Washington D.C., USA, 22-27 July 2012www.aids2012.org

Future Global Prioritiesor

Beyond 2015

Gorik OomsResearcher, Institute of Tropical Medicine

Executive director, Hélène De Beir Foundation

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Beyond 2015?

• My guess is as good as yours...

• My guess:Only 1 health goal→ Universal Health Coverage (UHC)

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Why this could be bad news for the fight against AIDS...

• UHC sounds like “health for all by the year 2000”, but then by the year 2100 or so

• The fatal flaw of the Alma Ata Declaration:

“Primary health care is essential health care … made universally accessible … at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.”

Washington D.C., USA, 22-27 July 2012www.aids2012.org

“Primary health care is essential health care … made universally accessible … at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.”

• Sounds good, but for people living with AIDS in low-income countries, it means death (for the sake of self-reliance)

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Why this could be good news for the fight against AIDS...

• ‘AIDS exceptionalism’ has run its course

• The paradigm shift it imposed is truly Copernican:– From national responsibility (with some external

assistance)– To human responsibility (national and

international) (Note: global responsibilization may have induced national deresponsibilization)

Washington D.C., USA, 22-27 July 2012www.aids2012.org

• The new paradigm is implicit, unclear, fragile,...

• The “Right To Health” (R2H) or health seen as a human right, with corresponding entitlements and national and global dues, could provide a solid foundation for the paradigm shift

Washington D.C., USA, 22-27 July 2012www.aids2012.org

TUESDAY:: NOON ::

Steps off fromIn front (South) of the Convention

Center & at archives metro

www.WeCanEndAIDS.org

Washington D.C., USA, 22-27 July 2012www.aids2012.org

• R2H does not support the prioritization of a single disease

• Could UHC = R2H???

Washington D.C., USA, 22-27 July 2012www.aids2012.org

How to make sure that UHC = R2H?

1. Question conventional understanding of ‘sustainability’

2. Clarify national and global responsibility, and where they meet (a.k.a. ‘shared responsibility’) – a Framework Convention on Global Health?

3. Promote ‘diagonal approach’

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Sustainability = context-specific = depends on who is held responsible

Washington D.C., USA, 22-27 July 2012www.aids2012.org

What does ‘shared responsibility’ really mean?

Washington D.C., USA, 22-27 July 2012www.aids2012.org

The ‘diagonal approach’…… now more than ever

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Conclusion (personal opinion)

UHC will work for the fight against AIDS...

...if and only if AIDS fighters work for UHC