Director-General

Meeting with State Ministers of Health

Erlangen, Bavaria, Germany
30 June 2005

Ladies and gentlemen,

Thank you for this opportunity to discuss the health system in Germany in relation to the global health system. Our international efforts and decisions can only be valuable if they enable health services to work better within countries. National plans likewise have to fit into the bigger picture if they are to succeed. So this meeting can be beneficial for all of us.

We welcome the support of the German health authorities for our current activities aimed at limiting antimicrobial resistance and ensuring hospital safety. This is an area in which the world is in danger of losing many of the extraordinary advantages that were gained for health during the 20th century. It requires a well-coordinated global response but it also requires the utmost vigilance on the part of individuals and local and national health facilities.

This need is made dramatically clear in the continued threat and high prevalence of tuberculosis. Eastern Europe has the highest rates of multidrug-resistant TB in the world and needs all the support it can get from its stronger healthier neighbours in scaling up this difficult problem especially in the poorest and worst-affected areas.

With co-infection, TB control is inseparable from the fight against AIDS, which is an equally grave concern in eastern Europe. The speed of expansion of AIDS in Russia is comparable with Africa. The current efforts of prevention and care at local and national level have to be drastically increased.

Europe's polio eradication was a major achievement, and an impressive demonstration of what immunization can do. But no country or region will be definitively polio-free until we have completed the job of global eradication. We very much need and value the support of Europe for the immunization campaigns now in progress in the remaining endemic areas and where imported cases are occurring. We also welcome your commitment to measles eradication in this Region by 2010.

As all of us are very much aware, global influenza pandemic is a possible and imminent threat. For more than a year now, the outbreak of H5N1 avian influenza in animals in parts of Asia, with the infection of a limited number of people who were in direct contact with infected animals, has been increasing the danger of a new influenza virus in humans. Today's high level of global interconnection makes all countries and all communities vulnerable to a possible global health emergency.

In past flu pandemics, large numbers of people had already died before much was known about the disease that was killing them. Today, however, thanks to current medical science and communication technology, the world has the chance to defend itself against a virus with pandemic potential before it strikes.

Defending ourselves means ensuring that there is an adequate surveillance network for human and animal influenza, and a system for alert, response, and outbreak management. WHO provides guidance, training and technical support to Member States in building national plans for pandemic preparedness. We welcome Germany's formulation of such a national plan, we also welcome its current debate on how to implement it in the setting of the country's health system. Countries have different organizational and budgetary set-ups and WHO is prepared and willing to work with all of them within the framework of the International Health Regulations.

The adoption of the revised International Health Regulations by the World Health Assembly last month was a great step forward for preventing the spread of disease and responding to emergencies.

The Regulations spell out the respective roles of WHO and governments during emergencies.

They show how each individual country can contribute to global protection.

They balance the needs of health with those of trade and international traffic.

The system of focal points, expertise and strengthened capacities for response required by the Regulations will be an asset in itself to national health services.

In sum, security may be the most pressing need for health systems now both globally and nationally. Germany, with its major role in the regional and global economy and its immense technological capacity, must continue to play a leading role. Health security does not consist only in responding to disasters. It means mainly avoiding them through an ongoing effort of disease prevention, care and coordination. This requires significant and sustained investment in health systems. Your current concerns and activities in these areas can make a very important contribution to global as well as national health security.

Thank you.

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