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Universal Health Coverage (UHC) Explanation of Position as Delivered by Courtney Nemroff (October 10, 2010)

  • The United States believes that our shared ambitions toward achieving Universal Health Coverage (UHC) must be viewed in the light of the goal toward which we as nations have been working toward at the United Nations (UN) and the World Health Organization (WHO) for more than half a century -- achieving the highest attainable standard of mental and physical health for every person.
  • Key to the goal of access to UHC is health care in which patients are in control and have access to high-quality, people-centered care. To achieve better health, we must expand access for our populations and target those vulnerable and at risk. Moreover, we must draw on the strengths and resources of both the public and private sectors by promoting partnerships that include government, civil society and non-governmental organizations (NGO), as well as faith- and community-based organizations. This multifaceted approach to UHC stands the best chance of delivering the high-quality care that centers on patients and improves their health. We also understand the important role the health-related Sustainable Development Goals (SDG) play in assisting countries toward realizing their own pathways to UHC, in accordance with national policies and legislation.
  • The United States, as the largest bilateral funder of global health programs, remains firmly committed to improve health around the world and advance the health-related SDGs. In FY2019, the U.S. Government invested 19 billion in global health programs. Through our investments, we collaborate with Member States and engage with the UN to advance global health and achieve our shared goals.
  • The United States firmly believes that we can do more for people by coming together on those broad areas of agreement on which we can achieve genuine progress, rather than pursuing divisive policies that promote abortion, diminish the role of the family, and compromise the sovereignty of nations by focusing on sensitive issues where we know consensus is not possible.
  • It was in this spirit that the United States delivered - in the context of the HLM - a joint statement on behalf of 21 UN Member States, to make clear that we support a positive, consensus-based vision for UHC that promotes better health and the preservation of human life and dignity. In that statement, we also strongly expressed certain reservations to the way elements of this declaration can be interpreted by some UN bodies and donor governments that we wish to enter into the official General Assembly record.
  • Our vision includes strong support for gender equality and the empowerment of women and girls, accelerating programs to end maternal mortality, improving girls' education opportunities, and ensuring that the health sector is responding effectively to gender-based violence.
  • The United States is compelled to address the UHC Political Declaration language that has been used to promote abortion as health care and promote sex education, which diminishes the protective role of the family in improving health. While the United States joins consensus on this Political Declaration, in recognition of the importance of better health for all, we firmly disassociate from Paragraph 68 of the Declaration. Despite months of good faith effort to find common ground and consensus, prominently on display when we reluctantly agreed to language from SDG health Target 3.7, our efforts were largely unreciprocated with the refusal to delete unacceptable language from 5.6.
  • In addition, the United States is concerned that the terms "sexual and reproductive health-care services" and "sexual and reproductive health" have accumulated connotations that suggest the promotion of abortion, or a right to abortion, that are unacceptable to our Administration. The United Nations should not be in the business of promoting abortion, whether in its humanitarian or development work, and its reports and recommendations should not advocate for the creation of new "human rights'' regarding sexual and reproductive health.
  • We remain deeply concerned that comprehensive sexuality education programs undermine the protective role of the family in such education and condone harmful sexual risks for young people. We continue to be a stalwart defender of all women, men, children, and families and support programs to improve their health, life, dignity, and well-being.
  • As President Trump said during his speech to the General Assembly: "Americans will never tire of defending innocent life. We are aware that many United Nations projects have attempted to assert a global right to taxpayer funded abortion on demand, right up until the moment of delivery. Global bureaucrats have absolutely no business attacking the sovereignty of nations that wish to protect innocent life. Like many nations here today, the United States affirms that every child, born and unborn, is a sacred gift from God."
  • The United States shares Hungary's concerns about the treatment of migration in this document. The term "migrant" is not well-defined in international law, and not all migrants are inherently vulnerable, as suggested by paragraphs 70, and 71. Further, with regard to those paragraphs and paragraph 9, the United States does not have any international obligations pertaining to the provision of social services to aliens. As a matter of policy, and under its domestic laws, the United States supports access to emergency health care for everyone on its territory, regardless of immigration status, but does not recognize any right to access to health care beyond emergency services. As a former U.S. Attorney General noted, "No great and prosperous nation can have both a generous welfare system and open borders."
  • Further, with regard to those paragraphs and paragraph 9, the United States does not have any international obligations pertaining to the provision of social services to aliens. As a matter of policy, and under its domestic laws, the United States supports access to emergency health care for everyone on its territory, regardless of immigration status, but does not recognize any right to access to health care beyond emergency services. As a former U.S. Attorney General noted, "No great and prosperous nation can have both a generous welfare system and open borders."
  • Finally, the United States looks forward to working with all Member States to forge international consensus that takes into account different national and cultural contexts and promotes families and communities as a vital part of the solution. By working together and focusing on the important work of expanding health and opportunities for all people, especially those in situations of risk and/or vulnerability, we can successfully accelerate health for all and achieve the goal of UHC.
  • Finally, we would like this EOP and our joint statement on September 23rd to be made part of the official General Assembly record. Thank you.
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Content last reviewed on October 25, 2019