2018 Political declaration of the HLM on the fight against TB

73rd UNGA
10 Oct 2018

Analysis of precedential value

This dec­la­ra­tion is the prod­uct of the first-ever UN High-Level Meet­ing on End­ing TB in Sep­tem­ber 2018. It was adopted by the UN Gen­eral Assem­bly (GA) with­out a gen­eral vote the fol­low­ing month. The Gen­eral Assem­bly is the pre­em­i­nent gov­ern­ing body of the UN sys­tem and con­sists of all 193 UN Mem­ber States.

The UN press team described the GA’s adop­tion as fol­lows: “world lead­ers in the Gen­eral Assem­bly today reaf­firmed their com­mit­ment to end the global tuber­cu­lo­sis epi­demic by 2030, unan­i­mously adopt­ing a polit­i­cal dec­la­ra­tion com­mit­ting them to accel­er­ate national and col­lec­tive actions, invest­ments and inno­va­tions in fight­ing the pre­ventable dis­ease.” It also noted that lead­ers were keen to col­lab­o­rate with HIV/AIDS pro­grams.

Used as precedent

key population and community leadership

Rec­og­nize the enor­mous, often cat­a­strophic, eco­nomic and social impacts and bur­den of tuber­cu­lo­sis for peo­ple affected by the dis­ease, their house­holds, and affected com­mu­ni­ties, and that the risk and impact of tuber­cu­lo­sis can vary depend­ing on demo­graphic, social, eco­nomic and envi­ron­men­tal cir­cum­stances, and, in order to make the elim­i­na­tion of tuber­cu­lo­sis pos­si­ble, pri­or­i­tiz­ing, as appro­pri­ate, notably through the involve­ment of com­mu­ni­ties and civil soci­ety and in a non-dis­crim­i­na­tory man­ner, high-risk groups and other peo­ple who are vul­ner­a­ble or in vul­ner­a­ble sit­u­a­tions, such as women and chil­dren, indige­nous peo­ples, health-care work­ers, migrants, refugees, inter­nally dis­placed peo­ple, peo­ple liv­ing in sit­u­a­tions of com­plex emer­gen­cies, pris­on­ers, peo­ple liv­ing with HIV, peo­ple who use drugs, in par­tic­u­lar those who inject drugs, min­ers and oth­ers exposed to sil­ica, the urban and rural poor, under­served pop­u­la­tions, under­nour­ished peo­ple, indi­vid­u­als who face food inse­cu­rity, eth­nic minori­ties, peo­ple and com­mu­ni­ties at risk of expo­sure to bovine tuber­cu­lo­sis, peo­ple liv­ing with dia­betes, peo­ple with men­tal and phys­i­cal dis­abil­i­ties, peo­ple with alco­hol use dis­or­ders and peo­ple who use tobacco, rec­og­niz­ing the higher preva­lence of tuber­cu­lo­sis among men.

human rights

Rec­og­nize the var­i­ous socio­cul­tural bar­ri­ers to tuber­cu­lo­sis pre­ven­tion, diag­no­sis and treat­ment ser­vices, espe­cially for those who are vul­ner­a­ble or in vul­ner­a­ble sit­u­a­tions, and the need to develop inte­grated, peo­ple-cen­tred, com­mu­nity-based and gen­der-respon­sive health ser­vices based on human rights.Com­mit to devel­op­ing com­mu­nity-based health ser­vices through approaches that pro­tect and pro­mote equity, ethics, gen­der equal­ity and human rights in address­ing tuber­cu­lo­sis by focus­ing on pre­ven­tion, diag­no­sis, treat­ment and care, includ­ing socioe­co­nomic and psy­choso­cial sup­port, based on indi­vid­ual needs, that reduce stigma, and inte­grated care for related health con­di­tions, such as HIV and AIDS, under­nu­tri­tion, men­tal health, non-com­mu­ni­ca­ble dis­eases includ­ing dia­betes and chronic lung dis­ease, and tobacco use, harm­ful use of alco­hol and other sub­stance abuse, includ­ing drug injec­tion, with access to exist­ing and new tools.

access to health products, universal health coverage

Com­mit to pro­mot­ing access to afford­able med­i­cines, includ­ing gener­ics, for scal­ing up access to afford­able tuber­cu­lo­sis treat­ment, includ­ing the treat­ment of mul­tidrug-resis­tant and exten­sively drug-resis­tant tuber­cu­lo­sis, reaf­firm­ing the World Trade Orga­ni­za­tion Agree­ment on Trade-Related Aspects of Intel­lec­tual Prop­erty Rights (TRIPS Agree­ment), as amended, and also reaf­firm­ing the 2001 World Trade Orga­ni­za­tion Doha Dec­la­ra­tion on the TRIPS Agree­ment and Pub­lic Health, which rec­og­nizes that intel­lec­tual prop­erty rights should be inter­preted and imple­mented in a man­ner sup­port­ive of the right of Mem­ber States to pro­tect pub­lic health and, in par­tic­u­lar, to pro­mote access to med­i­cines for all, and notes the need for appro­pri­ate incen­tives in the devel­op­ment of new health prod­ucts.

key and vulnerable populations

Com­mit to pre­vent­ing tuber­cu­lo­sis for those most at risk of falling ill through the rapid scal­ing up of access to test­ing for tuber­cu­lo­sis infec­tion, accord­ing to the domes­tic sit­u­a­tion, and the pro­vi­sion of pre­ven­tive treat­ment, with a focus on high-bur­den coun­tries, so that at least 30 mil­lion peo­ple, includ­ing 4 mil­lion chil­dren under 5 years of age, 20 mil­lion other house­hold con­tacts of peo­ple affected by tuber­cu­lo­sis, and 6 mil­lion peo­ple liv­ing with HIV, receive pre­ven­tive treat­ment by 2022, and with the vision of reach­ing mil­lions more, and fur­ther com­mit to the devel­op­ment of new vac­cines and the pro­vi­sion of other tuber­cu­lo­sis pre­ven­tion strate­gies, includ­ing infec­tion pre­ven­tion and con­trol and tai­lored approaches, and to enact­ing mea­sures to pre­vent tuber­cu­lo­sis trans­mis­sion in work­places, schools, trans­porta­tion sys­tems, incar­cer­a­tion sys­tems and other con­gre­gate set­tings.Com­mit to pro­vid­ing spe­cial atten­tion to the poor, those who are vul­ner­a­ble, includ­ing infants, young chil­dren and ado­les­cents, as well as elderly peo­ple and com­mu­ni­ties espe­cially at risk of and affected by tuber­cu­lo­sis, in accor­dance with the prin­ci­ple of social inclu­sion, espe­cially through ensur­ing strong and mean­ing­ful engage­ment of civil soci­ety and affected com­mu­ni­ties in the plan­ning, imple­men­ta­tion, mon­i­tor­ing and eval­u­a­tion of the tuber­cu­lo­sis response, within and beyond the health sec­tor; we fur­ther acknowl­edge the link between incar­cer­a­tion and tuber­cu­lo­sis and there­fore reaf­firm the United Nations Stan­dard Min­i­mum Rules for the Treat­ment of Pris­on­ers (the Nel­son Man­dela Rules) as defined in Gen­eral Assem­bly res­o­lu­tion 70/175 of 17 Decem­ber 2015.

negative legal determinants, universal health coverage

Com­mit to pro­tect and pro­mote the right to the enjoy­ment of the high­est attain­able stan­dard of phys­i­cal and men­tal health, in order to advance towards uni­ver­sal access to qual­ity, afford­able and equi­table pre­ven­tion, diag­no­sis, treat­ment, care and edu­ca­tion related to tuber­cu­lo­sis and mul­tidrug-resis­tant tuber­cu­lo­sis and sup­port for those who become dis­abled due to tuber­cu­lo­sis, inte­grated within health sys­tems towards achiev­ing uni­ver­sal health cov­er­age and remov­ing bar­ri­ers to care; to address the eco­nomic and social deter­mi­nants of the dis­ease; and to pro­mote and sup­port an end to stigma and all forms of dis­crim­i­na­tion, includ­ing by remov­ing dis­crim­i­na­tory laws, poli­cies and pro­grammes against peo­ple with tuber­cu­lo­sis, and through the pro­tec­tion and pro­mo­tion of human rights and dig­nity, as well as poli­cies and prac­tices which improve out­reach, edu­ca­tion and care.