Berlin, Germany
Thank you very much, Ilona.
Your Excellency Vice President Howard-Taylor, Honourable Minister Luiz, Vice-Minister Steffen, our Goodwill Ambassador Keizo Takemi, Professor Detlev, Stefania Giannini,
Excellencies, dear colleagues and friends,
Good afternoon. It gives me enormous pleasure and pride to be back in Berlin for the World Health Summit.
As a member of the founding committee more than 10 years ago, and now as its patron, I’m delighted to see the way the Summit has grown in both size and stature.
Today, I would like to talk about one of the scarcest commodities in global health.
I do not mean money. Money by itself is not enough. It’s how its spent, and where. And when.
The commodity I’m talking about is political will.
We often say that we know what to do, and how to do it. If only there was political will.
It’s the biggest deficit we face.
Health is a fundamental human right.
I’ve been practicing this in German, by the way. Gesundheit ist ein Menschenrecht!
But it’s a right that must be realized through political choice.
It’s a choice that Germany made 135 years ago, in the Bismarck era.
It’s a choice that Japan made, not when it was strong and prosperous, but when it was weak after the Second World War.
It’s a choice that Brazil made in 1988, when it adopted a constitution that says health is the right of all persons, and the duty of the state.
It’s a choice that Liberia has made, as it rebuilds after years of civil war and the devastating Ebola outbreak of 2014.
These four countries show that each country has a different path towards universal health coverage, and each is at a different point on that journey. There is no one-size-fits-all approach.
But they all have the same destination, and they all have the same starting point – a political choice. The starting point in all countries represented here was a political choice.
Today, there are many other countries making the same choice, and forging their own path: Egypt, the Kyrgyz Republic, Peru, the Philippines, Rwanda, South Africa, Thailand, Tunisia and more.
In fact, I believe we are living at a time of unprecedented political commitment for health.
Just in the past month there have been three very significant demonstrations of that commitment.
First, at the United Nations General Assembly, all 193 UN Member States approved the political declaration on universal health coverage, the most comprehensive international health agreement in history. But unless it’s implemented, it’s just paper.
Second, just as countries are coming together, so the international health community is also coming together to support them.
The General Assembly also saw the launch of the Global Action Plan for Healthy Lives and Well-Being for All. This is a unique commitment by 12 multilateral agencies to work together in new ways to support countries to accelerate progress towards the SDG health targets.
Together, we will engage with countries to identify their priorities, to accelerate progress through joint action, to align our operational and financial strategies, and most importantly, to be accountable.
As you remember, the initial draft of the Global Action Plan for Healthy Lives and Well-Being for All was launched at this meeting last year.
Importantly, it was endorsed by the G20 leaders in the communique that came out of the Osaka Summit in Japan earlier this year.
I’d especially like to thank Chancellor Merkel, one of the prime movers behind this historic commitment, and also to Prime Minister Abe for his longstanding leadership and commitment to UHC.
Third, at the Inter-Parliamentary Union Congress in Belgrade two weeks ago, countries adopted a resolution on universal health coverage, committing to leverage the power of parliaments to translate political commitment into hard realities.
It was one of the Assemblies that was attended by the highest number of speakers from many countries.
Taken together, these three documents have brought us to unique moment in global health.
There has never been a better opportunity to work together to transform the health of billions of people.
History will not judge us kindly if we fail to grasp this moment and capitalize on it.
We still have a long way to go on the road to UHC.
On current trends, up to 5 billion people will lack access to essential health services by 2030.
That means children not getting vaccinated, expectant mothers and people with chronic illness unable to see a health worker, or people without life-saving treatment for HIV.
Although we have made enormous progress, we have also learned valuable lessons.
We cannot improve global health one disease at a time.
Changing patterns in demographics, economics and politics put new stresses on already overstretched health systems.
Our failure to invest in health systems doesn’t only leave individuals, families and communities at risk, it also leaves the world vulnerable to outbreaks and other health emergencies.
Health systems and health security are two sides of the same coin.
The ongoing Ebola outbreak in the Democratic Republic of the Congo illustrates this point with devastating clarity.
The weakness of the health system, coupled with insecurity and political instability, has created an environment ideally suited for Ebola to spread.
Thanks to the government’s leadership, the selfless dedication of thousands of health workers, and the support of donors like Germany, the outbreak has been reduced to less than 15 cases a week, from more than 120 at the peak in April.
But any single case could spark a new and bigger outbreak. Until we get to zero, we are in full response mode.
We will end this outbreak. But unless we address the root cause of the outbreak – the weak health system – there will be another.
We must ask ourselves whether we will invest in preparedness now, or wait for the next outbreak and spend far more trying to stop it.
The power of preparedness, we have seen it in Uganda. When a few cases crossed the border into Uganda, it was controlled swiftly.
Thank you my sister Jane, the Minister of Health of Uganda, who is with us today.
This is not just an issue in DRC. It is a global myopia.
The recent report of the Global Preparedness Monitoring Board shows that the world remains dangerously unprepared for the next global pandemic.
It is frankly difficult to understand why countries would invest so heavily in protecting their people from terrorist attacks, but not against the attack of a virus, which could be far more deadly, and far more damaging economically and socially.
A pandemic could bring economies and nations to their knees. Which is why health security cannot be a matter for the health ministry alone.
We are now preparing to bring foreign ministers, finance ministers and health ministers together in Marrakech next year to discuss how to step up the implementation of the International Health Regulations globally, to keep the world safe by investing in preparedness.
Excellencies, dear colleagues and friends,
Let me outline three challenges that we must meet in order to realize the commitments we have made.
First, universal health coverage is not a choice a country makes once. It’s a choice that must be made every day, in every policy decision.
Disease patterns are always changing, and so are the needs and demands of populations.
There are always people at risk of being left behind. There are always new challenges to confront, like antimicrobial resistance and the health effects of air pollution and climate change. New treatments offer many benefits, but also pose new challenges for the financial sustainability of health systems.
WHO stands ready to work with all countries, at all income levels, to provide our technical expertise on how to ensure countries make the investments that deliver the greatest impact.
Which leads me to my second challenge: primary health care.
There is simply no better investment in health than primary health care.
That’s why WHO is calling on all countries to increase spending on primary health care by 1% of GDP by 2030, either through new investments, reallocation or both.
Globally, we need a radical reorientation of our health systems towards promoting health and preventing diseases, not simply managing them in hospitals.
To do that, we need to address the reasons people get sick and die, in the air we breathe, the food we eat, the water we drink, and the conditions in which we live, work and play.
As part of WHO’s transformation, we have created a new division of healthier populations, to support countries to address the economic, commercial, environmental and social determinants of health. This will help us to concentrate on the root causes of health problems and keep people healthy.
Third, multilateralism.
In our fractured and divided world, health is one of the few areas in which international cooperation offers the opportunity for countries to work together for a common cause.
The political declaration on universal health coverage, the Global Action Plan on Health and Well-Being for All and the Inter-Parliamentary Union resolution on UHC all demonstrate that the death of multilateralism has been greatly exaggerated. It is alive and well.
The G7 and the G20 are both vital fora for promoting the healthier, safer, fairer world we all want.
Multilateral engagement is not only the smart option, it’s the only option.
Working together for a healthier world not only improves the lives of billions of people, it also builds a platform for sustainable development, and can truly be a bridge to peace.
We are one species. We all share 99.9% of the same DNA. We share the same planet. We share the same hopes and dreams – rich and poor, rural and urban, citizen and refugee.
There are two types of people on earth. Because life started in Africa, there are Africans and former Africans. Then one of my colleagues corrected me: you shouldn’t say former Africans, say the African diaspora.
We may never agree on which system of government is best, or which system of trade is best, or which economic system is best. Some of us are left, some right, some in the middle.
But we can agree on this: health is not a privilege for the few. It is a right for everyone, everywhere.
Our job as politicians and as leaders is to defend that right every day, and to make it our life’s work to see it realized.
All roads lead to universal health coverage. If we believe in health for all we can make it happen.
Thank you very much. Vielen dank.