Expressing Grave Concern over Rise in Tuberculosis Cases, General Assembly Also Highlights Gap in Progress towards Treatment of Duchenne Muscular Dystrophy
Assembly Also Designates 7 September World Duchenne Awareness Day to Spark Awareness of Rare Genetic Disorder
The General Assembly today designated 7 September as World Duchenne Awareness Day, to be observed as a United Nations day every year, beginning in 2024, as it held its annual debate on global health, with speakers expressing deep alarm over the persistent and deadly spread of tuberculosis.
By the terms of the text titled “World Duchenne Awareness Day” (document A/78/L.12), which the 193-member body adopted by consensus, the Assembly also invited all Member States, the United Nations and other international organizations and civil society to observe World Duchenne Awareness Day.
Also before the Assembly was the Secretary-General’s report titled “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” (document A/78/88).
Introducing the draft text on World Duchenne Awareness Day, the representative of Kuwait said Duchenne muscular dystrophy is a rare disease impacting one in every 3,500 to 5,000 boys, with approximately 20,000 new cases each year. Duchenne is one of the largest paediatric genetic rare diseases. It knows no boundaries, affecting individuals regardless of race or socioeconomic status. The plight of Duchenne remains obscure due to insufficient awareness among public health-care professionals and policymakers.
That critical gap impedes progress towards effective treatments and potential cures, he said. Designating 7 September World Duchenne Awareness Day is more than a campaign. It is a resounding pledge to uphold the dignity of every child afflicted by this condition, he added.
Over a dozen speakers also debated best practices to fight tuberculosis, which they worryingly noted saw an increase in cases during the height of the COVID‑19 pandemic, when resources and facilities were diverted to fighting the coronavirus.
The representative of the European Union, speaking in its capacity as observer, said tuberculosis claimed the lives of 1.6 million people in 2021 alone — a concerning increase after several years of decline. The obstacles to ending tuberculosis are enormous. Early prevention and detection must be prioritized, especially in high-risk populations. “We must exploit the new rapid molecular diagnostics, treatment regimens for drug-resistant tuberculosis, fighting antimicrobial resistance, digital health solutions and innovative service delivery,” she added.
Australia’s delegate, speaking also on behalf of Canada and New Zealand, said the Indo-Pacific region hosts 60 per cent of the world’s new tuberculosis cases. She noted with concern findings contained in the Secretary-General’s report, including that the tuberculosis incidence rate increased by 3.6 per cent between 2020 and 2021 after many years of slow decline. There is hope, as the total number of tuberculosis-related deaths was 1.3 million in 2022, down from 1.4 million in 2021. But despite this, progress remains insufficient.
Venezuela’s delegate, speaking on behalf of the Group of Friends in Defense of the Charter of the United Nations, said that health cannot be just a privilege for the richest, nor can it remain a business. Tuberculosis is one of the communicable diseases that have historically caused the greatest devastation to humanity. He further condemned the imposition of unilateral coercive measures, including amid the worst pandemic humanity has faced in the past 100 years. These illegal measures constitute mass violations of the human rights of entire populations, as they continue to endanger the lives of people while violating their human rights, including the rights to life and health.
Namibia’s representative said the Secretary-General’s report underscores a stark reality — only 7 out of 30 high tuberculosis burden countries report adequate access to rapid diagnostic tests recommended by the World Health Organization (WHO), showing 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,” he said.
Egypt’s delegate said that developing countries, particularly in Africa, will require strengthened support. What is needed is the transfer of technology and building of programmes for research and innovation, he noted.
Several speakers also highlighted the collapsing health-care sector in the Gaza Strip, expressing deep concern for the state of civilians there who do not have access to medical care.
Saudi Arabia’s representative said her country watches with pain the deteriorating health-care system in Gaza. She denounced the bombing of the Al-Shifa health complex and the Jordanian field hospital, calling it a clear violation of international humanitarian law.
Introduction of Report
TAREQ M. A. M. ALBANAI (Kuwait), introducing the resolution titled “World Duchenne Awareness Day” (document A/78/L.12), said Duchenne Muscular Dystrophy is a rare disease impacting one in every 3,500 to 5,000 boys, with approximately 20,000 new cases each year. Duchenne is one of the largest paediatric genetic rare diseases; it also knows no boundaries, affecting individuals regardless of race, ethnicity, geography or socioeconomic status. Its consistent incidence rates make it a universal concern that requires international attention. The plight of Duchenne remains obscure due to insufficient awareness among public health-care professionals and policymakers. This critical gap impedes progress towards effective treatments and potential cures. Designating 7 September as World Duchenne Awareness Day will help usher in transformative change in the realm of rare diseases.
Underscoring the importance of the Sustainable Development Goals (SDGs), he said that Goal 5, on high-quality health care, is critical, as it aims to improve the quality of services in the public health-care system. Duchenne is not merely a medical condition — it serves as a symbol of struggles faced by children with rare diseases globally. “It is time for us to recognize our collective responsibility to protect and empower the most vulnerable,” he added. 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 this condition, leaving no one behind in the pursuit of a more compassionate and inclusive world.
Statements
GERARDO PEÑALVER PORTAL (Cuba), speaking on behalf of the Group of Friends in Defense of the Charter of the United Nations, said scientific advancement and financial resources make it possible today to treat preventable disease. However, the world is increasingly unequal, and some countries claim that resources are lacking for treatment. The current international order is unjust and gives priority to the interests of the few, he said, adding that unilateral coercive measures prevent the realization of a more just and equitable international order. In such an order, the gap between the Global North and Global South can be closed and the health of developing countries lifted. The business of the pharmaceutical industry is counter to universal health coverage, even within industrialized countries such as the United States, which is unable to ensure access to quality health care for all, he said, noting that Cuba has a free health-care system accessible to all.
TIINA SATULI, representative of the European Union, speaking in its capacity as observer, described tuberculosis as a serious threat to human health and development requiring urgent action. As the Secretary-General’s report documents, the epidemic shows no sign of weakening. The Union has 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 to 2025. Additionally, it has long invested in tuberculosis research, including in drug development, and has just reinforced programmes for innovation and improved access to antimicrobial medical countermeasures, including studies for tuberculosis medicines.
In 2021 alone, tuberculosis claimed the lives of 1.6 million people — a worrying increase after years of decline, she warned, underscoring the urgent need for renewed focus. However, obstacles to ending tuberculosis are enormous, particularly when faced with multiple and intersecting crises. Accordingly, she stressed the need to ensure universal health coverage and ensure access to treatment. Furthermore, work should be rights-based and inclusive, prioritizing support for the most vulnerable communities, which disproportionately bear the brunt of tuberculosis. This includes addressing stigma and discrimination. Also, early prevention and early detection must be fostered, including through awareness-raising, especially in high-risk populations. This means promoting testing, providing information and education and improving diagnosis and surveillance. All of this depends on strengthening health-care infrastructure, ensuring availability of accurate diagnostic tools and enhancing health-care worker training. “We must exploit the new rapid molecular diagnostics, treatment regimens for drug-resistant tuberculosis, fighting antimicrobial resistance, digital health solutions and innovative service delivery,” she added. She also called for intensification of research and development, in collaboration with low- and middle-income countries, to enhance access to a new tuberculosis vaccine and improved diagnostics and treatment.
SHILPA KADAMBARI PULLELA (Australia), speaking also on behalf of Canada and New Zealand, said that the Indo-Pacific region hosts 60 per cent of the world’s new tuberculosis cases. The fight against tuberculosis is intrinsically linked to protecting human rights, addressing health inequities and other social determinants and accelerating research and innovation. She noted with concern findings contained in the Secretary-General’s report, including that the tuberculosis incidence rate increased by 3.6 per cent between 2020 and 2021 after many years of slow decline.
As expected, COVID‑19 has also had a devastating impact on progress, she added. However, the total number of tuberculosis-related deaths was 1.3 million in 2022, down from 1.4 million in 2021. Despite this, progress remains insufficient to meet the global tuberculosis targets set in 2018. It is important to increase discussion and community-driven solutions to address the underlying health inequities and complex risk factors and determinants associated with tuberculosis. It is also vital to increase focus on prevention, including by investing in research and development and adopting innovative strategies to develop new diagnostics, vaccines and medicines.
MOHAMED OMAR ELFAROUK HASSAN MOHAMED (Egypt) said today’s session makes it possible to clarify the gap between countries in achieving universal health coverage by 2030, especially in light of the challenges after the COVID19 pandemic. He welcomed the resolution presented by Kuwait and noted that the disparities in the response to the pandemic make it clear that an ambitious, global and equitable approach is necessary to strengthen support for developing countries, especially in Africa. What is needed is the transfer of technology and the building of programmes for research and innovation, he said, adding that Egypt has launched its national programme for universal health-care coverage and has enhanced the quality of its care, making great strides that have been recognized by the World Health Organization (WHO). With Israel bombing medical facilities in Gaza, Egypt has also received hundreds of Palestinian patients, he said, adding that health care is a human right.
JOAQUÍN ALBERTO PÉREZ AYESTARÁN (Venezuela), speaking on behalf of the Group of Friends in Defense of the Charter of the United Nations, said tuberculosis is one of the communicable diseases that have historically caused the greatest devastation to humanity, with an immense sequel of suffering. At the same time, it is one of the diseases that has been most defeated, attacked and diminished as a result of collective efforts and scientific advances. Health cannot be just a privilege for the richest, nor can it remain a business; instead, it is a universal right for rich and poor alike, and both States and the United Nations are obliged to ensure that it is achieved for all, he asserted.
Relatedly, he condemned the imposition, and even intensification, of unilateral coercive measures, including amid the worst pandemic humanity has faced in the past 100 years. These illegal measures constitute mass violations of the human rights of entire populations, as they continue to endanger the lives of people while violating their human rights, including the rights to life and health. Furthermore, they have hindered the timely and effective access of States subjected to the so-called sanctions to medicines, medical supplies and equipment, personal protective equipment, screening tests, treatments and vaccines, which undermines national efforts in the fight against tuberculosis and other communicable and non-communicable diseases. The question of unilateral coercive measures can no longer be ignored or swept under the carpet, he emphasized, highlighting their negative impact on targeted nations, the global economy, supply chains, food and energetic security.
He also drew attention to the ongoing catastrophic humanitarian situation in Palestine, including the collapse of health systems in the Gaza Strip, which is the result of systematic and widespread attacks against the Palestinian people. The world is witnessing in anguish deliberate and indiscriminate attacks against the Palestinian people that have claimed the lives of thousands, including women, children and the elderly. Against this backdrop, he highlighted the importance of ensuring that humanitarian assistance, including food, medicines and clean water, enters the Gaza Strip in an unimpeded manner and that it can be swiftly distributed to all those in desperate need.
HARI PRABOWO (Indonesia) said that tuberculosis is still spreading. In 2021, around 10.6 million people were infected with the disease. “We are still far from over in our fight to end tuberculosis,” he added. It is up to Member States to turn commitment into action. In accelerating efforts to end tuberculosis, it is important not to be defined by old paradigms. The spread of tuberculosis knows no boundaries. Indonesia calls for stronger and more inclusive international solidarity. Ending tuberculosis must be of the highest priority among global health officials. Multi-stakeholder partnerships that include academics, the private sector and civil society will complement solutions. “We can win the fight against this long battle,” he said. Indonesia remains committed to working closer with all partners to end tuberculosis.
SURIYA CHINDAWONGSE (Thailand) said 2023 is the year of progress for global health, with the successful adoption of three political declarations that highlight commitments at the highest level to advance measures to prevent, prepare for and respond to pandemics, promote universal health coverage and fight against tuberculosis. However, the Secretary-General’s report serves as a grim reminder that political commitment in New York is not enough. Action on the ground is needed. To achieve a tuberculosis-free world, progress is also needed in other areas such as Universal Health Coverage, addressing funding gaps, and response to antimicrobial resistance. “We need to look at global health as a complete and comprehensive agenda rather than addressing each health issue in a silo manner,” he said, adding that health equity for all must be ensured and expressing his commitment to accelerating global progress towards achieving Universal Health Coverage by 2030.
MUHAMMAD USMAN IQBAL JADOON (Pakistan) said public health today is not merely a humanitarian concern but an economic, social and strategic imperative that affects all. Highlighting the principle of equity, solidarity and burden-sharing, he recalled that the COVID‑19 pandemic uncovered how unprepared the international community is. Accordingly, he stressed the need to invest in a global health security system. The need for action has become even more pressing in the context of ongoing conflicts, climate change, the global energy crisis and associated impacts on food security. He welcomed the adoption of three landmark political declarations by the General Assembly on pandemic preparedness, prevention and response, universal health coverage and the fight against tuberculosis. Detailing major obstacles faced by health systems in developing countries, he cited universal health coverage as Pakistan’s key national priority, for which his Government has undertaken a range of initiatives. Further, he urged the international community to provide adequate funding to WHO to assist developing countries in improving their health infrastructure.
NEVILLE MELVIN GERTZE (Namibia) said that tuberculosis continues to be the most deadly infectious disease, having claimed the lives of 1.5 million people in 2022, standing as the leading cause of death for individuals with HIV. Moreover, the Secretary-General’s report underscores a stark reality: only 7 out of 30 high tuberculosis burden countries report adequate access to WHO-recommended rapid diagnostic tests, 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,” he said. The compounding effects of the pandemic underscore the imperative for increased dedication and funding for essential tuberculosis services and research. “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,” he added.
SULAFA HAMID I. MOUSA (Saudi Arabia) said 20,000 children are affected by Duchenne across the globe and that her country was among the first to sponsor the draft resolution before the General Assembly. She took note of the Secretary-General’s report and said the pandemic adversely affected progress made towards putting an end to tuberculosis. She reiterated her country’s commitment to the international strategy to eradicate the disease and noted its progress through early detection and treatment programmes. Saudi Arabia watches with pain the deteriorating health-care system in the Gaza Strip, she said, denouncing the bombing of the Al-Shifa health complex and the Jordanian field hospital in clear violation of international humanitarian law. She welcomed the humanitarian truce and said her country would like to see a more permanent ceasefire that would allow for the rehabilitation and reconstruction of the area.
BORIS A. MESCHCHANOV (Russian Federation) said that, despite progress achieved in 2018 and 2019, tuberculosis continues to have devastating consequences for people, families and economies worldwide. Systemic work and attention to the topic of tuberculosis during the COVID‑19 pandemic has allowed his country to maintain a high level of accessibility of medical assistance to patients with tuberculosis. In this regard, he spotlighted the national system of preventive screening that makes it possible to examine adults every two years. He further highlighted the important role played by BRICS (Brazil, Russian Federation, India, China and South Africa), which continues to develop innovations and carry out research projects. Responding to the statement delivered earlier by the European Union, he said the Russian Federation did not start a war but is seeking to end the unjustified and unprovoked war of the Kyiv regime against the Russian-speaking population in the East of Ukraine, supported by the West. “We have an obligation to end this war, and we will do that,” he asserted.
JONATHAN DAVID PASSMOOR (South Africa) said that in addition to targeted Government efforts, his country has also benefited from international partnerships and support from organizations such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. These partnerships have been instrumental in strengthening the country’s health system and improving access to tuberculosis diagnosis and treatment services. It is, however, unfortunate to note the worsening of the tuberculosis crisis during the pandemic. The end of this pandemic requires us to refocus our efforts beyond initial targets to new challenges presented by the post-COVID world, he said. South Africa developed a tuberculosis recovery plan through comprehensive stakeholder involvement, particularly with civil society. He noted with concern that the Secretary-General’s report indicates that half of people who have tuberculosis face financial hardship. “We need to mobilize adequate funding resources, particularly in high burden countries, to advance science, research and innovation,” he added.
BILLEL HASSANI (Algeria) said collective well-being must be ensured through international cooperation, which is an essential tool to address health issues, particularly in the Global South. Despite the means to prevent and treat the global tuberculosis epidemic, 10.6 million people got sick and 1.6 million died in 2021, he said, noting that the COVID‑19 pandemic had a devastating impact on the delivery of, and access to, critical tuberculosis services. The spread of tuberculosis is fuelled by poverty, inequality and failing health-care systems, he said, adding that further international cooperation is needed to end the disease, save lives and reduce suffering. There is a need to strengthen funding for the global response plan to end the tuberculosis epidemic, accelerate the pace of research to reach an effective vaccine available to all, ensure that all sick and injured people have access to basic health services and address the root causes of the disease, he said.
ZHANG SISI (China) welcomed Kuwait’s initiative to establish World Duchenne Awareness Day to raise awareness of Duchenne muscular dystrophy. The fact that the international community pays attention to rare diseases such as Duchenne muscular dystrophy will help countless patients live a promising life. China actively supports the treatment and rehabilitation of patients of Duchenne muscular dystrophy and other rare diseases, promoting a world free of pain, she said.
Action on Draft Resolution
The Assembly then adopted the draft resolution titled “World Duchenne Awareness Day” (document A/78/L.12) without a vote.
Right of Reply
The representative of Israel, in exercise of the right of reply, expressed regret that some delegations have chosen to exploit this platform to disseminate falsehoods. Hamas started this war, and Israel is conducting its military response to remove the threat posed by this Jihadist genocidal organization. There is on the one side a democratic State, which abides by international law and does everything within its power to minimize civilian casualties, and on the other side a genocidal terrorist organization, which ignores and violates international law to maximize civilian casualties on the Israeli side as well as the Palestinian side.
It is in the hands of Hamas to stop this war right now, he said. Hamas must release all the Israeli hostages — women, men and babies, the youngest of which is only 10 months old. The leadership of Hamas bears full responsibility for the current deterioration and for the actions Israel must take in response. “We have many hours of footage” from Hamas’ body cams and GoPros showing the killing, beheading, raping, and desecrating of bodies of innocent Israeli civilians “in the most cruel and abhorrent ways”, he said. “We cannot and will not allow people to go through such horrors for the second time in history,” he added. Hamas is exploiting the civilian population of Gaza, including in hospitals and medical facilities, operating from within and underneath the facilities and using civilians as human shields, he continued. Hamas prevented the evacuation of injured Palestinians civilians. Hamas tries to maximize civilian casualties.
ELIE ALTARSHA (Syria) noted that the representative of the occupying Power of Israel said its army bombed ambulances because they thought members of Hamas were inside them. This is an official admission by the representative of the occupying Power of Israel that they are bombing hospitals and ambulances, officially and on the record. Bombing a hospital is a violation of international humanitarian law, he added. “They don’t know what they are saying. They just want everyone to be on their side in any way possible. We’ve said this before, but they are spoiled by the Western countries,” he said.
The representative of Egypt, responding to a statement delivered earlier by Israel’s delegate, rejected the argument that this session has been exploited by delegations and lies have been presented. The bombardment of hospitals — “Are these lies or reality?” he asked. Some 15,000 martyrs as a result of Israel’s brutal aggression, including 6,000 children — “Is this a lie or a staggering reality?” he continued, condemning Israel’s war against unarmed civilians. Today is the International Day of Solidarity with the Palestinian People, he said, reaffirming Egypt’s unshakeable support. His country remains determined to abide by its position and ensure the Palestinian people recover their legitimate right to establish an independent State. He called for an unconditional cessation of hostilities, an immediate ceasefire without any preconditions and the provision of humanitarian assistance to Gaza.
The representative of Israel, taking the floor for a second time, said that her country did not bomb the hospital. The one who targeted the hospital was Hamas. The Palestinian Islamic Jihad bombed Al-Aqsa Hospital, and that was proven by evidence. Hamas is exploiting hospitals and medical facilities by operating from within and underneath these facilities while using those inside as human shields. “My advice to the Syrian representative is to remain silent after his Syrian regime killed in the most cruel way 400,000 of their civilian population,” he added.
The representative of Syria, taking the floor for a second time, said he wanted to respond to the Zionist entity, which is an occupying Power, as determined by the United Nations. “Why should a country that’s been in existence for more than 5,000 years have to respond to an occupation of less than 100 years that continues to be labelled and described as an occupation?” he asked. “This is a stain on our reputation, and we shall not lower ourselves to this level.”