A/78/PV.41 General Assembly

I now give the floor to the representative of Kuwait to introduce draft resolution A/78/L.12.

In the vast tapestry of global health, where complexities abound, more than 10,000 rare diseases cast a shadow over the lives of countless individuals. Among them is Duchenne muscular dystrophy — a rare disease that affects one in every 3,500 to 5,000 boys and results in approximately 20,000 new cases every year. The condition manifests itself in severe muscle weakness and degradation, with an extensive impact on the quality of life for those diagnosed with it. Duchenne is not only one of the most prevalent rare genetic diseases in children, but it also knows no bounds, affecting individuals regardless of race, ethnicity, geography or socioeconomic status. Its consistent incidence makes it a universal concern that should receive international attention. But despite its global impact and life-limiting nature, Duchenne remains underrecognized and underresearched. The plight of Duchenne sufferers remains obscure, owing to a lack of awareness among the general public, health- care professionals and policymakers. That critical gap impedes progress towards effective treatments and potential cures. Kuwait’s proposed draft resolution A/78/L.12, desig­ nating 7 September as World Duchenne Awareness Day, represents a beacon of transformative change in the realm of rare diseases. It seeks to illuminate the issue by foster­ ing public education, mobilizing resources and celebrat­ ing collective achievements. The choice to recognize 7 September as World Duchenne Awareness Day was made in symbolic tribute to the 79 exons of the dystro­ phin gene, the gene that is affected in Duchenne muscu­ lar dystrophy. The day will become a poignant reminder of the intricacies of the condition, honouring the genetic complexities that underlie the struggles of those affected and the profound impact on their families, who constant­ ly have to juggle the ups and downs of the condition. While it is human nature to want crystal-clear information and diagnosis, that unfortunately is not the case with Duchenne muscular dystrophy. Individuals around the world dealing with Duchenne are confronted with ambiguity. Adopting the draft resolution today will change that. It will give hope and encouragement to individuals living with Duchenne, their families and the medical professionals that grapple with this condition. It is a milestone and a step forward, entwined with optimism for enlisting future collaboration that can serve the global rare-diseases community. This initiative aligns with Kuwait’s Vision 2035, which consists of seven main pillars, incorporating all 17 Sustainable Development Goals (SDGs). I would like to highlight pillar 5, on high-quality health care, which aims to improve the quality of services in the public health-care system and develop national capabilities at reasonable cost. In line with the Sustainable Development Goals, the initiative advocates for health and well-being, per SDG 3; champions inclusive education, per SDG 4; acknowledges the economic impact on caregivers, per SDG 8; strives to reduce inequalities for those with rare diseases, per SDG 10; and fosters supportive, sustainable communities for the differently abled, per SDG 11. It weaves a narrative that transcends health, education, economic stability, equality and community development in a holistic approach to forging a more inclusive world. Duchenne is not merely a medical condition. It serves as a symbol of the struggles that children with rare diseases have to face all over the world. It is time for us to recognize our collective responsibility to protect and empower the most vulnerable. Our draft resolution on World Duchenne Awareness Day is more than a campaign — it is a resounding pledge to uphold the dignity and rights of every child afflicted by the condition, leaving no one behind in our pursuit of a more compassionate and inclusive world. I would like to thank all Member States for their steadfast support and sponsorship of the draft resolution.

We align ourselves with the statement to be delivered by Venezuela on behalf of the Group of Friends in Defence of the Charter of the United Nations, and I would also like to highlight the following points in our national capacity. We live in an increasingly unequal world, with profound social injustices and contradictions that are ethically unsustainable. Humankind has the scientific and technological development and the financial resources needed to treat curable and preventable diseases. However, there are millions of human beings who suffer and die from such diseases. Billions of dollars are invested in the arms race, and then people argue that we do not have the resources to prioritize health and life. That reality is a result of the current international order, which is unjust at its core and privileges the interests of a few. Developing countries face systemic and structural obstacles to access to the resources, knowledge and technologies that can enable us to provide our peoples with better health care. We urgently need to build a fairer, more inclusive and equitable international order that prioritizes solidarity, cooperation, technology transfer and the exchange of experiences with a view to closing the gaps between North and South and improving our peoples’ health indicators. We cannot make progress on global health while millions are dealing with the impact of unilateral coercive measures that violate the Charter of the United Nations and international law and have a direct and very negative impact on health services. At the same time, the world view that regards health services and the pharmaceutical industry as strictly business propositions helps make universal coverage an increasingly distant goal, including in rich countries. The deteriorating health-care access indicators for minorities and the poorest sectors of society in the United States attest to that. The country that presents itself to the world as a champion and enforcer of human rights is incapable of ensuring that the entirety of its population has access to quality health services, which are essential for the exercise of that important human right. In Cuba, public health is a constitutional right. It is the State’s responsibility to ensure access to free, high- quality care, protection and recovery services. To that end, we have a health system that is universal, free and accessible at all levels throughout our national territory. At great sacrifice, and thanks to our State’s humanistic mission, we have been able to achieve health indicators normally seen only in developed countries — indicators that we are proud of. However, in order to achieve those results, Cuba has had to overcome not only its status as a developing country and the challenges associated with the coronavirus disease pandemic, but also the unremitting hostility of the United States, which has opportunistically and criminally intensified the longest economic, commercial and financial blockade ever imposed on any nation. The blockade seriously obstructs Cuba’s access to equipment, technology, equipment, treatments and drugs, which can be obtained only at higher prices, through intermediaries and with delays, or that must be replaced by less effective generic drugs. That makes it difficult to obtain medicines that are needed on a daily basis in a timely manner and also renders the supply of certain drugs for use in hospitals scarce or unreliable. All of that has a direct impact on our people’s health and quality of life. Nevertheless, the blockade has not been able to daunt the Cuban people’s creative resistance or their commitment to solidarity. In these difficult circumstances, Cuba continues to prioritize its international medical cooperation programmes. They are a legitimate expression of South-South cooperation and have enabled us to contribute to promoting and protecting the right to health of millions in 165 nations over the past 60 years, with 23,000 Cuban doctors currently working in 56 countries. Our country could do much more to benefit the health of its population and support the efforts of other nations if it could count on the resources that the blockade imposed by the United States illegitimately deprives it of. Cuba will continue to advocate for the promotion of a more just world for all nations and peoples, a world in which solidarity, cooperation and multilateralism reign and priority is given to the full exercise of the right to health. In conclusion, I would like to reiterate my country’s condemnation of the genocide being committed against the Palestinian people in Gaza. Israel’s bombing of civilians, hospitals and health infrastructure constitutes war crimes and crimes against humanity and has already cost the lives of thousands of people, including health professionals, more than 100 humanitarian personnel and, according to recent reports, a World Health Organization staffer. The aggression against Gaza must cease, and the Palestinian people must be allowed to exercise their right to self-determination.

I now give the floor to the representative of the European Union, in its capacity as observer.

I have the honour of speaking on behalf of the European Union (EU) and its member States. Tuberculosis is a very serious threat to human health and development, requiring our urgent attention and action. As the Secretary-General’s report (A/78/88) documents, the epidemic shows no sign of weakening. Despite our collective efforts, pre-coronavirus disease progress was reversed during the global pandemic. The high-level meeting in September and the political declaration of the high-level meeting on the fight against tuberculosis (resolution 78/5), adopted by our leaders, provided a crucial opportunity to reaffirm our strong commitment to the fight against tuberculosis. For the EU and its member States, that marked a very concrete commitment. We have lent unwavering support to the Global Fund to Fight AIDS, Tuberculosis and Malaria since its inception, with a total contribution of more than €4.5 billion for the period 2023-2025. The EU has long invested in tuberculosis research, including in drug development. We have just reinforced our programmes for innovation and improved access to antimicrobial medical countermeasures, including studies for tuberculosis medicines. We have been and will continue to be resolute in our support of the World Health Organization’s tireless efforts in the fight against the scourge of tuberculosis. And more broadly, our bilateral programmes — with an emphasis on health systems strengthening — are aimed at delivering better health and well-being to all people. That support is more important than ever. In 2021 alone, tuberculosis claimed the lives of 1.6 million people — a worrisome increase after years of decline. We urgently need a renewed focus to get back on track with regard to the fight against tuberculosis and the achievement of the Sustainable Development Goals. The EU’s new Global Health Strategy is an important vehicle that will guide our efforts. But the obstacles to ending tuberculosis are enormous, particularly when faced with multiple and intersecting crises, so this needs to be a united, global and collective undertaking. We believe it should focus on five key aspects. First, we must ensure universal health coverage by strengthening climate-resilient and sustainable health systems and ensure access to treatment by strengthening primary health care and enhancing equitable access to vital health services, including sexual reproductive health. Secondly, work should be rights-based and inclusive and should prioritize support for the most vulnerable and marginalized communities, which disproportionately bear the brunt of tuberculosis. That includes addressing stigma and discrimination. Thirdly, we have to foster early prevention and early detection. That means raising public awareness, especially in high-risk populations. It means promoting testing and providing information and education, and it means improving diagnosis and surveillance. All of that depends on strengthening the health-care infrastructure, ensuring the availability of accurate diagnostic tools and enhancing health-care worker training. Fourthly, we must exploit the new rapid molecular diagnostics treatment regimens for drug-resistant tuberculosis, fighting antimicrobial resistance using digital health solutions and innovative service delivery — all of which will enhance equity. Fifthly, we should intensify research and development, in collaboration with low- and middle-income countries, to enhance access to a new tuberculosis vaccine and improved diagnostics and treatment. Armed conflict only adds to the enormous challenges we face when it comes to tackling tuberculosis and getting the Sustainable Development Goals back on track. And Russia’s unjustified war of aggression must end now. The responsibility for health systems lies with national authorities, which is why strengthening governance and the mobilization of national public and private resources are key. To support national efforts, the EU will continue to support its partners in their endeavours. We commit to using our finances in much more innovative and impactful ways to regain lost ground. The Secretary General’s report was clear on the following points, and the political declaration sent a strong message in that vein. Together, we must strengthen our high-level political engagement and collective commitment to fighting tuberculosis, including its prevention. We need to build genuine global cooperation that is truly inclusive. The involvement of civil society organizations, global agencies and the private sector is key. And enhancing equitable access must be our central, guiding principle. That is the only way to ensure success against that dangerous disease and the only way to get the Sustainable Development Goals back on track — maintaining health at the centre of our global agenda.

I will be delivering this statement on behalf of Canada, New Zealand and my own country, Australia (CANZ). Tuberculosis (TB) is an issue of key importance to CANZ. The Indo-Pacific, a region to which we belong, hosts 60 per cent of the world’s new TB cases and almost half the global cases of drug-resistant TB. The disease is undermining efforts to lift people out of poverty and increase economic prosperity. And the fight against TB is intrinsically linked to protecting human rights, addressing health inequities and other social determinants and accelerating research and innovation, in companion with increasing access to diagnostics, treatment and support. Therefore, we welcome the continued focus on TB in the United Nations context, where so much of our work is dedicated to development efforts, inclusivity and improved health outcomes. CANZ notes the sobering findings contained in the Secretary-General’s report (A/78/88), including that the TB incidence rate increased by 3.6 per cent between 2020 and 2021, after many years of slow decline. As expected, the coronavirus disease (COVID-19) has also had a devastating impact on progress. Against that backdrop, we are pleased to see that the World Health Organization’s Global Tuberculosis Report 2023, which was released earlier this month, underscored a worldwide recovery in TB diagnosis and treatment services in 2022. The total number of TB-related deaths was 1.3 million in 2022, down from 1.4 million in 2021. That is an encouraging trend signalling the negative impact of COVID-19 is being arrested. Despite that, progress remains insufficient to meet the global TB targets set in 2018. It is as important as ever that all countries work collectively to prevent TB prevalence from rising, and we must do that in step with our support for universal health coverage, so that everyone can obtain the health services they need without suffering financial hardship. CANZ is encouraged by the significant momentum created by the high-level meeting on the fight to end TB in September this year, and we were pleased to support the political declaration of the high-level meeting on the fight against tuberculosis (resolution 78/5). As we said at the high-level meeting, the following priorities need to be addressed. There must be increased discussion, action and community-driven solutions to address the underlying health inequities and complex risk factors and determinants associated with TB. There must be increased focus on prevention, including by investing in research and development, adopting innovative strategies to develop new diagnostics, vaccines and medicines, and scaling up innovative technologies and access to those. The development of laboratory and surveillance systems to build on capacities developed during COVID-19 must be leveraged. We encourage sustained cooperation among Member States and look forward to working with all delegations to realize the ambition to end TB.

The delegation of Egypt welcomes the holding of this meeting which represents an important opportunity to follow up on the international efforts aimed at implementing Goal 3 of the Sustainable Development Goals and the international commitments to achieve that Goal, including the three political declarations adopted by the General Assembly in September, namely, the political declaration of the high-level meeting on pandemic prevention, preparedness and response (resolution 78/3); the political declaration of the high-level meeting on universal health coverage (resolution 78/4); and the political declaration of the high-level meeting on the fight against tuberculosis (resolution 78/5). It is important that this meeting contributes to clarifying the gaps in international efforts to achieve universal health coverage by 2030 and addressing deficiencies in the provision of health care for all, especially in the light of the challenges that the coronavirus disease (COVID-19) pandemic has posed to the ability of the populations of every country to enjoy the highest possible levels of health care on an equal footing. In that context, the delegation of Egypt welcomes draft resolution A/78/L.12, introduced by our sister State of Kuwait and aimed at designating 7 September World Duchenne Awareness Day, which the delegation of Egypt is delighted to co-sponsor. It is clear that the world has witnessed significant disparities in the response to the COVID-19 pandemic, especially given the explicit differences in various national health systems’ ability to ensure continuity with the same degree of effectiveness. That shows how important it is to adopt a comprehensive, ambitious and equitable international approach to providing more financing and expanding technological facilities. In that context, Egypt stresses the importance of greater support for developing countries, especially in terms of providing universal health coverage, addressing pandemics and strengthening the effectiveness of health-care systems, particularly in Africa, in view of the challenges that African countries have been facing for decades. We emphasize that such efforts should take into account those States’ industrial capacities while also developing programmes aimed at the transfer of technologies, technical capacity-building and the enhancement of projects related to research, development and innovation, in addition to supporting industrialization projects for health-care products at the local and regional levels. Egypt has continued to work to improve its health services. We have launched an ambitious national programme for promoting universal health-care coverage and strengthening our health-care system while improving the level of medical services for all our citizens. That has coincided with our implementation of a number of health-care campaigns in the framework of our 100 Million Healthy Lives initiative, including a national campaign to eliminate the hepatitis C virus and screen people for non-communicable diseases. The campaign culminated in the announcement that hepatitis C is on a path to elimination in Egypt, and our efforts in that regard have been commended by the World Health Organization. Egypt has also implemented other initiatives supporting the health of women and children, as well as the early detection of hereditary and chronic diseases, care for the elderly and universal health-care insurance, with a view to reducing the burden of health costs for our citizens. Egypt is also eager to enable the more than 9 million migrants and refugees living in Egypt to benefit without discrimination from the progress that has been made in the health-care sector and in primary health-care coverage. Respect for hospitals, medical facilities and personnel is an absolute imperative, especially during conflicts. International humanitarian law requires the protection of the injured, the sick and medical and humanitarian personnel, as well as of hospitals and medical facilities. Hindering the provision of the relief and medical assistance that represent a lifeline for those affected is also forbidden. Egypt therefore reaffirms its condemnation of Israel’s bombing of hospitals and medical facilities in the Gaza Strip and its obstruction of the humanitarian and medical aid needed to protect Palestinian civilians. We stress the importance of ensuring that the recent developments related to the extended truce result in benefits and enable an immediate and unconditional ceasefire in the Gaza Strip. In keeping with its historical responsibility towards our brother people of Palestine, and the duty to ensure that everyone has access to health-care coverage, Egypt has dealt with dozens of critical medical cases among Palestinians. We have set up a comprehensive plan to provide diagnostic and therapeutic treatment alongside urgent surgical operations as Israel’s brutal crimes of aggression have continued in the Gaza Strip. We reiterate our condemnation and rejection of any attempts to displace the Palestinian population within or outside their territory or to eliminate the Palestinian question altogether. In conclusion, Egypt stresses the importance of intensifying international efforts to address the ongoing obstacles and achieve Goal 3 of the Sustainable Development Goals. There is also a need to reiterate the international commitment to supporting developing countries in achieving universal health coverage by 2030 so that everyone has the basic human right of access to high levels of health care. None of the citizens of those countries should be left behind. Egypt remains committed to supporting all international and regional efforts to that end.

The Bolivarian Republic of Venezuela has the honour to be taking the floor on behalf of the Group of Friends in Defence of the Charter of the United Nations. Sustainable Development Goal 3, on good health and well-being, calls on us to ensure healthy lives and promote well-being at all ages, as a key to achieving sustainable development. In that regard, we cannot overstate the importance of the topic bringing us together today, as it addresses one of the most important and far- reaching issues that the international community, and humankind as a whole, has faced in recent times — the need to prioritize global health, including in foreign policy. Global health is a fundamental aspect of the welfare of individuals and societies, and we need to strengthen cooperation, collaboration and an inclusive approach that transcends borders in order to address the challenges to global health. The coronavirus disease (COVID-19) pandemic highlighted the need for greater international cooperation and solidarity, as well as the importance of further strengthening multilateralism, which we know is the only way to overcome our shared challenges in an increasingly interconnected world. In that context, we believe that the suffering resulting from tuberculosis has historically had some of the most devastating consequences for humankind of any communicable disease. At the same time, it is also one such disease that has been most successfully vanquished, aggressively treated and diminished, thanks to collective efforts and major scientific advances. In that regard, it is vital to support the more than 10.6 million patients who suffer from that scourge, while redoubling our efforts to raise awareness and global coordination in our public policies with a view to eradicating it in the next few years. In that regard, we would like to take this opportunity to pay tribute to the victims and families of communicable diseases, including tuberculosis and COVID-19, and the millions of men and women who were on the front lines during the COVID pandemic — health workers and scientists, who have worked devotedly and provided their knowledge in the service of life and hope, while demonstrating great courage and resilience amid uncertainty and suffering. Their example should further inspire and compel all other national and global health workers to redouble their efforts to better coordinate their action and policies at the international level so as to enable us to overcome that threat together, and ultimately to better prevent, prepare for and respond to public health emergencies in the future. In September three major health-related meetings took place within the framework of the high-level segment of the General Assembly, at which world leaders reaffirmed their political commitment and determination to engage in dialogue and ensure cooperation on all these issues, which are so vital to the present and future of humankind. One message clearly resounded from every one of those meetings, which is that we cannot allow good health to be a privilege merely for the richest or to continue to be treated as a business. Health is an inalienable and universal right for rich and poor alike, and it is incumbent on both States and the United Nations to ensure that it is guaranteed to all, without discrimination or exclusion of any kind. Unfortunately, besides the acknowledgement by the Heads of State and Government of the importance of those global health issues, the negative impact of unilateral coercive measures on the urgent issue of health was not meaningfully reflected in any of the outcome documents adopted at the meetings (resolutions 78/3, 78/4 and 78/5). That was a result of the intransigence of a few delegations whose Governments, not coincidentally, are responsible for the promulgation and application of such illegal measures. It was therefore decided to once again ignore the persistent and growing clamour of a majority of States regarding an issue affecting more than a third of humankind. The regrettable situation related to procedural issues and our Organization’s inability to act must never be repeated. In that context, the Group of Friends would also like to take this opportunity to condemn the imposition  — indeed, the intensification  — of unilateral coercive measures, including in the midst of the worst pandemic facing humankind for the past 100 years, despite numerous calls for their removal. In addition, those illegal measures are genuine violations on a mass scale of the human rights of entire populations in more than 30 countries around the world. Unfortunately, they continue to endanger the lives of millions of people around the world, while violating their human rights, including the right to health and to life itself, on a daily basis. For States subject to so-called sanctions, those illegal measures have also hindered timely and effective access to medicines, medical supplies and equipment, personal protective equipment, screening tests, treatments, vaccines and other essential goods, and have unquestionably undermined national efforts to combat tuberculosis, COVID-19 and other communicable and non-communicable diseases, as independent United Nations experts have warned and as has also been recognized by the United Nations system itself in general. The total, immediate and unconditional lifting of such measures is urgent, especially considering that the so-called humanitarian exemptions supposedly in force have proved ineffective if not non-existent in practice. In that regard, we would also like to point to the initiative to create green corridors that are free of trade wars and sanctions, mainly for the supply of essential goods, food, medicines and personal protective equipment needed to fight tuberculosis, COVID-19 and other diseases. We cannot overemphasize that the issue of unilateral coercive measures can no longer continue to be ignored or hidden, especially amid the current international situation. We are facing a growing trend towards a continued, systematic, relentless, unprecedented, increasing recourse to promulgating, applying and even expanding such criminal measures. That is having a negative impact not only on the nations subject to them, but on the global economy and on supply chains and food and energy security, as well as other areas. Such unilateral coercive measures are therefore deliberately aggravating the multifaceted global crises facing humankind today. In the debate on this agenda item, which addresses an issue as essential as health, we should not fail to mention the current catastrophic humanitarian situation in Palestine, including the collapse of health systems in the Gaza Strip, resulting from systematic, widespread attacks on the Palestinian people. Today the world is witnessing, with anguish and anger, deliberate and indiscriminate attacks on Palestinians, including those under siege in Gaza. The attacks have claimed the lives of thousands, including women, children and the elderly, while also threatening the health and welfare of those who have survived the attacks so far. Unfortunately, as the Director-General of the World Health Organization stated just days ago, “More than 2,000 patients with cancer, 1,000 with kidney disease, 50,000 with cardiovascular disease and 60,000 with diabetes [are] all at risk as their treatment is interrupted. Meanwhile, up to 200 women [are] giving birth daily in the worst conditions imaginable. An estimated 20,000 people and counting [are] in need of specialized mental health services.” We cannot discuss this agenda item and be indifferent to such a dire and overwhelming situation. That said, we once again highlight the importance of ensuring that humanitarian aid — including crucial life-saving supplies such as sufficient fuel, among other things, for conducting basic humanitarian operations, as well as food, medicine and clean water — is able to reach the Gaza Strip, unimpeded and at scale, and can be distributed quickly to all who need it most. Article 1 of the Charter of the United Nations urges us to undertake international cooperation in resolving various kinds of international problems without distinction of any kind. In the context of the fight against tuberculosis, COVID-19 and other diseases, as well as guarantees of universal health coverage and pandemic prevention, preparedness and response, the imposition of economic, commercial and financial blockades represents a direct violation of the founding Charter of our Organization, in both letter and spirit, as well as of the founding pillars of the United Nations itself — peace and security, human rights and sustainable development. In conclusion, we reaffirm our call to renew the original spirit of the United Nations and its Charter, together with an active awareness of the lessons learned so far from the COVID-19 pandemic and the urgent need to evaluate the scope and need for reform of crucial aspects of the current model of relations between science, public policy and social justice. We must do so with a view to providing more equitable and immediate responses to the important challenges facing humankind, which require a coordinated and effective response from the United Nations system through its specialized agencies, programmes and funds.

I would like to thank the Secretary-General for his report (A/78/88) on the progress achieved and challenges remaining in realizing tuberculosis (TB) goals within the context of achieving the Sustainable Development Goals (SDGs). Despite the many years of the fight against tuberculosis, that infectious disease is still spreading among us. As mentioned in the Secretary-General’s report, in 2021 it infected around 10.6 million people, 1.6 million of whom died. The numbers speak for themselves. Our fight to end TB is far from over. To date, it remains the second leading killer among infectious diseases after the coronavirus (COVID-19). SDG target 3.3 is a very ambitious one. We aimed to end tuberculosis by 2030 and we wanted to ensure that people could fully participate in enjoying the benefits of sustainable development. Yet today we are still far behind that target. We must do more  — and urgently — to put an end to tuberculosis. At the global level, we have seen much political momentum. In September, our leaders gathered here at the United Nations to strengthen their political commitment to ending tuberculosis in a high-level meeting at which we adopted a political declaration (resolution 78/5) to push for more concrete actions to get us back on track. It is now up to us to turn commitment into action. In that regard, allow me to highlight three points. First, as we accelerate efforts to end TB, we must not be defined by old paradigms. It is not a problem confined to only a few countries — its spread knows no bounds, and no country is immune. The increasing rate of antimicrobial resistance also continues to pose great risks. Indonesia therefore calls for stronger and more inclusive global solidarity through enhanced financing, research and development. Governments, international organizations, academia, the private sector and all stakeholders must take part in this collective fight. The maxim that no one is safe until everyone is safe also applies to the fight against TB. Secondly, we must get our priorities right. Ending tuberculosis should be a high priority on the health agenda. We managed to develop the coronavirus disease vaccines in less than two years. Unfortunately, despite being the second deadliest infection, tuberculosis has not received the same attention. That is where investment and innovation must come into play to strengthen the collective efforts to fight TB. Multi-stakeholder partnerships, among other things, represent a strategy that can help ensure progress in investment and innovation. Through their different sources of expertise, academia, the private sector, civil society and others can complement one another’s role. Thirdly, we must be persistent and consistent. There is no quick fix in ending TB. But with global solidarity, persistence and consistency, we can win this long battle. In that spirit, I am pleased to announce that together with the Philippines, Poland and Nigeria, Indonesia has established an alliance of countries for the fight against TB, designed to give the issue a stronger political push across the United Nations system and beyond. I invite all countries to join us. It is now time to keep the TB agenda in mind in all the relevant issues we are looking into, which includes the high-level meeting on antimicrobial resistance that is scheduled for 2024. In that regard, Indonesia remains committed to strengthening international cooperation and working closely with all members and partners to end tuberculosis. Before I conclude, I would also like to take this opportunity to thank Kuwait for introducing draft resolution A/78/L.12, on World Duchenne Awareness Day. Indonesia is pleased to support and co-sponsor the draft.

On the issue of global health and foreign policy, what we have is good news and sometimes not so good news. Turning to the good news first, 2023 has been a year of progress for global health, with the successful adoption of three political declarations (resolutions 78/3, 78/4 and 78/5) that highlight commitments at the highest level to advancing measures to prevent, prepare for and respond to pandemics, promote universal health coverage and fight tuberculosis. But we also have not so good news. The Secretary-General’s report (A/78/88) on the comprehensive review of progress towards the achievement of global tuberculosis targets and the implementation of the political declaration of the United Nations high-level meeting on the fight against tuberculosis serves as a grim reminder that the political commitment shown by our leaders here in New York is not enough. We need more action on the ground, because the situation on the ground with regard to the overall health picture is still challenging and requires our constant attention. The fact remains that a large part of humankind — especially vulnerable groups — does not have access to adequate health care and continues to lack health security. The picture is further complicated with ongoing conflicts in various parts of the world and crises in development gaps and food and energy security. All these have had adverse impacts on health security. An all-out effort is therefore needed. As reflected in the report, especially its 12 recommendations for achieving a tuberculosis-free world, we need progress in other areas, such as providing universal health coverage, addressing funding gaps and responding to antimicrobial resistance. In other words, we need to look at global health as a complete and comprehensive agenda rather than addressing each health issue in a siloed manner. Ensuring interconnectedness between each and every health priority and harmonizing our efforts can contribute to global responses and global health security. In that regard, Thailand would like to highlight three points. First, we must ensure health equity for all. Health is a fundamental human right and a basic foundation for human security. We therefore remain committed to accelerating global progress towards achieving universal health coverage by 2030, including by placing it at the core of our upcoming chairmanship of the Foreign Policy and Global Health Initiative group next year. We also look forward to sharing our experiences and being part of driving universal health coverage in the next Universal Health Preparedness Review dialogue. At the national level, we have expanded primary health care to include those with vulnerabilities, including the migrants and refugees living in our country. As they constitute 6 per cent of the total population, we have been working with the World Health Organization, through the Country Cooperation Strategy 2022–2026 project, to promote their welfare and health literacy. We have also extended health coverage to cover additional health benefits under our Universal Health Coverage Scheme-plus to provide further health benefits, including health promotion and palliative care, with many physical-therapy and rehabilitation clinics across the country already registered as part of our network to make our universal health coverage truly accessible. For universal health coverage to work and be truly accessible and universal, it must reach everyone. Secondly, we need a strong commitment to sustainable health financing and investments. As the report shows, funding for tuberculosis services, research and innovation remains far below the global targets. We therefore call for increased contributions in health financing to narrow the development gaps, because without good health there can be no sustainable future. We believe that investing in health is one of the most cost-effective long-term investments for a secure, prosperous and sustainable future. Health financing must be geared to ensuring adequate social and financial protection from unforeseen public health emergencies, promoting capacity-building for workers and institutions in the health sectors and enhancing digital health rather than technology in the health system for those in need. Thirdly, inclusivity and partnership are essential to an equitable and responsive health system. We must listen to the people to understand their needs and engage them in decision-making. Thailand supports active engagement with all stakeholders, communities and civil society in the prevention, preparedness and response process. We witnessed the success of our village health and migrant volunteers during the coronavirus disease pandemic, as they are empowered to promote health care and health literacy for their local communities. We have been consistently implementing capacity-building programmes to address shortages of personnel in the health workforce. We continue to encourage participation from various stakeholders to further strengthen global health decisions. The workshop on social participation in health decision-making organized among Asian countries in Bangkok this week is one such initiative in that endeavour. Moreover, Thailand has been working with health-related core groups and partners to address critical health challenges. Combating antimicrobial resistance and pursuing a pandemic treaty are among the efforts that require global solidarity. We therefore call for the active engagement of all parties at the high- level meeting on antimicrobial resistance to be held next year. Lastly, rare diseases are a challenge that affects many people everywhere, but they are not often on the general population’s radar screen. That has to change. Draft resolution A/78/L.12, “World Duchenne Awareness Day”, seeks to address that, and we look forward to its adoption. To conclude, at a time when the views of many are polarized, cooperation on global health care and health issues can be a powerful centripetal force bringing nations and humankind closer together. It is therefore a very good time for the international community to show strong solidarity with the concept of more equitable, sustainable and resilient health systems. For Thailand, promoting global health is an integral part of foreign policy and a sound, cost-effective investment in a sustainable future for humankind. Thailand therefore stands ready to engage constructively and actively with all our partners to advance that common aspiration.

Our world has become increasingly interdependent. The state of public health in one nation is undeniably linked to well-being in others. Public health is not merely a humanitarian concern today. As illustrated by the coronavirus disease (COVID-19) pandemic, it has become an economic, social and strategic imperative that affects us all without distinction. Our ongoing global health challenges, including infectious and non-communicable diseases, underscore how urgent the need is for a collaborative and comprehensive approach premised on the principles of equity, non-discrimination, global solidarity and burden-sharing. COVID-19 particularly highlighted the limitations of our health systems. It made us realize how unprepared we were and probably still are. It convinced us of the dire need to invest in the global health security system. Pakistan, as a signatory to the International Health Regulations of 2005, firmly believes in working collectively to create a health system that is fit for purpose for all of humankind. We have noted with appreciation the report of the Secretary-General (A/78/88), a comprehensive review of progress towards the achievement of global tuberculosis targets, presented under this agenda item. We share the concern that the COVID-19 pandemic had a damaging impact on access to tuberculosis diagnosis and treatment and the burden of the disease. The progress that had been made before 2019 slowed, stalled and in some cases was reversed. Intensified efforts backed by increased funding are urgently required to mitigate and reverse the pandemic’s negative effects on tuberculosis. The need for action has become even more pressing in a context of ongoing conflicts, climate change and the global energy crisis, as well as their associated consequences for food security, likely to further worsen some of the broader determinants of tuberculosis. We welcomed the General Assembly’s adoption a few weeks ago of three landmark political declarations on pandemic preparedness, prevention and response (resolution 78/3), universal health coverage (resolution 78/4) and the fight against tuberculosis (resolution 78/5). But despite being at the midpoint of the timeline, the world is not on track to achieve Sustainable Development Goal (SDG) 3, which cannot be realized without universal health coverage. In developing countries where health systems were already underresourced, those systems have faced major setbacks in delivering essential services to millions of people. Providing universal health coverage is a key national priority and a primary objective of Pakistan’s National Health Vision 2016–2025, aimed at leaving no one behind. We have undertaken a range of initiatives, which include issuing millions of health insurance cards; the finalization of a national health support package; completing a localization process for health-related SDG indicators to set targets for 2030 at the national and provincial levels; the introduction of a national immunization support programme and the Sehat Sahulat programme as part of our social protection system; training programmes for women health workers and increased budgetary allocations for the health sector. In developing countries today, the lack of universal health coverage that results from resource constraints, poor health infrastructure, limited access to medicines and vaccines and technology transfer and capacity issues is affecting the health and welfare of our people and impeding their socioeconomic development. We need concrete action at the national, regional and international levels if we are to secure good health care for all. First, health financing requires global solidarity. We urge Member States, international financial institutions, United Nations agencies and donors to improve international cooperation in support of efforts to strengthen capacities in developing countries, including through enhanced official development assistance, concessional financing and public-private partnerships. We should not only leverage existing financing tools to mobilize additional funding but also promote funding for rapid-surge financing to respond to public health emergencies of international concern through innovative mechanisms, including debt swaps and a dedicated pandemic fund. We also urge the international community to provide adequate funding to the World Health Organization to assist developing countries in improving their health infrastructure. Secondly, developing countries need access to essential health-care services and safe, effective, quality, affordable essential medicines, vaccines and the latest diagnostics and health technologies, including assistive technologies. The high prices of some health products and inequitable access to them continue to impede progress towards achieving universal health coverage. Such practices must be discouraged, and health for all should be promoted as a global public good. Thirdly, we must redouble efforts to promote global solidarity and partnerships to support developing countries, including for technical capacity-building and the improvement of health infrastructures. Fourthly, we must enhance emergency health preparedness and response systems and strengthen capacities and resilience at the national, regional and international levels in order to mitigate the effects of climate change and natural disasters on health. Fifthly, uneven access to medical countermeasures, including diagnostics, therapeutics and other health products, as well as export restrictions, reflects the inherent inequalities that are prevalent globally. The international community should prioritize investments to increase the scale and geographic diversity of vaccine-manufacturing capacity, particularly in developing countries, and to support technology transfer. Let us commit to removing trade barriers, strengthening supply chains, facilitating the movement of medical and public health goods and diversifying manufacturing capacities across regions. Finally, we believe that the issue of pandemic preparedness, prevention and response can be best addressed through a legally binding treaty that is mandated by the World Health Assembly, and such an instrument is currently being negotiated in Geneva. It should be based on the principles of equity, solidarity, inclusiveness, transparency and common but differentiated responsibilities, and it should enable collective and coordinated action that ensures universal and equitable access to the diagnostics, vaccines and medicines needed to address a pandemic. Those must be effectively operationalized through appropriate provisions and mechanisms in the treaty. We look forward to the adoption of an ambitious, legally binding treaty at the next World Health Assembly in 2024.

Tuberculosis (TB) continues to be the deadliest infectious disease, claiming the lives of 1.5 million people last year and being the leading cause of death in individuals with HIV/AIDS. The epidemic is fuelled by a complex interplay between health and social determinants, including poverty, undernutrition and the HIV/AIDS pandemic. The progress achieved prior to 2019 has encountered setbacks, slowdowns and reversals, with global TB targets veering off course. The coronavirus disease (COVID-19) pandemic has further exacerbated that regression, affecting not only health systems but also various socioeconomic facets. Since the adoption of the political declaration of the 2018 high-level meeting on the fight against tuberculosis, Namibia has undertaken substantial actions, including carrying out its inaugural disease prevalence survey and implementing robust monitoring and evaluation systems aligned with the End TB Strategy. Our commitment to combating tuberculosis is evident through its comprehensive and inclusive approaches aimed at extending social protection to those affected by the disease. Despite the adoption earlier this year of the political declaration of the 2023 high-level meeting (resolution 78/5), equitable access to new tuberculosis medicines and technologies remains a significant hurdle. Our shared commitment to ending TB by 2030 lacks concrete action to ensure reliable and affordable access to crucial medical interventions, and that hinders progress. The Secretary-General’s report (A/78/88) underscores the stark reality that only seven of 30 high- tuberculosis-burden-countries report adequate access to the rapid diagnostic tests recommended by the World Health Organization, showing the vast disparities in access to new technologies and medicine. The urgency to end tuberculosis is heightened in our current global landscape marked by conflicts, an energy crisis and threats to food security. The compounding effects of the COVID-19 pandemic underscore the imperative for increased dedication and funding for essential TB services and research. Swift restoration of access to vital TB services is essential if we are to return case-detection and treatment rates to pre-pandemic levels. Ensuring sustainable progress necessitates vital investment in research and development for affordable, accessible and contextually appropriate medical countermeasures, including vaccines, tests and medicines suitable for resource-limited settings. Simultaneously, addressing stigmas and discriminatory practices is crucial. Adequate resources must support community-based interventions through community health workers and non-governmental organizations, bridging gaps in case-finding, prevention and treatment support. As we confront the dual challenges of TB and COVID-19, a holistic strategy is imperative  — one that not only addresses medical dimensions, but also intricately navigates the interwoven dynamics of health and socioeconomic welfare.

At the outset, the Kingdom of Saudi Arabia would like to extend its sincere thanks to the State of Kuwait for submitting draft resolution A/78/L.12, entitled “World Duchenne Awareness Day”. International statistics indicate that there are about 20,000 children globally that are affected by Duchenne muscular dystrophy, undermining their ability to enjoy their lives. The draft resolution can serve to highlight the suffering of those affected and to urge the international community to show solidarity with their families. My country was one of the first to sponsor the draft resolution, which exceeds 100 countries. That is a positive and promising indicator of the interest of countries in this rare disease, and we urge the countries that have not yet sponsored it to do so. My delegation takes note of the Secretary-General’s report (A/78/88) on achieving the global TB targets, and we appreciate the efforts made in its preparation. The coronavirus disease (COVID-19) pandemic has adversely affected the efforts and progress made during the past decade to achieve the Sustainable Development Goals and to put an end the tuberculosis (TB) epidemic by 2030, as well as the goals of the Global Plan to end TB by reducing its infection and mortality rights, which requires enhanced global collaboration in that endeavour. We would like to renew our commitment to the Global Plan to end TB, as the Kingdom is one of the countries that has made concrete progress through our ongoing monitoring of the strategies of the national tuberculosis programme, which was successful in reducing the TB rate by 60 per cent between 2000 and 2015. That success was possible thanks to the many activities aimed at improving the detection and monitoring system for early detection and treatment, with a view to preventing its spread. As we meet to discuss public health, my country looks on in pain as the health situation in the Gaza Strip deteriorates. In that connection, we reject and denounce the bombing of the Al-Shifa health complex and the bombing of the Jordanian field hospital in a sheer and blatant violation of international humanitarian law and international regulations. That was a clear targeting of medical staff. As we welcome the humanitarian truce or pause that was reached, we would like to see a continued ceasefire that enables the reconstruction of the area. In conclusion, we would like to reiterate our readiness to collaborate with the international community in order to improve the public health and welfare of all people around the globe.

We are grateful to Kuwait for presenting draft resolution A/78/L.12, on Duchenne muscular dystrophy disease. We are also grateful to the Secretariat for preparing the Secretary-General’s report (A/78/88) on progress and remaining challenges in implementing the goals of combating tuberculosis in the context of the 2030 Agenda for Sustainable Development. Russia associates itself with the statement made by the representative of Venezuela on behalf of the Group of Friends in Defence of the Charter of the United Nations. Despite the progress achieved in 2018 and 2019, tuberculosis (TB) continues to have a devastating impact on individuals, families and economies around the world. The encouraging results of measures to reduce the morbidity and mortality of tuberculosis were derailed after the negative impact of the new coronavirus disease (COVID-19) pandemic. Systematic work and maintaining priority attention on the topic of tuberculosis during the COVID-19 pandemic has allowed our country to maintain a high level of accessibility to medical care for patients with tuberculosis and to maintain the trend of a sustained reduction in the burden of tuberculosis. In Russia, we have a national system of preventive screenings of our population, which makes it possible to examine adults no less than once every two years, using X-rays, and children, using skin tests for tuberculosis. Every year, we have high indicators of medical screening of our population. For example, in 2022, more than 70 per cent of Russia’s population was screened for tuberculosis. As highlighted in the Secretary-General’s report, from 2018 to 2021, the BRICS countries  — Brazil, Russian, India, China and South Africa — consistently accounted for more than 50 per cent of available funding for ensuring access to treatment for tuberculosis, with 90 per cent coming from domestic sources. Taking into account the expansion of the circle of BRICS participants next year, the influence of the BRICS countries on global financing indicators for universal access to TB treatment will further increase. In that context, an important role is played by the BRICS TB Research Network, supported by the World Health Organization, which was initiated by our country. To date, 11 meetings have been held. The Network continues to develop innovations in the prevention and treatment of the disease through joint research projects and information exchanges. We will continue to focus on health care during Russia’s presidency of the BRICS group in 2024. In response to the statement delivered by the observer of the European Union, we would like to affirm that Russia did not start any war and seeks to end the unjustified, unprovoked war of the Kyiv regime against the Russian-speaking population in eastern Ukraine, being waged with the tacit support of the West. We have an obligation to end this war, and we will do that.

South Africa appreciates the convening of this critical debate on tuberculosis (TB) both in terms of the recent high- level meeting on TB and the Secretary-General’s report (A/78/88). The report provides us with an opportunity to reflect on progress towards and challenges regarding the global goal of eradicating TB by 2030 by measuring achievement against global tuberculosis targets and the implementation of the political declaration on the fight against TB. South Africa has long been plagued by the devastating effects of TB and is a high-burden TB country, with approximately 300,000 people suffering from it every year. While there can be no doubt that the topic is critically important to my country, in recent years we have seen significant progress in our fight against this deadly disease, as we have made strides in our efforts to control TB and improve the health of our population. We have therefore also carefully studied the Secretary-General’s report on progress towards achieving target 3.3 of the Sustainable Development Goals (SDGs) and compared it with South Africa’s own progress. We have experienced developments similar to those highlighted in the report  — stable progress through goal-setting, followed by a sudden stall and in some regards a regression, owing to the coronavirus disease (COVID-19) pandemic. There can be no doubt that there has been global progress towards the elimination of TB since 2018. That is credit to the target-setting by Member States and the World Health Organization (WHO), through the SDGs and the WHO End TB Strategy, respectively, as well as the new targets set out in the 2018 political declaration. The data from all Member States compiled by the WHO’s Global TB Programme has clearly demonstrated the marked progress and efforts that have been made towards achieving those targets. One of the key factors in South Africa’s own fight against TB has been our Government’s commitment to addressing the issue. South Africa has developed and implemented a robust national TB-control programme that focuses on the early detection, effective treatment and prevention of the disease. We have also dedicated substantial resources to TB control, including funding for TB clinics, laboratory facilities and community- based programmes. In addition to our Government’s efforts, South Africa has also benefited from international partnerships and support. Organizations such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the WHO and other non-governmental organizations have worked with South Africa to provide technical assistance, funding and expertise in TB control and prevention. Those partnerships have been instrumental in strengthening our country’s health system and improving access to TB diagnosis and treatment services. It is, however, unfortunate to note that the TB crisis worsened during the COVID-19 pandemic owing to the pandemic’s particularly arresting impact on national health-care systems. In some instances, systems established for TB were taken over and adapted to the prioritized fight against COVID-19 and to countering its rapid spread. However, the end of the pandemic demands that we refocus our efforts, beyond the initial targets, on the new challenges presented by a post- COVID-19 world, which include the need for revitalizing health systems, the decline in resources dedicated to fighting TB and the real financial consequences of that. Sadly, South Africa was not spared from the effects of COVID-19, which reversed the gains made on TB since 2018. The report indicates that TB incidence increased in 80 countries and territories between 2020 and 2021, and that can be attributed to the disruptions to essential TB services during the pandemic. It has been distressing to learn that progress has been reversed on the cumulative reduction rate of TB incidence, which dropped from 13.5 per cent in 2015 to 10.4 per cent by 2021. That is owing to challenges associated with the COVID-19 pandemic. In addition, we are deeply concerned about the TB- related death rate, which is more prevalent among people living with HIV. That rate increased between 2020 and 2021. Achieving the targeted 80 per cent reduction by 2025 in TB-related deaths among people living with HIV will require comprehensive consideration of the full implementation of the 2021 Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030. However, we also recognize that the pandemic taught us many lessons about the importance of an established and strengthened health system, capacity-building in research, development and innovation and adequate financing. In that regard, South Africa has developed a TB recovery plan through comprehensive stakeholder involvement, particularly from civil society. The plan aims to find missing people with TB and link them to care. Our TB recovery strategy reflects our commitment to leaving no one behind. Tuberculosis has been a recognized illness for centuries, and the bacteria that causes it has similarly been known about for more than a century. Yet the global epidemic remains a threat to human health and development and a stifling burden on humankind’s advancement, particularly in developing countries. We note with concern that as the report indicates, half of all people who have TB, together with their households, face financial hardship because of TB and its treatment. Few people in developing countries are able to access treatment, owing to their limited access to the tools of prevention, diagnosis, treatment, care, as well as to insufficient financial support and social protection. We must mobilize adequate funding resources, particularly in high-burden countries, if we are to advance science, research and innovation. In that regard, we appreciate the potential for progress through the development of a vaccine that could effectively end TB by 2030. That requires an urgent, multisectoral approach and cooperation in the development of affordable and effective TB vaccines, diagnostics, medicines  — including those aimed at drug-resistant forms of TB — and other health technologies. The recently adopted political declaration on TB (resolution 78/5) expressed deep concern about the inadequacy of the financing available for TB prevention, diagnosis, treatment and care. Less than half of the $13 billion annual target is being met. Another concern is the fact that domestic funding declined during the COVID-19 pandemic, although it is acknowledged that investment in care and in preventing TB brings some of the largest gains in terms of lives saved and the economic benefits derived from development investments. Overall international funding has stagnated since 2018, and it will be crucial to replenish voluntary international financing mechanisms such as the Global Fund, Unitaid and other sources of financing, including development assistance and innovative financing models. It will be critical to provide financial support to comprehensive, innovative tuberculosis strategies, multilateral efforts and other initiatives if we are to eradicate TB. The fight against TB remains an ongoing and complex challenge. While significant progress has been made in expanding TB diagnosis and treatment coverage, the efforts to reduce its incidence and mortality have been slower. The COVID-19 pandemic has also posed significant challenges to control efforts, threatening to undo the gains made in recent years. To achieve the goals outlined in the political declaration, it will be crucial for countries to recommit to TB control efforts, strengthen health systems and address the social determinants of TB. In addition, greater international cooperation and investment in TB research and development are needed to develop new tools and strategies. The review of the progress made towards the achievement of global TB targets and the implementation of the political declaration has highlighted the need for sustained political commitment and investment in TB control in order to tackle this persistent public health threat. Only through concerted and coordinated efforts can we hope to achieve the ambitious targets set out in the political declaration and ultimately end the global TB epidemic.

At the outset, we would like to congratulate our brother country of Kuwait on draft resolution A/78/L.12, “World Duchenne Awareness Day”, which Algeria is honoured to co-sponsor. The growing mobility of populations around the world has shown that infectious diseases are becoming more frequent and more widespread in a world where we can only ensure our collective well-being through international cooperation, which is an essential tool for addressing the health issues facing Governments and their populations, particularly those pertaining to the global South. The report of the Secretary-General (A/78/88), entitled “Comprehensive review of progress towards the achievement of global tuberculosis targets and implementation of the political declaration of the United Nations high-level meeting of the General Assembly on the fight against tuberculosis”, indicates that despite the fact that we have the means to prevent and treat the global tuberculosis (TB) epidemic, in 2021 10.6 million people got sick and 1.6 million died from the disease. The coronavirus disease pandemic has had a devastating impact on countries’ economies, societies and health, including their delivery of and access to critical TB services. The pandemic has also had an impact on the diagnosis of tuberculosis, which saw a drop in the number of cases recorded in 2020 and 2021 owing to the diversion of TB health services to use in the fight against the coronavirus pandemic. Like many other diseases, tuberculosis also has significant links to development. Recent statistics show that the spread of TB is fuelled by poverty, inequality and failing health systems. That is a major public health problem that demands appropriate measures and further international cooperation  — particularly in the framework of Sustainable Development Goals 1 and 3, whose aims are eradicating poverty and ending TB — with a view to saving lives and reducing suffering. In that regard, it is important to strengthen the funding for the global response plan to the tuberculosis epidemic, accelerate research aimed at achieving an effective vaccine against tuberculosis available to all, ensure that all sick and injured people have access to basic health services, from diagnosis to treatment, and address the root causes of the disease, including those related to social and economic aspects and their devastating effects. Algeria, which introduced an anti-TB vaccine in 1969, is fully committed to implementing the strategy of the World Health Organization (WHO) in this field and to ending tuberculosis, which has been one of our national health system’s priorities since independence. Our continued efforts over the past 10 years have seen infections decrease by approximately 58 per cent, from 23.1 cases per 100,000 people in 2010 to 9.8 per 100,000 in 2022. We have merged the treatments for cases of pulmonary and extrapulmonary tuberculosis and are currently updating our TB guide in accordance with the WHO’s new recommendations as well as recent demographic, epidemiological and therapeutic changes. Given the importance of the early detection of TB, we have strengthened our alert and early-warning systems in coordination with all the relevant institutions. We also ensure that all preventive measures are taken and that follow-up on medical care for infections is carried out at the level of health institutions. We have also launched awareness campaigns in order to educate citizens about the dangers of the disease and how to prevent it. Ending the global tuberculosis epidemic requires translating the commitments made at this year’s high-level meeting into action. International cooperation, through the transfer of technology and knowledge, is a key element in saving the lives of future generations. Finally, we would like to emphasize that global health and foreign policy also mean showing solidarity with people who suffer from a lack of health infrastructure and immediate care, as the Palestinian people have been experiencing in Gaza since the start of the terrible and unjustified attacks there, which have led to the loss of thousands of lives, including children, women and the elderly.

Duchenne muscular dystrophy is one of the most prominent rare genetic paediatric diseases. It has no effective treatment, which poses a major challenge to children’s full enjoyment worldwide of the right to health and places an enormous emotional and financial burden on families. Since 2014, when Parent Project Muscular Dystrophy designated 7 September World Duchenne Awareness Day, the international community’s attention to the disease has been growing. In that context, China welcomes and supports draft resolution A/78/L.12, on World Duchenne Awareness Day, which Kuwait has proposed and which we have joined as a co-sponsor. We support the designation of 7 September as the day to mark Duchenne recognized by the United Nations, which will not only help raise international awareness and promote research and treatment but will also contribute to the implementation of the 2030 Agenda for Sustainable Development and the goal of leaving no one behind. China has given great attention to rare diseases such as Duchenne muscular dystrophy. In recent years we have continued to strengthen our medical teams, improve our health-care system and intensify our efforts in scientific research and innovation. That has led to major progress in the prevention and treatment of rare diseases and has helped countless patients regain health, return to society and live a life of promise. While the diseases may be rare, the love is constant. China is willing to work with all parties to actively support the treatment and rehabilitation of patients living with Duchenne muscular dystrophy and other rare diseases and to promote international attention and cooperation for a world free of pain.

We have heard the last speaker in the debate on this item. We shall now proceed to consider draft resolution A/78/L.12. I give the floor to the representative of the Secretariat.

I should like to announce that, since the submission of the draft resolution, and in addition to the delegations listed in document A/78/L.12, the following countries have become sponsors of the draft resolution: Albania, Andorra, Argentina, Armenia, Belarus, Brazil, Brunei Darussalam, the Central African Republic, Colombia, Congo, Croatia, El Salvador, Estonia, Guinea, Hungary, Ireland, Lesotho, Malaysia, Marshall Islands, Mongolia, Montenegro, Mozambique, Namibia, Nepal, the Niger, North Macedonia, Norway, Palau, Panama, Paraguay, Philippines, Poland, the Republic of Moldova, San Marino, South Sudan, Spain, Suriname, Sweden, Thailand, Togo, Tonga, Trinidad and Tobago, Türkiye, the United Republic of Tanzania and Uzbekistan.

The Assembly will now take a decision on draft resolution A/78/L.12, entitled “World Duchenne Awareness Day”. May I take it that the Assembly wishes to adopt draft resolution A/78/L.12?

The exercise of the right of reply has been requested. I would like to remind members that statements in exercise of the right of reply are limited to 10 minutes for the first intervention and five minutes for the second, and should be made by delegations from their seats.

I regret that once again some delegations in this Hall have chosen to exploit its platform to disseminate falsehoods and fake news. We refuse to see it used for such distortions but will rather uphold the truth regarding the conflict in Gaza and Israel’s war on Hamas. Let me be clear — and it is not too complex — Israel is at war against a terrorist organization in the Gaza Strip, not the Palestinian civilian population. Hamas started the war, and Israel is conducting a military response to remove the threat posed by a jihadist, genocidal organization. In asymmetric warfare, everything is asymmetric. There is one side, a democratic State that abides by international law and does everything in its power to minimize civilian casualties. On the other side, there is a genocidal terrorist organization that blatantly ignores and violates international law time and again and strives to maximize civilian casualties on both the Israeli and Palestinian sides. The ability to stop this war right now is in Hamas’s hands. Hamas must release all the Israeli hostages  — women, men and babies, the youngest of whom, Kfir Bibas, is now 10 months old  — who have been held incommunicado, in blatant violation of international law. Hamas rules the Gaza Strip, controlling every aspect of people’s lives there. Its leadership bears full responsibility for the current deterioration and for the actions that Israel has been obliged to take in response. Hamas will be held accountable for the results of those events. Another issue, which is also not very complex, is that to stop the war, Hamas must lay down its arms and surrender. If it does, the war will end tomorrow. We feel that we should present some verified first- hand evidence to counter all the lies that have been told in this Hall. We have many hours of footage of the inhuman beings who call themselves Hamas filmed by their body cams and GoPros as they were intentionally killing, beheading, raping and desecrating the bodies of innocent Israeli civilians in the most cruel and abhorrent ways. That is why Israel is at war against Hamas. We cannot and will not allow our people to endure such horrors for a second time in history. “Never again” is now. Hamas will continue to spread lies, and we will continue to tell the truth. Hamas will not say that inside the ambulances that were hit by the Israel Defense Forces there were Hamas terrorists who tried to escape from the hospital that served as their headquarters. It will not say that Hamas is exploiting the civilian population of Gaza, including its medical teams and medical infrastructure. It is exploiting hospitals and medical facilities by operating from within and beneath those facilities, using them as human shields. It will not say that 200 trucks with humanitarian aid are crossing into Gaza every day or that thousands of tons of humanitarian aid have entered Gaza since the beginning of the war. It will not say that Hamas has prevented the evacuation of injured Palestinians civilians to the Rafah crossing because it tried to hide among those injured Palestinians some of the monsters from among the Nukhba combatants who took part in the massacre in Israel. Hamas will not say that it targeted the evacuation corridors from the north to the south of Gaza while trying to prevent the civilian population from evacuating the hostile zone in northern Gaza. It tried to maximize the civilian casualties and to prevent them from leaving. Hamas wants them to stay close. It needs them so that it can hide behind them and use them as human shields. There are no limits to the cruelty of Hamas, including towards its own Palestinian population. Our prayers and thoughts remain with the Israeli and foreign hostages who are currently being held captive by the cruel hands of Hamas. We call for their immediate release. We will not give up on them. We condemn Hamas, as every human being should. And we urge everyone here to do the same.

I want to comment on one thing that the representative of the occupying Power of Israel just said, which is that the forces of the occupying Power of Israel bombed ambulances because they thought that there were members of Hamas in them. I believe that is an official admission by the representative of the occupying Power, Israel, that it is bombing both hospitals and ambulances. It is on the record. I believe — and I do not just believe, I know  — that bombing a hospital is a violation of international law and international humanitarian law. The Israeli representative just said that was what Israel’s forces did. It is my humble understanding that we are all here to represent someone. And therefore when he says that, he is actually telling everyone that Israel bombed a hospital. He said so. The representative of Israel just said so. He is representing his so-called Government, and that therefore means that it is bombing hospitals. He said that. He admitted it just now. That will look great in the media. I believe that this might also be the last day of his career. We can see that Israel is simply blinkered. Its representatives do not understand what they are saying. They just want everyone to be on their side in any way possible. We have said this before, but they are so protected by Western countries that they cannot handle the truth. And the representative here is just trying to repeat the same lies over and over again. I do not think that at this stage anyone believes him any more. But the Israeli forces are bombing hospitals, which is a major violation of international humanitarian law, if I am correct. Once again, they are bombing hospitals. He just said so. Wow.

The delegation of Egypt has requested the floor to respond to the statement just made by the representative of Israel and his incomprehensible claim that some delegations in this Hall have chosen to exploit the platform of the General Assembly to disseminate falsehoods and fake news. We do not understand or accept what he said. Was it a lie that Al-Ahli Hospital and Al-Shifa Hospital were bombed or was it a reality that took place before everyone’s eyes? Has Israel’s brutal aggression against the Gaza Strip left 15,000 martyrs so far, including approximately 6,000 children? Is that a lie or a horrific and shameful reality that amounts to war crimes against unarmed civilians? Is its prevention of assistance a lie and is its blocking of relief assistance not a reality that the whole world witnessed? Today is the International Day of Solidarity with the Palestinian People. Based on its historic responsibility regarding the fraternal Palestinian people, Egypt reaffirms its unwavering and unlimited solidarity with the Palestinian people in defending their question which is the foremost cause for the Arab nation. Egypt stresses that its established principled position towards the Palestinian question has not and will not change. It remains committed to shouldering its responsibility towards the Palestinian question and is making every effort to ensure that the fraternal Palestinian people enjoy their legitimate right to establish their independent State. Egypt calls upon the international community as a whole to take serious action to put an end to the gross and repeated Israeli violations against the fraternal Palestinian people in the occupied Palestinian territory, namely, the Gaza Strip and the West Bank. We call for an end to the injustice and suffering of the Palestinian people. Egypt also calls for an immediate, permanent and unconditional ceasefire in the Gaza Strip in order to stop the bloodshed of unarmed innocent Palestinians, who are being targeted even in hospitals, and the provision of necessary relief and humanitarian assistance. Egypt reaffirms that regional stability in the Middle East will be achieved only through a comprehensive and just settlement of the Palestinian question on the basis of the two-State solution and resolutions of international legitimacy. That requires concerted international efforts for a two-State solution to be implemented and the creation of an independent Palestinian State along the borders of 4 June 1967, with East Jerusalem as its capital.

Let me reiterate for those who did not hear correctly what I have just said. Israel did not bomb hospitals. The one who targeted and is using hospitals is Hamas. The Palestinian Islamic Jihad bombed Al Ahli Hospital, and that was just proven by evidence. Let me say it again. Hamas is exploiting the civilian population of Gaza, including medical teams. Hamas is exploiting specifically hospitals and medical facilities, operating from, within and underneath those facilities while using them as human shields. Lastly, as a final note, my advice to the Syrian representative is to remain silent, given that his Syrian regime killed in the cruellest way 400,000 of its civilians. The Syrian representative does not have any moral right to reply.

As members know, the delegation of the Syrian Arab Republic is exercising its right of reply in response to statements by Member States. However, the Zionist entity is an occupying Power. Those are not my words but rather those of United Nations resolutions. Therefore, why would the representative of a State that is more than 5,000 years old respond to a representative of an occupying entity that is less than 100 years old and is still considered an occupation to date? Doing so would greatly affect our reputation, and we will not stoop that level.

The General Assembly has thus concluded this stage of its consideration of agenda item 125.