Ladies and gentlemen,
The report of the Commission on Macroeconomics and
Health was launched last December. Only six months ago. But since
then, much has happened. The report has aroused intense interest
around the world.
This meeting is important as it is the first time
that we have had a chance to focus specifically on what the CMH Report
means for individual countries. We are fortunate to have with us today
such a distinguished group of participants. From ministries of
finance, ministries of planning, ministries of health; the World Bank,
UN organizations, donor agencies, foundations and regional
commissions. We have with us members of the CMH family – both
Commissioners and working group members. From WHO too – we bring
together staff from our regional and country offices, as well as
colleagues from headquarters.
Let me warmly welcome you all, and thank you for
making this meeting possible.
Transformation. To me that is the central message
of the CMH Report. Transformation from better health to better
livelihoods. From better livelihoods to economic growth. And from
economic growth to a sustained, and sustainable, reduction in poverty.
One reason why the CMH Report has aroused such
intense interest is that it contains a powerful blend of aspiration
and realism. It is clearly an important advocacy document, but it also
contains many practical recommendations to national authorities.
This provides the theme for our meeting.
Transformation once again: but this time from advocacy to action. From
a global framework to country specific strategies. Not prescriptions,
of course – as each country will factor in its own circumstances –
but shared ideas, core functions and common objectives, as we work
collectively towards the Millennium Development Goals for health.
Ladies and gentlemen,
Two and a half years ago, when I asked Jeff Sachs
to lead an independent Commission, we had two objectives. The first
was a technical one. We were seeking a way of bringing together the
best brains in the world and getting them to focus on the complex set
of relationships that exist between health, economic development,
trade and poverty reduction. If we are to present the case for greater
investment in health, we must be standing on solid ground. We have to
get the facts straight and marshal the evidence. In this respect, the
Commission and its six working groups have helped us enormously.
But the Commission also had a political objective.
Including macro-economists and senior policy makers as members of the
Commission certainly brought a fresh perspective to the analytical
work. But these eminent individuals also have the ear of other
decision-makers who are less familiar with the world of health and
development. The Commissioners are powerful advocates for our message.
If I think back fifteen years, to the time when we
launched the report of the World Commission on Environment and
Development, we learnt some useful lessons. As with the CMH, there was
an inner circle of Commissioners – and around them a wider network
of people from government, researchers and academics, NGOs and many,
many others. Once the initial launch was over our strategy was to
keep widening the circle. Continuously expanding the network of
people that were actively debating and spreading the Commission’s
We see similar developments with the CMH and its
widening circle. The CMH was extensively discussed at the World
Economic Forum in New York this year, at the International Conference
on Financing for Development in Monterrey in March, and at the World
Health Assembly. In the discussions between heads of state and
ministers at Monterrey health featured prominently – and the CMH
helped in providing a well-argued case to illustrate the need for
increases in development spending by governments and international
agencies. And we are beginning to see a difference in renewed
commitments for increases in development assistance.
At this year’s World Health Assembly, the
recommendations of the CMH were explicitly recognized as part of the
strategy for achieving the millennium development goals. In August
this year, the follow-up to CMH will be central to WHO’s inputs to
the World Conference on Sustainable Development in Johannesburg.
All new ideas need their champions. Internationally
there are now many people that have internalized the ideas contained
in the CMH Report and made them part of their thinking. We now need
similar champions at national level.
As we work together over the next two days, we will
look at some of the responses that are being considered by countries
represented in this room. We will discuss some of the specific
recommendations of the CMH, such as the establishment of time-limited
national commissions. These are but one means of providing a national
focus for scaling up work on health.
From my experience with sustainable development, it
is important to recognize that a national commission, or its
equivalent, will only be a success if it is part of a much broader
national debate on health and poverty - which involves legislators,
civil society, local authorities, the media, academics, industry and
Health is now higher on the development agenda than
ever before. With global political commitment have come global
initiatives, new partnerships between public and private sectors, and
new alliances between countries. These are positive and exciting
developments. But they also bring with them a complexity that is new
for both national governments and their development partners. Our
challenge – which underpins the purpose of this meeting – is to
understand and to manage these developments in a way that brings
maximal benefit to poor people.
As we interpret the messages of the report –
balancing aspiration with realism – we have to take account of what
is feasible. But I am sure that Jeff Sachs would join me in urging you
not to lose sight of the aspirations. Achieving the Millennium
Development Goals will not happen if we stick to business as usual. We
have to scale up, think in terms of a quantum leap. Doing more, doing
it differently and doing it better.
A key challenge is to make sure that what we plan
is firmly embedded in national development processes. The CMH is not a
new stand-alone initiative. Let us see it as a stimulus to act. A
stimulus that will make us look closely to see whether health is
adequately reflected in a national poverty reduction strategies. A
stimulus to look closely at existing national health plans: are they
sufficiently focused? how can we make sure that poor people really
benefit? how can we create new partnerships that extend the reach of
health services? These are the kind of questions I hope you will be
The Commissioners' central message applies to
countries: it focuses on the need for additional resources and on the
ways in which these will be used. This is why our meeting brings
together officials from finance ministries and development agencies,
as well as health professionals. To achieve our shared goals will
require much more money than is currently available to many countries.
But let us remember: we know that we can ask for more, because we know
now how to spend it and we can show that we can spend it well.
Scaling up requires not only that we have a clear
sense of the cost of interventions, but that we can track progress and
measure results. It is not just a case of showing that there is a gap
between what is needed and what is available. We have to be able to
demonstrate clearly what can be achieved with the additional monies
that are becoming available: then we can seize current opportunities
and make the case for a long-term step increase in funding and action
We need to use the momentum generated by the CMH
Report to follow through actions at the country level that widen the
traditional constituencies of health, bringing in new and varied
partners working across sectors, placing poor people and poor
communities squarely at the centre. These new ways of working at
country level will yield rich dividends in terms of more monies and
better health outcomes for all.
Thank you very much, and I look forward to working with you over
the next two days.