High-Level Forum on the Health Millennium Development Goals

Geneva, Switzerland
8 January 2004

Distinguished Ministers, Colleagues, Ladies and Gentlemen,

It is a pleasure to welcome you to this important Forum.

We were very happy three years ago to see the global community agreeing so strongly about the central importance of health for the future of the world. The Millennium Declaration was a great event. Now, however, we have a much clearer idea of what will be involved in achieving the goals and targets for health by 2015. It will require a much more determined and creative effort than many of us imagined.

A major requirement, without which the others cannot be met, is effective and equitable health systems. A clear and straightforward agenda for health systems development is needed. Where the right policies and systems are in place, money can always be put to good use.

Secondly, we need better ways to work across sectors. Reducing child and maternal mortality, for example, involves education, transport, communications and employment, as well as good midwives.

Thirdly, the poor usually lose out on the benefits of development. We need specific methods to ensure that this does not happen.

During the discussions you will be looking at these and some of the other challenges that have become more apparent.

All of them point to the need for new ways of working and new ways of thinking about health as part of development. This Forum brings together some of the most creative and influential minds in this field, so that we can spell out and pursue these new approaches.

I see several areas in which we need to find a way forward:

Harmonization is one. Donors have become better at working together but there is still much to be done if we are to reduce the administrative burden on countries, especially the poorest ones.

Then, what about countries in crisis, where services are all but non-existent? These are the ones furthest from being on track to achieve the MDGs. Many of the countries represented in this room are trailblazers in showing the way to better health, and we need to see how the neediest can benefit from their expertise.

Next, how should we handle the issue of resources for health, particularly for AIDS? The needs are huge, as are the costs of not tackling this epidemic effectively. There are conflicting opinions on this, and the challenge is to find a convergence that works - not just for the institutions involved but for the people affected.

This is closely related to monitoring. We have to know how we are doing - what results we are getting on the ground. Countries need better information with which to plan; donors need better information on which to base disbursements. Meeting these matching needs will point the way forward. Where the specific requirements are known in detail, it is usually much easier to find the resources for meeting them.

Lastly, but perhaps most importantly: trained and reliable human resources are very often the most pressing shortage. Here as in other areas, the challenge now is to move from analysis to action. What can be done on a country-by-country basis? What needs action at the global level - and how can we as members of this Forum make it happen?

The trouble with long-term objectives such as goals to achieve by 2015 is that they do not necessarily make any immediate demand on a specific person or group. At first it seems too soon to take urgent action and then, after a few short years, it seems too late. Where the targets are the product of a large consensus there is also the hazard of everyone waiting for everyone else to risk making the first move.

We still have time to avoid these pitfalls with the targets for 2015, but to do so we have to act now. The campaign to get three million people onto antiretroviral therapy by 2005 is aimed at providing this kind of catalyst for three of the targets. Mortality reduction will be the direct outcome. Poverty reduction through restored capacity to work and reduced local medical costs will follow. The preventive effect of providing treatment is a vital step towards reversing the spread of HIV/AIDS. In addition, the "3 by 5" initiative is already contributing to the millennium goal of stronger partnerships between UN agencies, governments and other organizations.

One burst of activity is not enough though, and part of the idea is that this one will set off others. Just as action on any one of the targets can stimulate progress towards the others, that activity itself needs the momentum of others.

Today and tomorrow you have a great opportunity to decide what some of those other activities need to be. Bold and coherent plans of action for the immediate future are what we most need now. This concerns not just our common agenda but that of each country and organization represented here today.

I wish all of us success in these discussions. Success will mean action. It is not an exaggeration to say that the future depends on it.

Thank you.