Address by Ms. Elena Salgado, Spanish Minister of Health and Consumer Affairs in her capacity as President of the 58th World Health Assembly
Mr. Director General of the World Health Organization, Honourable Ministers, Excellencies, Distinguished Delegates and Guests, Ladies and Gentlemen,
First and foremost, allow me to thank you all for having elected me President of the 58th World Health Assembly. It is an honour for me, for Spain, my country - which had never presided this great assembly before - and for the European region of the WHO.
First of all, I would like to congratulate Dr. Muhammad Nasir Khan, Minister of Health of Pakistan, for his excellent presidency of the 57th Assembly.
It has been six years since another woman, Mrs. Maria de Belem Roseira, the Minister of Health of Portugal, presided over the World Health Assembly. On the 57 previous occasions, only four women have been elected to this post.
Allow me as a woman, as a mother, and as a female minister of the first gender-balanced government in my country's history, to underscore this fact. In particular at the start of an Assembly whose theme has much to do with women, namely: “Every mother and every child counts!”
Women's health means the health of more than half the world. Women represent just over half of the world's population. In the majority of countries, they account for most of the health sector labour force. And almost everywhere, including the developed countries, mothers, wives and daughters provide health care within families that, in the best of cases, complements - if not replaces- the shortcomings of the formal health systems.
In many countries, including my own, women live longer, on average, than men, yet complain of living their lives in a poorer state of health. Until fairly recently, physiological normalcy parameters only referred to what is normal in men. And yet today many health situations that are frequent in women receive little or no attention whatsoever.
It is not a question of "medicalizing", more than is reasonably necessary, what may be regarded as the normal physiological situations of women's lives. It is a question of paying appropriate attention to women's most frequent health problems, and of conducting more and better research into the health situations that women face; symptoms of malaise about which still little is known, and are often labelled as “diffuse” or “functional”.
Let us start with the most evident facts: every year, 529,000 women around the world die in childbirth. Meanwhile, 3.3 million children are born dead, more than 4 million die with the first 28 days of life and 10.6 million die before reaching the age of five.
In other words, we live in a world where every minute a woman dies from pregnancy or childbirth-related complications, most of which can be avoided. The proof of this is that, while in many disadvantaged areas of the world, one woman in 16 dies for this reason, the rate in the more developed areas is only one in every 2,800. It is estimated that up to 100,000 maternal deaths could be avoided every year if those women who do not want to have a child had access to efficient methods of contraception.
We live in a world where women's access to professional care during pregnancy has risen 20% over the last ten years, but where there are still many countries where only 35% of the women who need such care actually receive it.
Where thousands of girls are genitally mutilated, forced to marry men who they do not love, and they suffer violence if they refuse. Where many women suffer sexual exploitation as well as coercion and violence at home.
A world where the under-five mortality rate is sixteen times higher in some areas than in others.
Where the large majority of the most frequent causes of illness and death are avoidable, and it is known how to avoid them. In most of the world, these causes are closely related to underdevelopment, and the consequent inequality, poverty and ignorance.
A world where the gap between those who have, and those who do not - in the health field too - is not closing and, sometimes, tends to widen.
We are witness to a huge gap between the high-income countries and their low-income counterparts. And also to manifest health inequalities in the inland areas of rich and poor countries alike.
The great challenge of this new century is to stop the gap from widening any further. On the contrary, we should narrow it. Health, health care and health research policies should bear this reality in mind. Health solidarity calls for practice rather than rhetoric.
A further US$ 52.4 Bn will be needed over the next ten years to deliver a basic package of health interventions to all the children and pregnant women in the 75 countries that account for the majority of maternal and infant mortality. In other words, US$ 5.2 Bn a year.
That money is not an expense, but rather an investment. Probably the best investment. Just as it is better to invest in drinking water, in vaccines, and in improving infant and child nutrition. In preparing the response to a possible influenza pandemic and fighting antimicrobial resistance. In prevent and controlling tuberculosis, malaria and cancer. In curbing alcohol consumption. In enhancing disaster-response capabilities and developing social health insurance systems. In fostering active-aging strategies or health research.
All these issues, and a few others, are on the agenda for this Assembly. Also on the Agenda is a follow up of the implementation of resolutions adopted at previous Assemblies, some of them highly important ones.
However, now I would like to refer briefly to three items on the Agenda of this 58th Assembly that are bound to attract our attention over the next few days.
The first regards the achievement of the health-related Millennium Development Goals.
The Millennium Declaration was solemnly signed by 189 Heads of State and of Government at the United Nations headquarters in September 2000.
The Declaration represents an unprecedented consensus, and a unique opportunity to move towards a global vision of development based on values of freedom, equity, solidarity, tolerance, respect for nature and shared responsibility.
This Assembly will hear a first assessment of the extent to which the health-related goals set forth in the Declaration have been achieved. Our discussions must enable us to draw conclusions that let us achieve the health goals proposed for the year 2015. Or earlier, if possible.
Many people depend on this assessment and these efforts. We must not let them down.
The second item that I would like to spotlight concerns the draft International Health Regulations.
An issue that is of the utmost importance. The draft Regulations that we have received have been under discussion for the last two years and will eventually replace the 1969 International Health Regulations that remain in force today.
Much has changed in the world since 1969. Just as public health challenges have changed, both at national and international level. So there seems to be a need for an instrument adapted to the present circumstances. An efficient instrument that serves everyone and that makes all of us, citizens and States alike, feel safe and confident.
The draft International Health Regulations that are being submitted for discussion probably represent the commitment that is now possible in this regard. In Spain we have a saying that goes like this: “The best is the enemy of the good”. It is up to us to ensure that these draft Health Regulations are devised in such a way as to be effective. And that they are adopted, and can be enforced, as soon as possible.
This is another matter that has logically prompted much expectation, which must not be dashed either.
The third item to which I want to refer is the Organization's proposed budget.
In recent years, health issues have gained increasingly wider attention, especially since health has been acknowledged as a basic human right, and protecting and promoting health is deemed an essential component of human development.
Recent events that remain in everyone's mind, such as the earthquakes and seaquakes that hit Southern Asia last December, have further underscored the need for international rapid-response mechanisms for dealing with extreme, natural or man-made situations. These mechanisms must necessarily include a major health component.
The World Health Organization is the United Nations agency that specializes in health issues. Throughout its almost sixty-year history, the Organization has satisfied countless demands and faced a wide variety of challenges. It has done, and continues to do so, with the resources that it receives from the Member States and other voluntary contributors. In the case of the tsunami, its actions have been of an exemplar and efficient character.
The WHO is an organization whose courses of action are guided by the principles of transparency, accountability and the forging of alliances. One might say that it is an organization that put the principles of “good corporate governance” into practice even before the idea, as such, was coined.
The team spearheaded by Dr. Lee has continued and strengthened that style of governance within the Organization.
However, over the last 12 years the WHO's ordinary budget has been prepared in strict keeping with the “zero nominal growth” criterion. In other words, every two years the budget actually grew smaller.
Although the reasons why such a policy was enforced are known, there is no doubt that if “zero nominal growth” is maintained indefinitely, it could end up comprising both the Organization's independence and its very ability to act.
This Assembly will be debating a proposed budget for the 2006 -2007 biennium which, for the first time since the 1994 -1995 biennium, will change this situation.
I trust that our debates on this matter will be rewarding and that they will send the international community a clear sign that health matters. And that, consequently, the resources required to enhance the instruments responsible for protecting and promoting it must be made available.
The WHO is one of our most valuable instruments. Since the end of the 57th. World Health Assembly, the General Director and his team have been working hard for a 58th successful Assembly.
This Assembly is a forum that mirrors the huge diversity of our world. As well as the achievements, desires and concerns of its inhabitants.
Today, more than ever, our world is one world. And if there is one field in which this statement is evident, that is the field of health.
More than ever before, the world needs bridges to bring us together. Major alliances in favour of life and the coexistence of civilizations and cultures. Forums where debate is frank and constructive. Shared solutions.
This Assembly is one of those forums. I am sure that the debates that we hold over the next few days, together with the resolutions that we adopt, will allow us to make headway in achieving a better health for everyone.
This effort, joined to the effort of the interpreters and the rest of staff, will facilitate the work of this Assembly and I want to thank them for this in advance.
I am sure the debates we are going to have the following days, and the resolutions we are going to adopt, we will allow us to go forward in the pursue of the health for all.
Doing so, we will be contributing to build a healthier, fairer and more liveable world.
Thank you very much.