Launch of the UK Department for International Development’s new health strategy
Dr Margaret Chan
Director-General of the World Health Organization
Honourable Secretary of State, honourable Ministers, colleagues from the World Bank and the Global Fund, ladies and gentlemen,
I am pleased to be here and thank you for this opportunity to address such a distinguished audience.
The United Kingdom has long enjoyed a leadership role in international health. Most recently, this leadership has been expressed in a series of outstanding reports.
I am referring to the Commission for Africa, the Stern review of the economic consequences of climate change, and the white papers that helped shape the new strategy.
I should also mention the unprecedented commitments made at the G8 summit in Gleneagles in 2005, under UK leadership.
When I speak about health development, I often mention the many reasons for optimism.
In just the past ten years, evidence that health can drive economic progress has spurred the growth of an unprecedented number of health initiatives, partnerships, and innovative funding mechanisms.
Health has never before enjoyed such attention or such wealth. Nor have the ambitions, commitment, and level of consensus ever been so high.
The launch of the DFID strategy gives me another reason to be optimistic about the outlook for public health.
The strategy is responsive. It incorporates changes that are a courageous answer to the complex challenges facing health development.
I mean, in particular, the need for predictable aid, the need to do more for HIV/AIDS, and the need to return sexual and reproductive health services to their rightful place.
I am also referring to its flexibility, its big-picture outlook, and its support for long-range planning.
The strategy is responsive, and it is also responsible. It places governments in the driver’s seat, but it also acknowledges that responsible aid is effective aid invested in strategic ways.
Above all, I applaud the firm emphasis placed on poverty reduction and on fairness.
Secretary of State, you have described poverty as a scandal.
Your Prime Minister has stated: eliminating global poverty is one of the greatest moral challenges that we face.
I agree entirely. Global poverty is a devastating injustice. Health development is the most effective way to tackle this injustice. Good health can indeed become a pathway to a fairer world.
I appreciate the coherence of this strategy. If you want to reduce poverty, it makes sense to help governments abolish user fees.
If you emphasize fairness, it makes sense to commit to deliver resources whatever the political environment.
The fact that people have the bad luck of being born in a country with poor governance does not negate their need for support. They, too, have a right to live-saving and health-promoting interventions.
Ladies and gentlemen,
We all know the reality. Globalization creates wealth, but has no rules that guarantee its fair distribution. Gaps in income and gaps in health outcomes keep getting wider.
The scandal deepens, as does the moral challenge.
In a sense, the new initiatives, partnerships, funds, and financing mechanisms are a compensation.
They compensate for the failure of the international system to take care of those in greatest need.
But the international community has been successful in other ways. We have the Millennium Development Goals as a single unifying framework of ambitions and commitment.
These goals are an absolute commitment to fairness.
I share your deep concern, expressed in the strategy, about slow progress in achieving the MDGs, especially in Africa.
Like financial aid, optimism must be strategically invested. Optimism gives us the strength to persist until we get the results that drive our vision.
I would argue that now is the time to concentrate on the hardest tasks.
We have our best chance ever to address inequity and settle the score. This time around, with the commitment, goals, strategies, and resources in place, we must get the other elements right.
I think we agree. The lack of capacity to deliver services to the poor is the greatest single obstacle facing health development.
If we want better health to work as a poverty-reduction strategy, we must do three things.
First, we must scale up pilot projects to reach larger populations. And we must do so in a way that integrates them into the very fabric of health systems.
Second, we must give priority to reaching the poor, those in the remote rural areas and shantytowns that are notoriously hard to reach.
Finally, we must develop the delivery systems for doing so.
None of this is easy, but it needs to be done.
I can sum up the principal concerns of the May Health Assembly with two words: interventions and implementation.
Ministers of health from different countries expressed their wish to have better access to existing interventions, and they want new ones for specific diseases.
Anyone who followed the news last week knows about the global threat posed by extensively drug-resistant TB.
We are all glad to know that DFID is doubling its investment in research.
Countries also want support with implementation. When good interventions are available, the greatest need is for the systems and infrastructure to deliver them, especially to the poor.
As acknowledged in the strategy, health systems also need staff. We are fortunate to have Lord Crisp working with WHO on this issue.
Ladies and gentlemen,
I have been especially attentive to the implications of this strategy for the work of WHO.
We are all concerned about the need for more coordination, coherence and cohesion, for less duplication and less waste.
Developing countries are littered with the debris of failed short-term projects. As I have said, this time we must get things right.
In the drive to increase the effectiveness of aid, you want greater clarity of roles and responsibilities, particularly where the strengthening of health systems is concerned.
You want to know which plans are suitable for large-scale aid support.
As I stated in my address to the May Health Assembly, I am using every opportunity to impress upon our partners the need for coordinated approaches to the improvement of service delivery.
A search for greater alignment will take place in July, when I meet with the heads of the eight main health-related international institutions. Health systems will be high on the agenda.
Ladies and gentlemen,
As I conclude, I would like to quote from a session of the Executive Board, held in 1999 under the chairmanship of Sir Kenneth Calman.
In his summary of that session, Sir Kenneth drew attention to what he considered one of the most striking statements, made by an African woman.
The woman asked: “How does it comfort us to know that our babies were fully immunized when they died from other causes?”
There is no comfort. This is a call to action.
We need a big-picture look at the causes of poor health. We need to measure results across the board, and not just for single diseases.
We need a comprehensive, integrated approach to service delivery. We need to fight fragmentation.
The DFID strategy addresses these problems head-on. It is a powerful new model for development assistance.
I am committed to moving forward with you, in our closely coordinated roles.