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5 Days at the United Nations

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I am thrilled to be representing representing the Global Alliance for Behavioral Health and Social Justice at the 78th Session of the UN (UNGA78) high-level week 2023! The Global Alliance has been informing policy, practice and research at the intersection of human rights, social justice and behavioural health for 100 years.  We have been actively advocating for the inclusion of mental health as part of pandemic prevention, preparedness and response, and universal health coverage, as mental health is fundamental to right to health.

This week, I will be attending sessions and posting about work on the pandemic, emergency response, universal health coverage, climate, youth resilience, and, of course, mental health. 

Day 1: September 17, 2023

Thank you World Health Organization for highlighting Sustainable Development Goal #3 (SDG3) — Good Health and Well-being — as central to achieving the SDGs.

#UNGA78 is underway. Earlier this week during International Institute for Sustainable Development, Cepei Think Tank and SDG Lab hosted a webinar entitled What to Expect from the SDG Summit 2023. Panelists discussed the importance and scale of the upcoming meetings. Here are a few key takeaways:

  • This year marks the half way point for the SDGs and the 2030 goals. While the general attitude is sombre due to the reality that only 15% of the goals are on track while 48% are completely off track, there is optimism that these gatherings can and will make a difference.
  • Nudhara Yusuf shared an analogy that compared UNGA78 and its various high level meetings and summits to that of a football (soccer) game at half time. Consider that our collective team is down and challenged to consider how to alter the game plan for the second half. Winning is still possible!
  • John Gilroy pointed out that in the 7.5 years since the SDGs were launched, the world has changed extensively. This is important because it means that significant change is possible in such a short amount of time. Therefore stakeholders need to come away from these meetings with clear commitments for action to achieve the 2030 agenda.
  • The SDG summit provides an opportunity to develop actionable pathways to implementation for the SDGs and carry forward through the other High Level Meetings and summits. While the complexity of SDGs are immense, Sheik Abdulrahman Al-Thani highlighted that these summits provide opportunities to mobilize partnerships and opportunities for sustained financing which are critical to their success.
  • Finally, technical expertise of youth must be meaningfully incorporated.  According to the UN, “the active engagement of youth in sustainable development efforts is central to achieving sustainable, inclusive and stable societies by the target date, and to averting the worst threats and challenges to sustainable development, including the impacts of climate change, unemployment, poverty, gender inequality, conflict, and migration.” Yet, the integration of youth expertise and voice has been largely on the sidelines at UNGA78.

Consistent with the Global Alliance’s advocacy, we are committed to listening, learning and building a path for youth well-being. Youth have a seat at our table and a voice in our processes and programs. To learn more about our efforts to include youth, check out the following:

If you are interested in learning more about the upcoming expectations of the SDG Summit, you can watch the recording: https://lnkd.in/gmRiDFPc

Day 2: September 18, 2023

Today, I’m participating in the Global #PeoplesAssembly Did you know that the Global People’s Assembly is the culmination of community and national People’s Assemblies in 35+ countries, where representatives of historically marginalized and excluded groups and civil society discussed #SDG implementation? Its objective is to bring civil society together and ensure that governments uphold their commitments, including the overarching principle of the 2030 Agenda and the SDGs: To Leave No One Behind.

The key focus today has been on ‘Bringing the Declaration into the Summit’ and its final drafting from this collective civil society voice.

At the Global Alliance for Behavioral Health and Social Justice, the idea of leaving no one behind is built into our very fabric. For example, check out our policy briefs on Fostering Social Connection Through the Built Environment: Considerations for Research, Policy and Practice and Cultivating Food Sovereignty: Considerations for Research, Policy and Practice. Ending inequality will require addressing the structural reasons for social, environmental and economic injustice and centering mental health and well-being in all of our efforts.

Day 3: September 19, 2023

Some highlights from NY in the past 36 hours:

  • World leaders adopted the political declaration to accelerate action on the Global Goals.
  • Hosted by the Business Council for International Understanding (BCIU), panelists spoke to “Achieving UHC Through Sustainable Financing and Access to Systematic Screening, early Diagnosis and Timely Treatment for NCDs”.  Ethel Maciel, Ministry of Health, Brazil, noted that civil society efforts in Brazil in 1988 to recognize health as a human right in their Constitution had a profound impact on access to Universal Health Coverage a generation later. Alison Cox, Policy and Advocacy Director at the NCD Alliance spoke to the importance of community, community voice and the reality of challenges that are faced on the ground to achieving UHC. Private investment, working together with communities, was also strongly emphasized by Michael Oberreiter as important to achieving the most effective and appropriate outcomes. While this event provided opportunities to network, learn of existing efforts and discuss future pathways, it was noted that mental health was not discussed during the panel. 
  • UNGA’s Science Summit, which focused on ‘Brain Health and Research,’ was hosted by the European Brain Council, The Rice University’s Baker Institute for Public Policy and Brain Capital Alliance. While the entire Summit raised interesting research to policy discussion and action, there were a few comments that stood out during the discussion of ‘Prospective Approaches in Policy Making’:
    • Shifting from brain health to brain care is important in decreasing stigma
    • A/Professor Jo-An Occhipinti (née Atkinson) discussed shaping economic and social environments to foster brain capital and rebuild the mental wealth of nations. This discussion emphasized the idea of improving the recognition of the ‘contributing life’ and how the value of recognizing the contributions of all individuals affects the mental wealth and ultimately well-being of nations.
    • Harris Eyre MD PhD and a team of authors have recently published and launched a discussion of a new framework and strategy for brain capital.
  • At Climatexhealth.org, a special networking event brought together individuals who work toward advancing the idea that climate change and human health are inextricably linked and urged joint action. In the lead up to COP28, including the first-ever Health Day on 3 December, this was a great opportunity to forge stronger relationships across the growing landscape. 

Day 4: September 20, 2023

Today, I attended the UN High-Level Meeting (HLM) on Pandemic Prevention, Preparedness and Response (PPPR) for discussions around creating and maintaining political momentum and solidarity. During the Multi-Stakeholder Panel: Ensuring Equity Through Governance and Accountability key themes emerged:

  • Trust is critical to effectively move forward with PPPR. Panelist Yassen Tcholakov further articulated that trust must be built through representation from all populations
  • Inger Andersen advocated for the ‘one health initiative’, which requires that all sectors adopt a unified vision for PPPR (with particular attention to prevention) among human, animal and environmental health.
  • Multisector collaboration is pivotal.

The Global Alliance for Behavioral Health and Social Justice has been actively advocating for the inclusion of mental health as part of #pandemic #prevention, #preparedness and #response, as #mentalhealth is fundamental to right to health.

We have developed a policy resolution on Centering Mental Health & Well-Being in an International Public Health Convention on Emergency Preparedness and released a statement for a WHO Listening Session on Centering #mentalhealth in Emergency Preparedness. Today, we submitted a short written statement that mental health should be included in PPPR. We were pleased that Sarah Kline from United for Global Mental Health was selected to share oral comments on the importance of #mentalhealth in PPPR.

Yesterday, the Kingdom of Belgium, Kingdom of Bhutan, UNICEF, United for Global Mental Health and the World Health Organization hosted a session, Mental Health for All: Leaving No One Behind. There was a strong recognition of the consistent neglect of mental health and well-being globally, yet collective energy with friends and colleagues old and new, to drive action across sectors, increase investment in mental health and well-being, ensuring universal access for everyone, everywhere.

At the Global Alliance, we believe that applying a human rights lens to mental health and well-being will improve the systems that govern and operate our global society. Mental health, understood across a continuum from prevention and promotion through recovery, must be integrated into institutions, systems and settings. However, inequities within must be addressed for this be successful. Such inequities result from historical #oppression, #injustice, and #inaction so to achieve integration, effective strategies that promote #equity must be implemented. Determinants and barriers across systems and settings that impede overall health must be actively addressed. To achieve SDG3, our call to action includes:

  • To embed mental health within and across all systems, and expand its definition across the continuum
  • To prioritize prevention and health promotion through person-centered and community-driven strategies that fundamentally include lived experience and meaningful engagement opportunities for all
  • To expand the diversification and training of the mental health workforce across sectors

Some of our other work on this topic includes:

  • Connecting the Past to the Future: The Role of Storytelling in Achieving Equity https://bit.ly/3IUaNJb
  • Supporting Schools in our Communities: A Critical Foundation for Child and Youth Mental Health https://bit.ly/3t0BZ37
  • Our white paper on Reconceptualizing the Mental Health Workforce: A Principle-based White Paper with Strategies for Operationalization https://bit.ly/44Z5Tlu
  • Our peer reviewed article on Centering Mental Health in Society: A Human Rights Approach to Well-Being for All https://bit.ly/3RsBicQ

Embedding a human rights approach to mental health is fundamental to individual and community well-being. Learn more at: https://www.bhjustice.org/.

Day 5: September 21, 2023

Today is the UN high level meeting on Universal Health Coverage. Member States of the United Nations approved the political declaration on Universal Health Coverage (UHC).   Representatives from more than 75 states spoke about their progress in implementing UHC, priorities and actions.   Overall mental health continues to be neglected in policy priorities and commitments to action. 

A few statements were notable: 

Argentina, Brazil and Uruguay each made individual statements in addition to a joint regional statement that included mental health. Their statements were supported by the upcoming 5th Global Mental Health Summit hosted by Argentina in Buenos Aires https://bit.ly/3Ppu07f.

Singapore called for reshaping their health system to have a greater focus on prevention due to their aging population.

Nepal highlighted the need for social inclusion to achieve SDG3 on health and well-being.

South Africa raised the importance of mental health integration and Sweden aligned their comments with those of South Africa.

The representative from the U.S. said that, under the Biden Administration, the direction has been on moving from a health care system to wellness care, which is a shift away from a focus on sick-care.

Key themes:

  • The push for primary health care prioritization, evidence-based strategies and community-based options were collectively agreed as the way forward for achieving UHC. Yet, there remains significant barriers to financing.
  • The capacity of, and challenges faced by the mental health workforce were recognized by some of the delegations.
  • Settings and the social determinants of health were included in a number of statements, though health promotion and prevention strategies were rarely addressed.
  • Trust and democracy are critical to achieving well-being.
  • Of the 75+ statements, less than 15 included mental health. While this is better than 2019, when the landmark declaration on UHC was signed, it is far from what is necessary.  There is no health without mental health.
  • Many countries referenced equity and the importance of health for all. Some shared examples of marginalized groups in their communities, including women, migrant and refugee populations, children and in a few instances LGBTQI+ populations. While meeting the needs of populations were discussed, and utilizing person-centered approaches was declared, inclusion of all voices in the process and the importance of lived experience was very rarely raised.
  • Statements that recognized the importance of multisectoral approaches to achieving health care were significantly more frequent this year. Some common sectors that were raised included education, social protection, housing, safety, transportation, water and sanitation, and economic development.

To conclude, the representative from Sweden reminded everyone, that we will come together again in 2027, to evaluate the progress on the commitments made during #UNGA78, 4 years since the original commitments were made.

Read more in the newest installment of our Perspectives series where Gita Jaffe, Director of Policy and Programming for the Global Alliance, reflects on key moments from the meetings, shares highlights of the discusssions and identifies critical gaps and considerations for action.

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