SRES358-119

That it is the sense of the Senate that— the Federal Government should adopt a new, 21st century global health solidarity strategy to end medically unnecessary deaths and respond to the full burden of disease in poor countries by— supporting developing countries to meet the material needs of their health systems by localizing investments in support of national public-sector and local priorities, referred to as accompaniment by Dr. Paul Farmer, and delivered through what Dr. Paul Farmer called the Five S's, which refers to— staff, meaning the human resources necessary for high-quality service delivery, including clinical staff, transportation teams, and community health workers, especially by— supporting long-term training and education systems, including medical schools and teaching hospitals to train the health workforce and improve the quality of care across diseases; and supporting professionalized community health worker programs whereby community health workers are recruited, adequately compensated, comprehensively trained, supported for long-term retention, positioned as bridges to care, and tasked with undertaking community work with appropriate patient ratios and a manageable scope of work; space, meaning the infrastructure needed for service delivery at primary, secondary, and tertiary levels to deliver safe and high-quality care to meet all health care needs; stuff, meaning the tools and resources necessary for high-quality care provision, including medical supplies, technologies, and equipment; systems, meaning the leadership and governance, health information systems, supply chain systems, logistics, laboratory capacity, and referral pathways required to meet the health needs of the population; and social support, meaning the resources needed, beyond the direct delivery of health care, to ensure effective care; and financing the discovery and development of new, urgently needed health technologies, such as diagnostics, treatments, and vaccines, particularly for neglected diseases of poverty, and ensuring their availability as global public goods; the objectives of adopting a 21st century global health solidarity strategy to end medically unnecessary deaths and responding to the full burden of disease in poor countries will require— increasing annual global health spending to $125,000,000,000, sufficient— for the first time, to meet the United Nations development assistance target of spending the equivalent of 0.7 percent gross national income on development assistance, which 6 other countries have previously met; and to close over 100 percent of the essential universal health coverage financing gap for low-income countries, and 30 percent of the overall financing gap for low- and lower-middle income countries; optimizing global health delivery spending by— introducing a new form of coordinated, multilateral fiscal cooperation for global public investment that— ensures increased and ongoing global public funding of common goods for health; and exhibits shared governance with global South governments and meaningful participation of civil society, which is also essential for addressing intersectional crises of social inequalities including the climate crisis; and ensuring funding directly supports national health plans, public institutions, local priorities, and donor coordination, practices aligned with what Dr. Paul Farmer called accompaniment; focusing on health service delivery for vulnerable populations, such as— people living in poverty; women; and children; and optimizing research and development spending for neglected diseases of poverty by ensuring the knowledge and technology produced by these efforts remains accessible to all as global public goods; the Federal Government should pass and enforce laws and use its diplomatic influence to stop ongoing economic harms to developing countries that deplete impoverished countries of the resources required to provide health and social services for their populations by— supporting debt cancellation initiatives for low- and middle-income countries, particularly countries in need of debt cancellation, across bilateral, multilateral, and private creditors; democratizing institutions of global governance, such as the International Monetary Fund, the World Bank, and the World Trade Organization, to ensure fair and equal representation among member countries so that low- and middle-income countries can have greater decisionmaking power in the creation of policies that affect them; supporting a United Nations Convention on Tax and other measures to dramatically reduce tax avoidance, tax evasion, and other forms of harmful licit and illicit financial flows from developing countries through fundamental reform of international tax cooperation; supporting global labor rights and living wages, such as a global minimum wage set at local living-income thresholds; and adopting new indicators of progress that measure social and ecological health and abandon gross domestic product as a measure of progress; and it is the duty of the Federal Government to issue reparations, containing multiple elements, including apology, award, and guarantees of non-repetition of harms, for— the institution of slavery, the subsequent racial and economic discrimination against African Americans that resulted from the institution of slavery, and the impact of these forces on living African Americans, following the establishment of a commission substantively similar to the commission established under the Commission to Study Reparation Proposals for African Americans Act, H.R. 40, as introduced on January 4, 2021; the harms of colonialism and subsequent forms of imperialism, which have undermined sovereignty, democracy, self-determination, social and economic rights, and human and ecological well-being in both the colonial and post-colonial eras; and the disproportionate responsibility of the Federal Government for climate breakdown, the burden of which unjustly and overwhelmingly falls on the global South.