Regional President Tondo,
Ladies and Gentlemen,
It is a great pleasure to be able to address you at
the opening of this important and trail-blazing conference.
Let me in particular thank Renzo Tondo, President
of Regione Friuli Venezia Giulia who is the meeting host and who,
together with the Ministry of Health has made a fantastic effort to
ensure that this conference can take place. WHO is very grateful for
the initiative, the energy and the generosity of the region and for
the understanding of the importance of the work to place disability
within the overall framework of health.
Over the past few years, there has been a growing
debate about the role of health in the development of societies. The
views have changed. For too many years, investments in health were
seen by many economists as an add-on which developing countries could
only afford after having reached a higher income level. I was
convinced this was wrong: you need a two-pillar approach. A healthy
population is a pre-requisite for growth as much as a result of it.
In 1999, I asked leading economists and health
experts from around the world, to come together and consider the links
between health and economic development. Five months ago, this
Commission on Macroeconomics and Health delivered its Report, based on
two years' work by several hundred leading scientists. It concludes,
quite simply, that disease is a drain on development, and that
investments in health can be a concrete input into economic
The long and arduous debate can really be summed up
in only three words: Health Comes First.
Only healthy people with the support of a
functioning health sector can ensure sustainable development of their
societies. A loss of health is a loss not only to the person but also
to the person's family and society as a whole.
Improving the health of an individual, or the
population as a whole, is not merely a matter of reducing premature
death due to disease and injury. Health is also about human
functioning, the capacity of individual's to live a full life as an
individual and as a member of society.
But to improve health, we need tools to measure it
and to measure the changes brought by interventions. This is where the
International Classification of Functioning Disability and Health come
in. It is a common international framework for describing and
ICF is WHO's framework for measuring health and
disability at both individual and population levels. While the
International Classification of Diseases classifies diseases as causes
of death, ICF classifies health. Together, the two provide us with
exceptionally broad and yet accurate tools to understand the health of
a population and how the individual and his or her environment
interact to hinder or promote a life lived to its full potential.
Such a tool is important both to developing
countries struggling to improve health conditions despite severe
financial limitations, and to industrial countries working to limit
costs and provide fair and responsive health services in a time of
changing expectations among their populations.
ICF is a truly global and universal tool. It was
developed and refined by means of a 10 year international process
involving over 65 Member States, which lead to a broad-based consensus
over the terminology and classification. Extensive field testing
provided for cross-cultural comparability making the ICF a truly
international standard for functioning and disability classification.
Given the unanimous endorsement of 191 Member
States of the ICF at last year's World Health Assembly, I am pleased,
but not surprised, to see this strong interest and participation.
WHO's mandate includes setting norms and standards,
promoting the basic global values of health, equity and inclusion, and
providing countries with tools and advice to improve their health
policies and the performance of their health systems.
The work to develop and promote the ICF has allowed
WHO to combine all these elements.
More than anything, the ICF is based on the value
of inclusion, and on a universal model of disability. It rejects the
view that disability is a defining feature of a separate minority
group of people.
Health is the ability to live life to its full
potential. For many people with disabilities, the realization of that
ability is dependent on factors in society. When a person in a
wheelchair finds it difficult to enter into her office building
because it does not provide ramps or elevators, the ICF identifies the
focus of an intervention: it is the building that should be modified
and not the person who should be forced to find a different place of
By adopting ICF as a basis for its policies and
legal framework, countries therefore do more than taking up a new
tool. They subscribe to an inclusive, equitable and humanistic view of
health. They accept the right of disabled to be a natural part of
Countries will be able to monitor their policies
and services to meet their international responsibilities of the
equalization of opportunities for persons with disabilities.
ICF provides the framework for health services, by
measuring health outcomes to monitor and assess the effectiveness of
health interventions. It meets the urgent demand for instruments to
measure the performance of health interventions and health systems.
WHO has already adopted ICF as the basis for its
survey program. We encourage Member States to follow this example by
making their health information systems and survey programs consistent
But the usefulness of ICF goes beyond the measuring
of overall health systems performance. It will also be the tool for
measuring the effectiveness of interventions funded by initiatives
such as the Global Fund to fight AIDS, Tuberculosis and Malaria.
In addition, with the ICF, countries will be able
to identify factors such as education, transportation or housing, both
as determinants of health and social factors influenced by
improvements in health. These links further support the relationship
between health and economic development.
In short, we have in front of us, in the shape of a
little red book, an extraordinarily versatile tool - a Swiss Army
Knife for health ministries, researchers and decision-makers.
This conference is the first step towards
exploiting ICF's many possibilities. I hope it will be stimulating and