Address by Ms Jane Halton
President of the 60th World Health Assembly
Vice Presidents of the Assembly,
Director-General of World Health Organization,
Honourable Ministers of Health,
Excellencies,
Distinguished Delegates,
Ladies and Gentlemen
Thank you for electing me as President of this, the 60th World Health Assembly. I would like to acknowledge the work of last year’s President, His Excellency Professor Garrido.
I would also like to recognize that it is almost one year since the untimely death of Dr Lee. I think Dr Lee would be proud of what the World Health Organization has achieved since the last World Health Assembly and I think we owe it to the memory of Dr Lee to ensure that we use this year’s Health Assembly to give the WHO and its new Director-General, clear and considered guidance for its future work. Our new Director-General now faces the significant challenge of building on Dr Lee’s legacy and continuing to reform and focus the Organization. She will also be called on to respond to the inevitable unseen challenges which will face us. I know she will do this well.
It goes without saying that it is a great honour to take this position. For myself, working with you all will be a privilege and a great pleasure.
Most of my career has been spent working directly on health matters, including the last five years as head of the Australian Department of Health and Ageing. Health is the issue which motivates me and, I know, all of the people in this room.
Australia is fortunate to enjoy a very good standard of health and long life expectancy. It is also lucky to be surrounded by oceans. But we are very aware that in the current age of rapid transport and trade, this is no defence against disease.
Indeed, the need for protection against overseas health threats was the main reason why Australian states agreed to create the national Department of Health, some 88 years ago.
Today, the risk from new, acute or rapidly spreading risks to health is far greater. No nation can afford to face this threat alone. We all need the WHO to inform us, advise us and to bind us together in collective action.
The WHO is and will remain the only forum which brings all of us together to address the range of health challenges we face both individually and collectively.
During this World Health Assembly, I would ask you all to keep the issue of global health security in mind in all of our discussions - not just in our general discussions in plenary. It has implications for health research, innovation and intellectual property; for health information systems and data sharing; and for public health.
While the WHO can do much, each of us as Member States also as responsibilities. These go beyond the usual role of the health ministers and officials seated in this room.
To reduce and respond to international health threats, we need action and planning across government. When we return to our countries, we must impress on our ministers and ministries of foreign affairs, finance, environment, trade, and defence - for example – that they have a role in building health security and in responding to crisis.
In Australia, the Prime Minister has taken an active interest in our preparations for pandemic influenza, and took part – along with the full Cabinet of Ministers – in the major exercise to simulate an avian influenza outbreak, in October of last year.
A key mechanism which the WHO has put in place on this issue is the new International Health Regulations, which enter into force one month from tomorrow – on the 15th of June.
Last year’s Health Assembly agreed to ask all Member States to comply immediately with the provisions of the IHRs relevant to the risk of avian influenza and pandemic influenza.
This has, I am sure, generated a great deal of work in many countries, but these efforts have already contributed to better surveillance and information sharing and other public health systems.
In implementing the IHRs, we must work closely with the WHO and with each other –sharing our experiences and our expertise – to produce a truly robust and global health security system.
Key technical and health matters
Avian and pandemic influenza
An immediate and ongoing health security concern is the possibility of, and our preparedness for, pandemic influenza.
Our response to avian influenza and potential pandemic influenza is of course a key issue for detailed discussion at this Health Assembly. We are all aware of the potential loss of lives associated with pandemic influenza, let alone the economic and social disruption. We estimate up to 44,000 deaths will occur in Australia alone.
We are also all acutely aware of the need to do whatever we can to protect our populations from this threat – ranging from having effective surveillance systems in place to having appropriate plans and systems and resources for controlling and responding to the spread of disease.
The Executive Board at its January meeting and a number of subsequent international meetings in Jakarta and Geneva has considered the very important issues relating to the sharing of virus samples with the WHO Global Influenza Surveillance Network and options for enabling developing countries to better share benefits through this system, including access to vaccines and vaccine production technology.
The issues are complex, with global production currently unable to meet the likely demand in the event of a wider pandemic. A careful path needs to be found to balance the global public health interest, the continuing need for sustainable commercial development and production of vaccines and the legitimate desire of all countries for affordable access to vaccines and other medicines to protect their populations.
I encourage all involved to participate constructively in the discussion. I hope this will lead to all countries continuing to participate in the WHO’s influenza strain sharing system, and to constructive and realistic proposals for improved transparency on virus sharing processes and increased vaccine production and the distribution of vaccines, in the short and longer term.
It is important that we also work together to ensure that all countries develop their diagnostic and response capabilities so that information on seasonal and pandemic influenza, including results from clinical, epidemiological and laboratory surveillance and investigations of human infections, can rapidly be disseminated to all Member States through the WHO Global Influenza Surveillance Network.
Tuberculosis and malaria
While pandemic influenza is an emerging and high-profile threat to international health security, we must not overlook the global impact of existing and well-established communicable diseases.
At this Health Assembly we will discuss the need for further work in relation to both tuberculosis and malaria.
For tuberculosis, the focus is on more concerted action to implement the Global Plan to Stop TB and meet the international target for tuberculosis control of halving tuberculosis prevalence and death rates by 2015 compared with 1990 levels.
There is also a need to address the emergence of strains of tuberculosis which are multi-drug resistant or extensively drug resistant.
The emergence of these strains is a reminder of the need for vigilance against existing diseases as well as new ones; of the dangers of inappropriate use of medicines; and of the importance for all countries of good disease surveillance and emergency response systems, linked to the international health community.
We also need to consider what additional things we can to do to deal with malaria – a disease that continues to cause more than 1 million preventable deaths a year. We need to recognize the importance of coordinated action not just by Member States but also by international organizations, the private sector and academics in tackling communicable diseases such as malaria.
Polio and smallpox
During this Health Assembly we will also look at issues associated with the eradication of communicable diseases. The first – on polio – will ask us to consider how to respond to the opportunity that we have been given, to actually eradicate this dreadful disease.
The second issue is smallpox eradication and the destruction of variola virus stocks. This was negotiated at length at last year’s World Health Assembly and at Executive Board meetings in recent years.
Non-communicable diseases
We also have ahead of us some important discussions on noncommunicable diseases.
Chronic noncommunicable diseases are causing a high and rapidly growing burden of disease across the globe.
In Australia – which many of you would regard as a sporting nation – we are seeing our population getting more overweight and less fit, and therefore less likely to win at the cricket…
The number of children considered overweight or obese is more than double the number in 1986 and current estimates are that we might see 3.3 million Australians with type II diabetes by 2030. The negative health and economic impacts of these changes are obvious.
Addressing noncommunicable diseases is an important area of activity for the WHO and many of you stressed at the Executive Board meeting in January that noncommunicable diseases (NCDs) should be given more attention in the six-year Medium Term Strategic Plan for the WHO.
This Health Assembly will be asked to approve a resolution on a global strategy for prevention and control of NCDs.
It asks all of us to work towards the target of reducing the death rates from NCDs by 2 per cent a year for the next 10 years.
This is the target that we set ourselves in the 11th General Programme of Work and the draft resolution before us sets out a range of activities to meet that target.
Better medicines for children
Just as it is incumbent on us as health leaders to recognize the very real threat to health posed by NCDs, we must also recognize and respond to the needs of vulnerable members of our community.
We have a special responsibility, globally, to consider the health security afforded to children. The work we will do at this Health Assembly on improving access to better medicines for children is an important step.
At present many essential medicines are neither developed nor produced in appropriate dosage forms or strengths for children.
This means that children in all countries of the world have medication needs that are not currently being met. It also means that every country needs to explore ways to overcome barriers for access to appropriate medicines for children - including encouraging research into medicines for children; regulatory approval of new medicines; innovative monitoring of safety; and inclusion of children’s medicines in national medicines subsidy and reimbursement schemes.
We also need to continue to work to lift the health status of peoples who have not shared fully in the benefits of our expanded health knowledge. This is a challenge for all of us as, even in developed countries, there remain people whose health and life expectancy is significantly lower than that of others.
In Australia the health status of our Aboriginal and Torres Strait Islander peoples is such a case. We are working assiduously and with a commitment which spans right across government to address this challenge.
As I have already indicated, it is through partnerships that we can and must tackle the health challenges we face. Not only do we need to work across government within our countries but we also need to work within and across regions. For the many countries in the Western Pacific this is crucial to ensure success in improving child and maternal health, reducing HIV/AIDs and preparing health systems for pandemic influenza.
Health systems/architecture/medicines
And in that vein, I would be remiss if I did not acknowledge that in securing the health of all of the world’s people, we need to build, finance and sustain health systems.
As we all know, well functioning national and international health systems – including information systems - are vital to addressing the many communicable and noncommunicable disease challenges that we all face.
These systems are also essential in delivering on other key objectives such as access to medicines and health technologies, and rational use of medicines – all issues we will discuss during this Health Assembly.
Future directions for the WHO
At the 59th World Health Assembly we approved the Eleventh General Programme of Work which sets a global agenda and direction for work which the WHO Member States, the Secretariat and key partners will have to undertake.
At this year’s Assembly we, the member states of the WHO will be required to agree to a Medium Term Strategic Plan encompassing three biennial budgets from 2008 to 2013.
This will provide a longer term perspective and also clearer and more focussed objectives for our WHO.
We need to sign off on the high level expected results set out in the strategic objectives of the plan, as well as the indicators and targets for the WHO’s detailed operational planning - what do we want to achieve and how will we know that we have succeeded.
The Medium Term Strategic Plan has been through an extensive consultation process involving regional committees, the Programme Budget and Administration Committee and the Executive Board.
We have all made significant contributions to this work and it will be important to move forward as part of our broader work to reform and make more outcomes focussed and more transparent, the work of the WHO.
We will also need to consider appropriate funding to enable the WHO to meet the objectives in the Medium Term Strategic Plan. This is a budget year and we will need to decide on the Programme Budget for 2008 and 2009.
The Director-General has proposed a budget of $4.227 billion, an increase of 15.2 per cent over expected spending in the previous biennium, including voluntary contributions.
As part of this proposed increase, the Director-General is seeking a 4 per cent increase in assessed contributions. She has outlined her plans for the effective financing of the programme and how she proposes to target the proposed budget increase.
We need to give final guidance to our Director-General on her proposed priorities, the funding request, and the mechanisms she has proposed to ensure that resources are used most effectively and efficiently, including the phasing out of some programmes.
This World Health Assembly is the vehicle through which each of us, and each of our nations, can have a positive impact on the world’s health – now and into the future.
It is also a great opportunity for people from across the globe to meet and share ideas and experiences on key health issues. I would encourage you to take advantage of this opportunity, of the presence of so many people in one place who are passionate and committed to improving health.
This Health Assembly will be a unique opportunity for us to improve the health security of ourselves and of our children, into the future and I look forward to achieving that with you over the next 10 days.