United Nations General Assembly (UNGA) 79 Side Event | New York, NY
Remarks
Anita Erskine, Executive Director at Erskine Communications: If I can have your attention. Those of you who are live with me in New York, I want to hear your energy. Give yourselves a round of applause. Now, you see I have a live studio audience, and today, you know, listen, we could look at the glass half empty. We could look at the pandemic shocks. We could look at climate change, food insecurity, and all of these elements are valid. But over the next one and a half hours, we want to look at the glass half full. There are individuals, governments, CSOs, that are taking their commitments to action with that said, you are ready for How Countries are Reimagining And Renewing Global Commitments to Primary Health Care.
The individuals who are going to be speaking today, I like to call them trailblazers, because they are drawing the blueprint on how to prioritize primary health care in their countries. And I dare say some of their examples are easily, easily adapted - adaptable and can be adopted anywhere you are. If you're joining us live on LinkedIn or Zoom, we're having a great time here in New York. It is morning for us. It could be afternoon or evening for you.
My name is Anita Erskinee. Now, just for the sake of those of us who are live with me in New York, I would kindly ask that you put your phones on silent so we avoid any disruptions. And also, if you are online and you'd like to move from English to French, at any time, you can tap on the button underneath your window. Let's start the show. My first conversation will be with Bupe Sinkala, Mentor Mother, mothers2mothers from Zambia and Dr. Atul Gawande, Assistant Administrator for Global Health, USAID, and essentially, he'll set the spirit, the energy, and the tone for the rest of our conversations here this morning. Atul, Bupe.
Bupe Sinkala, Mentor Mother at mothers2mothers: Thank you so much. Good morning, everyone. I'm so happy to be here in New York. I could say I'm getting the hang of this. Yes, thank you for that question. So for me, coming from the ground, the one who is doing the work, it's very easy for me to share with you from a real life perspective. So I'll tell you about one of my clients. Her name is Imelda, and so she's a woman that is living with HIV and has three children, and just recently, she lost her husband as a result of cholera. And so, me coming from the same community, and found at the health facility, I saw that she was not coping emotionally, and for me, I took it upon myself and other community health workers to ensure that she got, firstly, the emotional support that she needed. And also, she also continued to take her ARV treatment, because for me, that is a lived experience. I know what it can do when you're not on your treatment. I know what it can do when you're not getting that emotional support, and also I feel the trust is built that we are coming from the very same community as our clients. I know to say we have a cholera outbreak. I am also going through the same so it's very easy for that client to trust and also, not only have them access the services, but also retain them in care, just like what we do at mothers2mothers. We are an African organization that trains and employs women that are living with HIV like myself to offer support to women and also not just have them access the services, but retain them in care.
Anita Erskine: And you know, that's why, essentially, I said commitment to action. You are living the real life commitment to action, and we celebrate you for that. Atul, I mean, you have been a long standing advocate for primary health care (PHC), what is the best case for investment.
Dr. Atul Gawande, USAID Assistant Administrator for Global Health: So at USAID, our job is to reduce inequities in survival between the richest and the poorest in the world and across the span in between. Our measure we've made is to reduce the percentage of deaths in a country that occur before the age of 50. We know we can get that below 10% of the population, but in many of the countries we work, in Africa, for example, over 50% will die before the age of 50. In Asia, in many of the countries where we work, it is a similar picture. So how do we go about doing that? Well, we have our programs in maternal health, we have our programs in family planning, we have programs in child health and immunization. We have global health security to deal with emerging threats, and we partner with many countries. I see many of our friends here where we're doing this work. Every single part of it relies on strong primary health care. They are the same people. It is Bupe who is looking to see if a pregnant woman has had her prenatal visits. But then it's also Bupe that is making sure that the child is getting immunizations. Then later in life, you know, you told me before you have 300 client households, and you are addressing everything, including the fact that in the same household, the father died, and what the health issues were there, and so on. So the case for investing in primary health care is we can't address the health threats emerging around the world that can threaten the entire world. We cannot address the inequities in survival unless it's through primary health care.
Anita Erskine: So primary health care essentially builds resilient communities, resilient nations, etc. Bupe, imagine I gave you an opportunity to tell us what three things would make your work better, not easier, because it'll never be easier, but better.
Bupe Sinkala: So for me to be here is a big thing. I will not make today about me. I am speaking on behalf of my fellow community health workers, because for me, I would say I am lucky. I am employed by mothers2mothers and they pay me. They train me, they support me with equipment for me to be able to do my job, but this is not the case for my fellow community health workers, and I would say it's the exception, but it's not a norm, and for me, it's really sad, and I would like that to change, because I believe community-centered care is a key to primary health care. So I am speaking on behalf of my fellow community health workers to be trained, to be supported, to be recognized, and just to have more of us on the table.
Anita Erskine: So you don't want to be the exception. You want to be the norm.
Bupe Sinkala: Yes.
Anita Erskine: Atul, if PHC is properly invested in and strengthened, what would look different in 10 years time?
Dr. Atul Gawande: Well, we've already had a chance to see it when programs like PEPFAR for HIV, the President's Malaria Initiative, and our global health investments were increased 20 years ago, in the early 2000s, we saw countries like Thailand, which were lower income, had 35% of their deaths occurred before the age of 50. They had all of the range of problems that you can imagine, and a massive HIV outbreak happening there needing to be addressed over time, they as they rose in their economic capacity, they made a universal health coverage commitment to investing in primary care as their first priority, enabling enough nurses and community health workers and even doctors to get out to communities. The result of that is that step by step, they have outpaced their neighbors because they made primary care their priority and now they have been able to achieve the same life expectancy as the United States on $300 per person per year for health care compared to our $12,000 per year for health care. That is what is possible. And we have multiple examples of countries that are now meeting high-income results with middle-income capacity. And I'll say one more thing about where Africa is on that journey. In the year 2000, less than a third of African states were rising to middle-income status. Today, it is 60% and it's projected by 2035 it would be in the range of three-quarters. So we are needing to build this foundation for the middle-income, middle-class Africa that all of us know and see is coming, and together with their part with with their countries U.S. is partnering, you see, with all of the ministers here and and the GFF to be able to enable strong country led systems, and not just our our disease and condition based investments. We need a better primary health care system coming out of all of it.