Report by the Director-General to the Executive Board at its 115th session

Geneva, Switzerland
17 January 2005

Mr Chairman, Members of the Executive Board, Excellencies, ladies and gentlemen,

It is twenty-two days since countries on the Indian Ocean were devastated by the tsunami, and we now know that over 160 000 people have lost their lives in this disaster. The world's attention has been focused on the countries most badly hit by the tsunami - India, Indonesia, Malaysia, Maldives, Myanmar, Sri Lanka and Thailand. But we must not forget that communities were seriously affected as far away as Bangladesh, Kenya, Somalia, Seychelles and Tanzania.

The week before last I was in Banda Aceh in Indonesia, and Galle and Ampara in Sri Lanka, and saw the devastation there. The local health workers who survived have been doing a truly impressive job, from the very start, of caring for the many thousands with injuries. All the survivors face a long and difficult struggle for recovery. It was heart-warming to see people already hard at work on rebuilding their homes and communities, and putting their lives back together.

Much has been achieved within the massive international and national relief effort over the last three weeks.

An early warning and control system for epidemics such as malaria, diarrhoeal disease, measles and dengue fever has been set up. So far, no outbreaks have been reported.

Assessments of health services in the affected areas are being carried out. In some areas, these are largely complete. In others they are ongoing, for example, on the west coast of Aceh. These assessments will also help to determine needs for reconstruction.

Health system supply chains are being restored and public health services re-established. These include vaccination campaigns, water and sanitation, nutrition, and services to meet the health needs of vulnerable population groups.

We are putting in place ways to meet the immediate and longer-term mental health needs of survivors, their families and care-givers.

WHO is also supporting national authorities with the demanding task of coordinating the response, which includes health workers with intergovernmental and nongovernmental agencies as well as local and national staff.

We will now speak with colleagues working in and around Banda Aceh, who can describe the local situation for us.

[Video conference with the Aircraft carrier USS Abraham Lincoln (Rob Holden, Operations Manager for the South Asia Crisis Assessment Team, Dr Wayan Widaya, Communicable Disease Specialist, CDC Indonesia, and Rear-Admiral Crowder, Commander, Naval Forces of the Combined Support Forces), Banda Aceh (Eigil Sorensen, Special WHO Representative for Disaster Relief and Coordination in Indonesia), and Jakarta (Georg Petersen, WHO Representative, Indonesia)]

WHO put together a team of seventy people, some working in the field in Banda Aceh, some on the aircraft carrier, as part of this excellent team. In spite the great challenges in Sumatra, the emergency phase is rapidly shifting to recovery, rehabilitation and self-reliance. Ultimately, we are working towards a situation in which people are less vulnerable, and are protected from health threats by an effective global system of alert and response.

This transition from relief to reconstruction must take place smoothly, with sustained support. Otherwise, as we have seen with other disasters, communities can languish for many years in a state of dependence, with high levels of disease and mortality.

Rebuilding permanent water and food supply and sanitation systems, health facilities, schools and infrastructure are major priorities and may take several years to complete. It is not just the physical infrastructure and the environment that will need long-term rehabilitation. We must also invest in people. Thousands of health workers and other public service employees were killed in the tragedy.

The tsunami crisis is a tragedy in itself. It is a major setback for the social, economic and health development gains of recent years within the region. Both immediate and long-term needs must be met now. It is imperative that the international support is adequate, effective, and sustained. It must be country-led, country-centred and country-coordinated.

Last week, as part of the UN Flash Appeal, WHO requested $67 million to fund these activities over the next six months. I am pleased to report that two-thirds of this money has already been pledged. And I thank the many countries represented around this table who have helped to make this possible.

The international response to this disaster has been generous. This, combined with local and national resilience, presents a real hope, both for rapid recovery and reconstruction, and for increased international understanding. The challenge now is to turn potential into reality. That means, among other things, ensuring that these resources are well used where they have been pledged, without reducing support for the many other areas of extreme need in the world.

An event that will help to keep these other global efforts on course is the launch of the UN 'Global Plan to Achieve the Millennium Development Goals' later today in New York. This is a detailed plan for international aid and lending, showing the investment needed between now and 2015 to fulfill the commitments made by world leaders in 2000.

Tomorrow, at lunchtime, there will be a special launch event here at WHO in Salle A, focused on the health components of the Global Plan. The launch will bring together international public health leaders and scientists to make recommendations for each of the health-related task forces.

The world's response to the tsunami disaster has shown the willingness of governments and the public to support communities when their affliction is sudden and dramatically apparent. The United Nations and its Specialized Agencies exist as the result of a similarly clear view of global need in earlier times, and the decision to meet it with an effective long-term system of support and cooperation.

Last month, the Secretary-General released the report on UN reform prepared by his High- Level Panel on Threats, Challenges and Change. The message for us that comes across very strongly from this report is this: WHO plays an indispensable role in assuring international security, and it has to be adequately funded and staffed to fulfill this responsibility. The Secretary-General asks the World Health Assembly to increase resources for global monitoring and response to emerging infectious diseases. These recommendations add to the importance of ensuring that we have an adequate Regular Budget in future bienniums. During this session you will be discussing the proposed Programme Budget for 2006–2007.

The demand for global public health activities has grown rapidly in recent years. Infectious diseases such as AIDS, tuberculosis and malaria require a major global control effort. Preventive measures against the growing burden of noncommunicable diseases also need urgently to be put in place. At the same time, the danger of a global epidemic of a new infection, such as SARS or avian influenza or pandemic influenza, requires us to have systems in place for a rapid response immediately. The need to tackle the social determinants of health is also increasingly apparent and pressing. All of this is in addition to the need to be prepared for disasters that happen without warning, like the current one in South-East Asia.

These are just some of the concerns of our Member States that are reflected in the present proposed Programme Budget. The overall increase recommended is 12.8%. The increase in the Regular Budget component is 9%. It is combined with a set of measures to reduce costs by increasing efficiency and accountability.

Voluntary funding has continued to be a major resource for our work, and we very much appreciate the goodwill and trust it represents. At the same time, I am proposing an increase in assessed contributions so that we can maintain the necessary stability in our activities. The world is pressing us to act with ever greater decisiveness, consistency and impartiality, and the mechanism of assessed contributions is the one that can best enable us to fulfill this triple obligation.

In two-and-a-half months' time, on 7 April, we will be celebrating World Health Day. The theme this year is maternal, newborn and child health. Every year, more than ten million children die, forty percent of them in the first month of life; and half a million women die from pregnancy-related causes. Nearly all these deaths occur in developing countries. They can be greatly reduced if the necessary resources are made available, as envisaged by the Millennium Development Goals. Tackling this global problem will be a major focus of this year.

I will switch now to French.

La Commission sur les droits de propriété intellectuelle, l'innovation et la santé publique achèvera ses travaux et présentera son rapport au cours de cette année. Nous allons aussi inaugurer la Commission des déterminants sociaux de la santé dans deux mois, à Santiago, Chili. Les ressources humaines pour la santé, bien qu'elles ne paraissent pas sur l'ordre du jour de cette session du Comité Exécutif, seront au centre de notre travail pendant cette année. L'année prochaine elles seront également le thème du Rapport de la santé mondiale pour l'an deux mille six (2006) et de la journée mondiale de la santé.

Nombreux sont les sujets de discussions mais il est préférable de les aborder au fur et à mesure de l'ordre du jour de notre agenda particulièrement chargé.

Monsieur le Président, les besoins de santé sont aujourd’hui plus que jamais au centre de l'attention mondiale. Nous nous devons non seulement de réagir rapidement aux situations d’urgences mais aussi de maintenir le travail continu de prévention et de contrôle. Pour satisfaire à ces obligations, il nous faut évoluer afin de refléter les changements de la situation sanitaire mondiale. D’avance je tiens à vous remercier pour le travail difficile que vous allez réaliser pendant les prochains jours pour définir les meilleurs moyens de répondre à ces besoins.


[The Commission on Intellectual Property Rights, Innovation and Public Health will be completing its consultations and reviewing the evidence during the coming year. We will also be launching the Commission on Social Determinants of Health in two months' time in Santiago, Chile. Human resources for health, although they do not appear on the agenda of this session of the Executive Board, will be a major focus for our work this year, and next year they will be the theme of the World Health Report 2006 and World Health Day.

There are many other developments to discuss, but it will be best to deal with these as they occur on our very full agenda.

Mr Chairman, health needs are at the centre of world attention as never before. We are called on not only to respond rapidly to emergencies but to support and maintain the steady work of prevention and control. To be able to do this, we have to evolve to reflect the world's changing health situation. Thank you in advance for the hard work you will be doing to make sure we find the best ways to meet these needs.]

Thank you.