Ladies and Gentlemen,
You are asking the question whether WHO can deal effectively with
deteriorating health conditions in the world.
The brief answer is yes. This is the very sense of being of the World Health
Organization. But we cannot do it alone - we need broad partnerships - with the UN family,
with civil society - and with the private sector. Here at Davos I would like to focus more
specifically on our relations to industry.
Despite the major health achievements in this century there is a large and unfulfilled
agenda ahead of us. One fifth of humanity has no access to health services and one half
lacks regular access to essential drugs. Inequalities are widening in the developed as
well as the developing world.
The poverty trend is negative. More than 1 billion live in extreme poverty and the
numbers are increasing. Here there needs to be a change. Poverty makes no sense - morally,
socially, politically and indeed economically.
We have studied the Global Burden of Disease into the next century. Looking ahead -
what are the causes of not only mortality but also disability - and how can we fight them?
The leading causes of mortality or disability in 1995 show the traditional three on
top: lung diseases, diarrhoea, and perinatal conditions, the same three that would have
been on top had we done this study back in 1965 or even earlier.
What about the leading risk factors? First, there is malnutrition. Then follows poor
water and sanitation. And then comes unsafe sexual behaviour - largely linked to the
spread of HIV/AIDS.
Looking towards 2020 there are major changes ahead - due to an ageing population - and
economic and social transition. The three leading causes of mortality and disability in
2020 are likely to be heart disease, mental depression and road accidents - unless there
are new and unpleasant surprises from the spread of communicable diseases.
And what about the leading risk factors?
Many are the ones as we know today. But our studies - and that of others - show one
remarkable shift. That is the dramatically increasing role of tobacco.
By 2020 the burden of disease due to tobacco is expected to outweigh that caused by
any single disease. From its 1990 level of being responsible for 2.6 per cent of all
disease burden worldwide, tobacco is expected to increase its share to close to 10 per
cent. These are the dry facts.
What, then, is WHO's strategy?
We take a broad perspective. The fact is that poverty is the main reason for disease
and suffering. But it also works the other way around. Ill-health breeds poverty.
We are assisting countries to fight the scourge of communicable diseases - such as
HIV/AIDS, malaria, tuberculosis and polio.
We are assisting countries to cope with the growing burden of noncommunicable diseases
- cancer, heart disease and diabetes. Many countries have to cope with a double burden of
disease - having to fight at the same time communicable diseases and the new epidemic of
We are assisting countries to cope with rising challenges - such as depression, ageing
and the health consequences of environmental degradation.
A fundamental role for us is to assist countries in reforming their health sectors so
that they can really cope with these trends and challenges.
We send an important and simple message: Investing in health is sound economics. From
being perceived as an unproductive consumer of public budgets, wise investment in health
is now increasingly understood to be key to productivity itself.
Let me then touch on our relations with the private sector.
With the pharmaceutical industry we have an unfinished agenda. They are in the business
of developing, producing and selling drugs and vaccines. We are in the business of helping
countries to get access to essential drugs. They are in the business of making profits. We
are in the business of seeing to it that the most vulnerable - those who have little or no
purchasing power - also get access to drugs. There are obvious bridges to build.
There are joint initiatives - such as our drive to develop new malaria drugs to combat
the re-emerging threat from malaria - currently killing 3000 children every day.
Malaria is a human and social tragedy. It is also a severe economic impediment.
Professor Sachs at Harvard has studied the economics of malaria and provided a deeper
understanding of the negative effects malaria has on development. To be precise: How many
of you would think twice before investing in an area where malaria is flourishing?
Our project Roll Back Malaria includes partners from industry. Together with the World
Bank and Rockefeller Foundation we will establish a Venture Capital Fund, initially
financed by grants from public sector institutions. It will stimulate the discovery of
promising and cost-effective new, anti-malarial products.
There are other innovative contributions such as the recent major donation of drugs by
Smith-Kline Beecham, joined in partnership by Merck, to support our struggle against the
tragic disease of lymphatic filariasis. Merck has also made crucial contributions to the
control of river blindness, which is now within reach through successful programmes in
Africa and Latin America.
Another example is our struggle against poliomyelitis. Thanks to steady progress in
vaccination, we are on the brink of eradicating this crippling disease - with an ambitious
target of eradication by the end of next year.
The success in the fight against polio has been greatly helped by Rotary International
who, by the end of this year, will have raised close to 500 million dollars for
vaccination programmes. That is a fantastic effort.
We need an estimated 370 million dollars more, in order to carry out those last
essential vaccination campaigns. A world free of polio would save 1.5 billion dollars
annually in vaccination costs. Think about it. A
one-time investment of 370 million dollars will give savings of 1.5 billion dollars every
year for as long as you can imagine. I can think of few investments with a better return
than this one.
I will end on another urgent area for cooperation - tobacco control. Three and a
half million die from tobacco every year - with two thirds dying in middle age - not in
old age. That figure is expected within one generation to triple to ten million. All of
that growth will be coming in the developing world. One out of three Chinese men who are
today under thirty are expected to die from tobacco.
We face a real epidemic - it will hit countries which at present have very weak means
of defence - it is driven by a part of industry which is massively focusing its marketing
efforts on youth and women in those countries.
Nicotine is addictive. Habits start in youth. Eighty per cent of smokers start their
dangerous habit before the age of 18. We are talking about 12, 13, 14 year-old kids
embarking on addiction. That is not freedom of choice.
We work with the World Bank, UNICEF and other UN partners to strengthen control,
taxation policies, and a ban on advertising.
But we also need to help people not to start smoking - and to help those who have
started to quit. How can industry help? Many of you do by urging and supporting your staff
to quit smoking and by setting the example yourself. Well done.
I am pleased to announce a new partnership here today. We have just set up a
Partnership Project in our European Region, with the objective of reducing tobacco-related
death and disease among smokers. The project, which is open to both private,
non-commercial and public-sector partners, will support the key strategic goals of our
Three major pharmaceutical companies have joined this partnership: Glaxo Wellcome,
Novartis, and Pharmacia & Upjohn. They all manufacture treatment products against
tobacco dependence. Together, these companies will support a common goal that will have a
significant impact on public health.
Tobacco dependence treatments are effective. Industry has the products which can help
people quit. Stopping is wise. Helping people to stop is a good idea.
In conclusion: We are facing major health challenges. There is a real scope for meeting
them. It is within our grasp to drastically reduce the global burden of disease. WHO is
determined to do its part. And I am happy to welcome other stakeholders - and that
includes industry - to join us - because investing in health yields high returns.