Address to the Fifty-sixth session of the WHO Regional Committee for South-East Asia
Chair, Honourable Ministers, Representatives, Dr Rafi Uton, Regional Director, Colleagues,
I am honoured to be with you here in New Delhi, and to join your discussions on our work in the countries of the South-East Asia Region.
A great deal is at stake for national and international health in this Region, particularly in the continuing fight against HIV/AIDS, TB and malaria, and the eradication of polio. I congratulate you on your overwhelming response to last years polio epidemic. That response has brought this disease to the brink of eradication. When we meet next year, this Region can be polio free.
The United Nations system is going through a testing time. We were profoundly shocked by the bombing of the UN premises in Baghdad and by the deaths and injuries of so many of our colleagues. Despite these terrible losses, we continue our missions with great determination.
Chair,
I feel a great responsibility being in charge of WHO, and I am grateful for all of your support and good wishes for success.
Most pressingly now, success means achieving specific goals in disease control. That is part of a longer-term effort to rethink and rebuild health systems in countries and for the world as a whole. A very recent reminder for this effort has been the danger represented by the SARS epidemic.
"Unequal development in different countries in the promotion of health and control of disease... is a common danger," our Constitution says. In some countries conditions associated with poverty are bringing life expectancy down to 40 years, while in others, wealth and health technology are enabling it to rise towards 80. Inequality of this magnitude is not only a danger but an injustice to human well-being.
On this 25th Anniversary of the Alma Ata Declaration on Primary Health Care, it is good to remind ourselves that health is for all. Everyone equally needs health, and, when society fails massively through negligence to meet that need, it is in very serious trouble.
The greatest challenge facing us globally now is the catastrophe of HIV/AIDS. More than 42 million people in the world are HIV-positive. In some countries of the Region, your prevention and control efforts have been effective, but in others the danger of continued relentless increase in cases persists. Each person infected urgently needs treatment. It has to come through an integrated global HIV/AIDS strategy linking prevention, care and treatment.
I am working with local, national and international partners to design the necessary programmes to treat three million people on antiretrovirals by the end of 2005. "Three by five" will not solve the problem of AIDS but it will mark the beginning of a solution, and proof that it is possible. A comprehensive strategy for making this happen will be announced on the first of December, World AIDS Day, three months from now; and our work with countries will be initiated immediately.
We are working with many partners, including UNAIDS and the Global Fund, to mobilize the resources to put these plans into action. It will require the commitment of civil society, United Nations agencies, the private sector and Member States. Above all, it will require the commitment of each one of us here today.
In this Region as elsewhere in the world, TB remains a great threat. We must do more to ensure that those suffering from TB receive the effective DOTS treatment they need and the care that will cure them. I look forward to returning to New Delhi in December for the meeting of the Stop TB Partners Forum. We must press home the hard won advantage that we are winning against polio in order to complete regional and global eradication. In doing so we will deliver substantial dividends for the health services of every country.
Likewise your continued progress towards leprosy elimination has build up an extremely valuable network of support, collaboration and training.
The need for health care starts at birth. Protection during pregnancy, childbearing and motherhood forms the core of the health system. Half a million women die every year from giving birth. Skilled attendants are needed in pregnancy and childbirth, with access to emergency obstetric care when complications arise.
Despite the struggle of parents for their children's survival, 10 million children in low- and middle-income countries die every year before reaching the age of five. Seven million of those deaths are from five preventable and treatable conditions: pneumonia, diarrhoea, malaria, measles and malnutrition. We can reduce this toll substantially by working with countries to build up strategies such as Making Pregnancy Safer and Integrated Management of Childhood Illnesses. Reducing child mortality worldwide by two-thirds by 2015 is probably achievable. But it will not happen without major rethinking and commitment.
Malaria remains a titanic health problem in the world and in this Region. It will be vitally important to maintain the stabilization you have achieved, and start the trend towards reducing incidence.
Surveillance systems showed their effectiveness in the eradication of smallpox, and earlier this year in stopping the SARS epidemic. They are a key to success now, both for the eradication of polio and for the control of new and re-emerging infections. We also need to finalize the important work on the Revision of the International Health Regulations.
Meanwhile, noncommunicable diseases and injuries account for a growing share - now about 60% - of the burden of disease worldwide. In May the World Health Assembly adopted the Framework Convention on Tobacco Control. This was a global achievement in the fight against tobacco-related diseases. The Convention has now been signed by 50 countries, and ratified by one, Norway. It will give the world the means to protect people from tobacco harm by banning advertising, preventing smuggling, raising tobacco taxes and enforcing warning notices on packages. We must do everything we can to speed the process to the ratification by 40 countries that will bring the Convention into force.
The unbalanced nutrition now affecting all societies, rich and poor, poses a major challenge for health. Our objective is integrated approaches that work against malnutrition - from deficiencies and excesses. WHO's Global Strategy on Diet, Physical Activity and Health will be presented to the World Health Assembly next May.
This year's Health Assembly reviewed the work of the Codex Alimentarius and concluded that the health sector should play a more prominent role in setting safety standards for food. The Health Assembly also stressed that developing countries should be given more support to participate fully in the process of international food standard-setting. In many cases this is a matter not just of food safety but of food security - of ensuring intake of the minimum calories essential for health and survival.
Every year, more than a million people die in traffic accidents around the world making it a leading cause of death in all regions. What is needed is to raise awareness and strengthen our response. World Health Day 2004 will be dedicated to Road Safety.
Everything we are doing is about reinforcing national health systems. Our work everywhere is important, but the real centre of it has to be countries. We have to give our country offices more people, more realistic budgets, and more authority. At the same time, we also have to ensure sound management and financial practice as well as transparent budgeting.
At headquarters, all the Assistant Directors-General are looking at the global issues under their responsibility, to see which of their activities could be better carried out in regional and country offices. Overall, I want to see these changes completed for the 2006-2007 budget. They are a major objective for me because, having worked for 20 years in WHO, I can see very clearly that strengthening our work in countries is by far the most effective way to achieve our goals.
Health systems depend most of all on skilled and dedicated personnel, and here we face a major challenge: the brain drain. It is, above all, good health workers that will enable us to reach "3 by 5", and achieve the Millennium Development Goals, and everyone is short of human resources. We will be working closely with countries on innovative methods to train, deploy and supervise health workers, with particular emphasis on the community and primary health care level. That is where we can make the swiftest progress in getting results.
In many countries, the systems for providing reliable health information are also inadequate. This is one area in which the trend is on our side: the means for building effective information systems are becoming more powerful and more affordable all the time. I believe this problem can be effectively addressed with the health metrics network being formed by WHO's information partnership with Member States, foundations, the World Bank and UNICEF.
Chair,
Over the years, WHO has built strong and effective working relations with governments, foundations, nongovernmental organizations, the private sector and fellow multilateral organizations. Our work depends on partnerships; some long-standing and some more recent. By combining our strengths we can do so much more.
There is a commitment to partnership by global leaders on a scale we have not seen before. At the United Nations Millennium Summit in September 2000, the global community committed itself to eight goals. Three of them were directly about health: to reduce child mortality, improve maternal health, and control major infectious diseases. The five others are about poverty, education, gender equality, the environment and global partnership. All these, as we have seen, have a direct bearing on health. We need to make the most of these opportunities.
Better health for all is our common goal. Let’s work to achieve this.
Thank you.