Background

The Committee had before it a paper on maintaining the Capacity of UN Clinics (CEB/2015/HLCM/8e), which was presented as part of a wider discussion regarding the health care facilities for UN personnel and eligible family members. The paper pointed to the need to discuss the issue specifically in the context of health care facilities for personnel serving in the countries primarily affected by Ebola (Guinea, Liberia and Sierra Leone - as well as Mali, where there is a need to maintain a level of preparedness). Given the situation in those countries, and the need to provide facilities both for personnel who might become infected with the Ebola Virus Disease (EVD), and for non-Ebola related treatment and care, it had been necessary to upgrade the existing UN clinics in the countries on an urgent basis.  This was done with funding provided on an exceptional basis by UNDP, with in-kind contributions by WFP and support by the UN Medical Services Division (UNMSD). 

Prior to the outbreak, UN clinics in the affected countries did not meet the standards set out in the new UN Clinic ToR that now apply across the system. It is envisaged that, after downsizing, the clinics will not revert to their pre-Ebola levels, but will continue in a status that is compliant with the new ToR, that ensure a minimum level of acceptable healthcare to UN staff and eligible dependents.

Discussion

The Committee noted the need to devise an appropriate approach to ensure that capacity and standards of UN clinics are maintained and funding streams managed on a sustainable basis, in a more comprehensive manner, in the context of a long term strategy.

It was proposed that the discussion on UN health facilities be carried forward by the Medical Directors and the UN Country Teams, in order to establish a global, cost effective, long-term and systemic approach. As part of this approach, many underlined that the cost related to ensuring adequate duty of care for UN system staff be part of the cost of doing business and therefore, be built into agreements with member states. Additionally, it was requested that the updated Terms of Reference for the UN clinics be shared with HLCM members to improve the understanding of standards.

The UN Secretariat noted that UNMEER funding will continue to be available until the Mission closes. It was therefore proposed that, until a long-term strategy is in place, the Ebola trust fund may present a possible funding source for the maintenance and upgrade of the UN clinics in the affected countries.

Moving forward, UNDP agreed to pursue the suggestion of financing current operation and upgrading of UN clinics through the Ebola trust fund and to revert to the Committee in the fall with a more long-term and sustainable approach to the provision of health clinics for UN personnel.

Action

The Committee:

  • Requested UNDP to consult with the UN Secretariat regarding the possibility of using the UNMEER Ebola trust fund as a financing source for the maintenance and upgrade of health clinics within Ebola stricken countries.
  • Requested the UN Medical Directors Working Group to carry out a systematic mapping exercise of the current UN clinics and the related national health facilities, and to formulate a more strategic approach to ensure a long-term and comprehensive response to the issue of funding of UN clinics. Such strategy should be based on sound data and information, and should also address the need to involve member states in considerations regarding the duty of care for UN personnel at the time of programme budgeting.