In drafting the outcome document for the Summit, Members States are asked to take note of – and integrate - the following messages and recommendations.
2.1 Eradicating multi-dimensional poverty |
Poverty is not just about lack of income; it is multidimensional, involving material, social, and institutional deprivation, exacerbated by systemic discrimination and exclusion. Accordingly, policies to address poverty must take a broad approach, based on in-depth and context-specific knowledge of the multi-dimensional nature of poverty and discrimination, and designed with the participation of those directly affected, so that their voices are heard. Ensuring the active involvement of people living in poverty in the design, implementation, and evaluation of anti-poverty policies is key to their effectiveness. Special attention must be given to those population groups at greatest risk of experiencing situations of vulnerability, including refugees, persons with disabilities, older persons, ethnic minorities, and women, especially when they belong to marginalized communities. Furthermore, discrimination on grounds of age, sex, gender, functional ability, socio-economic status, ethnicity, religion, legal status, sexual orientation or any other grounds can intersect; intersecting discrimination compounds disadvantage and accumulates over the life course.
2.2 Implementing universal social protection systems and floors |
Universal social protection systems and floors must be embedded in national legislation, budgets and programmes with long-term budget provision to provide for sustainability and reach, and to support their resilience and expansion in the event of climate and conflict-related shocks that affect people and their communities, from the cradle to the grave. The legislation of social protection systems and floors is essential for long-term financial sustainability, and institutional stability; established as a national institution, social protection must be protected from the vicissitudes of partisan politics.
To guarantee broad societal support and ownership of social protection systems and to contribute as much as possible to stronger social cohesion, it is important that social protection systems are developed, implemented and monitored with the active involvement of social partners and relevant civil society actors, as well as those directly affected.
Furthermore, social protection systems must be founded on universal inclusion, ensuring accessibility for all, across the life course, and in all the systems’ dimensions - from the design to the implementation. This requires an in-depth understanding of the specific needs, risks and circumstances of different population groups, especially of persons more likely to encounter barriers based, for example, on gender, age and disability, of the drivers of inequalities and discrimination, while putting users at the centre of the design and conceiving implementation on the basis of a rights-based and people-centred approach. Accessibility must be designed to ensure the most vulnerable and marginalized are not left behind.
2.3 Guaranteeing universal access to essential health care |
As stipulated in ILO Social Protection Floors Recommendation, 2012 (No. 202) and in SDG3, providing access to basic health care is the responsibility of the State. “Access to a nationally defined set of goods and services, constituting essential health care, including maternity care, that meets the criteria of availability, accessibility, acceptability and quality”is the first of the four guarantees of National Floors of Social Protection outlined in Recommendation 202.
In countries that have pursued universal access, health care delivery based on quasi-public social insurance systems have contributed to a good status of health, judging by morbidity and mortality indicators (which more generally applies to European and other nations, in particular the post-World War II welfare states).
However, countries with weak health care delivery systems and which are also often dependent on external aid show deplorable health status levels and poor measures of wellbeing. They may show segmentation of access to care and in care itself. A local health centre might ensure postpartum and new-born care, even childhood vaccinations, but balk at pregnancy or delivery complications, a broken leg, a traumatic injury, or treatment for a noncommunicable disease, requiring a means of referral to a next level of care or continuous care, that may or may not be in place (which applies to a number of least developed countries in Asia, Africa and the Americas).
Lacking comprehensive and holistic health systems that are people-centred, Member States may be subject to donor objectives of measuring impact based on short-term visible intervention effectiveness rather than successful health outcomes in the longer-term. Such micro-goals lack scope, with health reduced to the success of multiple microinterventions. Furthermore, if each micro-intervention is sponsored by a different donor, demonstrating success becomes a competition to the detriment of improvements in health infrastructure and building stronger health systems, which require longer-term targeting, sustained and sustainable investments.
Yet other countries show coexisting high-quality private care and lower quality public care. Two-tier systems arose as the profitability of medical interventions visibly interested the financial world. The for-profit yet health-dedicated medical and pharmaceutical industries have been overtaken in sectoral investments by financial funds in search of higher profitability.
The stake of profitability in delivering health is considerable. At present, annual global health expenditure exceeds ten trillion US dollars. There is forceful pecuniary motivation to privatize health as widely and deeply as possible.
Universal access to health care means going against the grain and overcoming these obstacles. Progress in this respect requires changes that ensure that everyone, everywhere, is able to access the health and care services that they need regardless of their circumstances and identity factors, and without facing financial hardship. Health is a human right and must therefore be redefined comprehensively, rather than as a haphazard assembly of elements. The objectives of reducing morbidity and mortality must apply to the entire population and employ interventions on all disease causes, with special attention to social and economic determinants, neither relying on interventions selected to bring rapid and measurable results, nor emanating from donor priorities, nor again meeting only the priorities of privileged strata. Importantly, it calls for greater public and national investment to build health systems that achieve the essential goal of truly equitable and universal access.
Social protection mechanisms in the domain of health must promote health equity and be inclusive, age and gender-sensitive, as well as adequately funded. Marginalized groups, such as persons with disabilities and older persons, often face limited access to healthcare despite requiring more support, including assistive technologies and long-term care. They experience poorer health outcomes, reduced functioning, and shorter life expectancy due to systemic inequities and structural barriers, such as inaccessible information, complex application processes, and restrictive eligibility criteria. Women with disabilities and caregivers, which include older women, face additional challenges in accessing health care, further increasing their vulnerability.
Progress towards universal access to essential health care requires multisectoral collaboration and a calendar of incremental steps to expand coverage to achieve universality. Progress requires stronger multilateral collaboration and solidarity through both World Health Organization (WHO) and UN Programmes and Specialized Agencies that address health and international financial institutions - the development banks and the Bretton Woods institutions. It requires greater flexibility from international financial institutions regarding national budgets to enable spending on health and social protection. This means tolerating deficits, allowing modification of budget allocations and treating loans and grants in general budgets.
2.4 Accessing social protection and services – digitalization and legal identity |
At least a billion people around the globe face challenges in proving who they are. According to United Nations International Children's Emergency Fund (UNICEF), hundreds of millions of children have no legal identity, lacking birth registration and the birth certificate they need to assert a legal identity. Millions of older persons and persons with disability lack identity documents. The lack of legal identity, limited access to technology and the internet, inaccessibility of forms and websites, and illiteracy—often coupled with unfamiliarity with administrative procedures—hinder many vulnerable groups from accessing social protection benefits and other public services where they do exist.
Changes in legislation on legal identity and its application at national and local level are needed to ensure a legal identity for everyone. This means free birth registration, simplified procedures to obtain legal identity for adults and children, as well as mobile administrative services for areas that are currently underserved. Additionally, disability cards that provide access to benefits compensating for disabilities and/or need for care are essential, in addition to the appropriate systems to support their implementation. The opportunity of national data collection exercises, such as decennial censuses, and intercensal surveys, should be used to establish and ensure universal registration of household members. Data must be disaggregated according to characteristics such as gender, age, disability and location, to ensure that members of specific groups are effectively included and their access to social protection benefits is ensured. Governments should also be assisted to provide and maintain civil registration systems.
Whereas digital technologies have strong potential to enhance access to social protection, delivery models that increasingly rely on the availability of digital technologies and digital skills carry the risk of excluding some population groups and exacerbating inequalities, if existing gaps in relation to access to technologies and digital skills are ignored and remain unaddressed. Beyond registration issues, the disbursement of benefits digitally is becoming widespread. Recent research suggests that this can increase exclusions, for example among older women, perpetuating discrimination and inequalities. Greater efforts are required to ensure that digital gaps are effectively addressed in the delivery of social protection, and that digital technologies support equality, inclusion, and the realisation of rights. In this respect, the GCSPF stresses the following points: -
- Any registry designed for the attribution of rights to social services and benefits should be a dedicated registry, designed for the purpose and fit for that purpose;
- The right to privacy and to confidentiality must be built into each registry that is utilized to grant access to social benefits and services of all kinds. Registration for the purpose of legal identity granting access to social services should not be accessible for any other purpose, especially purposes of selection or exclusion of individuals from access to such services. There should be firewalls between the registry and other sources of individual information, to protect rights-bearers from cross-classification with other data sets because of the link to individual identity;
- Affordable access to internet and digital support should be provided to everyone, particularly in rural areas. Websites and interfaces should be easy to use;
- When persons are not able to digitally access public services, the right to a physical human reception should be ensured so that human contact is always present in administrative processes;
- Digital registration should apply to the entire resident population of any State, to ensure that access to benefits is not limited for migrants, refugees and asylum seekers on the basis of their documentary status; and
- Rights-holders in respect of public services should meaningfully participate in the design, implementation and evaluation of digital policies.
2.5 Gender equality and care work |
Thirty years after both the Copenhagen plan for action and the Beijing Platform for Action, women’s disproportionate share of unpaid care work and responsibilities continues to prevent them from fully engaging in public life and in income-generating activities. Care responsibilities often remain a key obstacle to women’s labour force participation, most often depriving them of the social protection benefits linked to formal employment. When women do work outside the home, they are frequently paid less than men, and experience discrimination, in particular in hiring, promotions and access to decision-making positions. Discrimination and inequality experienced by women throughout their life course across multiple domains accumulate in old age – manifest in gender gaps in pension coverage and income inadequacy - making women less likely to enjoy income security and economic independence in old age than men. Many older women are in poverty, globally.
Unpaid care work is a major cause of social and economic injustice and hardship for women across the life course, all the more so when maternity, race, migratory status, age, disability and other intersecting grounds of discrimination come into play. Women who raise children alone and widows are also particularly vulnerable to poverty and social exclusion.
Unpaid care work must be shared equitably, first between men and women, but also across society; every stakeholder, including government and the private sector, must assure their share of responsibility and costs. Public provisioning of care should have a sustainable and reliable source to reduce potential inequities in the availability of care services. Public policies should frame care as a social and collective responsibility rather than an individual problem; these policies should also treat unpaid caregivers and those they care for as rights holders. Ensuring universal social protection by creating social protection floors and universal quality public services would be an important step towards this objective, contributing to the broader care systems of a society. It would also support recognition of the contribution to the economy of unpaid and underpaid care work done by women, as well as the critical value of care.
At the Summit, Governments must re-commit to their 1995 commitments, renewed in SDG5.4 of the 2030 global development agenda: “Recognize and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies and the promotion of shared responsibility within the household and the family as nationally appropriate”.
Appropriate macroeconomic policies are vital in addressing socio-economic disparities in accessing care services and to provide the adequate fiscal space needed. Moreover, the cross-cutting nature of care must be recognized in cross-sectoral policy approaches. States must ensure care systems are adequately funded and sufficiently staffed. They must mobilize the necessary resources both domestically and through international assistance and cooperation, ensuring that expenditure and public policy comply with human rights standards, taking account the long-standing demands of unpaid care workers, their right to self-care, and evolving standards of care.
2.6 Ratification of existing and adoption of new international instruments |
The ILO, the UN and regional institutions have adopted international legal instruments that have important implications for social protection. Notable instruments of the United Nations are the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW, 1979), Convention on the Rights of the Child (CRC, 1989), and the Convention on the Rights of Persons with Disabilities (CRPD, 2006). Moreover, there is a body of relevant ILO Conventions and Recommendations, including the Social Protection Floors Recommendation, 2012 (No. 202) and, importantly, the ILO Social Security (Minimum Standards) Convention, 1952 (No. 102) that is currently the object of an active ratification campaign.
Regional instruments are also essential tools, including the Protocol to the African Charter on Human and Peoples' Rights on the Rights of Citizens to Social Protection and Social Security (2022), recently adopted by the African Union. Ratification by all eligible Member States is being urged and should proceed apace.
New instruments will be important tools of the multilateral system to ensure the establishment and expansion of floors of social protection. An ILO Convention for Social Protection would give new impetus to rachet the agenda for social protection into international public law. A UN Convention on the Rights of Older Persons would also greatly expand protection to one of the most unprotected groups globally. |