Executive Board Retreat - Organizational Priorities
Chairman, Members of the Executive Board, Regional Directors, Colleagues,
It is appropriate that we begin this retreat with a look into the future. It is now four months since I took office as the sixth Director-General of WHO. In July I brought in several new colleagues. Many of them are here with us. I have also introduced several new initiatives that I will describe to you shortly.
Change, renewal and reform are important values. But I also want to emphasize continuity. Our work has to be built on understanding tradition and continuity. Otherwise we will be in the business of re-inventing wheels, again and again.
Continuity in leadership is crucial. It is your leadership as the Executive Board that ensures this organization maintains its mission and vision. Continuity of leadership within the secretariat is also important, and I have retained several senior staff from Dr Brundtland’s Cabinet as Assistant Directors-General.
Continuity in priorities is also essential if we are to finish off the work that has already started. For example, we need to finish polio eradication and get the Framework Convention on Tobacco Control in force.
Continuity of resources is also imperative. On our regular budget, you will remember there is an option for countries who pay an increased share under the new UN formula to ask for relief against some of their increase. This relief is paid for from our miscellaneous resources. Some countries whose burden is great have said they will not take this relief. Others, whose burden is not so great, have indicated that they will. I am appealing to countries to minimize the demand for relief as that will mean more money for programmes.
Voluntary contributions now constitute two thirds of our total budget. Sudden reductions, or delays in contributions, have a severe and negative impact on our work. We very much value the planning discussions we have with Member States on these issues as they help us develop an integrated budget. Later in the retreat we will have an opportunity to discuss progress in integration of our budget for 2004-2005 and for 2006-2007. A unified budget is also an important part of developing one WHO, bringing together all our Offices and activities.
My first priority is results in countries. On September 22nd, I declared a global health emergency, and announced the “3 by 5” Initiative. It means getting three million of the people living with HIV infection in developing countries on antiretroviral therapy by 2005.
In terms of need, it was not hard to choose this emphasis from among all the other possible choices. HIV/AIDS is the worst social and health disaster the world has seen for many centuries. What is most disturbing is that effective treatment exists but this disease continues to kill almost all those infected in poor countries. The key question is not whether we can afford to do this, but whether we can not afford to do this. By getting three million people on ARV therapy by the end of 2005, we will demonstrate that it must and can be changed.
Earlier this year, by moving decisively against SARS, we stopped the epidemic in 120 days. By “we” of course I do not just mean WHO, but include governments, health systems, laboratories, information networks, financial institutions, hospitals, airports, the press and the general public. In that case, all of us responded quickly with concerted action to meet an urgent need. The result was success, although we did not even know how to stop the progress of this new disease once it had become symptomatic. We do know how to do this in the case of AIDS, and we have just over two years left in which to demonstrate that “3 by 5” can succeed.
Often we set targets 10 to 15 or 20 years down the line, and my colleagues follow them. I doubted that linkages of targets with day-to-day work is seen. In this case, the target is actually short: about two years’ time to demonstrate progress. This is a deliberate attempt to inject a sense of urgency.
Because of co-infection, AIDS is fuelling the TB epidemic and so the “3 by 5” activities are being closely coordinated with TB. The other lethal epidemic that thrives on poverty – malaria – is also controllable wherever health systems are functioning properly. The malaria control programmes are therefore also working side-by-side with “3 by 5”.
SARS also emphasized the need to strengthen global disease surveillance and to get the revised International Health Regulations agreed over the next 18 months. Let me also say that there is no guarantee that SARS will not return and, if that were to happen, WHO would continue to take the necessary decisive action.
I also want to highlight the important and critical work that we are doing in crisis situations in many locations around the world.
A second priority is the development of health systems and human resources.
Last month I was in Kazakhstan to celebrate the 25th Anniversary of the Declaration of Alma-Ata. Next month I will be in Brazil for similar celebrations. “Health for All” was not only a moral challenge but a rationale and a set of principles for responding to it. It enabled everyone at every level of expertise to contribute to strengthening national health systems.
A key requirement for achieving Health for All is skilled and motivated human resources. For our staff, this means more direct participation in supporting the work in countries, more mobility, more diverse experiences and more training opportunities. We are putting in place a mobility and rotation policy that will facilitate the optimum deployment of staff in support of WHO's aims. An interim system will be in place by the end of this year.
We are also ready to launch the Health Leadership Service. This will provide a training opportunity for young public health professionals, primarily from under represented developing countries, to gain training and supervised experience in WHO. In this way we will contribute to the development of future public health leaders. We have established a secretariat for the HLS, we have developed the curriculum, and we are identifying the training locations. As the financial resources become available, we will operationalize this important initiative, expanding the number of trainees each year.
But national health systems also need to develop human resources. Especially in low-income countries, it is the first requirement for rebuilding health infrastructures shattered by epidemics, poverty and conflict. It is also a way of helping to revive economic life by stimulating employment where it is badly needed. No amount of facilities, equipment and supplies, can get results until they are in the hands of skilled, motivated and coordinated human beings.
A third priority is to make the organization more effective, particularly at the country level. I would like to highlight two areas where this is important. These are the decentralization of resources, and improved communications and connectivity.
I have made a commitment to have 75% of the resources in our programme budget for 2006-2007 allocated to regions and countries. In order to meet that target I am increasing the portion of resources for regions and countries in the programme budget for 2004-2005 to 70%.
We are making rapid progress in using information technology to improve communications. By the end of the year, nine more country offices will be added to the WHO global IT system. A ‘situation room’ in HQ will be completed by the time of the Executive Board meeting in January. Member States will have online access to the information generated in the situation room – concerning outbreaks, health emergencies, and progress towards health targets.
The priorities that I have briefly described do not cover the entire work of the organization. For example, we are also taking important steps in noncommunicable diseases, maternal health, reproductive health and child survival. But they illustrate the progress we are making, and the importance of our work together.
I look forward to our discussions over the next two days, and to meeting you again at the Executive Board meeting in January.