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APPENDIX F
Selected Provisions from the Final Draft Ministerial Declaration


10 July 2009


Paragraph 10: We recognize the role of social determinants of health in health outcomes and take note of the conclusions and recommendations formulated by the Commission on Social Determinants of Health, which aim to improve living conditions, tackle the inequitable distribution of resources, and measure, understand and assess their impact. We call upon the international community to support efforts of States to address the social determinants of health and to strengthen their public policies aimed at promoting full access to health and social protection for, inter alia, the most vulnerable sectors of society, including through, as appropriate, action plans to promote risk-pooling and pro-poor social protection schemes, and to include support for the efforts of developing countries in building up and improving basic social protection floors.

Paragraph 13: We call for action to promote gender equality and the empowerment of women and concerted action to ensure the equal access of women and girls to education, basic services, including primary health care, economic opportunities and decision-making at all levels.

Paragraph 14: We stress the importance of addressing stereotypes and eliminating all harmful practices which constrain the achievement of gender equality and empowerment of women, including through concerted efforts to counteract violence against women and girls, which constitutes a severe threat to physical and mental health. We further stress the importance of strengthening the participation of women in decision-making processes and developing gender-sensitive multisectoral health policies and programmes in order to address their needs.

Paragraph 15: While noting that some progress has been made in the past decade in advancing global health, we express concern at the lack of overall progress in improving global health, as evidenced by across-the-board inequities in respect of health which persist among and within countries. In particular, we are deeply concerned that maternal health remains one area constrained by some of the largest health inequities in the world and by the slow progress in achieving Millennium Development Goals 4 and 5 on improving child and maternal health. In this context, we call on all states to renew their commitment to preventing and eliminating child and maternal mortality and morbidity, at all levels, which are rising globally at an unacceptably high rate. We call for health system strengthening as a key component of an integrated approach to achieving a rapid and substantial reduction in maternal morbidity and mortality, including through:

  1. Increased political will, commitment and engagement at the national level supported by international cooperation and assistance to ensure accessibility, availability, acceptability and affordability of health-care services, skilled health workers, facilities, infrastructure and nutritional support for all women and children, with special attention to sub-Saharan Africa;
  2. Achieving universal access to reproductive health by 2015, through increased political leadership at all levels, allocation of domestic and donor resources and emerging innovative financing and by strengthening basic infrastructure, and specific health interventions, including voluntary family planning, emergency obstetric care and skilled birth attendance;
  3. Scaling up efforts to achieve integrated management and care of child health, including actions to address the main causes of child mortality, including newborn and infant mortality, these being, inter alia, pneumonia, diarrhea, malaria and malnutrition, and by developing and/or implementing appropriate national strategies, policies and programmes for child survival, including prevention measures, vaccinations, medicine and improved nutrition, drinking water and sanitation;
  4. Integrating HIV/AIDS interventions into programmes for primary health care, sexual and reproductive health, and mother and child health, including efforts to strengthen mother-to-child transmission of HIV.

Paragraph 18: We also recognize that non-communicable diseases are emerging as a heavy burden on society with serious social and economic consequences and the need to respond to cardiovascular diseases, cancers, diabetes and chronic respiratory diseases which represent a leading threat to human health and development. In this regard, we:

  1. Call for urgent action to implement the WHO Global Strategy for the Prevention and Control of NCDs and its related action plan;
  2. Recognize that diabetes is a chronic, debilitating and costly disease associated with severe complications;
  3. Stress the need to scale up care for mental health conditions, including prevention, treatment and rehabilitation;
  4. Reaffirm the importance of the Framework Convention on Tobacco Control within the global public health and call upon States Parties to the Convention to fully implement it.

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