Category Archives: Global Health

Universal Health Coverage: New Political Declaration

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Earlier this year I wrote about Universal Health Coverage (UHC) being on the agenda for 2023 in anticipation of the United Nations High-Level Meeting on UHC. The meeting took place in New York this September during the 78th Session of the United Nations General Assembly (UNGA). The resulting political declaration adopted on September 21 is entitled “Universal Health Coverage: expanding our ambition for health and well-being in a post-COVID world.”

The Political Declaration has 109 points beginning with background on past agreements and UNGA resolutions and moving into our current global context including urgent action needed to achieve the Sustainable Development Goals (SDGs).

The World Health Organization issued a media release on September 21 celebrating the approved declaration with its strong focus on primary health care:

“In the Political Declaration, Heads of State and world leaders committed to take key national actions, make essential investments, strengthen international cooperation and global solidarity at the highest political level to accelerate progress towards UHC by 2030, using a primary health care (PHC) approach.

For health care to be truly universal, it requires a shift from health systems designed around diseases to systems designed for people. PHC, an approach to strengthening health systems centred on people’s needs, is one of the most effective areas for investment to accelerate progress towards UHC.”

Further, as stated in the declaration , political leaders are called to recognize and act upon the health inequities that exist within and among countries. Throughout the document there is a call for greater political commitment along with global solidarity and cooperation to tackle “social, economic, environmental and other determinants of health” and to eliminate barriers to health care access. There are numerous points on Health Human Resources highlighting the need for national governments to invest in their health workforce and to attend to issues of migration.

UHC2030 Coalition

The UHC2030 Coalition continues its excellent advocacy as well as its educational work on UHC. The Action Agenda serves as a clear framework: Action Agenda from the UHC Movement – UHC2030

Credit: UHC2030 Coalition

See also the statement issued on September 26: Statement of the UHC2030 co-chairs on the adoption of the Political Declaration on Universal Health Coverage – UHC2030

International Council of Nurses

The International Council of Nurses (ICN) was represented at the UNGA by President Dr. Pam Cipriano who gave presentations during the High-Level Meetings on Health. It was great to know that ICN brought strong global nursing expertise and presence to the deliberations. ICN had contributed to the Action Agenda as a member of UN High-Level Meeting Task Force. As Dr. Cipriano stated:

“The political declaration gives governments an opportunity to make a clearsighted and enduring change that will make a real difference by giving everyone equitable access to the health care that they need. Governments must not only make these commitments; They must follow through with the necessary investment to make these historic changes a reality that will benefit many millions of people who currently have little or no access to basic health care.”

ICN’s coverage included these media releases:

https://www.icn.ch/news/icn-president-says-universal-health-coverage-will-only-be-achieved-2030-if-there-dramatic

https://www.icn.ch/news/icn-president-calls-resilient-health-systems-un-high-level-meeting-pandemic-prevention

Much more will be written about the UHC movement, the SDGs and the UHC 2030 action agenda. We need to ensure that the momentum is sustained along with the renewed enthusiasm for primary health care.

Credit: World Health Organization

By Nora Whyte – September 27, 2023

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

ICN Congress 2023

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Volunteers welcoming delegates
Credit: Renata Mares

The International Council of Nurses (ICN) held its 2023 Congress in Montreal from July 1 to 5, co-hosted by the Canadian Nurses Association. It marked the first in-person congress since 2019 and attracted 6,200 nurses from 145 countries. 

Delegates at ICN Congress, in national dress, before opening ceremony.
Delegates before opening ceremony – July 1st.

The congress theme – Nurses together: a force for global health – was evident throughout the event with inspiring plenary sessions by global leaders. In particular, I enjoyed several panel presentations featuring leaders from different countries and two policy cafés facilitated by ICN staff. Although it was impossible to take in all the presentations, it helped to talk with other participants about sessions they had attended. A customized congress app provided the daily schedule and access to all the abstracts and e-posters; it served as a useful tool throughout the event and to review information later.

Three volunteers at Booth at ICN Congress.
Volunteers at ICN Booth
Credit: Renata Mares

Plenary sessions focused on nursing workforce issues in the aftermath of the pandemic. I noticed greater awareness about ethical international recruitment practices and the urgency to ensure safe working environments. ICN leaders highlighted the new Charter for Change directed at government policy actions as the focus of a campaign, “Our Nurses. Our Future.” On the final day, we listened to powerful video presentations by nursing leaders living through current conflicts and disasters; we were touched by their courage in the midst of all the losses they have experienced.

Policy café: (Left to right) Mr. Howard Catton,
Dr. Amelia Tuipulotu & Dr. James Buchan

The new WHO Chief Nurse, Dr. Amelia Latu Afuhaamango Tuipulotu, was an active presence throughout the congress (and I was so pleased to have had a chance to speak with her at the end!). She moderated an excellent session on the current global agenda for nursing and midwifery in the context of Universal Health Coverage and also spoke about the importance of nurses’ voices in health policy.

Personal highlights included seeing people I’ve known over the years, especially nursing leaders from other countries and Canadian friends and colleagues. As we’ve remarked to one another, the mood was somewhat sombre and we sensed the fatigue nurses have experienced from the pandemic period along with global conflicts and humanitarian disasters. Some of the usual excitement found in these gatherings was missing although many attendees were enthusiastic about the opportunity to be together in Montreal. I especially enjoyed hearing impressions from first-time participants.

Outdoor Break at Congress Centre

Social media provided a glimpse into participants’ reactions to sessions and meetings throughout the congress. It gave us a sense of what was happening and who was attending; I made some new social media connections too! The ICN team sent out a daily summary each evening and used the app to notify participants of the next day’s sessions. The entire event required comprehensive planning and communication. Thank you to all the board members and staff of ICN and CNA for your leadership, along with many nurses who served on committees. The on-site volunteers – visible in their red shirts – were a great help to participants throughout the five days.

Dr. Carolyn Pepler & Renata Mares
Credit: Renata Mares

At the closing ceremony, a new ICN logo was launched – now featured on the revamped website. Visit the ICN Website for summaries of the congress and informative items about pre-congress meetings including the Student Assembly and the Council of National Representatives. During the closing ceremony, the Finnish Nurses Association issued a lovely invitation to the next ICN Congress to be held in Helsinki in June 2025. Please see this summary of the closing session: ICN Congress in Montreal closes with inspiring ceremony and the launch of its new visual image and logo | ICN – International Council of Nurses

By Nora Whyte – July 26, 2023

Updated: July 30, 2023

Thanks to Renata Mares for her kindness in sharing her photos of ICN volunteers and for giving me permission to use them in this post.

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

New ICN Campaign: “Our Nurses. Our Future”

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The International Council of Nurses (ICN) launched an exciting new campaign – “Our Nurses. Our Future.” – on International Nurses Day, May 12, 2023. A key resource is a ten-point Charter for Change that provides guidance for the future.

Courtesy of ICN – 2023

The first point sets the tone for global health action:

“Protect and invest in the nursing profession to rebuild health systems that can deliver the Sustainable Development Goals and Universal Health Coverage to improve global health. Recognise and value health and health care as an investment not a cost. Secure commitments for investment to maintain equitable and people-centred care.“

Each point is worth attention and action this year. I will reflect on point 8 as we prepare for the ICN Congress in Montreal this July:

“Actively and meaningfully engage national nursing associations as critical professional partners in all aspects of health and social care policy, delivery and leadership as the experienced and trusted voice of nursing. Build local, national and global multilateral partnerships.”

On this day, I am reminded of warm connections with international colleagues I have met through partnerships, exchange visits and conferences over many decades. In particular I’m thinking about the nurses, faculty members and students at Guru Nanak College of Nursing in Punjab and my friends at the Canada India Education Society and UBC School of Nursing. The hospitality and conversations were wonderful! Also remembering nurse leaders I met and admired in the Japanese Nursing Association and the Democratic Nursing Organization of South Africa (DENOSA). Thank you and best wishes for International Nurses Day and beyond!

By Nora Whyte – May 12, 2023

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

Congress Banner courtesy of ICN.

Universal Health Coverage on the Agenda in 2023

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The World Health Organization (WHO) Executive Board met recently from January 30 to February 7 in Geneva. A major theme this year is Universal Health Coverage (UHC) in preparation for the UN High-Level Meeting on UHC in September 2023. The previous High-Level Meeting on UHC in 2019 resulted in a commitment “to ensuring that, by 2030, everyone, everywhere will be able to receive quality health services without suffering financial hardship.” Further, UHC “covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course.” (WHO 2022).

Courtesy of UHC Coalition

There is an important connection between primary health care and sustaining the workforce to achieve the goal of UHC. I like the way it was expressed by the United Nations Foundation following the Executive Board meetings:

“Member States emphasized that stronger primary health care delivery and a robust health workforce were force multipliers that could jointly serve UHC and pandemic preparedness, response, and resilience goals and the Sustainable Development Goals writ large.” (UN Foundation 2023).

WHO’s Executive Board meeting sets the tone for a big year in global health (unfoundation.org)

The International Council of Nurses (ICN) delivered statements at the Executive Board meetings as part of civil society coalitions urging Member States to commit to investing in the health workforce for UHC. Themes of equity, patient advocacy, emergency preparedness & response and quality of care came through in the statements. A summary of ICN interventions on health care issues during this Executive Board session is worth reading to see the topics covered.

In keeping with the strong global health presence of ICN and its national nursing association members, the next ICN Congress holds promise for discussion of global policy directions. The ICN Congress co-hosted by the Canadian Nurses Association is taking place in Montreal from July 1-5. I have enjoyed participating in past congresses and look forward to attending this one on Canadian soil. The theme – Nurses Together: A Force for Global Health – provides optimism amidst troubling times for the profession and the world. I expect to hear perspectives on current global health challenges and examples of solutions to common issues: nursing retention, Sustainable Development Goals and contributions to achieving UHC. There will be symposia profiling national nursing associations and their activities, plenary sessions, a student assembly, posters and concurrent presentations.

Another feature is the Policy Cafés – highly informative and interactive as I observed in Singapore in 2019. For this congress ICN describes them as: “Located in the exhibition hall, the two Cafés give the opportunity for small group discussion with a panel of experts on a key ICN policy or priority topic. Arranged in an informal setting, the Cafés allow delegates to ask in-depth questions and interact with keynote speakers.” For registration and further details, please visit the ICN Congress Site and follow updates on social media.

By Nora Whyte – February 22, 2023

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

Resources

UHC 2030 Coalition: Taking Action for Universal Health Coverage.

UHC 2023 Coalition: Universal Health Coverage Message Sheet for 2023.

World Health Organization (2022). Fact Sheet on Universal Health Coverage.

Public Health and Climate Change

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The COP26 conference opens in Glasgow on October 31, 2021 and is generating considerable interest in the weeks leading up to the event. Officially known as the 2021 United Nations Climate Change Conference, it is the 26th UN Climate Change conference. As explained on the COP26 website, “COP stands for Conference of the Parties – the signatories of the United Nations Framework Convention on Climate Change (UNFCCC) – a treaty agreed in 1994 which has 197 Parties (196 countries and the EU).”

Telegraph Cove, Vancouver Island, BC – August 2021

It is heartening to see the growing public awareness of climate change impacts and the sense of urgency being expressed this year. Leading health organizations have formed coalitions to advocate for climate action. A recent open letter – Healthy Climate Prescription – issued by the Global Climate and Health Alliance (a coalition of organizations representing 45 million health professionals) is a good example of this important collaboration. Describing the climate crisis as “the single biggest health threat facing humanity” the authors of the letter call on world leaders to deliver on climate action. Among the key demands listed are: “a rapid and just transition away from fossil fuels; for high income countries to provide the promised transfer of climate funds; and for pandemic recovery investments to support climate action and reduce social and health inequities.” Likewise, leading international health journals have published a strong editorial that appeared in multiple journals in September with a vital message: “Reflecting the severity of the moment, this editorial appears in health journals across the world. We are united in recognising that only fundamental and equitable changes to societies will reverse our current trajectory.”  

The annual Lancet Countdown: Tracking Progress on Health and Climate Change report was released on October 21, 2021. Key findings are presented in five domains: 1) climate change impacts, exposures, and vulnerabilities; 2) adaptation, planning, and resilience for health; 3) mitigation actions and health co-benefits; 4) economics and finance; and 5) public and political engagement. Indicators are provided under each of the domains to give a quick view of changes since the previous report. 

In Canada, the Canadian Association of Nurses for the Environment (CANE-AIIE) has been active since 2009. Their website features articles, presentations, and campaigns. CANE was among the Canadian signatories to the Healthy Climate Prescription letter, along with the Canadian Nurses Association, Canadian Medical Association, Canadian Public Health Association, and other organizations. I found CANE’s definition of planetary health quite helpful in thinking about the health of populations and the natural world:

Planetary health is a recognition of the fact that human health depends on healthy natural environments/ecosystems, and moreover, that we as a civilization find ourselves at a tipping point. We have depended on our natural systems to promote human health to the point where the human population is healthier than ever before, but to achieve this, we have exploited the planet at an unprecedented rate. If we want to continue to safeguard human health, we also need to maintain the health of the planet and its natural systems on which we depend (CANE website, n.d.).

Nurses are being called upon to use our individual and collective influence. Writing in the International Nursing Review, Dr. Pamela Mitchell (2021) offers a thoughtful piece on Nursing’s mandate in climate change. She notes that nurses have written about climate change in the context of the UN Sustainable Development Goals, and now urges collective advocacy to move our focus to climate justice and equity.

Dr. Sally Thorne’s recent editorial in Nursing Inquiry, Awakening to the climate emergency, is a fitting reminder to nurses to pay attention to planetary health. As Editor-in Chief, she anticipates an increase in manuscripts on “a nursing response to the climate crisis” as we take up a shared goal (Thorne, 2021).

I believe that events of recent years are awakening us to the urgency to act as part of our organizations, coalitions, and nations in the quest for climate justice.

Post COP26 Update: The Global Climate and Health Alliance provided an assessment of what was achieved and what work remains. There is positive news in COP26’s Glasgow Climate Pact “that re-commits governments to limiting temperature rise to 1.5C, in line with the most recent science” with concern about the lack of substance in the countries’ commitments. Read more in the media release from Glasgow dated November 13, 2021.

The International Council of Nurses issued a strong statement on the final day of COP26: “ICN is calling for nurses and other healthcare workers to be included at the centre of climate change policymaking, underscoring that climate change is a health issue. As COP26 closes and leaders look ahead to COP27 next year, ICN says it is more important than ever that the voice of health professionals is heard on the climate change debate because if nothing changes nurses and health systems will suffer the consequences.” See full media release (November 12, 2021).

By Nora Whyte – October 24, 2021 (Updated November 22, 2021)

I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.

References:

Mitchell, P.H. (2021). Nursing’s mandate in climate change. International NursingReview, 68, 279– 280. https://doi.org/10.1111/inr.12704

Thorne, S. (2021). Awakening to the climate emergency. Nursing Inquiry, 28: e12459. https://doi.org/10.1111/nin.12459

February Update: ICN and WHO

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This week I received the first newsletter for the 2021 International Council of Nurses (ICN) virtual congress taking place in November. This congress promises to be a highly relevant one for these times with the theme of “Nursing Around the World” using a virtual format that will increase access to the event.

Abstracts are due by March 11, 2021 for e-posters and oral concurrent sessions on eight sub-themes.  Sub-themes include Nursing Workforce, Epidemics & Pandemics, Global Health Challenges, and Digital Health & Innovation. The concurrent sessions will be 10-minute pre-recorded video presentations grouped by sub-theme.

Having attended past ICN congresses – in Barcelona, Durban, Singapore, and Vancouver – I can attest to the value of meeting nurses from around the world, listening to their presentations, and learning about policy advocacy to apply to my own work. Along with colleagues, I have submitted abstracts and been part of presentations. And sometimes an encounter at a congress has led to later collaboration and exchanges.

Global Vaccine Equity

Throughout the pandemic ICN has been vocal on the behalf of nurses and health workers globally and is supporting the current WHO campaign on vaccine equity in the first months of 2021, the Year of the Health and Care Worker.

The WHO Declaration calls on “global, national and local leaders to accelerate the equitable rollout of vaccines in every country, starting with health workers and those at highest risk for COVID-19. This includes scaling up vaccine manufacturing and rejecting vaccine nationalism at every turn.”

WHO urges world leaders to increase contributions to the COVAX facility and also calls on Ministries of Health “to work with WHO and others to invest in and prepare their primary health care systems for distribution of COVID-19 vaccines to their health workers.” Further, as is expressed often these days, distribution of vaccines quickly and equitably will be key to ending the pandemic. Individuals and organizations can lend their support by signing the declaration and by getting messages out through social media. #VaccinEquity

By Nora Whyte – February 18, 2021

I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.

Nursing the World to Health

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I am writing this post as National Nursing Week in Canada draws to a close. It has been a strange time of celebration mixed with sadness at the losses experienced globally and the ongoing concern about the health of populations and the long road to recovery.

During this Nursing Week, I found that our Canadian nursing leaders reflected what many of us have been thinking about our profession during the time of COVID. I greatly appreciated reading CNA President Claire Betker’s editorial in the Canadian Nurse: On the importance of nurses in 2020. Claire highlighted the opportunity to raise the profile of the profession during the International Year of the Nurse and the Midwife and demonstrated the many ways in which Canadian nurses have made an impact.

International Nurses Day was celebrated globally on May 12, the 200th anniversary of Florence Nightingale’s birth. This year’s theme, Nurses: A Voice to Lead – Nursing the World to Health captured both the spirit and the urgency of nursing’s vital global role. The International Council of Nurses provided excellent resources on its International Nurses Day site and was highly visible in media interviews and in generating social media energy. ICN’s CEO Howard Catton tweeted: “Let our celebrations be a clarion call for real commitments to actions and investments to support nurses to do the work that the world desperately needs them to do.” Annette Kennedy, ICN President, expressed her appreciation to the global nursing community and held a great video conversation with Dr. Tedros on May 12. It’s worth viewing and reflecting on their messages!

This week also provided opportunities to profile the State of the World’s Nursing 2020 Report, released in April 2020 and now gaining attention. This landmark publication has highlighted the urgent need for acceleration of nursing education, job creation and leadership. The report’s call to strengthen nursing leadership is “to ensure that nurses have an influential role in health policy formulation and decision-making, and contribute to the effectiveness of health and social care systems” (WHO, 2020).

Nursing Week 2020 has played out in a vastly different way than anticipated; however, there is no doubt that the theme of “Nursing the World to Health” is more important than ever as we face the remainder of 2020 using a professional, powerful and collective voice to lead.

By Nora Whyte – May 15, 2020

Nursing Now: Ready for 2020

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Nursing Now launched in 2018 as a global collaboration among the Burdett Trust for Nursing, the International Council of Nurses (ICN) and the World Health Organization (WHO). I have been following developments and have used this Blog to share highlights and links to updates from time to time.

On the cusp of 2020, Nursing Now is perfectly positioned to play a leadership role during the 2020 Year of the Nurse and the Midwife. Events and celebrations are planned throughout the year. In their most recent update (November 2019), the Nursing Now campaign team stated: “During 2020, we are united in our ambition to propel nursing and midwifery into the spotlight and onto the agenda of governments, with the ultimate goal of improving health globally.”

As Nursing Now has gained momentum, I have been pleased to note the connection to the Sustainable Development Goals (SDGs). There’s increasing recognition that nurses and midwives are contributing to the SDGs and are absolutely vital to delivering Universal Health Coverage by 2030.

A new aspect of Nursing Now announced during the ICN Congress in Singapore in June is the Nightingale Challenge currently being promoted as a key leadership development strategy for 2020 and beyond:

The Challenge is asking every health employer around the world to provide leadership and development training for a group of their young nurses and midwives during 2020, the Year of the Nurse and the Midwife, to support them as practitioners, and enhance their skills as advocates and leaders in health.

Nursing Now Canada launched in 2019 with plans for national initiatives in three ‘pillars’ as outlined in its June 3, 2019 media release:

  • Nursing Leadership pillar – to establish a hub to educate, empower and support regulated nurses to lead, advocate, innovate, influence public policy and create sustainable change in health.
  • Chief Nursing Officer pillar – to establish federal, provincial and territorial chief nursing officers in leadership positions within ministries of health.
  • Indigenous pillar – to support nurses and midwives in providing culturally safe care and to strengthen the power of Indigenous nurses.

The Canadian Nurses Association is the official link for Canadian nurses to the global Nursing Now campaign and is carrying out this three-point action plan in partnership with the Canadian Indigenous Nurses Association and Indigenous Services Canada.

From here at home to events on the world stage, communities of nurses and midwives will be joining their colleagues and supporters in celebrating the Year of the Nurse and the Midwife in 2020.

Update November 23, 2019

It was a delight to read an editorial published in The Lancet today (Volume 394) entitled 2020: unleashing the full potential of nursing and drawing attention to Nursing Now and the Nightingale Challenge. The editorial makes the case for enhancing nursing to enhance health and looks to the opportunity of 2020 “to showcase the evidence and impact of what nurses and midwives do, and to ensure that they are enabled, resources and supported to meet the world’s health needs.” Thanks to The Lancet for this timely editorial and the social media interest it is generating.

By Nora Whyte – November 21, 2019


Summer 2019 Reflections

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The highlight of this summer was the opportunity to be part of a global gathering of 5,300 nurses at the International Council of Nurses Congress in Singapore from June 27 to July 1. Hosted by the Singapore Nurses Association, it was truly a banner event: well-organized in every aspect and with a warm welcome from local volunteers as delegates arrived each day.

Welcome from Singapore Nurses Association at Opening Ceremony.
Photo Credit: ICN

Susan Duncan and I have written a summary of our experiences in a post on the University of Victoria School of Nursing Blog: ICN Singapore Congress – Reflections for Canadian Nursing: Onward to 2020.

We describe recent ICN initiatives including the partnership with Nursing Now and the exciting launch of the Nightingale Challenge. We reflect on the dynamic presence of the World Health Organization throughout the Congress and the increasing recognition of the vital role of nurses in achieving the WHO goal of Universal Health Coverage. The designation by WHO of 2020 as the Year of the Nurse and the Midwife presents a great opportunity for participation in decision-making bodies and in events including the World Health Assembly next year.

ICN President Annette Kennedy.
Photo credit: ICN

Other highlights included meeting delegates from many countries during receptions, lunches, poster sessions and policy cafés.  We reconnected with colleagues from our national organizations and enjoyed encounters with Canadian students and early career nurses.

Canadian Nurses Association President Claire Betker

For further details on the 2019 Congress and to view presentation slides, photos and speaker profiles, see the archives here.

Onward to 2020!

Trinidad & Tobago Registered Nurses Association.
Photo credit: ICN

Posted by Nora Whyte – August 25, 2019

ICN Congress: Beyond Healthcare to Health

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Courtesy of ICN

The International Council of Nurses 2019 Congress is set to begin on June 27 in Singapore. It promises to be a banner event with a strong focus on global health and nursing issues. I am looking forward to attending once again and to stimulating sessions on universal health coverage, primary health care and other policy topics.  

In particular I will be interested in an update on the Nursing Now campaign, launched in 2018 and growing into a social movement to advance nursing and midwifery in many countries. There will be updates on ICN’s recent initiatives and networking opportunities for participants as well as exhibits and poster sessions. Susan Duncan and I are presenting a poster, Launching a Global Inquiry into Nursing Organizations’ Points of Policy Influence: Key Questions. We intend to connect with nurses in other countries to learn about their strategies to influence health and public policy issues and to determine interest in ongoing collaboration. We will write an ICN summary report when we return to Canada.

Posted by Nora Whyte – June 18, 2019