Address to the Fifty-fourth session of the WHO Regional Committee for the Western Pacific
Mr Chairman, Dr Dayrit, the former Chairman, Dr Shinozaki, Honourable Ministers, Representatives, Dr Omi, Regional Director, and Colleagues,
Good morning,
I am honoured to be back here in Manila, and to join your discussions on our work in the Western Pacific.
The countries in the Western Pacific have been in the news and on the front pages for much of this year as a result of SARS. SARS tested us to the full. This was the area hardest hit by the world's newest disease. We had to work to understand what was causing it at the same time as we struggled to treat those most directly affected. Together, we won this battle for the time. Of course, none of us can predict what will happen later this year. Will SARS come back or not? We have to prepare on the assumption that it will come back. Our challenge now is to enhance surveillance networks that will detect and deal with SARS if it does come back.
The United Nations system is now 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.
Mr Chairman,
I feel a great responsibility being in charge of WHO, a key part of the UN system, and am grateful for all of your support and expressions of 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. This need is seen more devastatingly in the continued spread of HIV/AIDS, tuberculosis and malaria.
"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 on this scale is not just 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 now across the globe is the catastrophe of HIV/AIDS. A growing number of affected people urgently need 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 with 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, less than 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 and the private sector. Above all, it will require the commitment of each one of us here today.
The growing epidemic of tuberculosis must be another of our key focuses. SARS has brought an extraordinary level of attention to respiratory infections. But the fact is that TB is a great threat. We must do more to ensure that those suffering from TB receive the effective DOTS treatment. The countries in the Western Pacific are free of polio - a great achievement for public health. We must now press home this hard-won advantage to complete global eradication during this year and next, delivering substantial dividends for the health services of every country.
The need for health care starts at birth. Protection, during pregnancy, childbearing and motherhood, forms the core of the health system. Around the world, 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, ten 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.
Surveillance systems in WHO and our Member States 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. Our Member States took a united stand. The Convention has now been signed by fifty countries, and ratified by one. It will give the world the means to protect people from tobacco harm by banning advertising, preventing smuggling, raising tobacco taxes and enforcing more visible warning notices on packages. We must do everything we can to speed the process to the ratification by forty 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 survival and health.
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 and to the clear public health interventions that can be taken to reduce the number of people injured and killed in traffic accidents.
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 practices, 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 come through in the 2006-2007 budget. Strengthening country offices is 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 help achieve the goals of our Member States.
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.
Mr Chairman,
Over the years, WHO has built up strong and effective working relations with Member States, 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.
I look forward to listening to your debate on all these issues.
Better health for all is our common goal. Let’s work together to achieve this.
Thank you.