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COMMITTEES

Sir Mutha MUN Conference

WHO

World Health Organisation


The World Health Organization is a specialised agency affiliated with the UN that is concerned with international public health. Its current priorities include communicable diseases, the mitigation of the effects of diseases with special emphasis on reproductive health, food security and healthy eating etc.

Agenda

Discussion on ways to alleviate the evident disparity in healthcare access across the world.


Letter from the Executive Board:

Dear Delegates,
It takes us immense pleasure in welcoming you to The Sir Mutha Model United Nations 2022 conference. We are honoured to serve you as Executive Board members in this edition of the conference.


We believe that each and every delegate should go through this guide, to have a clear understanding of the agenda at hand. However, this would only serve as a “Background” of the agenda and would not be covering all the aspects linked to it. Your real research lies beyond this guide and we are eager to see all of you discussing possible solutions together, applying all of your extensive research and great knowledge of the topics discussed in this committee.


Understanding both the importance and complexity of this agenda, we strongly recommend you to be prepared and well researched in committee, and at the same time request you to participate at all times, making it a learning experience for all of us. Also note, it will be important for you to have a basic understanding of how various rights get affected in the socio-legal context.


If you are participating in a MUN conference for the very first time, we would request you to have an idea of the UNA USA rules of procedure followed in committee, links to the same would be provided at the end of this guide. The rest of the work as a delegate remains the same for you, wherein you research about the agenda, your foreign policy and laws relating to the same. Please take the initiative and research accordingly.


We strongly hope that you all will come prepared and motivated to discuss the situation at hand, brainstorm together to find out solutions of the same, applying legal frameworks and in the process, take back a lot from committee. Our goal for you in this committee is to have an enriching experience by learning the art of diplomacy and at the same time see you solve real life problems happening in this world. We are looking forward to see you in committee,

Happy Researching!

Regards,


Arvind Krishnan

Chairperson


Vice Chairperson


Introduction

Poor health cannot be explained simply by germs and genes. It is much more complex, involving both the circumstances in which people live (access to health care, schools and education, and conditions of work, leisure, homes, communities, towns or cities) and their individual and cultural characteristics (such as social status; gender, age and ethnicity norms; values and discrimination). All of these factors influence an individual’s chances of leading a flourishing, healthy life. Chances for good health are not equally distributed in our societies and this causes health inequities.


Addressing these health inequities requires dealing with their root causes: the unequal distribution of power, income, goods and services in our societies. Robust evidence collected at the global, European, national and subnational levels has led to an increasing call for action on social determinants.The call to action goes beyond health ministries, reaching out across borders and sectors to all the players and stakeholders that can contribute to a fairer and healthier World. The wide range of stakeholders includes ministries and other governmental entities, academic/research institutions, NGOs and civil society organizations


The Significance of Racial and Ethnic Disparities in Healthcare

The annual National Healthcare Quality and Disparities Reports document widespread and persistent racial and ethnic disparities. These disparities result from complex interactions between patient factors related to social disadvantage, clinicians, and organizational and health care system factors. Separate and unequal systems of health care between states, between health care systems, and between clinicians constrain the resources that are available to meet the needs of disadvantaged groups, contribute to unequal outcomes, and reinforce implicit bias. Recent data suggest slow progress in many areas but have documented a few notable successes in eliminating these disparities. To eliminate these disparities, continued progress will require a collective national will to ensure health care equity through expanded health insurance coverage, support for primary care, and public accountability based on progress toward defined, time-limited objectives using evidence-based, sufficiently resourced, multilevel quality improvement strategies that engage patients, clinicians, health care organizations, and communities.


Racial disparity of healthcare in USA- an overview

Racial and ethnic disparities in healthcare are important for a number of reasons. They pose significant moral and ethical dilemmas for the US healthcare system. As a nation, we have an abundance of healthcare facilities, cutting edge technologies, and pharmacotherapeutics and other assets that are the envy of the world, but which are not accessible for a myriad of reasons to all segments of the population. Also, healthcare as a resource is tied to various notions of social justice, opportunity, and quality of life for our patients, our communities, and the nation at large. A closely allied concern is the nation's economic well-being, which is both directly and indirectly tied to the health status of our population in general, and of specific population groups in particular. As a result, inadequate, inaccessible, and/or poor medical care further exacerbates increasing healthcare costs that have broad implications for the overall quality of care experienced by all Americans.


Evidence garnered over the past 3 to 4 decades is compelling. Health and disease states are unevenly visited upon various population groups. A few examples are illustrative: infant mortality for black babies remains nearly 2.5 times higher than for white babies; the life expectancy for black men and women remains at nearly 1 decade fewer years of life compared with their white counterparts; diabetes rates are more than 30% higher among Native Americans and Latinos than among whites; rates of death attributable to heart disease, stroke, and prostate and breast cancers remain much higher in black populations, and minorities remain grossly under-represented in the health profession's workforce relative to their proportions in the population.

Health Disparities Defined

Health disparities are differences and/or gaps in the quality of health and healthcare across racial, ethnic, and socio-economic groups. It can also be understood as population-specific differences in the presence of disease, health outcomes, or access to healthcare. Another useful definition has been provided by the Institute of Medicine that suggests that health disparities are racial or ethnic differences in the quality of healthcare that are not due to access-related factors or clinical needs, preferences, and appropriateness of intervention. Despite the usefulness of these definitions, it is important to understand that health disparities are not just based on race, ethnic, and cultural differences within the population. Lifestyle choices, age, sexual orientation, lack of access, and personal, socio-economic, and environmental characteristics are also to be included.


The landmark Framework Convention On Global Health

The lack of access to quality health care is emblematic of the range of failings of the right to health to have yet been translated into the lived reality for large swaths of the world’s people, and the vast inequalities in health and quality health care that persist. Huge portions of the world’s population are also unable to access the underlying determinants of health, meaningfully participate in policymaking affecting their health, or hold governments, or anyone else, accountable for progress in health or quality health care. Health ministries lack the power and resources to provide quality universal health coverage.


Closing health inequities and gaps in access to quality health care, as well as to the underlying determinants of health, while addressing social and other determinants, demands raising accountability to the right to health in all of its dimensions – including its commitment to equality, meaningful participation, and adequate resources – to the highest possible level of commitment. A Framework Convention on Global Health (FCGH) would do just that. This global treaty would advance the right to health and health accountability, aiming to vastly reduce cavernous health inequities, including the quality chasm, and empower people and governments to better realize the right to health.


The right to health is codified in international law through the International Covenant on Economic, Social and Cultural Rights and other treaties, but this has been deeply insufficient for realizing the right. And the right to health focuses on government responsibilities to their own populations, which remain central, yet also inadequate in our globalized world, where actions in one country can significantly contribute to or harm health elsewhere, and corporate action and power increasingly affect the right to health.


An important right given by the FCGH

By clarifying currently binding but presently vague human rights norms…: Presently human rights norms applicable to the right to health are vague, such as requirements on international assistance and cooperation, progressive realization, participation, non-discrimination, and respecting the right to health in all government actions. These requirements are ill-defined, or – like access to quality care – developed through treaty bodies or other mechanisms. Negotiated and agreed to by states, a treaty would create government ownership and buy-in around clarified right to health-related norms – for instance, that progressive realization requires continuous quality improvement. The Framework Convention on Tobacco Control (FCTC), which has stimulated many states to take far-reaching tobacco control measures, demonstrates that the power of treaty norms can far exceed the force of norms in non-binding instruments. The FCGH could do the same for the right to health.

Disparities in Cost And Affordability

While FCGH stipulations would require certain government actions, they could do so in ways that maximize national ownership and involve joint and inclusive governance. Drawing on the approach of the Paris Agreement on climate change, at the heart of which is national target-setting within the scope of the overall shared commitment on greenhouse gas reduction, the FCGH could itself feature national target-setting, plus other flexibilities. For example, the FCGH could provide guidance and parameters in areas such as financing, equity, quality, health coverage, and participation and accountability mechanisms, with inclusive national processes then establishing national targets and timelines, selecting among a menu of options, or otherwise tailoring FCGH stipulations to national circumstances. Thus, with a carefully calibrated mix of binding stipulations and national flexibility, the FCGH has the potential to be a create a powerful, innovative, 21st-century approach to the right to health, achieving under its auspices a healthy world, ones in which quality health care is universal, everyone benefits from the underlying and social determinants of health, and equity, participation, and accountability are at the center of national and global efforts to protect the public’s health.


Goals and targets for reducing inequalities in health

Tackling inequalities in health is currently an overarching goal of all public health policies. It is usually the second of two main goals, the first being to increase health in the whole population, measured by life expectancy or health expectancy. Some countries have had a goal on inequalities in health for many years, while for others it is a more recent development. As early as 1986 Finland’s Health for All Programme aimed to reduce disparities between population groups. This was in line with the Health for All by the Year 2000 targets. Healthy People 2000, launched by the United States Government in 1990, included “reducing health disparities among Americans” as one of its three goals. Countries differ in the amount of reduction desired in the gap between groups and also in the choice of indicators used to measure progress towards the goal of reducing inequalities in health. Goals can be set for many different subgroups within the population using a variety of different indicators of ill-health.


Goals that have been set for reducing inequalities in health are long term. However many indicators have also been identified so that progress in the short and medium term can be monitored. The indicators may be broad ranging to identify the many areas where inequalities in health are apparent. Examples from four countries –


England, New Zealand, Northern Ireland and Scotland – illustrate the variety of indicators which may be used.

Indicators from England and Northern Ireland are identified from policy.

Those from New Zealand can be found in the Ministry of Health publication Indicators of Inequality, and the Scottish indicators have been proposed in the recent report Inequalities in Health.

How has the COVID-19 pandemic affected disparities?

The COVID-19 pandemic has exposed the link between socio-economic inequalities and health outcomes, especially in the area of rheumatic and musculoskeletal (RMDs) diseases. Women are more adversely affected by RMDs diseases compared to men. Epidemiological research carried out over several decades has demonstrated the presence of clear gender patterns in the manifestation of musculoskeletal diseases, including osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SS) and osteoporosis (OP). The public health measures that have been adopted to curb the spread of Sars-COV-2 are expected to have a particularly detrimental impact on women in the long term precisely because of the nexus between health outcomes and socio-economic structures.


Moreover, the prioritization of urgent care will further compound this effect. COVID-19 has created a condition of ontological insecurity that is becoming increasingly manifested through various chronic diseases and associated comorbidities. RMDs and their impact on mobility and the ability of individuals to be independent, happy and mobile is a key public health challenge in the post-COVID-19 reality and a key part of the ongoing pandemic. There is an urgent need to engage with policymakers to publicize and prioritize this problem and develop viable solutions to address it.


What are the broader implications of disparities?

Gender disparities are also emerging in terms of health outcomes. As a result gendered work and division of the healthcare labor market, women are more exposed to COVID-19, and at a much higher viral load than men. We do not yet know the long term health consequences of this level of exposure. Whereas, women make up a smaller percentage of the severe COVID-19 cases presenting in hospitals, they seem to be more likely to suffer from long-COVID-19 .


• There are also serious issues regarding the impact of COVID-19 on Black, Asian and Minority Ethnic (BAME) communities. A systematic review of the published literature on COVID-19 articles in some of the most prestigious medical journals including New England Journal of Medicine, Lancet, British Medical Journal and the Journal of the American Medical Association plus EMBASE, MEDLINE, Cochrane Library, PROSPERO, clinical trial protocols, gray literature, surveillance data and preprint articles in MedRxiv has revealed that BAME individuals had an increased risk of infection with SARS-CoV-2 compared to white individuals and, 12 studies eported worse clinical outcomes, including intensive care unit admission and mortality .


• It is interesting to note that traditionally, very few analyses have drawn the link between co-morbidities associated with pandemics and socio-economic structures e.g., gender, class and race. The wealth of data collected during this pandemic is forcing us to re-evaluate the way we think about the serious shortcoming of any socio-political, economic and medical analysis of the pandemic that does not centers the link between these “social issues” and health outcomes.


• COVID-19 is bringing to light a number of “blind-spots” in public and health policy . It is thus an opportunity to draw attention to the importance of impact assessments, not just in policy making but also research in order to avoid “unintended” consequences that have an asymmetrical impact on different demographic groups.

QARMA

How does the lack of healthcare access affect population health and patient well-being in a community?

What are barriers to healthcare access in rural areas?

Why is primary care access important for rural residents?

What types of healthcare services are frequently difficult to access in rural areas?

How do rural healthcare facility and service closures impact access to care?

What are some strategies to improve access to care in rural communities?

Introduction to Chairperson

Arvind Krishnan is in his final year of engineering in Vit Chennai and has always had a keen interest towards culturals and Muns from the very beginning. Having won almost all the events he has attended, Arvind has shown interest in Adzap, Channel Surfing, Shipwreck and Block and Tackle. Apart from his interest in culturals, Arvind also enjoys playing basketball (Go GSW). He has been successful in making his school and college proud having attended Muns in the capacity of a delegate, executive board member and organising committee member.