Your Excellency Chancellor Merkel,
Minister Spahn, Minister Müller, Minister Karliczek,
Herr Brinkhuas, Herr Gröhe,
Honourable Members of the Bundestag,
My sister Ilona,
Guten abend.
It’s an honour to join you in the Bundestag, and I would like to thank Chancellor Merkel for the invitation to address you today, and for your kind words earlier.
Thank you, too, to Ilona, for your strong support, and for your work in chairing the International Advisory Board, which has just delivered its report.
Thank you to Minister Spahn for leading this initiative. WHO is fully committed to its implementation, and I have asked my Chef de Cabinet, Dr Bernhard Schwartländer, to support it by participating in the steering committee.
I think it’s fair to say that Germany is one of WHO’s greatest supporters and best friends.
Of course, Germany is one of WHO’s leading financial partners. Your support helps to fund vital work such as our mission to eradicate polio, and on health security, access to medicines, health and environment, and much more.
Thanks to you, WHO has helped to provide urgent care in Iraq, treat malnourished children in Yemen and provide HIV treatment in eastern Europe.
I am grateful not just for your support for WHO, but for all your support for health, including the large investments Germany has made in the Global Fund.
Sometimes people think organizations like WHO and the Global Fund are in competition with each other. Not at all. An investment in the Global Fund is an investment in global health, and in our collective efforts to achieve the Sustainable Development Goals.
But just as important as your financial support is your exceptional political leadership.
Germany has put health firmly on the international agenda through its leadership of the G7 and the G20.
In fact, one of my first speaking engagements after being elected Director-General two years ago was to address the G20 in Hamburg at Chancellor Merkel’s invitation.
Germany is also one of three countries, together with Norway and Ghana, which has asked WHO to take the lead in developing a Global Action Plan for Healthy Lives and Well-Being, to realise the vision of the health-related targets in the Sustainable Development Goals.
Germany has rightly recognized that the global health architecture is much more complex than it was 20 years ago, with many more actors. This is both an opportunity and a challenge. We must leverage our collective strength, while avoiding overlap and duplication.
We thank Chancellor Merkel for the confidence she has put in WHO to lead this process. We are now finalizing the plan and look forward to presenting it at the United Nations General Assembly in September.
And we look forward to your continued leadership on health through Germany’s Presidency of the EU next year.
Germany has also been a generous supporter of the current fight against Ebola in the Democratic Republic of the Congo.
The current outbreak is one of the most complex health emergencies any of us have ever dealt with.
We are fighting one of the world’s most dangerous viruses in one of the world’s most dangerous areas.
Multiple armed groups operate in this area of DRC. Since January there have been 119 attacks on healthcare facilities that have caused 4 deaths and 33 injuries.
Every attack disrupts our operations. Every attack impedes our access to communities. Every attack gives the virus an advantage.
Some of our partners have even pulled out because of the insecurity.
Just last week I was in DRC after one of our colleagues, Dr Richard Mouzoko, was shot dead while attending a meeting at Butembo University Hospital. He left behind a wife and four young children, aged 12, 10, 8 and 6. On Saturday I had the honour of attending Dr Mouzoko’s funeral in Cameroon, and meeting his wife and kids.
For me, he typifies what WHO is and does – we work to protect health all over the world. Sometimes that means we risk our own lives.
When I visited our staff in Butembo, they were understandably shocked and shaken by Dr Mouzoko’s death. But they were undeterred.
They said to me, “We’re here to save lives. We will not be intimidated by violence. We will finish the job.”
On top of the attacks, we are also battling against myths and misinformation, and against the politicization of the outbreak.
Unfortunately, some politicians have used the outbreak to their own advantage.
Some denied the existence of Ebola, claiming the government invented it as a way to control the population.
Then during the elections, the Ebola hit areas, including the current epicentres of the outbreak, Katwa and Butembo, were excluded from voting.
As a result, people were understandably angry and attacked the Ebola treatment centres.
I have met personally with the President of DRC and opposition leaders to urge them to take a bipartisan approach to this epidemic. Because Ebola does not take sides. It attacks everyone equally. If you politicise it, it’s like playing with fire.
Despite all these challenges, we have many successes to celebrate, and many reasons for optimism.
Although the outbreak has been continuing for 9 months, it has not spread beyond a confined area in North Kivu, and has not spread internationally, even though the epicenter of the outbreak is very close to the border with Uganda. But the risk of further spread is still high.
We also have more advanced tools than ever before with which to fight Ebola.
We have a new vaccine that we have used to protect more than 110,000 people, and we have evidence that the vaccine is more than 97% effective in preventing Ebola.
We also have new drugs – so far about 700 people have been treated and we have more than 430 survivors.
This outbreak could well have been much, much worse without these new tools.
But the outbreak is teaching us an important lesson: that even the best tools are less effective without the most important ingredient in health care – trust.
Earlier last year there was another Ebola outbreak in the western part of DRC, an area that is relatively stable and peaceful. That outbreak was controlled in three months.
We are fighting this outbreak with the same tools we used to bring that outbreak under control – even better tools, in fact.
But this outbreak is continuing because of the insecurity in this area of DRC and the politicization of the outbreak. It’s the first time that you have Ebola overlapping with war and elections.
Ending the outbreak is not just a technical challenge, it is a political challenge and a security challenge.
Just yesterday I had a teleconference with the United Nations Secretary-General and the leaders of other UN agencies to discuss the challenges we face and the changes we must make to address them as one UN.
But even as we work to end this outbreak, we must look beyond it and ask a bigger question. This is DRC’s tenth Ebola outbreak since the virus first emerged in 1976. How can we make sure it’s the last?
To answer that question, we must take a step back and look at why we have Ebola outbreaks at all.
Although Ebola is a highly lethal disease, it is not as contagious as airborne viruses like influenza. With good infection prevention and control practices, it can be easily stopped.
But that’s the problem. Every Ebola outbreak since 1976 has happened in countries with weak health systems with poor infection prevention and control practices.
To build an Ebola-free future, we must invest in building stronger health systems that can promote health and prevent disease. An outbreak is the wrong time for a country to discover it has weaknesses in its health system. We must fix the roof before the rain comes.
Strong health systems, built on the foundation of primary health care, are the best defense against emergencies of all kinds, from the personal crisis of a heart attack to severe outbreaks.
Health systems and health security are truly two sides of the same coin.
But investments in health systems are not only good medicine, they’re good economics.
The devastating West African Ebola epidemic of 2014 and 2015 cost an estimated 53 billion U.S. dollars, in terms of economic loss and the impact on human capital.
The investments needed to build strong and resilient in health systems in those same countries would have been far less.
So the question is not whether the world can afford to invest in strong health systems, the question is whether we can afford not to.
It makes no sense, either morally or economically, to continue responding to outbreaks without addressing their root cause.
That’s why WHO’s top priority is universal health coverage, so that all people have access to the health services they need, without facing financial hardship.
Universal health coverage is based on the conviction that access to health services is a human right for all people, not a privilege for the rich.
But today, too many people are deprived of that right.
Today, more than half the world’s population lacks access to essential health services like vaccination, the ability to see a health worker, or treatment for HIV, TB and malaria.
And every year, almost 100 million people are pushed into extreme poverty by the costs of paying for care out of their own pockets.
This scandal not only endangers life, it perpetuates the cycle of poverty. It’s a drag on economic growth. It makes all of us less safe.
Together with our Member States, we have agreed on an ambitious target to see 1 billion more people enjoying the benefits of universal health coverage over the next five years.
And we are already seeing unprecedented momentum for universal health coverage. Just in the past year, Kenya, India, the Philippines and Egypt have all made significant progress on expanding access to services and increasing financial protection.
Later this year, the United Nations General Assembly will hold the first High-Level Meeting on Universal Health Coverage. This is an incredible opportunity to bring world leaders together not to address a single disease, but to address all diseases and conditions – to address health as a whole.
This is an opportunity to change the lives of billions of people for generations to come.
Earlier I mentioned the Global Action Plan that we are developing to deliver the health-related targets in the Sustainable Development Goals.
One of the defining features of the SDGs is that they are for all countries, rich and poor.
In the same way, WHO must be for all countries. We are the World Health Organization. Our experience and expertise are relevant for all nations, although our focus should be on those who need our support most. No health system is perfect, and all countries have room for improvement. Health trends are constantly evolving, and health systems must evolve with them.
That’s why one of my priorities is to ensure WHO engages in regular policy dialogue with all countries to identify vulnerabilities in their health systems and design solutions.
In fact, Germany already benefits from WHO in many ways you may not even realize.
For example, Germany is a long-time user of the International Classification of Diseases, a database of thousands of codes for all diseases and conditions that is used to track disease trends, make planning decisions and is also used for health insurance.
In other words, every diagnosis of a disease or condition in Germany is assigned a code that comes from WHO’s International Classification Diseases.
ICD helps to standardize the diagnosis of disease, making it an integral part of Germany’s health system and the global health system.
Another example is the work we are now doing to combat the spread of antimicrobial resistance – one of the most urgent health threats of our time.
As you may be aware, the inappropriate use of antibiotics means that some bacteria have developed resistance to those drugs. That means that some infections that were once easily cleared with a course of antibiotics are now much more difficult and much more expensive to treat. Some cannot be treated at all.
This trend is effectively undoing some of the most important gains in modern medicine. A market failure in research and development means there are very few new antibiotics in the pipeline.
This is a threat to all countries, rich and poor.
To address it, WHO is working with the World Organization for Animal Health, the Food and Agriculture Organization of the United Nations and UN Environment to slow the spread of these new “superbugs” and accelerate the development of new medicines.
Last month we presented our recommendations to the Secretary General, and will continue to work with all partners and all countries to implement those recommendations.
Chancellor Merkel, Excellencies, ladies and gentlemen,
I leave you with three requests.
First, we continue to need your strong political support. As I said at the beginning, Germany’s leadership, and particularly the leadership of Chancellor Merkel, has been instrumental in elevating health on the international agenda.
That support will continue to be vital at the G7, the G20, the High-Level Meeting on Universal Health Coverage, and the implementation of the Global Action Plan on Healthy Lives and Well-Being.
Second, we continue to need your financial support for the Ebola response. If we lose our focus now, we could lose control of the outbreak. Your support is helping to save lives and keep the world safe. We cannot wait until this outbreak becomes even more dangerous – and even more expensive. We will also need your support to overcome the politicization of the virus.
But we also need your support for emergency preparedness, and for building strong health systems so countries can prevent, detect and respond quickly to outbreaks when they occur.
And finally, I have a proposal. As part of WHO’s transformation we are moving to a model where WHO is relevant in all countries. We call it strategic policy dialogue.
Germany already enjoys one of the world’s most advanced health systems. But even the best system has faultlines and weaknesses. We would welcome the opportunity for WHO’s experts to engage with you in strategic policy dialogue about how the German health system can be made even stronger than it already is. Those lessons could then be used to strengthen other health systems all over the world.
Thank you once again for your support and commitment to health.
As you may know, my Chef de Cabinet, Dr Schwartländer, is a proud German, and he taught me a little of your language.
Gesundheit ist ein Menschenrecht!
Gesundheit für Alle!
Vielen Dank!