Mr Malloch Brown,
Ladies and Gentlemen,
Unless we can make globalization work in the
interests of all, we will foster the global spread of illness. In
the modern world, bacteria and viruses travel almost as fast as money.
With globalization, a single microbial sea washes all of humankind.
There are no health sanctuaries.
The separation between domestic and international
health problems is no longer useful, as over two million people cross
international borders every single day. A tenth of humanity each year.
It is not only the infectious diseases that spread
with globalization. Changes in lifestyle and diet prompt an increase
in heart disease, diabetes and cancer. More than anything, tobacco is
sweeping the globe as it is criss-crossed by market forces. Only weeks
after the old socialist economies in Europe and Asia opened up to
Western goods and capital, camels and cowboys began to appear on
buildings and billboards.
If the growth in tobacco use goes unchecked, the
numbers of deaths related to its use will nearly triple, from four
million each year today, to 10 million each year in thirty years.
Practically the entire growth in tobacco-related mortality, more than
70% of these ten million deaths, will take place in developing
Clearly, globalization does not have to lead
to human insecurity because of the spread of illness. Nor does it have
to contribute to inequity. Forces of globalization can be
channelled so that they lead to a more just and equitable global
We need to define key global public goods: Together,
we need to identify areas in which the production and dissemination of
essential goods at a reasonable price cannot be assured through normal
market forces. In the health field, this includes essential vaccines,
diagnostics, and medications.
We need to identify instances when globalization
leads to an undesirable impact: This may mean putting forward the
case for international regulation of global negatives. In the
health field we are already progressing - through the ongoing
political and legal negotiations for an International Framework
Convention on Tobacco control.
We know that the poor suffer disproportionately
from the ravages of communicable diseases. In 1998, communicable
diseases were responsible for about 34% of the total burden of disease
world-wide, but nearly twice that - 64% - among the fifth of the
global population living in countries with the lowest per capita
income. Most of these diseases can be prevented or easily cured with
available vaccines and drugs, but poor countries and poor people do
not have access to them.
We know too that HIV/AIDS, TB and malaria are
themselves major causes of poverty. The success or failure of
our collective response to these threats is critical. It holds the key
to the economic and physical security - not just of individuals and
communities - but of nations and continents.
HIV prevalence rates of 10-15% - which are no
longer uncommon - can translate into a reduction in growth rate of GDP
per capita of up to 1% per year. TB, which is made worse by HIV, takes
an economic toll equivalent to $12 billion dollars from the incomes of
Africa's GDP would probably be about $100 billion
more now if malaria had been tackled 30 years ago, when effective
control measures first became available.
So we need to focus on how the forces of
globalization can be harnessed to bring benefits to poorer people
within and between countries. There are great gaps that need to be
filled, but it is doable, if are able to achieve the scale-up of
resources that is very urgently needed.
There is an increasing political consensus behind
global health equity. It is manifested through the international
development targets that have been built up in recent Summits and
backed by the recent G8-G77 focus on addressing the key diseases of
At the same time, we see a vital need for the
continuing involvement of the private sector and of civil society
organizations in this process. This is why the idea of a global health
initiative has been launched. Most companies care about the health of
their workforces, the communities with whom they work, and those with
whom they interact throughout the world.
Some companies have already given higher priority
to people's health, within global initiatives. They contribute to
polio eradication through the Rotary Movement; to the elimination of
leprosy through the Novartis and Sasakawa Foundations and Merck to the
control of river blindness through the Mectizan programme.
They contribute to childhood immunization, under
the umbrella of GAVI, a Global Alliance launched at the World Economic
Forum in January 2000 with the critical backing of the Gates
By joining partnerships - like Roll Back Malaria,
GAVI and Stop TB - companies support the adoption of tried and tested
strategies in communities affected by illness. They focus on results.
Take the example of ENI, working with government and civil society in
Azerbaijan, helping people to reduce the risk of malaria infection and
increasing access to effective treatment.
Many companies have now joined the movements to
reduce the risk of HIV infection and to enable people living with HIV
and AIDS to access care. The companies that have established the
Global Business Council on HIV-AIDS have set a powerful example,
encouraging individual actions, collective advocacy and the sharing of
Much more could be done, if companies commit
themselves to global health and work together, using best
Companies could make a greater contribution to
improving the health of the world's poorest people. A Forum Initiative
could lead to the much needed scaling up of effective action. It could
do this by providing an umbrella, and by building on the many actions
currently under way.
It could certainly provide an excellent opportunity
for sharing good corporate practice.
It could also inspire a wider corporate involvement
in public policy.
I would be happy for WHO to support the
establishment of such an initiative.
As we have heard, the world has set major goals for
equity in health. They can be fulfilled, and the result will be
significant reductions in levels of poverty. But to do this we need
sustained partnerships between the public and private sectors, based
on shared values and strategies.