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Reflections From UNGA78

Global health discussions should prioritize voices from the real experts—health workers on the ground.
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Health workers and advocates, from left: Dr. Madeleine Ballard, Irma Nolasco, Dr. Anthony Charles, Bupe Sinkala, and Valerie Rzepka, take the stage at an UNGA78 event hosted by Johnson & Johnson Foundation.

There were a few themes around health that kept resurfacing during the recently concluded UN General Assembly (UNGA78) in New York City. The sobering statistic that at least 4.5 billion people—more than half of the world’s population—were not fully covered by essential health services was on everyone’s mind, lending a sense of urgency to global health discussions. The three UN High-level meetings sought to get health back on the highest political agenda and mobilize government commitments and strategic investments to invigorate progress on the stalling Sustainable Development Goals health targets

As I reflect upon the UNGA week and where I found the most inspiration, I’m encouraged by three enduring facets of the work I’ve been privileged to lead at Johnson & Johnson, that were reinforced during UNGA78. 

1. Health workers need to be present wherever health workers are discussed
It used to be that government, the public sector and the private sector made up the golden triangle in global health discussions. Until now. Over and over in conversations around town, it became clear that the health worker is now squarely in the middle of that triangle. “Nothing about us, without us,” was heard in every session. Finding solutions to global health challenges should begin with listening to health workers. The storytellers hosted by Johnson & Johnson Foundation at UNGA78 could not have been more different or have represented more different parts of the world. Yet their struggles—including stress and burnout—were mostly the same. At Johnson & Johnson we believe solving the challenges facing health workers will improve healthcare for everyone. It’s why we and others are making sure heath worker voices are central to everything we do. Additionally, because women account for 70% of the global health workforce, solving health worker challenges is imperative to addressing gender equity issues as well. 

2. Prioritize technology and digital solutions to achieve health for all
The COVID-19 pandemic was a watershed moment for digital health. We saw the immense potential of digital health and data-driven solutions to enhance delivery of primary healthcare. As we work towards a digital transformation in public health, we must ensure that we are reducing health disparities and leaving no one behind. Advancements in digital technology and data for health offer tremendous promise, but adoption has been uneven, particularly in low- and middle-income countries. We must invest in equitable and sustainable technology-based solutions such as digital public goods that can extend the reach and capacity of health workers and enhance primary healthcare across all contexts.

3. No one entity can do it alone—we must do it together
With limited resources available and big challenges to overcome, at Johnson & Johnson we advocate for and take a systems approach, working where governments are taking the lead to help build resilient and sustainable platforms aligned with national goals. Last year, the Johnson & Johnson Foundation, together with the Skoll Foundation, donated $25 million as initial funders to the Africa Frontline First Catalytic Fund (AFF-CF). Matched by $25 million from the Global Fund, AFF-CF seeks to drive a fundamental shift in health systems strengthening and financing to enable the scaling and sustainability of community health service delivery across 12 African countries. Rather than doing one-off projects that may be important to a specific donor, we must align as development partners to avoid fragmentation and become a bigger presence that can influence governments to take the lead. The global health space is one of the few areas where we can collaborate with our competitors. We want our competitors to join the coalition and we want them to be successful—because then we stand a better chance of actually making real impact. 

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Right on the heels of UNGA, I was honored to be in Kenya to witness the results of such work unfold in a truly historic way. Before a gathering that included more than 7,000 community health workers, His Excellency Dr. William Ruto, President of Kenya formally launched a new initiative to professionalize the country’s community health workers, paying them stipends and health insurance and providing uniforms and smart phones using the government’s own resources. Political prioritization is a key prerequisite for progress and ensures sustainable change, no matter what the donor landscape looks like. 

At Johnson & Johnson, we rely on experts on the ground to understand the needs within local contexts, and in the celebration of those local contexts we bring to bear what we know about collaboration and partnerships. That felt very real and very inspirational in many of the UNGA78 sessions I attended. There were several familiar faces as well as new people coming to the table—stakeholders across all sectors. 

At one meeting, we were asked to write one word on our name tags that we hoped would be part of the conversation. I thought about it for a minute and wrote down “humility.” Oftentimes, in our role as donors, it takes a lot of humility to realize we are not the experts, that we are trying to learn every day. The real experts are the health workers themselves—those are the voices we need to raise and support, and at Johnson & Johnson we’re proud to do so.