Rio de Janeiro, october 2013

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Countries of the Americas prioritize universal access to health care During the first week of October the American

countries defined a series of joint measures seeking to improve health systems, to advance in the area of universal coverage and work with other sectors seeking to improve social, environmental and economic conditions related to health. The authorities of the region met during the sessions of the 52nd Directive Council of the Pan-American Health Organization (PAHO/WHO) and approved the Strategic Plan 2014-2019, as well as actions in the areas of Noncommunicable Diseases (NCDs), sexual health, human resources for primary attention in remote areas and health in the Post 2015 Development Agenda.

In her annual report, PAHO´s Director, Carissa Etienne, said that “conditions converge to create a unique momentum for health in the region (...) I believe that we are able to make the necessary changes in the area of mother-child health, in Noncommunicable diseases, infectious diseases, in the strengthening of health systems and in the area of universal access to health services”. “We have now the chance for health to become a driving force for transformation” said the Director in her document.

During the opening session of the meeting, which took place from September 30 to October 4, Etienne highlighted the importance of health in economic development, peace and security and said that universal health coverage represents the best framework allowing PAHO and member countries’ progress. “Universal health coverage is not only meant for the best resourced countries. It is at the reach of all the countries in the Americas. Each country will follow its own path in order to achieve this goal, but all of us can hope to achieve it”.

The Director General of the World Health Organization (WHO), Margaret Chan, praised the Americas for their world leadership in public health and urged countries to ensure the maintenance of such a condition throughout the region whilst progressing in universal coverage

issues. “For a long time now the Americas have been the world leader in primary attention of health, and we hope something similar, so that countries commit themselves with the goal of universal health coverage”. Together with the PAHO 52nd Directing Council, the 65th WHO Regional Committee Session for the Americas was also held, continuing with the meetings of the other regional committees of the organization.

According to Etienne, the PAHO 52nd Directing Council concluded with a “clear consensus in favor of universal health coverage” which is “essential for improving health and well-being”. The concept, however, has raised certain reservations from critics that defend the idea of universal health systems focusing universality of the system instead of coverage. The topic was addressed in a conference by Dr. Asa Cristina Laurell at the ISAGS headquarters in February of this year.

Strategic Plan, Post 2015 and SDHDelegates present approved also the 2014-

2019 Strategic Plan “Championing health, sustainable development and equity”, which was prepared following the priorities of the 2008-2017 Health Agenda for the Americas. The plan includes new equity indicators and mother-child health attention, also addressing NCDs and the strengthening of health systems, as well as of information systems. It also gives priority to regional questions that had been neglected, to the focus on social determinants of health and to the question involving human

resources in health.On the third day of the meetings, delegates

discussed the inclusion of health in the Post-2015 Agenda (see more on page 2). With the presence of Etienne and Chan, the delegates present defended the need for health to be incorporated to the debate as an essential axis. Other topics addressed were international cooperation, immunization policies, implementation of the International Health Regulation (IHR/RSI) and the fulfillment of the Development Millennium Goals (MDGs).

Finally, Brazil was elected to preside the 2013-2014 PAHO Executive Committee. The organ is a workgroup with focus on the annual meeting of the Directing Council. The Pan-American Health Conference is organized every five years, and the last meeting took place in 2012.

The 52nd PAHO/WHO Directing Council defined actions for improving health systems, progress in the area of universal coverage and work on the SDH

“Conditions converge to create a unique momentum for health in the countries of

the Americas region”

Director of the Pan American Health Organization, Carissa Etienne, during the inauguration of the 52nd Directive Council of PAHO/WHO

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READ MORE• UN General As-sembly defines Post 2015 Development Agenda as priority Page 2

• Publication gathers articles about natural resources in South America Page 3

• Interview: ‘Unasur communication must promote the democratization’ Page 4

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UN General Assembly sets the Post 2015 Agenda and the Sustainable Development as priorities

Leaders of Unasur direct strong criticism on global matters

The official opening session of the 68th UN General Assembly declared that the definition of the Post 2015 Development Agenda and the Sustainable Development Objectives (SDO) were next year´s priorities. During the opening session, the President of the General Assembly, John Ashe, stated that the months to come would be “crucial” in defining the new agenda of global objectives and highlighted that the challenge will depend on the decisive and high-level action of cooperation and collaboration among member States.

The “Post-2015 Development Agenda: Setting the Stage!” was the theme determined for the 68th General Assembly Session. States were asked to intensify efforts in order to define “a set of objectives on sustainable development” in tune with the global complex challenges. The president of the 67th Session, Vuk Jeremic, said in his address that the definition of the Post-2015 Agenda would be the “most challenging project in the history of diplomacy”.

The UN General Secretary, Ban Ki-moon, also stressed the importance for countries to step up their efforts in terms of the fulfillment of the Millennium Development Goals (MDG), a set of global goals defined in 2000 which will expire in 2015 and which will be replaced by the SDGs. “We will intensify our efforts in defining a new agenda, including a set of objectives to meet the expectations of people, as well as of the MDGs.”

According to Ban and Ashe, among the central themes for the post 2015 Agenda there are topics such as health, sustainable development, climate change and the fight against hunger. Last July, the World Health Organization (WHO) distributed a report on the defense of new development objectives to be oriented through Social Determinants

Presidents of Unasur countries expressed their criticisms in several topics of the global agenda during their speeches at the 68th UN General Assembly. They addressed topics ranging from the US global surveillance activities to the incentive towards consumption in capitalist societies, involving also claims on the imperialist practices of some international powers and the deficit in terms of democracy in the operation of international organizations, such as the UN itself.

Brazil´s President, Dilma Rousseff, opened the debates during the high-level session of the General Assembly, and stated that the recently disclosed US global surveillance practices, having Brazil as one of the main targets, “are a breach of international law and an attack against the principles governing relationships among countries, especially in the case of friendly countries”. Dilma has recently cancelled her State visit to Washington in response to the American espionage practices.

Uruguay´s president, José Mujica, criticized consumption in modern societies. “It seems to be that we were born only to consume more and more. If humanity wished to live as an average American, three planets would be necessary”, he said. “The god of the market organizes economy, life and provides the funding for apparent happiness”, said Mujica, who also criticized the US embargo on Cuba and the imperialist practices in the Malvinas Islands.

Argentina´s president, Cristina Kirchner, questioned the practices of vulture funds and their procedures against the Argentinean state in the restructuring of Argentina´s debt. “We are serial victims of lobbyists and of vulture funds”, she said. In turn, the Chilean president Sebastián Piñera claimed for the reform of the UN Security Council. “If we wish to have democracy in our countries, I see no reason for not applying these principles in the decisions that impact the whole world.”

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President of Brazil, Dilma Rousseff, speaks in the inauguration of the high level debate at the 68th Session of the UN General Assembly

High-Level Political Forum is holding its first meeting. Health to be one of the core themes

of Health, in crossed perspective vis-à-vis the other global objectives. The report was included in the topics covered by the August ISAGS Report.

In the last year, 11 thematic consultations under the UN guidance were conducted towards the definition of new MDGs. The final report on the consultations in the area of health, which was consolidated in Botswana last March, contains guidelines on the inclusion of the topic in the post-2015 Agenda.

High Level Political Forum

On the 24th, during the opening of the high-level discussions of the General Assembly, the presidents of member-states highlighted once again the urgency of the theme. The authorities spoke on the developments achieved with the MDGs, while discussing the need for the post 2015 Agenda to establish universal goals, without failing to acknowledge regional issues.

During the same day the first meeting of the new High-Level Political Forum on Sustainable Development was held, that replaces the former UN Commission on Sustainable Development. The topic of the session was “Building the Future we want: From Rio+20 to the post 2015 Development Agenda”. The UN Secretary General, the president of Brazil, Dilma Rousseff, and leaders from other countries and international organizations were also present.

“We will intensify our efforts in defining a new agenda, a set of objectives to meet the

expectations of people”

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Uruguay President, José Mujica, speaks in the UN

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Publication includes texts on development and natural resources in South American integration

ONLINE CONFERENCEThe ISAGS will receive the visit, on October 17, of the Secretary for Science, Technology and Health Strategic Supplies of the Brazilian Ministry of Health, Dr. Carlos Augusto Grabois Gadelha, who will give a conference on “Innovation, Access e Development: a theoretical and political perspec-tive of the health economic-industrial complex”. The event will take place at 10am (GMT-3), and will be transmitted on the internet in Portuguese, English and Spanish from aovivonaweb.tv/isags. RINC, RETS AND RESPThe Network of National Cancer Institutes (RINC-Unasur) is promoting meetings of the Cervical Can-cer Operational Control Group and Management Members in Lima (Peru). Meetings will take place after the International Cancer Control Congress (ICCC5), with the presence of the ISAGS Director, José Gomes Temporão. Also in november, there will be meetings of the Network of Health Technicians Eduction, the Network of Public Health Schools and the Technical Group of Human Resources. WORKSHOP IN BOLIVIAFrom October 31 to November 1, a Workshop on Management Models, Funding and Participative Administration for South-American Health Sys-tems will be held in Santa Cruz de la Sierra (Bo-livia). The event will be organized by the ISAGS and will host a meeting of the Techincal Group of Universal Systems.

RISK MANAGEMENTThe Risk Management Network on Disasters (Rede de Gestão do Risco de Desastres) held its first meeting in early September, in Lima (Peru). The purpose of the meeting was to strengthen the integration of the policies of South-American countries in the area of risk management, from the perspective of health, as well as to approve the Plan of Action of the network. The informations of the net-work are available at ogdn.minsa.gob.pe/unasur.

VISIT OF ISALUDA group of students from the ISALUD University in Argentina visited the ISAGS headquarters in Rio de Janeiro last September. The group was involved in discussions on topics such as the challenges of the Universal Health Systems in South America and the creation of the ISAGS, under the coordination of Arturo Schweiger, Director of the Program on Eco-nomics and Management of the institution.

A publication launched last month by the Latin-American Information Agency (ALAI) contains a series of texts on development and natural resources for the integration strategies in South America. The September edition of “América Latina en Movimiento”, under the title “Recursos y desarrollo, estrategias en la Union Suramericana [Resources and development: strategies in the South-American Union] comprises contributions by Unasur´s Secretary General, Alí Rodríguez Araque; and also by Dr. Monica Bruckman, consultant of the bloc and coordinator of a research group on natural resources headquartered at the ISAGS; and by Dr. Alfredo Forti, Director of the Unasur Center for Strategic Studies in Defense (CEED).

The publication seeks to retrieve some of the discussions of the I Unasur Conference on Natural Resources and Integral Development of the Region, held in Caracas (Venezuela). The 4-day event was attended by Heads of State, academicians, experts and regional leaders who discussed topics on the development of the Continent on the basis of the use of its resources and defended the drafting of a continental strategy on the issue and the definition of a schedule of meetings in order to provide continuity to the debate.

In his article “Unasul: Uma estratégia

HEALTH CONNECTION

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ISALUD visit at ISAGS headquarters in september

Magazine of the Latin-American Information Agency includes a text from Unasur´s Secretary

integral” [Unasur, an integral strategy] Alí Rodríguez stated that natural resources are “by far, the largest fortress in our region”. “This demands the need to define a common policy, a strategy and a plan leveraged by the rational use of these resources”. According to the Secretary General, the main challenge of the countries in the region is to promote well-being and to overcome poverty through the good use of the resources and also by adding value “as this implies scientific and technological development, the qualification of human resources, in addition to the setting up of institutions such as the Southern Bank (Banco do Sul)”.

Monica Bruckman points out in her text that the “Latin-American situation takes place in the context of a sound re-definition of hegemonic power structures worldwide”, and having within its most outstanding characteristics the growing relevance of natural resources”. Alfredo Forti, on the other hand, considers the possibility of articulating a regional strategy in which natural resources become “the core factor of regional interest” and a defense policy focusing the protection of such an interest.

In November, Unasur´ s General Secretariat will hold in Rio de Janeiro a “Forum on Science, Technology, Innovation and Industrialization in South America”.

Read the publication “Resources and Development...”, of the Latin-American Information Agency, and the English ver-

sion of the book “Health Systems…” in bit.ly/ISAGSLibrary

ISAGS present book ‘Health Systems’ in EnglishLast September the ISAGS released the

English translation of the book on “Health Systems in South America: challenges to the universality, integrality and equity” (Sistemas de Salud en Suramérica: desafíos para la universalidad, la integralidad y la equidad). The publication includes a broad outlook of the health systems in the region. The English edition seeks to increase the outreach of the publication which was released in November

2012 in Spanish, so that information and knowledge on health services in South-America may reach English-speaking countries and anyone interested in this area.

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ISAGS-UNASULExecutive Director: José Gomes Temporão Head of Office: Mariana Faria Technical Coordinator: Henri Jouval

INFORMATION AND KNOWLEDGE MANAGEMENTCoordinator: Camilla Ibiapina ISAGS Report Editor: Amaro GrassiTeam: Flávia Bueno, Felippe Amarante and Mariana Moreno

Contact: comunicacao@isags-unasur.org Phone: +55 21 2215 1858

This is the report from the South American Institute of Government in Health (ISAGS), the think tank on health of the Union of South American Nations (UNASUR) that aims to contribute to improving South America government quality in health by means of leadership training, knowledge management and technical support to health systems.

INSTITUTIONAL

SCHEDULE• 17/10 - “Innovation, access and development: the politi-cal and theoretical perspectives on the health economic-industrial complex”, by Carlos Gadelha - ISAGS• 17-18/10 - Workshop “Availability of Access, Industrial Development and Innovation in Health” - Rio de Janeiro (Brazil)• 31/10-1st/11 - Workshop on “Models of Manage-ment, Financing and Participatory Management in National Health Systems in South America” - Santa Cruz de la Sierra (Bolivia)

Kintto Lucas from Uruguay was appointed in september Director of the Information and Communication Center of the UNASUR´s General Secretariat, which was inaugurated in June. The inauguration of the Center was celebrated by Secretary Alí Rodríguez as an important step towards South-American integration. The structuration of the CCI had the support of Surinam PTP, ISAGS and the Unasur Center of Defense Strategic Studies (CEED). During an interview with Informe ISAGS, Kintto Lucas spoke about the objectives of the ICC and the relevance of strategic communication for consolidation of the bloc.

In the inauguration of the ICC in June, Secretary General Ali Rodríguez defined it as a “step towards South-American integration”. Which is the relevance of the center in this regard?

The Information and Communication Center of the General Secretariat furthers connectivity among the various Unasur areas through state-of-the-art technology. Meetings are held through video-conferences and other tools. This will speed up processes in sector councils, workgroups and other areas, allowing a permanent follow-up work on common policies, agreements and projects devised by the Union and therefore strengthening integration.

What principles should guide a communication strategy aligned with the objectives of Unasur?

The fundamental principle is democratization

of communication, which liaises with the need of an integrated and integrating communication policy. The fundamental purpose is the strengthening of integration in every single aspect. An integrated and integrating policy is also able to encourage debates in all the South–American countries on the meaning of integrations and the benefits derived from the consolidation of Unasur in a world of blocs.

The ICC is engaged in the storage and management of documents. What is the role of documentation and strategic data management within the Unasur project?

An effort for recovering all the historical Unasur memory is underway, involving the classification of documentation, which is of the utmost importance, as it forms the basis of the strategic project of South-American integration which will certainly consolidate through the strengthening of Unasur. In order to strengthen and build up an integrating future the recovery of information is essential, in order to start with an integrating past. Documentation needs to be available for universities, institutions and organizations related to integration, as well as for communication media.

Which is the relevance of ISAGS and the Center for Strategic Studies of Defense for the Unasur and how can they complement the ICC communication strategy?

The Centers are a fundamental part of Unasur because they provide the essential basis for devising common public policies for the areas

Uruguayan diplomat Kintto Lucas, Director of the Communication and Information Center (CCI) of Unasur General Secretariat

‘Communication in UNASUR must strengthen Project of regional integration and promote democratization’Kintto Lucas, Director of the CCI of Unasur General Secretariat speaks to the ISAGS Report

they are engaged in. The ISAGS provides the Unasur with the necessary know-how in order to implement enhanced health policies in our countries, in terms of common policies. Therefore, it makes an essential contribution to improve the situation of South-American populations as far as health is concerned. The CEED´s contribution consists of analyses, studies and theoretical basis. This is necessary for consolidating a strategic defense policy in South-America on the basis of a common viewpoint in our countries. It is an essential stage for South America; however, in past years, implementing such a policy was not viable due to different interests. For example, in the communication area we used to adopt a common defense strategy through the eyes of foreign powers. An integrating communication policy should be integrated between the centers and the ICC. In addition, this policy should be implemented in the mid-term.

How do you evaluate the growth of Unasur in this period of five years since its creation and which are the main challenges for the years to come and in the long term?

Unasur is the most important integration proposal involving the whole of South America. It emerged as an integration proposal from a political viewpoint, and performed relevant actions seeking to resolve conflicts and consolidating a common attempt to defend democracy, strengthening defense and social integration policies and also positioning itself as a bloc to be taken into consideration within a world of blocs. Nestor Kirchner set the political basis of the Secretariat. Then Ema Mejía and Alí Rodríguez strengthened the institutional process. In addition, Rodriguez provided Unasur with a practical and theoretical structure, by means of the proposal on natural resources as an integrating axis. We are now in a different historical moment and the current situation claims for a definitely institutional consolidation and the projection of the Union in a world of blocs.