First of all, Goddag. Hvordan har du det? Tak skal du have.
I studied in Denmark in 1988 – long ago – and I just said what I picked up then.
I studied epidemiology, and the first health insurance actually – I got cover for one year – was in Denmark.
I studied the health system of Denmark. I was really impressed, and that influenced me forever, to be honest.
Whatever I say in WHO comes from that influence. I really adore Denmark, because of the early experience and what I have seen here – not only the health system, but freedom and democracy and what you have.
It’s an honour to be here, and I thank Mads, Lars and your colleagues at the Novo Nordisk Foundation for the invitation, and for organizing this event.
I congratulate the Foundation on its 100th birthday, and for everything it has achieved in the past century.
We very much appreciate your support for WHO, and for global health more broadly.
And we very much welcome the announcement you have made today with the Bill & Melinda Gates Foundation and the Wellcome Trust, to invest US$ 300 million in research and development for some of the most pressing global health challenges.
As the opening video described, many of these challenges are overlapping and intersecting, with profound impacts on human health.
Since the late 1990s, noncommunicable diseases have overtaken infectious diseases as the world’s leading cause of premature mortality at the global level, and in every region except my continent, Africa.
And although we made substantial gains against HIV, malaria and TB in the first two decades of this century, progress in the past few years has plateaued.
And of course, the climate crisis threatens the very habitability of the planet on which all life depends.
That’s not to mention the threats to health from conflict, displacement and migration; antimicrobial resistance, which threatens to unwind a century of progress; and the challenge of ageing populations.
We all know that these threats are interconnected.
NCDs can weaken the immune system, making people more vulnerable to infectious diseases.
In turn, infectious diseases can exacerbate the progression of NCDs and cause complications.
And the climate crisis exacerbates both of them.
These are the problems. What are the solutions? Let me suggest four things, and I will not focus deeply on innovation that Bill had already said, but of course the first should be science.
Science, research, data and innovation have always been the engine of improvements in public health, and they are central to everything we do at WHO.
One of the things of which I am most proud is establishing a Science Division at WHO for the first time. Our first Chief Scientist was Dr Soumya Swaminathan, and now of course, Sir Jeremy Farrar.
Thanks to science and research, all of the problems I have described have solutions.
Many NCDs can be prevented through healthier diets, physical activity or by stopping smoking.
Premature deaths from NCDs can be prevented with the right diagnosis and treatment.
Most cases and deaths from infectious diseases can be prevented with vaccines, prophylaxis, bed nets or other tools to prevent exposure.
And climate change can be reversed, and its impacts mitigated, by weaning ourselves off our addiction to fossil fuels.
The health challenges we face globally are not fundamentally scientific challenges; they are largely political, economic and social challenges.
Of course, we need more technologies, but using the existing ones to the maximum is important.
Which brings me to the second solution: equity.
The problem is not that we don’t have the tools or the knowledge to address these threats; the problem is that those tools are not equally available, for multiple reasons.
Take polio, for example. Thanks to the investments of the Gates Foundation and others, we’re on the verge of eradicating polio forever.
The reason we haven’t done it yet is not because we lack the tools, but because the last communities of unprotected children are in the most insecure regions of Afghanistan and Pakistan.
We were discussing with Bill actually the good news today that Afghanistan decided now to allow us to do house-to-house vaccination in the Kandahar region. It was announced today.
We have all the tools, but the insecurity is preventing us from eradicating polio once and for all.
That’s just one example, and I would like to thank Bill for his incredible commitment and passion for eradicating polio.
Insecurity, poverty, isolation, gender and many other factors mean that more than half the world’s population lacks access to one or more essential health services.
And two billion people face financial hardship as a result of paying for care out of their own pockets.
Although we have made significant progress against individual diseases in the past 20 years, we have not invested sufficiently in building strong health systems, based on primary health care, with a commitment to universal health coverage.
Most of the gaps, of course, are in the lowest-income countries.
The most shocking example of this inequity was the COVID-19 pandemic.
The development of multiple safe and effective vaccines in record time was a stunning success for science.
But inequitable access to those vaccines is a stain on our collective conscience.
To truly address the most pressing global health challenges, we must address inequity. And that is not a job for the health sector alone.
This brings me to the third solution: multisectoralism.
None of the challenges we face are just health challenges; they are social, economic and political challenges.
They cut across agriculture, education, energy, finance, trade, transport, and more. I’m glad Bill did a deep dive into nutrition.
Which means we cannot address them without addressing their drivers, in the air people breathe, the food people eat, the products they consume, and the conditions in which they live and work.
In particular, we need a One Health approach that recognizes the intimate links between the health of humans, animals and our environment.
The private sector also plays a vital role as a provider of medical products and services.
As do philanthropies, who are so important in promoting equity and investing in research, science and innovation for the most pressing health challenges.
That includes areas that attract little private sector investment, such as the development of new antimicrobials or vaccines against tuberculosis.
And just as the threats we face cross sectors, they also cross borders, which brings me to my fourth solution: multilateralism.
Global threats demand a global response.
Cigarettes and sugary drinks manufactured in one country cause disease and death in another;
An outbreak in one country can quickly become a global pandemic, as we know;
And burning fossil fuels in the most-industrialised countries means the least-industrialised pay the price.
This is why the United Nations and WHO were created in the wake of the Second World War, when countries recognized that global cooperation was the only alternative to global conflict.
Multilateral cooperation is needed now more than any time since then, even though multilateralism is being challenged now more than any time since then.
The Pandemic Agreement, which countries are negotiating as we speak, encapsulates the four solutions I have described.
It is science and data based, aiming to strengthen the collection, analysis and sharing of information about outbreaks;
It is equity-centred, by strengthening sharing of vaccines, diagnostics and therapeutics;
It is multi-sectoral, acknowledging the importance of a One Health approach and the role of the private sector and philanthropies;
And it is by definition multilateral, bringing together all 194 WHO Member States in a binding agreement to make the world safer from pandemics.
It recognises that no one is safe until everyone is safe.
And yet there are those who are trying to prevent the agreement by claiming falsely that it will cede sovereignty to WHO, and give it the power to impose mask or vaccine mandates or lockdowns on countries.
These claims, as you know, are completely and utterly false. The agreement will give WHO no such powers.
It’s being negotiated by countries, for countries, and will be implemented in countries, in accordance with their own national laws.
More than ever, this is a time for countries to come together to acknowledge that pathogens have no regard for the lines humans draw on maps, nor for ideologies, the size of our economies, nor for anything else that we use to divide ourselves from each other.
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Dear colleagues and friends,
The challenges we face from NCDs, infectious diseases and climate change are complex, and so must be our response.
They must be science-based;
They must be equitable;
They must be multisectoral;
And they must be multilateral.
My thanks once again to Mads, Lars and the Novo Nordisk Foundation for the invitation to address you today, and for your partnership.
WHO very much appreciates the work that you and the other organizations represented here do, and we look forward to our continued partnership in the years ahead.
I’m glad to be back in Copenhagen. Tak skal du have.