Director-General

Health Ministers Meeting

Colombo, Sri Lanka
5 September 2005

Honourable Ministers of South-East Asia , Regional Director, Colleagues,

It is a great pleasure to be back here. Thank you, Honourable Minister Nimal Siripala de Silva, for your invitation.

So much progress has been made since that terrible day of devastation in December last year. You have rebuilt homes and health facilities. The potential disasters of the aftermath have been almost completely avoided. Although so many lives were lost to the sea, people's lives were successfully protected from major outbreaks of disease.

Of the appeal for 70 million dollars to address health needs, 90% of funds have already been committed. They will all have been used for the reconstruction process by the end of this year. The main focus has been on building national capacity within health protection and disease prevention; health policy and coordination; and on health services delivery. We will continue to work with you and others to extend this work as needed.

The Tsunami touched all our lives, whether we live here or not. It was a humbling reminder to millions of people throughout the world of our human fragility. Nature has the power to change our lives in one sweeping event. We are reminded again of those effects by Hurricane Katrina.

Right now we have the opportunity to prepare for another natural disaster. Avian flu. We don't know when it will strike, or how hard it will hit. But we have the chance to put our action plan into place to save thousands, maybe millions of lives.

Since January 2004, H5N1 has caused at least 112 human cases and almost 60 deaths in four South-East Asian countries. Last year we discovered that domestic ducks had become a silent reservoir of the virus. They can excrete large quantities of virus in its most deadly form, yet show no sign of illness. This means that there are no warning signs for families in rural areas - where the majority of human cases have occurred. This makes the control of outbreaks in poultry far more challenging. The virus has a new niche in domestic birds in Asia. It has also got a firm foothold in migratory birds. At least 6000 wild birds died in the last outbreak in China. Prior to this event, deaths of migratory birds from any flu virus were extremely rare.

The expanding geographical range of the virus increases opportunities for human cases to occur. This in turn increases opportunities for it to become more contagious.

Our response is outlined in this strategic action plan for all Member States. It has three phases with recommended actions. In the first, we need to improve case detection and diagnostic capacity in affected countries and countries at greatest risk. This is the early warning system. The warnings may originate from single countries, but they have global implications.

In the second phase, at the emergence of a pandemic virus, we need to build up the international stockpile of antiviral drugs. This will be used to treat the emerging cases. They will provide protection until a vaccine is available.

In the third phase, during pandemic spread, the priority is to find ways to speed up vaccine development, and technology transfer, expand manufacturing capacity and ensure that all countries have access to sufficient vaccine at affordable prices.

Health workers have to be trained to deal with a pandemic. There are communication issues to address: the general public needs to understand what is going on without panic and know what to do if quarantine measures are needed, if schools or other public places have to close. We know, from India's recent success in stamping out type 1 poliovirus with its new monovalent vaccine, that it is possible to develop new products quickly, and use them to great effect. We have the experience, from previous outbreaks, of mobilizing rapid response teams to "mop up". Indonesia has done an excellent job in its recent national immunization days, drawing on 750 000 volunteers and health workers to vaccinate 24 million children across the country to squash transmission of imported polio. This is a lesson for the future: we must work to establish the "early warning" reporting systems. We must deliberately and without fail build up health worker resources.

There are other important political and social dimensions to such a pandemic. There are central issues to face, for example, of equity of access to life-saving vaccines or medicines. The wealthier countries need to act now, generously, to make sure that no population is disadvantaged. We have an opportunity here to live up to our ideals of health for all. Who here could choose which people are protected against flu and which we allow to die? We have to avoid those impossible questions by making sure, as best we can, that there enough supplies of medicine and vaccine for everyone, equally. The issue of universal access is central to our efforts to combat disease. The 3 by 5 initiative has made a start in changing the global mind set that access to drugs is only for those who can afford it. The G8 recently set an even more ambitious target. This was to get "as close as possible to universal access to treatment for all those who need it by 2010". Access for everyone to the treatment they need is now recognized as not only absolutely necessary for people who live with HIV, but entirely feasible.

Disease outbreaks in one country are everyone's business. The International Health Regulations 2005 recognized this. It will be increasingly important to coordinate information and activities on disease prevention and control. You are already doing this successfully with your close neighbours in the Western Pacific Region, in several areas. Next week I will be attending the meeting of ASEAN Heads of States in New York. I will speak there on the issues I have raised this morning and on the fruits of our discussions today.

We face today some truly challenging issues in health security and health equity. They will take all our resolve and strength of purpose to achieve. It is a pleasure to be back with you all in this Region and to discuss with you how best WHO can provide support.

Thank you.

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