for Sustainable Development, we addressed our concerns in our Second Committee General Statement delivered on November 21, 2019.

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