A/74/PV.14 General Assembly

The positions of delegations regarding the recommendations of the Fifth Committee have been made clear in the Committee and are reflected in the relevant official records. Therefore, if there is no proposal under rule 66 of the rules of procedure, may I take it that the General Assembly decides not to discuss the reports of the Fifth Committee that are before the Assembly today?

Statements will therefore be limited to explanations of vote or position. I would like to remind delegations that explanations are limited to 10 minutes and should be made by delegations from their seats. Before we begin to take action on the recommendations contained in the reports of the Fifth Committee, I would like to advise representatives that we are going to proceed to take decisions in the same manner as was done in the Fifth Committee. In paragraph 4 of its report, the Fifth Committee recommends that the General Assembly appoint Ms. Donna-Marie Chiurazzi-Maxfield of the United States of America as a member of the Advisory Committee on Administrative and Budgetary Questions for a term of office beginning on 14 October 2019 and ending on 31 December 2020. May I take it that it is the wish of the Assembly to appoint Ms. Donna-Marie Chiurazzi-Maxfield as a member of the Advisory Committee on Administrative and Budgetary Questions for a term of office beginning on 14 October 2019 and ending on 31 December 2020? It was so decided (decision 74/402).

The General Assembly has thus concluded this stage of its consideration of sub-item (a) of agenda item 115.

The Assembly will now take a decision on the draft resolution recommended by the Fifth Committee in paragraph 6 of its report. The Fifth Committee adopted the draft resolution, entitled “Scale of assessments for the apportionment of the expenses of the United Nations: requests under Article 19 of the Charter”, without a vote. May I take it that the Assembly wishes to do the same?

The Assembly has thus concluded this stage of its consideration of agenda item 139.

The creation of the United Nations embodied the natural aspiration of the peoples of our planet to live in peace, good-neighbourliness and prosperity. The Preamble to the Charter calls for all “to practice tolerance and live together in peace with one another as good neighbours”, but we cannot say that States have faithfully abided by that precept since the inception of the United Nations. We know that the history of the United Nations is one of successes and failures, expectations met or unfulfilled, and a dedication to the ideals and principles of the Organization that is not always matched by consistency in their realization. There can be no doubt, however, that the United Nations has contributed to ensuring a timely response to many, if not all, of the global challenges that humankind has had to confront. Next year the United Nations will celebrate its seventy-fifth anniversary, and that longevity confirms that the Organization is still needed. There is no alternative to it. Nor is there any alternative to multilateralism and dialogue, which are capable of changing the general perception of conflicts today and of the pathways to emerging from them. In that regard, we believe that the main direction we should take to strengthen the United Nations should be through the creation of a genuinely multilateral format aimed at seeking a consensus based on the principles of common sense and mutual compromise. The Member States decided through their adoption of resolution 73/299 that the theme of the high-level meeting commemorating the anniversary in 2020 will be “The future we want, the United Nations we need: reaffirming our collective commitment to multilateralism”. The forthcoming anniversary should be an excellent opportunity to recall the reasons  — not just victory in the Second World War, but also the importance of preserving peace and security  — that led our predecessors to establish the United Nations in that far-off year of 1945. International Delegate’s Day was established this year (resolution 73/286) on the initiative of Belarus and will be celebrated on 25 April, the day that the United Nations Conference on International Organization began in San Francisco in 1945, the Conference that ended with the signing of the Charter. That day is a reminder of the history of the creation of the United Nations and of the fact that it is the human factor that is the most important guarantee of the success of any dialogue and of our ability to strengthen multilateralism and trust. We invite anyone interested to consider what the format of its celebration at the United Nations might be. Throughout its existence the United Nations has tried not only to deal with challenges and threats that have emerged but also to improve its institutional structure in order to react effectively to conflict situations. It was the late former Secretary-General Kofi Annan who first called for large-scale reform of the United Nations, and we believe that our current Secretary-General, Mr. António Guterres, is successfully continuing that legacy. He has achieved a great deal, especially with regard to the reorganization of the United Nations development system. We hope that the reoriented development system will become a driving force for the achievement of the Sustainable Development Goals and will end the fragmentation of the Organization’s efforts on the ground. The Funding Compact (A/74/73/Add.1) for the reorganization of financing, which Belarus helped to develop, is an important tool for supporting States in their implementation of the 2030 Agenda for Sustainable Development. We welcome the Secretary-General’s initiatives developing reforms designed to help the Organization cope with the crisis it is facing in dealing with the prevention of international conflicts. The steps taken to reorganize the peace and security components of the Secretariat and revitalize the peacekeeping system as a whole have had broad support from States. However, if we are to add further success to these beginnings, we call for a considered and balanced interpretation of those initiatives, especially when they involve the imposition of issues that are not central to peacekeeping, such as the protection of human rights, interference in political processes and the involvement of civil society in peacekeeping activities. They are the prerogative of the States themselves. Belarus has repeatedly raised the issue of ending duplication in the work of the General Assembly and its Main Committees and the Economic and Social Council. The time has come to review the agendas of the General Assembly and the Economic and Social Council and to remove duplicative items. For example, the Economic and Social Council segment on operational activities for development is virtually a duplicate of the agenda of the Second Committee, and its humanitarian affairs segment of that of the Third Committee. Nor are we convinced of the necessity of fully aligning those agendas with the 2030 Agenda for Sustainable Development, which is intrinsically temporary, and we have to look at it with the future in mind. We cannot strengthen the United Nations without supporting the effective functioning of the Security Council and its subsidiary bodies. The Sanctions Committees of the Security Council unquestionably play an important role in ensuring compliance with its decisions. The reports of its groups of experts are designed to provide an objective, impartial picture of the implementation and monitoring of compliance with Security Council’s restrictive measures. We believe that the practice whereby one or another conclusion in the reports of the expert groups on sanctions is based on an arbitrary interpretation of the facts and on entirely unsupported assumptions about violations of the sanction regime undermines the effectiveness of the work of the Council’s subsidiary bodies. In our opinion, attempts to focus unnecessarily on issues that are not relevant to the subject of restrictive measures are counterproductive, wasteful and detrimental to the real tasks of the Sanctions Committees. Life goes on, and the United Nations, too, will need strengthening and renewal in future. However, we believe that we should always remember that the steps taken to strengthen should be reasonable and useful, and that renewal should not become reform for reform’s sake.

We have heard the only speaker in the debate on this item. The Assembly has thus concluded this stage of its consideration of agenda items 14, 117, 123 and 124.

I have been informed that no Member State has requested to take the floor under this item. The General Assembly has thus concluded this stage of its consideration of agenda item 117.

I would like to remind members that the debate on agenda item 126 is scheduled to be held on Wednesday, 11 December, as announced on the General Assembly website. We shall now proceed to consider draft resolution A/73/L.4. I give the floor to the representative of the Secretariat.

This oral statement is made in accordance with rule 153 of the rules of procedure of the General Assembly. Under the terms of paragraphs 82 and 83 of the political declaration contained in draft resolution A/74/L.4, the General Assembly requests the Secretary- General to provide, in consultation with the World Health Organization and other relevant agencies, a progress report during the seventy-fifth session of the General Assembly, and a report, including recommendations on the implementation of the political declaration towards achieving universal health coverage, during the seventy-seventh session of the General Assembly, which will serve to inform the high-level meeting to be convened in 2023. The Secretary-General is also requested to convene a high-level meeting on universal health coverage in 2023 in New York, aimed at undertaking a comprehensive review of the implementation of the political declaration in order to identify gaps and solutions to accelerate progress towards the achievement of universal health coverage by 2030, the scope and modalities of which shall be decided no later than the seventy-fifth session of the General Assembly, taking into consideration the outcomes of other existing health-related processes and the revitalization of the work of the General Assembly. Pursuant to the request contained in paragraph 82 of the draft resolution, the request for documentation would constitute an addition to the documentation workload of the Department for General Assembly and Conference Management of one pre-session document with a total word-count of 8,500 words, in all six languages, in 2020, and one pre-session document of with a total word-count of 8,500 words, in all six languages, in 2022. Those would constitute an addition to the documentation workload for the Department for General Assembly and Conference Management in 2020 and 2022. The additional requirements for documentation would arise in 2022 in the amount of $27,200, while the additional requirements for 2020 in the amount of $27,200 would be met within the programme budget proposed for approval for 2020. With regard to paragraph 83, it is understood that issues related to the high-level meeting to be convened in 2023, including the scope and modalities, are yet to be determined. Accordingly, in the absence of modalities for the meeting, it is not possible at the present time to estimate the potential cost implications of meetings and documentation requirements. Upon the decision on the modalities of the meeting, the Secretary-General would submit the relevant costs of such requirements in accordance with rule 153 of the rules of procedure of the General Assembly. Furthermore, the dates of the meetings would have to be determined in consultation with the Department for General Assembly and Conference Management. Accordingly, should the General Assembly adopt draft resolution A/74/L.4, additional resource requirements currently estimated in the amount of $27,200 would be included in the proposed programme budget for 2022 under section 2, General Assembly and Economic and Social Council Affairs and Conference Management. The statement that I have just read out has been made available on the PaperSmart portal.

The Assembly will now take action on draft resolution A/74/L.4, entitled “Political declaration of the high-level meeting on universal health coverage”. May I take it that the Assembly decides to adopt draft resolution A/74/L.4?

Before giving the floor to speakers in explanation of position, I would like to remind delegations that explanations are limited to 10 minutes and should be made by delegations from their seats.

Guatemala welcomes resolution 74/2, by which the General Assembly has adopted the political declaration approved by the high-level meeting on universal health coverage on 23 September, and appreciates the efforts of the co-facilitators of the process, Ambassadors Kaha Imnadze of Georgia and Vitavas Srivihok of Thailand. Our Magna Carta, the Constitution of the World Health Organization, states that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” As a State that values multilateralism, we therefore recognize the relevance of the political declaration and reaffirm Guatemala’s commitment to the physical, social and mental well-being of its citizens and commit to joining efforts to make universal health coverage a reality for all in accordance with the 2030 Agenda for Sustainable Development, particularly Sustainable Development Goal 3, which reads “Ensure healthy lives and promote well-being for all at all ages”. With regard to the integral approach to health, Guatemala would like to express a reservation concerning paragraph 68 of the political declaration, which relates to references and interpretations of universal access to sexual and reproductive health-care services. We reaffirm before the General Assembly that article 3 of our Constitution establishes that the Guatemalan State guarantees and protects human life from its conception, as well as the integrity and safety of the person.

I am personally thrilled to be here in the Hall of the General Assembly as we formally adopt the political declaration on universal health coverage (resolution 74/2). As Chair of the Group of Friends of Universal Health Coverage and Global Health, I would like to express my heartfelt appreciation and deep respect for everyone who contributed to the political declaration of the high-level meeting on universal health coverage. I would particularly like to thank the co-facilitators, Ambassadors Kaha Imnadze and Vitavas Srivihok, the Permanent Representatives of Georgia and Thailand, for their dedicated and skilful facilitation of the efforts to achieve this truly historic consensus. I am grateful that the Group of Friends was able to contribute to the process by building momentum and deepening understanding of universal health coverage as a fundamental enabler of the Sustainable Development Goals, as well as building on multi-stakeholder engagement, including the key task of ensuring universal health coverage by 2030. As Prime Minister Abe stated in his closing remarks at the high-level meeting, Japan emphasizes the importance of achieving universal health coverage at the global level while using its own experience of managing universal health coverage as key to socioeconomic development and to an ageing society that is a healthy one. With the conviction that universal health coverage embodies the notion of human security, which is to leave no one behind, we have sought to promote universal health coverage both bilaterally and through global forums, including international organizations, the Group of Seven and, most recently, through our presidency of the Group of Twenty. Those efforts culminated in the political declaration on universal health coverage, which, in the words of the Secretary-General, is “the most comprehensive agreement ever reached on global health”. It represents the highest commitment of world leaders to achieving universal health coverage by 2030, which includes coverage for all people through quality essential health services, and to eliminating the possibility of being impoverished by excessive health-related expenses, to name only a few objectives. Those commitments cut across all health challenges, including communicable and non-communicable diseases, and even go beyond health to include human rights and financing, which all necessitate intense political commitment and multi-stakeholder engagement. It is now time for us Member States to deliver our on commitments. Japan stands ready to accelerate its efforts while leveraging relevant forums, including the second Universal Health Coverage Forum, to be held in Bangkok, and the Tokyo Nutrition for Growth Summit in 2020, as well as the high-level review meeting on universal health coverage here in New York in 2023, with a view to achieving universal health coverage by the year 2030.

From Hungary’s perspective, universal health coverage was seen as a good initiative because its fundamental objective is to provide a high level of health care to those in need in developing countries. We therefore assumed that the initiative would be supported. And yet it is with regret that we have seen such a well-intentioned political initiative draw heavily on the Global Compact for Safe, Orderly and Regular Migration, which one fifth of Member States have not supported. During the negotiations of the political declaration of the high- level meeting on universal health coverage (resolution 74/2), Hungary had several reservations and repeatedly expressed its doubts. However, in a spirit of compromise and constructiveness, the Hungarian Government decided to support the adoption of the Declaration, as stated by Péter Szijjártó, Minister of Foreign Affairs and Trade of Hungary, at the recent high-level event on universal health coverage. Hungary is of the view that the political declaration, like any other similar document, should respect national competencies and the principle of sovereignty, as every State has the right to formulate and decide the structure of its national health policy. We do not agree with an approach based on the notion that all are entitled to enjoy the same quality of health care regardless of their status. We cannot adopt any legislation that would discriminate against our own citizens. That is why Hungary expressed reservations with regard to paragraphs 70 and 71. Regarding paragraphs 68 and 69, Hungary remains dedicated to its human rights commitments, including the protection and promotion of women’s rights and equality between men and women. Hungary is deeply committed to the implementation of the Programme of Action of the International Conference on Population and Development and the Beijing Declaration and Platform for Action, as well as the 2030 Agenda for Sustainable Development, which also serve as basic references in the area of sexual and reproductive health and rights. Hungary notes that the term “sexual and reproductive health and rights” and related issues, such as sexual rights, comprehensive sexual education, modern methods of contraception and emergency contraception, lack consensus definitions at the international level, including within the European Union. Those issues are interpreted and promoted by Hungary in the context of the 2030 Agenda, the Programme of Action of the International Conference on Population and Development and the Beijing Declaration and Platform for Action and in line with its national legislation. That is why Hungary joined the initiative of the United States and is committed to further cooperation to promote those values.

My delegation would like to express its appreciation and thanks for the efforts of the co-facilitators, the Ambassadors of Georgia and Thailand, who helped us reach consensus on the political declaration of the high-level meeting on universal health coverage (resolution 74/2). The declaration includes highly important objectives aimed at enabling us to truly tackle the challenges that many peoples and societies face in aspiring to affordable and quality health care. Achieving those goals would constitute a further step towards realizing the Sustainable Development Goals of the 2030 Agenda for Sustainable Development. International cooperation based on genuine political will and determination is essential if we are to ensure solidarity with the health-care sector in poor countries and countries dealing with instability and conflict. That is the best means of implementing the declaration. Following up and monitoring its implementation, while addressing the problems and difficulties facing it, would help with its implementation on the ground, including its noble humanitarian goals for the benefit of humankind. That is why my delegation joined the consensus on the declaration. We had hoped that other delegations would not include any controversial concepts in the declaration, especially since we are all aware that the Third Committee is often a scene of serious controversies in discussions of issues of sexual and reproductive health. Those two concepts are broad and not clearly defined. They run counter to the constitutions, national legislation, religious teachings and social specificities of many countries. Consequently, while my delegation would like to join the consensus on the political declaration related to comprehensive health care, that does not mean that we agree with any reference to sexual and reproductive health or sex education, as set out in paragraphs 29, 68 and 69. We have reservations regarding any paragraphs that run counter to our national legislation and the teachings of Islam, as well as the values and ethics of Libyan society.

The United States supports efforts to expand access to universal health coverage and believes that we should view them in the light of the ultimate goal towards which we as nations have been working at the United Nations and the World Health Organization for more than half a century, that is, achieving the highest attainable standard of mental and physical health for every person. Key to the goal of access to universal health coverage is health care where patients are in control and have access to high-quality, people-centred care. To achieve better health, we must draw on the strengths and resources of both the public and private sectors by promoting partnerships that include civil society and non-governmental organizations, as well as faith- and community-based organizations. This multifaceted approach to universal health coverage stands the best chance of delivering high-quality care that is focused on patients and on improving their health. We also understand the important role that the health-related Sustainable Development Goals (SDGs) play in assisting countries towards realizing their own pathways to universal health coverage in accordance with their national policies and legislation. The United States, as the world’s largest bilateral funder of global health programmes, remains firmly committed to expanding efforts to improve health around the world. In fiscal year 2019, the United States Government invested $19 billion in global health programmes. Through our investments, we collaborate with Member States and engage with the United Nations to advance global health and achieve our shared goals. The United States firmly believes that we can do more for people by coming together on those broad areas of agreement where we can achieve genuine progress, rather than pursuing divisive policies that promote abortion, diminish the role of the family and compromise the sovereignty of nations by focusing on sensitive issues where we know consensus is not possible. It was in that spirit that the United States delivered a joint statement at the high-level meeting on universal health coverage, where 1.3 billion people from 21 Member States were represented, to make it clear that we support a positive, consensus-based vision for universal health coverage that promotes better health and the preservation of human life and dignity. Our vision includes strong support for advancing gender equality and the empowerment of women and girls, accelerating programmes to end maternal mortality, improving education opportunities for girls and ensuring that the health sector is responding effectively to gender-based violence. The United States recognizes that each nation has its own needs and also shares our common goal of ensuring better health. However, we deplore the fact that some countries are politicizing the negotiation of the holitical declaration on universal health coverage (resolution 74/2) by including language that has been used to promote abortion as health care and support sex education, which diminishes the protective role of the family in improving health. While the United States joins the consensus on the political declaration in recognition of the importance of better health for all, we firmly dissociate ourselves from paragraph 68 of the declaration. Despite the months of good-faith efforts to find common ground and consensus that were prominently displayed when we reluctantly agreed to the language in target 3.7 of SDG 3, our efforts were largely unreciprocated when we were met with a refusal to delete unacceptable language from target 5.6 of SDG 5, which is outside the scope of the declaration under discussion. Furthermore, we note that only documents approved by the General Assembly may inform understanding and implementation in multilateral forums. We do not accept references to ambiguous terms and expressions such as “sexual and reproductive health and reproductive rights”, which can undermine the critical role of the family and promote practices such as abortion in circumstances that do not enjoy international consensus, and which can be misinterpreted by United Nations agencies. There is no international right to abortion. We remain deeply concerned about the possibility that comprehensive sexuality education programmes can undermine the protective role of the family in such education and condone harmful sexual risks for young people. We continue to be a stalwart defender of all women, men, children and families, and we support programmes to improve their health, life, dignity and well-being. As President Trump said in his address to the General Assembly, “Americans will also never tire of defending innocent life. We are aware that many United Nations projects have attempted to assert a global right to taxpayer-funded abortion on demand right up until the moment of delivery. Global bureaucrats have absolutely no business attacking the sovereignty of nations that wish to protect innocent life. Like many nations here today, we in America believe that every child, born and unborn, is a sacred gift from God.” (A/74/PV.3, p.15) Furthermore, the United States wishes to express solidarity with Hungary on the issue of migration as it is captured in the political declaration. The United States shares Hungary’s concerns about the document’s treatment of the issue of migration. The term “migrant” is not well defined in international law and not all migrants are inherently vulnerable, as is suggested in paragraphs 70 and 71. Furthermore, with regard to those paragraphs and paragraph 9, the United States does not have any international obligations pertaining to the provision of social services to aliens. As a matter of policy and under its domestic law, the United States supports access to emergency health care for everyone on its territory, regardless of immigration status, but does not recognize any right to access to health care beyond emergency services. As a former United States Attorney General has noted, “No great and prosperous nation can have both a generous welfare system and open borders.” Finally, the United States looks forward to working with all Member States to forge an international consensus that takes varying national and cultural contexts into account and promotes families and communities as a vital part of the solution. By working together and focusing on the important work of expanding health and opportunities for all people, especially those in situations of risk or vulnerability, we can successfully accelerate health for all and achieve the goal of universal health coverage.

We have heard the last speaker in explanation of position. We will now hear statements after the adoption of the resolution. I give the floor to the observer of the European Union.

I have the honour to speak on behalf of the European Union (EU) and its member States. The candidate countries North Macedonia, Montenegro, Serbia and Albania; the country of the Stabilization and Association Process and potential candidate Bosnia and Herzegovina; as well as Ukraine and the Republic of Moldova, align themselves with this statement. At the outset, I would like to express my appreciation for the leadership of the United Nations in the global challenges we face and to commend the work of the co-facilitators of the political declaration of the high- level meeting on universal health coverage (resolution 74/2), Mr. Kaha Imnadze and Mr. Vitavas Srivihok, the Permanent Representatives of Georgia and Thailand, as well as their teams, for their passion and energy in reaching consensus on the political declaration. We in the European Union are firmly committed to delivering on the Sustainable Development Goals, which are our guiding policy framework. The EU is committed to protecting and promoting the right of everyone to enjoy the highest attainable standard of physical and mental health, in line with national regulations, and to promoting human dignity, well-being and prosperity as essential investments in achieving stable and prosperous societies, economic and social well-being and security. We follow a rights-based approach, in accordance with the values that health systems within the EU are built on and that are also enshrined in the European Consensus on Development. The EU remains committed to promoting, protecting and fulfilling all human rights and to the full and effective implementation of the Beijing Declaration and Platform for Action, as well as the Programme of Action of the International Conference on Population and Development and the outcomes of its review conferences. We also remain committed to sexual and reproductive health and rights. In that context, the EU reaffirms its commitment to promoting, protecting and fulfilling the right of every individual to have full control over and decide freely and responsibly matters related to their sexuality and sexual and reproductive health, free from discrimination, coercion or violence. The EU further stresses the need for universal access to quality, affordable, comprehensive sexual and reproductive health information and education, including comprehensive sexual education and health- care services. The EU will also continue to support its partner countries in their efforts to build strong, good-quality and resilient health systems by promoting equitable access to medical services and universal health coverage. Eradicating poverty, tackling discrimination and inequalities and leaving no one behind will remain at the heart of the EU development cooperation policy. The EU promotes a health-in-all-policies approach to ensure that the underlying determinants of health are addressed beyond the health sector, in areas such as gender equality, water and sanitation, education, food and nutrition security, decent work and social protection, environment and security. We need a comprehensive outlook, one where we work to have more qualified health workers, access to vaccinations and affordable medicines, and where we make sure that the health sector gets the financing it needs. Together we must face demographic challenges, the increasing prevalence of non-communicable diseases, particularly cancer, the growing threat of antimicrobial resistance and vaccine hesitancy. In conclusion, I want to assure the General Assembly of our ongoing and unwavering action aimed at addressing the issue of universal health coverage at home and globally in order to achieve universal health coverage by 2030.

Russia supports the General Assembly’s adoption, in resolution 74/2, of the political declaration of the high-level meeting on universal health coverage. We welcome its affirmation of universal health coverage as an important factor in fostering healthy lifestyles and sustainable development in general. We are pleased that the declaration positions primary health care as the foundation for achieving universal health coverage that addresses the tasks of preventing disease and promoting health. We greatly appreciate the fact that it reflects aspects such as combating the spread of non-infectious diseases, tuberculosis, HIV/AIDS and antimicrobial resistance, as well as the leading role of Governments in ensuring universal health coverage, taking into account their national contexts. With regard to paragraph 68 of the political declaration, on sexual and reproductive health, we want to once again point out that in this area we are guided only by documents that we have agreed on in an intergovernmental format and that correspond to our national priorities. We urge all delegations to engage in a constructive dialogue on a unifying health- care agenda.

I now give the floor to the observer of the Observer State of the Holy See. Monsignor Hansen (Holy See): My delegation would like to thank the co-facilitators, the Permanent Representatives of Georgia and Thailand, for their leadership and efforts during the negotiations leading to today’s adoption of the political declaration of the high- level meeting on universal health coverage (resolution 74/2). The Holy See welcomes the fact that the political declaration sets out important commitments to supporting the most vulnerable and engaging all relevant stakeholders in designing better health systems. As such, it represents a significant step forward in our common efforts to provide every man, woman and child with health care. Greater efforts are clearly needed. We should focus attention on the health-care needs of the poorest and of all those who are most at risk of being left behind. Besides being a question of responding to a right denied, taking care of the basic health-care needs of the poorest is key in breaking the vicious cycle of poverty from one generation to the next. As for the specific issues covered in the political declaration, the Holy See commends the emphasis placed on policies responding to the food and nutrition needs of all people, with special emphasis on the nutrition needs of pregnant and lactating women, women of reproductive age, adolescent girls and infants and young children, especially during the first 1,000 days of life. Good nutrition in the first 1,000 days provides a foundation for lifelong health for both women and children from conception, and investing in cost- effective nutrition interventions in the first 1,000 days can therefore lead to lower child and maternal mortality and healthier mothers and babies. My delegation is also pleased to see the recognition of the importance of the engagement of families and communities as one of the core components of health-system governance, as well as the emphasis placed on antimicrobial resistance, mental health and non-communicable diseases. While affirming the intention and purpose of the declaration before us as I have outlined, my delegation wishes to express reservations about various concepts in it. First, in line with its reservations already expressed at the international conferences in Beijing and Cairo, the Holy See reiterates that it considers the phrase “reproductive health” and related terms to apply to a holistic concept of health that embraces the person in the entirety of his or her personality, mind and body. In particular, the Holy See rejects an interpretation that considers abortion, or access to abortion, sex-selective abortion, the abortion of foetuses diagnosed with health challenges, maternal surrogacy and sterilization as dimensions of these terms or of universal health coverage. Secondly, the Holy See emphasizes that any reference to gender and related terms are understood according to the ordinary, generally accepted usage of the word “gender” based on biological identity that is male and female.

Switzerland welcomes the commitment and the efforts of the international community to guarantee that all should benefit from the health care they need without encountering financial difficulties. It is crucial to ensure that essential health services are of high quality. In that regard, Switzerland emphasizes three specific requirements. The first is high-quality health-care systems that strengthen patient security and focus on patients’ well-being. The second is health-care systems that implement universal health coverage while remaining financially viable in the long term. The third is universal health coverage that guarantees access to high-quality care in emergency situations. We welcome the fact that these elements are included in the political declaration of the high-level meeting on universal health coverage (resolution 74/2), and that all the gains that have been made in the framework of the 2030 Agenda for Sustainable Development on sexual and reproductive health and rights have been preserved. Switzerland is also committed to a system that encourages research and development in the area of innovative medicine and treatment, building on the capacities of both the private and public sectors. Lastly, in order to strengthen the universal coverage of our health-care systems and fulfil our obligations in that regard, it is essential to take an approach that includes a constructive dialogue with all the relevant stakeholders at the regional, national and international levels.

We have heard the last speaker on this item. I would like to express my sincere thanks to Ambassadors Kaha Imnadze of Georgia and Vitavas Srivihok of Thailand, the co-facilitators of the informal consultations, who demonstrated great skill and patience in their conduct of the discussion and complex negotiations on the draft resolution. I also thank Member States for their valuable contributions to reaching an agreement on resolution 74/2. The General Assembly has thus concluded this stage of its consideration of agenda item 126.

Members will recall that the General Assembly, at its 2nd plenary meeting, on 20 September 2019, decided to allocate sub-item (b) of agenda item 19 also to the plenary meeting for the purpose of the adoption of the draft political declaration of the high- level meeting to review progress made in addressing the priorities of small island developing States (SIDS) through the implementation of the SIDS Accelerated Modalities of Action (SAMOA) Pathway. We shall now proceed to consider draft resolution A/74/L.3, entitled “Political declaration of the high- level meeting to review progress made in addressing the priorities of small island developing States through the implementation of the SIDS Accelerated Modalities of Action (SAMOA) Pathway”. May I take it that the Assembly decides to adopt draft resolution A/74/L.3?

Before giving the floor to speakers in explanation of position, I would like to remind delegations that explanations are limited to 10 minutes and should be made by delegations from their seats.

I would like to begin by reiterating the Guatemalan Government’s solidarity with the Commonwealth of the Bahamas and the other countries affected by the recent passage of Hurricane Dorian. We wish them a speedy recovery. Guatemala welcomes the recent successful midterm review of the Small Island Developing States Accelerated Modalities of Action (SAMOA) Pathway and the unanimous adoption of the political declaration today (resolution 74/3), which we see as a sign that the world is waking up to climate change and its adverse effects. We are pleased that the political declaration highlights the importance not only of partnerships for development but also of family remittances, which, as established in resolution 72/281, on the International Day of Family Remittances, have a transformative effect on the communities to which they are sent. We also welcome the Economic Commission for Latin America and the Caribbean’s debt relief initiative, which takes into account the needs of Caribbean nations and recommends an approach that encompasses the financing for development principles and the Sustainable Development Goals of the 2030 Agenda for Sustainable Development, and among other things proposes a Caribbean resilience fund for countries that benefit from debt reduction. The initiative demonstrates the value of regional commissions as drivers of technical research-based solutions tailored to local realities and as promoters of cooperation and support among nearby countries. We also stress the importance of the transfer of appropriate, reliable, affordable, modern and environmentally friendly technology, as well as the advancement of traditional knowledge and women’s empowerment. With that in mind, we would like to take this opportunity to extend our solidarity and support to small island developing States (SIDS), in view of their extreme vulnerability to the effects of climate change. Although we are all facing those effects, SIDS are likely to be their primary victims, and any solution will therefore require a comprehensive approach to improving their adaptation and resilience. While Guatemala is not an island State, it is located in the Central American isthmus, in the same highly vulnerable geographic area as the Caribbean, and as such the lives, financial stability, basic infrastructure and livelihoods of our citizens are under threat. As a middle-income country, we continue to face particular challenges. That is why we also urge the United Nations to draw up a comprehensive, long- term strategy aimed at facilitating cooperation for sustainable development and coordinating support for a more appropriate and refined classification of the middle-income country category, based on criteria beyond the simple one of per capita income. I would like to conclude by congratulating the small island developing States on a successful meeting and on today’s adoption of the political declaration, which will enable us to make progress with the revision of an instrument that has been crucial to recognition by the United Nations of the special circumstances that those countries face and to concerted efforts to ensure that, as the 2030 Agenda says, no one is left behind.

On behalf of the United States Government, I would like to extend our thanks to the co-facilitators, Ambassadors Prasad and Byrne Nason, the Permanent Representatives of Fiji and Ireland, for their excellent facilitation of the Small Island Developing States Accelerated Modalities of Action (SAMOA) Pathway midterm review. The United States appreciated the opportunity to participate in the important discussions on 27 September during the high-level week of the General Assembly. Furthermore, we understand the unique circumstances facing small island developing States and are committed to working with them to tackle global and regional challenges, including promoting regional security and stability, advancing sustainable growth, addressing environmental challenges, responding to natural disasters and strengthening our people-to-people ties. We particularly stand with the people of the Commonwealth of the Bahamas in their efforts to recover from Hurricane Dorian, and we are proud to have provided approximately $34 million in immediate relief after the storm. The United States has a long history of working with small island developing States and looks forward to continuing our fruitful cooperation in the years to come. The United States supports nearly every United Nations- designated small island developing State that is eligible to receive official development assistance (ODA). Over the past five years, net United States bilateral ODA to small island developing States has amounted to a total of $3.2 billion. Notably, on the margins of the General Assembly high-level week, Secretary of State Pompeo announced that the United States would be providing more than $100 million in new support to the Pacific island countries, in addition to the $350 million that United States departments and agencies already invest annually to promote self-reliance and humanitarian response in the Pacific region. We want to take this opportunity to make important clarifications regarding language in the political declaration that we adopted today (resolution 74/3). We underscore that many of the outcome documents referenced in the declaration, including the 2030 Agenda for Sustainable Development and the Addis Ababa Action Agenda, are non-binding documents that do not create rights or obligations under international law or any new financial commitments. The United States recognizes the 2030 Agenda as a global framework for sustainable development that can help countries work towards global peace and prosperity. We applaud the call for shared responsibility, including national responsibility, in the 2030 Agenda, and emphasize that all countries have a role to play in achieving its vision. The 2030 Agenda recognizes that each country must work towards implementation in accordance with its own national policies and priorities. The United States underscores paragraph 18 of the 2030 Agenda, which calls on countries to implement it in a manner that is consistent with the rights and obligations of States under international law. We also highlight our mutual recognition, in paragraph 58, that the implementation of the 2030 Agenda must respect and be without prejudice to the independent mandates of other processes and institutions, including negotiations, and does not prejudge or serve as a precedent for decisions and actions under way in other forums. For example, the 2030 Agenda does not represent a commitment to providing new market access for goods or services. Neither does it interpret or alter any World Trade Organization agreement or decision, including the Agreement on Trade-Related Aspects of Intellectual Property. Furthermore, regarding the Addis Ababa Action Agenda reference, we note that much of the trade-related language in the Addis Ababa outcome document (resolution 69/313, annex) has been overtaken by events since July 2015. It is therefore immaterial, and our reaffirmation of the outcome document has no standing for ongoing work and negotiations that involve trade. With respect to the Paris Agreement on Climate Change and the climate-change language referenced in the outcome document, the United States reaffirms its intention to withdraw from the Paris Agreement at the earliest opportunity. The Paris Agreement and climate-change language is therefore without prejudice to United States positions. We affirm our support for promoting economic growth and improving energy security while protecting the environment. With respect to the Intergovernmental Panel on Climate Change (IPCC) special report, Global Warming of 1.5°C, referenced in the declaration, we note that, as the United States has already conveyed to the IPCC, acceptance of the report and approval of its summary for policymakers by the IPPC does not imply endorsement of the specific findings or underlying contents of the report by the United States. The United States therefore does not concur with the references to the IPCC in the resolution, and that language is without prejudice to United States positions. The United States reiterates its views on the Sendai Framework for Disaster Risk Reduction 2015-2030 from the United States explanation of position delivered at that document’s adoption in 2015 (see A/69/PV.92). We strongly support disaster risk reduction initiatives designed to decrease the loss of life and the social and economic impacts of disasters. Such assistance helps increase preparedness and promote greater resilience for everyone. With respect to the New Urban Agenda referenced in the political declaration, the United States notes that each Member State has the sovereign right to determine how it conducts trade with other countries and that this includes restricting trade in certain circumstances. Economic sanctions, whether unilateral or multilateral, can be a successful means of achieving foreign-policy objectives. In cases where the United States has applied sanctions, we have used them with specific objectives in mind, including as a means to promote a return to the rule of law or democratic systems, to insist on the protection of human rights and fundamental freedoms, or to prevent threats to international security. We are within our rights to deploy our trade and commercial policy as tools to achieve our objectives. Targeted economic sanctions can be an appropriate, effective and legitimate alternative to the use of force. The United States enjoys strong and growing trade relationships across the globe. We welcome efforts to bolster those relationships, increase economic cooperation and drive prosperity for all of our peoples through free, fair and reciprocal trade. However, as President Trump stated in his address to the General Assembly at its seventy-third session, on 25 September 2018 (see A/73/PV.6), the United States will act in its sovereign interest, including on trade matters. The United States does not take its trade policy direction from the United Nations. It is our view that the United Nations must respect the independent mandates of other processes and institutions, including trade negotiations, and must not involve itself in decisions and actions in other forums, including at the World Trade Organization. The United Nations is not an appropriate venue for those discussions, and there should be no expectation or misconception that the United States would understand recommendations made by the General Assembly or the Economic and Social Council on such issues to be binding. That includes calls that undermine incentives for innovation, such as technology transfer that is not both voluntary and on mutually agreed terms. Regarding paragraphs 22 and 30 (g), according to publicly available data, we have seen a rise in correspondent bank payment volumes and in remittances, with access to correspondent services for most regions remaining stable. However, we have also seen some countries contend with a narrowing of their opportunities to access the international payments system. We would like to take this opportunity to stress the importance of strengthening controls countering money-laundering and financing for terrorism for small island developing States. Such improvements will not only contribute to an environment in which access to correspondent services is less difficult to procure but also mitigate the risk that any funds derived from remittances might erode good governance and security. With regard to paragraphs 19, 20, 30 (e) and 30 (f), regarding official development assistance, the proper forums for discussing eligibility measures are the boards of the multilateral development banks and the Organization for Economic Cooperation and Development. We do not accept the United Nations as the appropriate forum for determining eligibility for these resources or their allocation. On paragraphs 30 (k) and 30 (o), the United States believes that women should have equal access to health care. We remain committed to the principles laid out in the Beijing Declaration and Platform for Action and the Programme of Action of the International Conference on Population and Development and their reports, as agreed on by the General Assembly. As has been made clear over many years, there was international consensus that these documents do not create new international rights, including any right to abortion. The United States fully supports ensuring maternal and child health and informed and voluntary access to family planning. We do not recognize abortion as a method of family planning, nor do we support abortion in our global health assistance. Finally, regarding paragraphs 30 (n), 30 (s) and 30 (t), disaster-related funds have been proposed under the loss and damage negotiation at the United Nations Framework Convention on Climate Change. The United States has opposed these proposals, as they imply liability for the impact of disasters allegedly caused by greenhouse-gas emissions in developing countries. The United States does not support the creation of a new financial instrument with unproven effectiveness that developed countries would subsequently be called on to fund.

We have heard the last speaker in explanation of position. We will now hear statements after the adoption of the resolution. I give the floor to the observer of the European Union.

I have the honour to deliver a shortened statement on behalf of the European Union (EU) and its member States. The European Union and its member States gladly join the consensus on the adoption by the General Assembly of the political declaration of the high- level meeting to review progress made in addressing the priorities of small island developing States (SIDS) through the implementation of the SIDS Accelerated Modalities of Action (SAMOA) Pathway (resolution 74/3). We would like to take this opportunity to thank Ireland and Fiji for their efforts as co-facilitators of the negotiations on the document and the Secretariat for its support throughout the process and for the organization of the successful high-level midterm review. We believe that the midterm review, which was held on 27 September in the context of the General Assembly high-level week, proved the importance of the full and effective implementation of the 2014 SAMOA Pathway, a comprehensive programme of action for small island developing States that cannot be seen in isolation from other groundbreaking documents containing provisions of importance to small island developing States, such as the 2030 Agenda for Sustainable Development, the Addis Ababa Action Agenda, the Sendai Framework for Disaster Risk Reduction and the Paris Agreement on Climate Change. The EU and its member States welcomed and engaged actively in the midterm review and related events. The statement delivered on that occasion by EU commissioner Julian King described in detail the broad scope of our cooperation with SIDS. The midterm review highlighted a number of challenges faced by SIDS and their specific vulnerabilities, with climate change described as the single biggest existential threat to island nations. This is very clearly reflected in the political declaration that we have just adopted. However, as the EU, we would have wished for stronger language around such topics as climate change, renewable energy, environmental protection, the oceans and social issues, including gender equality. After all, these issues are extensively and progressively treated in the SAMOA Pathway, whose review was the main objective of the September meeting. As announced in the context of informal consultations on the document, the EU and its member States would like to register with the General Assembly its position on paragraph 30 of the political declaration. We recognize the particular importance of efficient disaster risk management to island nations. We acknowledge the growing frequency and strength of the disasters face by island States, which are unquestionably a negative consequence of climate change. For that reason, disaster risk management should be, and in fact already is, the subject of special focus on the part of SIDS themselves and their development partners. There are a vast number of disaster-related funds, financial mechanisms and other instruments in which SIDS are prioritized in terms of access to funds and their replenishment. Any deliberation on the disaster- related funding environment must take into account the mandate of the United Nations Framework Convention on Climate Change and other relevant processes and bodies where these issues have been extensively discussed and where the examination of the disaster- related funding and support environment takes place. Let me conclude by saying that we see the implementation of the provisions of resolution 74/3 as a collective effort, with important parts to be played by the countries concerned and the international community, and action undertaken at the national, regional and global levels. The EU and its member States would like to reassure their SIDS partners that we heard their voices loud and clear during the September meeting. We remain committed to their goals, and we will continue to show our engagement and support, including for the implementation of the SAMOA Pathway.

Let me thank all members for the decision to adopt the political declaration today (resolution 74/3). At the outset, on behalf of the members of the Alliance of Small Island States (AOSIS), I want to extend our appreciation to the co-facilitators, the Ambassadors of Fiji and Ireland, for their hard work and for steering us towards an outcome that garnered the full support of the States Members of the United Nations. We would also like to express our appreciation for the constructive engagement of all our partners and the very strong solidarity of our fellow developing countries throughout the negotiations and during the high-level midterm review itself. The political declaration signals a step forward for a more targeted approach to the implementation of the Small Island Developing States (SIDS) Accelerated Modalities of Action (SAMOA) Pathway, so as to speed up its progress. But it is now incumbent on all of us to turn those words into actions and thoughts into deeds. As a first step, we look forward to seeing the Secretary- General transmit the declaration system-wide as soon as possible and ensure its dissemination well beyond the United Nations so that we can begin effectively implementing and following up the SAMOA Pathway with urgency. Another important step forward during this session is operationalizing through the work of the General Assembly the provisions agreed to in the declaration. We now need to fashion an appropriate response — or multiple responses, as the case may demand — in order to drive a wedge between the cycle of extreme events and attendant high debt so that small island developing States can sustain socioeconomic gains and build the resilience of our fledgling islands and low-lying coastal States. There are many processes involved in different ways in addressing these responses, but we should look at them through a cross-cutting lens. We now need to issue an unequivocal call for urgent integrated action in order to slow the loss of biodiversity and rapidly reduce greenhouse-gas emissions globally through investments in low-emission, climate-resilient pathways with the goal of limiting our planet’s warming to 1.5°C. We must also revisit the terms of access to grants and concessionary financing for SIDS. We should reduce gaps in data capacity and develop a monitoring and evaluation framework to support evidence-based decision-making. And we need to retrofit multi-country offices and orient the relevant regional commissions so that we see greater gains on the ground, with the steady support of the United Nations system. Those early steps are critical, as the window of opportunity for SIDS to achieve sustainable development is rapidly closing. We would even say that those measures represent the bare minimum of what this institution can do to ensure it makes good on its commitment to SIDS. AOSIS will continue to advocate for ambitious action on sustainable development and climate change, and we will do so in a truly multilateral spirit. We will do so as a responsibility to our own people, but equally, as responsible members of the United Nations.

I would like to express my sincere thanks to Ambassador Satyendra Prasad of Fiji and Ambassador Geraldine Byrne Nason of Ireland, the co-facilitators of the informal consultations, who demonstrated great skill and patience in their conducting of the discussions and complex negotiations on resolution 74/3. I also want to thank Member States for their valuable contributions to reaching an agreement on the draft resolution. The Assembly has thus concluded this stage of its consideration of sub-item (b) of agenda item 19. Announcement by the President

Before concluding, I wish to make an announcement concerning the membership of the General Committee of the General Assembly at its seventy-fourth session. Members will recall that for the seventy-fourth session, the President, the 21 Vice-Presidents and the Chairs of five of the six Main Committees were elected during the previous session. I would like to inform members that subsequently, on 7 October, His Excellency Mr. Andreas Mavroyiannis of Cyprus was elected Chair of the Administrative and Budgetary Committee (Fifth Committee) of the General Assembly at its seventy-fourth session and is accordingly a member of the General Committee for this session. I congratulate the Chair of the Fifth Committee on his election.