A/HRC/29/44 treatment. Additional challenges in Afghanistan included: stigmatization of mental health patients; unequal integration of mental health services in primary and secondary health care; lack of quality referral health care, funding and prioritization by the Government and donors; staff capacity, supply of medicines in health facilities, quality of medicines and compliance. 17. Msgr. Robert J. Vitillo, Head, Caritas Internationalis, Geneva, while acknowledging the role of States, pointed to the complementary role in health crises of various stakeholders including faith-based organizations. Following the Ebola outbreak, while governments and international organizations struggled to respond, organizations like Caritas had acted immediately at the local, national, regional and international levels. They strengthened and maintained support provided by local Catholic health services and mobilized international volunteers, working with local communities. Faith-based organizations were particularly well placed to ensure that human dignity was upheld in all circumstances, and to provide local communities with material, pastoral and spiritual support that complemented medical support from health-service providers. 18. Mahmoud Daher, Head, WHO Gaza sub-office for the occupied Palestinian territories, explained how since 1967 military occupation had impeded development in the region, weakening all aspects of development for 4.2 million Palestinians and adversely affecting health systems. In Gaza, multiple external and internal factors had caused chronic shortages in essential medicines averaging 30 per cent over the past five years, and, averaging 50 per cent in disposable medical supplies. Unreliable fuel supplies and inadequate equipment and financial resources also posed obstacles to health services delivery, especially in Gaza. He noted that the Palestinian health sector would continue to suffer until the structural causes of those deficiencies were addressed and barriers were removed to control over resources and planning, to economic and educational opportunities and to self-determination. 19. During the interactive dialogue, interventions were made by representatives of the Congo, Associazione Comunità Papa Giovanni XXIII, the China Medical Association, Health Innovation in Practice, New Generation Ishaka, the People’s Health Movement, and by Dr. Bermudez and Raffaela Schiavon, General Director, Ipas Mexico. Suggestions included: (a) the international community must guarantee access to essential drugs and protect and support health-care professionals even in challenging contexts and people in vulnerable situations including women, must have access to medicines; (b) renew the focus on direct actions to improve health systems, including in rural areas, and to train medical personnel and support staff; (c) build trust between communities and health workers; (d) effectively coordinate international responses to health challenges; (e) base long-term, sustainable approaches to improve access to medicines, on data and not politics. 20. In his concluding remarks, Msgr. Vitillo observed that maternal health care was often neglected in challenging contexts, for example, Ebola treatment units had no facilities designed for childbirth. However, increased cooperation between governments, international medical teams and non-governmental organizations working with local communities could support better health outcomes. Mr. Daher noted that many health-care professionals in Gaza had not received their salaries for over a year, causing serious strains on the system. Dr. Siddiqi stated that donors adopted different approaches, but that there had been some recent success in streamlining and improving the effectiveness of international assistance to improve access to essential medicines in challenging contexts. Panellists agreed on the need for pharmaceutical companies, governments and the international community to improve responsiveness to crises and ensure the realization of human rights. 7

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