Health situation in Syria

Dr Margaret Chan
Director-General of the World Health Organization

Briefing to the UN General Assembly
25 February 2014

Mr President, Secretary-General, distinguished delegates, ladies and gentlemen,

I am speaking to you with a heavy heart. In March, the Syrian crisis will enter its fourth year. The long duration of the conflict has created a crisis for health. The health needs of the Syrian people are enormous, as is their suffering.

In the course of this conflict, more than 100,000 people have been killed, and more than 600,000 have been injured.

At least 6.5 million Syrians have been internally displaced, often crowded together under unsanitary conditions that favour the spread of disease. Another 2.3 million have fled to Lebanon, Jordan, Turkey, Iraq, and Egypt, creating a heavy burden on these countries.

Health needs have skyrocketed at a time when domestic capacity to respond has been decimated. The country’s previously excellent health system has collapsed in a significant number of areas.

More than half the country’s public hospitals have been damaged, often following direct attacks, and many no longer function. The number of doctors, nurses, and other health workers still at work has dropped by more than half.

A once vibrant pharmaceutical manufacturing industry has nearly ceased operations, resulting in severe shortages of drugs. Many patients with chronic diseases, like heart disease, cancer, and diabetes, are not being treated.

Immunization programmes, which reached 90% of children before the conflict, have been disrupted, leaving young children vulnerable to entirely preventable diseases. Safe childbirth is no longer readily accessible, placing pregnant women with life-threatening complications at heightened risk of losing their lives.

The suffering of the Syrian people is reflected in increased mental health disorders, food shortages, undernutrition, and an increase in sexual violence.

The steep drop in childhood immunization opened the door for vaccine-preventable diseases to return to Syria. And they did, including polio.

The first cases of polio in Syria since 1999 were reported in October 2013. This marked a significant added threat to Syria’s children, but also a setback to the global initiative to eradicate polio. Most significantly, it confirmed the renewed vulnerability of the Syrian people to diseases that had long disappeared from the country.

Since detection of the polio cases in October, four mass vaccination campaigns have been conducted in Syria. The most recent campaigns, undertaken in January and February of this year, appear to have reached all districts in all governorates. Preliminary results indicate that immunization coverage was higher than 80% in all but two governorates.

However, to control the outbreak, efforts on a similarly massive scale need to be sustained during three to four additional campaigns extending until at least June. The future of many Syrian children, and a worldwide eradication effort, are at stake.

Ladies and gentlemen,

Last year, life-saving medicines and supplies reached nearly 5 million Syrians. Much more needs to be done, despite the challenges.

All of these efforts to address the deteriorating health situation are being conducted under extremely difficult and dangerous conditions. Despite the greatest possible will to provide assistance, lack of access to people in need, wherever they reside, remains the most critical barrier to improving the health situation in Syria.

I began my intervention with a heavy heart, and conclude with a heartfelt plea. All parties in the conflict must respect the integrity and neutrality of health facilities.

They must ensure the protection of health workers and patients, in line with their obligations under international humanitarian law.

Thank you.