Kicking off the UNGA81 High-level week

Dear Colleagues,

Officially, the 81st UNGA High-level week  (18-28 Sept) kicks off today, although the General Debate only starts next Tuesday. Later today, the annual  ‘SDG moment’  is taking place. Doubt it’ll be a festive occasion, even if I largely agree with Jonathan Glennie’s  take on the SDGs:  they told us what matters. Sadly, though, instead of steadily getting closer to the SDGs as the deadline is approaching, mankind is increasingly flirting with ‘end times’, it appears (see eg Naomi Klein  & Vance for some slightly different takes on these end times). Unlike the MDG agenda, the SDG agenda turned out a ‘universal one’ indeed. Trouble is: we collectively botched it – even if some people are obviously far more guilty than others.

And so, instead of the sustainable development we were promised, we now face three existential risks ( & counting): the climate breakdown (& more in general planetary boundaries emergency); nuclear risks/weapons of mass destruction (back from never really having gone in the first place);and AI ( the new kid on the block).  In an interview from this week, UN SG Guterres also considers ‘deepening inequalities’ an existential threat, and he’s not wrong.   Sometimes you get the impression this newsletter isn’t any longer about global health policies & governance but about existential risks – in the short or medium term. In case you wonder: it’s not that I particularly like it (in spite of an undeniable Schopenhauer streak on decaffeinated days).  Moreover, as I don’t need to tell you, on all these accounts (ànd plenty of others), hundreds of millions of people are currently already suffering really awful consequences and real harm – with ‘swarms of tech billionaires’ behaving like ‘rogue agents’ in many of these areas : )

It’s against that rather dire (and for many even increasingly nihilist ) backdrop that the global health community continues to work towards a brighter future – while trying to avoid feeling too much like Don Quichote on a windy day.

With that in mind, this newsletter issue features updates on the Global Health reform efforts, with this week among others an important new Nature Medicine article by some heavy-hitters,  ‘Rethinking the global health system for a new international order’. One of the co-authors, Wellcome’s J-A  Røttingen, warned the window for global health reform is closing  over the next year or so. The first author, the Alliance’s Kumanan Rasanathan reckons ‘this time could be different’ (for a number of reasons): unlike in previous decades global health reform is possible now. We tend to agree.  Still on global health reform, on Monday the Accra Reset High-Level Panel releases its – highly anticipated – recommendations in New York. Do read a hard-hitting Lancet Comment by Ebere Okereke et al, ahead of next week’s launch,   ‘The Accra Reset must turn sovereignty into country power’.

In the run-up to UNGA’s High-level week, as usual a number of high-profile reports were also published, among others the 2026 Gates Foundation Goalkeepers report   ( this time with Bill’s ‘complicated’ view on AI and health, plus an (uncomplicated) 1 billion investment); a new BMJ Collection on protecting global SRHR in difficult times; a Rockefeller foundation global poll with some mixed messages; and the Global Fund’s  annual  Results report.   With no doubt more reports still to come in the coming days.

In Hangzhou, China, the Global Initiative on AI for Health (GI-AI4H) (a joint WHO/ITU/WIPO body) is holding its third meeting  (16-18 Sept). Among others, to push forward global AI-in-health governance standards. They have their work cut out. Interesting setting too.  

We also pay quite some attention to the BRICS summit from last weekend in Delhi – rather important from a public health point of view as well.  And today, September 18^th, the America First Global Health Strategy turns one year old. ( Nope, no cake …)

In the Ebola emergency in the DRC, earlier this week media reported for the first time some ‘cautious optimism’ from DRC government officials. Talk of a ‘peak’ is perhaps premature, but  on Wednesday, WHO staff (including Tedros himself) also  expressed some cautious optimism about the fight, while acknowledging the battle is going to take many more months. Which brings us not just to the PPPR UN High-level event in New York next week (25 Sept), but also to the resumed PABS discussions in Geneva (14-18 Sept). According to  Geneva Health Files, “….both sides acknowledged that the unfolding Ebola emergency had so far failed to make an impact on these talks. “Each side is drawing their own lessons from Ebola, and is using the outbreak to serve their own narratives” (a developed country diplomat told us).  …”   Granted, the fact that the EU negotiator was lamenting  ‘ideological polarization’ and a ‘transactional approach’ (not from the EU, mind you : ))’, as this latest round was about to start, probably didn’t help much.   

But let’s hope for some ‘recursive self-improvement’ among negotiators in the coming round(s)  (if necessary, with a little help from Claude)!

Enjoy your reading.