Malta Declaration on Governance for Resilience

The combined efforts of civil society from around the Commonwealth have produce a new declaration on governance for resilience to be submitted to the Commonwealth Heads of Government meeting in Malta. Developed as an outcome of the Commonwealth People’s Forum (CPF) 2015, held from 23-26 November 2015 in Malta, CPF brought together more than 350 civil society participants. The full declaration can be found here: Malta Declaration on Governance for Resilience.

Sections 57, 58 and 59 specifically relate to building resilient health systems for an ageing population:

57. The Commonwealth reflect the realities of countries whose populations are either mostly populated by children and youth, or ageing populations. Civil society highlighted the stark contrast of inequalities within the Commonwealth when viewed from the lens of health, where some people suffer from obesity while others have no access to food, where children’s growth is stunted because of lack of nutrition while others get sick because of overeating. These inequalities need to be spoken of simultaneously because they are also reproduced into health systems structures or the lack of them. Health is a crosscutting issue requiring the engagement of a wide range of stakeholders particularly when responding to the challenge of ageing populations. Health is also deeply inter-sectional and resilient health systems brings this to the forefront by involving diverse community representatives in policy discussions to design better health systems which are the basis of resilient societies.

58. When health systems are in place, accessibility and affordability are binding constraints for most people and in many cases governance systems hinder their ability to adapt and respond, rendering them weak and unable to provide adequate care. They are also not immune to the globalisation processes. By contrast resilient societies invest in just health systems that are able to proactively respond to hte needs of the communities they serve and are able to plan for the future, prevent and control disease when this is possible. Inter-regional and international partnerships enhance the process for scaling up resilient health systems. Participatory governance and inclusion of communities in the planning, design and decision making process for service delivery enhances resilient health systems.

59.  Resilience is also about fostering a culture of respect for both the child, and the ageing, for the youth and those who are marginalised. Participatory processes open spaces for unheard voices, and new knowledge, bringing these to the centre of dialogue and improve the efficiency of health systems and their capacity to deliver. Population ageing opens possibilities for both new forms of exploitation and alternately the harnessing of wisdom. Resilient health systems provide the tools to identify the most appropriate policy path.