Summit of the Future: Will it deliver for health and HIV?

What were your first impressions of UNGA79?

Dr Pasquine Ogunsanya: This was a unique gathering of global leaders, presidents, prime ministers and ex pats. The security was very tight and there was a lot of bureaucracy to enter meetings. I had to attend some sessions online as rooms were already full. What struck me was that in all these places we were discussing issues that concern the world such as global governance, climate change and universal health coverage. We were all discussing the same thing. There has been a lot of talk. Now, what about implementation?

Clare Morrison: The Summit of the Future was all about revitalising multilateralism and accelerating the Sustainable Development agenda, which gave it a different tone to previous meetings. You could feel the tension in the room. Some controversial topics were discussed with Security Council reform being especially urgent, given the ongoing conflicts in Ukraine, Gaza, and Lebanon. While there were great moments with lots of protests and activism on show, and exciting opportunities to strategise and connect with decision makers, it felt like civil society were on the margins, whilst the ‘real work’ was happening behind closed doors.

What were some of your key highlights?

Clare: One of the big wins for Frontline AIDS and civil society came from the Health Impact Coalition, a new platform established to feed into the Summit of the Future process and shape the Pact for the Future. We were one of the few civil society coalitions granted a speaking slot in the interactive dialogues. It was a rare opportunity to hear civil society voices in the main, high-level plenary. It wasn’t clear why we’d been selected, it was all quite arbitrary, but we were able to deliver a speech in the main UN room to get our key messages across to member states and the observers in the room.

Health-specific language was retained in final draft of the Pact for the Future, including references to ‘sexual and reproductive health and rights’ and ‘universal health coverage’. Having this type of language included was a real victory, and is testament to the ongoing advocacy work of the Health Impact Coalition, despite attempts by Russia and others to derail to the process at the eleventh hour.

While the Pact for the Future acknowledges the importance of involving civil society, the language has been diluted compared to earlier drafts. States were keen to reinforce that this was an inter-governmental process. This was evident in the closed negotiations, weak feedback loops, and inadequate information sharing throughout the process. This sets a dangerous precedent for future UN-process, including post-2030 agenda negotiations which are set to begin in early 2027.

It meant a lot to me to represent Africa, but I realised at that meeting that they are not listening to the communities… it was important to be in the roomDr Pasquine Ogunsanya, Alive Medical Services, Uganda

Dr Pasquine: Frontline AIDS and the Health Impact Coalition were fortunate to access information as you need permission to attend some meetings. A former colleague told me about a closed drug policy meeting on shifting from punitive drug laws to health-centred approaches where I was the only person from Africa in the room. It meant a lot to me to represent Africa, but I realised at that meeting that they are not listening to the communities: information isn’t going to people who really need it. It was good to share the challenges we have in Africa, and it was important to be in the room.

What’s next and how will you keep HIV and health on the agenda?

Dr Pasquine: Without this trip to UNGA79, I wouldn’t have met potential new partners or connected with Ugandan ministers to help us with the sustainability of our work in Uganda. I had the honour of participating as a speaker on behalf of Procter & Gamble at the Global Citizen Festival, which focused on inspiring collective action to accelerate progress on the United Nations Sustainable Development Goals (SDGs) amplifying some of the engagements at UNGA79. The guests, including presidents, were saying good things, but implementation of the SDG’s lags behind. How can we hold the world accountable? What M&E system can we put in place? Civil society needs resources to be at the table where discussions about implementation are taking place.

At Frontline AIDS, we are committed to raising awareness among our national and community partners about recent developments… we believe it is crucial to advocate for greater accountability through the Health Impact CoalitionClare Morrison, Frontline AIDS

Clare: Whilst the Pact for the Future retained some of the key language we wanted, we need to be more ambitious when it comes to delivery and push to ‘act beyond the pact’, a phrase coined by some of the people within in the pan-African feminist movement. We need to position health within broader conversations on development, strengthen civil society engagement within the UN and engage with other major groups and allies to clarify our role and value add.

Currently, there is no attention on follow-up mechanisms, accountability, or how this is going to work at a national or country level. We’ve essentially developed another 56 targets for countries to report on with no real guidance as to how that reporting is going to happen or how to build ownership at a country level for those commitments. Country representatives have been negotiating the text but is there buy-in beyond those small groups of people who’ve been involved in the negotiation?

At Frontline AIDS, we are committed to raising awareness among our national and community partners about recent developments, including both the successes and challenges we’ve faced throughout the process. We believe it is crucial to advocate for greater accountability through the Health Impact Coalition. A key aspect of this effort involves engaging with donors to secure short-term funding that will help us establish a lasting platform, where health-focused organisations can collaborate and ensure our issues are heard – both within the UN space and beyond.

Dr Pasquine Ogunsanya is the Executive Director, Alive Medical Services in Uganda, and Clare Morrison is the Senior Advisor: HIV Prevention. Frontline AIDS.