24 October 2023
Your Excellency President Tokayev,
Honourable Prime Minister Smailov,
Honourable Minister Beishenaliev,
Director-General Gallina,
Honourable ministers and heads of delegation,
Dr Hans Kluge,
Excellencies, dear colleagues and friends,
Good morning, it’s an honour to be with you.
I thank Your Excellency and the government and people of Kazakhstan for your hospitality in hosting this year’s Regional Committee for Europe, in tandem with yesterday’s conference marking the anniversaries of the Alma-Ata and Astana declarations.
As I said yesterday, Kazakhstan has both a professional and a personal significance for me.
A professional significance, of course, as the birthplace of primary health care.
But a personal significance because my daughter-in-law is Kazakh, and two of my grandkids are part Kazakh.
So, my thanks again to Your Excellency for your hospitality, and also for your leadership on health, especially primary health care.
But as you all know, we meet at a dark time for our world and for this region.
The Russian Federation’s war on Ukraine is heading for a third year, with no end in sight.
In Armenia, WHO is responding to a humanitarian crisis, with more than 100 thousand people crossing from Karabakh in less than a week.
Türkiye is still recovering and rebuilding from the devastating earthquakes earlier this year.
And the eruption of violence in Israel and the occupied Palestinian territory has shocked and saddened all of us.
The attacks by Hamas and other armed groups on the 7th of October that targeted Israeli civilians were horrific and unjustifiable, and should be condemned.
At the same time, WHO is gravely concerned about the health and well-being of civilians in Gaza, who are suffering from bombardment and siege.
On Saturday, WHO supplies were among the first deliveries of humanitarian aid to enter Gaza from Egypt through the Rafah crossing.
This is based on our discussion ten days ago with President El-Sisi when I was visiting the EMRO regional committee meeting.
This is a good start, but it’s nowhere near enough. We need continuous access to Gaza, a continuous flow.
I support the United Nations Secretary-General’s call for an immediate humanitarian ceasefire.
I call for the immediate and safe release of hostages seized and taken into Gaza by Hamas and other armed groups, among them children, older people and those who need urgent medical care.
I continue to appeal to Israel and Hamas to abide by their obligations under international law to protect civilians and health care.
And I appeal to Israel to restore supplies of electricity, water and fuel. In general, unfettered access to Gaza.
In our fractured and divided world, we must continue to seek common ground and common good. The only solution is dialogue, understanding, compassion, and peace. As we all know, war only brings devastation, tragedy, loss and suffering. I have seen it as a child. I witnessed it as a child. I do not remember anything except destruction. I was also trapped in the middle of war. What we get from war is destruction and horror.
I wish to be clear that as a United Nations agency, WHO is impartial, and is committed to supporting the health and well-being of all Israelis and all Palestinians.
The many crises in our world have resulted in a record number of people on the move, seeking to escape war or climate-related disasters.
Many seek refuge in the relative safety and security of Europe. Like everybody else, they have health needs that must be met, but they often face severe difficulties in accessing the health services they need.
So, I welcome the Action plan for refugee and migrant health which you will consider this week.
Excellencies, distinguished delegates,
Last month’s United Nations General Assembly in New York was a historic one for health, with three High-level meetings on health issues.
Member States approved strong political declarations on pandemic prevention, preparedness and response, universal health coverage and tuberculosis.
All three are relevant to the work of this region. And all three depend on a strong WHO, and a strong European region.
I’m very pleased to note in the Regional Director’s report the progress you have made against the European Programme of Work.
Over the past six years, WHO has undergone the most significant transformation in its history, grounded in a bold new strategy, the 13th General Programme of Work.
As you know, we are now working with Member States to develop the 14th General Programme of Work for 2025 to 2028.
In my address to the Regional Committee last year, I outlined five priorities – the “Five Ps” – which are now becoming the basis of GPW14: to promote, provide, protect, power and perform for health.
A few words on each.
The first priority is to promote health and prevent disease by addressing its root causes, in the air people breathe, the products they consume, and the conditions in which they live and work.
This is especially important for the prevention of noncommunicable diseases, which account for almost 90% of deaths in this region.
Action to reduce tobacco use and harmful alcohol use are particularly important for this region.
While rates of tobacco and alcohol use have decreased in the region, they remain among the highest in the world.
Improving diets and increasing physical activity must be key priorities for all Member States.
As must be action to reduce emissions to address climate change. I note with alarm that the average temperature in this region has increased almost twice as much as the global average.
I welcome the Budapest Declaration on Environment and Health, and I know that the Regional Director and his team are committed to supporting Member States to implement it.
I am also looking forward to COP28 in the United Arab Emirates in December, which for the first time will include a day dedicated to heath. I'd like to use this time to thank the United Arab Emirates, and I encourage all Member States to participate actively.
The second priority is to provide health, by radically reorienting health systems towards primary health care, as the foundation of universal health coverage.
The most recent edition of the Global Monitoring Report on UHC, published just a few weeks ago, shows that the European region enjoys relatively high service coverage, and relatively low levels of catastrophic out-of-pocket health spending. Of this, you should be proud.
However, there are of course wide variations between Member States, and the data show that the households with the highest levels of catastrophic health spending are those with the lowest incomes.
Protecting the most vulnerable populations from financial hardship caused by out-of-pocket health spending must be a key priority for all Member States.
A strong health and care workforce is the backbone of a strong health system, so I welcome the Framework for action on the health and care workforce which you will consider this week.
We also continue to remind countries to respect the Global Code of Practice on the International Recruitment of Health Personnel, and in particular to protect the 55 countries on the Support and Safeguards list against international recruitment.
The third priority is to protect health, by preparing countries to mitigate health risks, and to rapidly detect and respond to both acute and protracted health emergencies.
We are all aware of the many crises afflicting our world, and this region, from the refugee crisis in Armenia to the violence in Israel and the occupied Palestinian territory, the devastating earthquakes in Türkiye and the war in Ukraine.
Meanwhile, regionally and globally, the same vulnerabilities that COVID-19 exposed persist.
During the pandemic, all countries built new capacities to prevent and control epidemics and pandemics. I urge all Member States to sustain those gains and not slip back into the cycle of panic and neglect.
The investments you have made must not go to waste. And we must not forget the painful lessons we have learned.
The new pandemic agreement, and targeted amendments to the International Health Regulations, will provide the vital legal foundations for this architecture.
I’m pleased to note that the Bureau of the International Negotiating Body has now complected its draft of the negotiating text of the pandemic agreement, which has been circulated to Member States. This will help the discussions focus on the important issues.
At the same time, I’m aware that there remain differences between Member States on critical issues.
I am concerned that negotiations are moving too slowly, and that the accord may not be agreed in time for next year’s World Health Assembly.
I urge all Member States to work with a sense of urgency, with a particular focus on resolving the most difficult and contentious issues, so that we can have the deal by May 2024, as agreed.
This is a unique opportunity that we must not miss to put in place a comprehensive agreement that addresses all of the lessons learned during the pandemic, with a particular emphasis on equity. This is a generational agreement that should only be written by this generation, who is the lived community, because of its experience during the pandemic, and we have a responsibility.
Promoting, providing and protecting health are proposed as the three key priorities for all Member States in the 14th General Programme of Work.
The other two Ps – powering and performing for health – are enablers of the first three.
Powering health means harnessing the power of science, research and development, data and digital technologies.
I congratulate the Regional Office for the progress made under the flagship initiative on digital health, in support of the WHO Global Strategy on Digital Health.
I also thank the European Commission for its partnership and support in establishing the WHO Global Digital Health Certification Network earlier this year. We value our partnership, and it is going from strength to strength, as Commissioner Kyriakides said earlier.
At the global level, WHO has recently launched the Global Initiative on Digital Health at the G20 Health Ministers’ Meeting in India.
The Global Initiative will support Member States by converging and convening global standards, best practices and resources for digital health transformation, rooted in people-centred, evidence-based solutions.
And the final P, performing for health, is about the work we are doing as the Secretariat to support you better.
In particular, one of my key focuses for the remainder of my second term is to strengthen our country offices, with a core country presence, delegation of authority, adequate financial and human resources, the implementation of global mobility, enhanced internal communications, and more. This initiative is led by the country office heads themselves.
To support these efforts, I have squeezed US$ 100 million from our budget to allocate to country offices.
Our Programme Budget for the next biennium is also the first in which country offices will be allocated more than half of the total budget for the biennium. So country offices can help Member States, based on their priorities, to achieve the SDGs. That is why we are fully focused on strengthening our country offices.
I’m especially pleased to note that in this region, there is now for the first-time parity between the number of staff in country offices and the number in the Regional Offices. Thank you, Hans, for that focus.
We have already increased funding flows to regions and countries, and the more flexible funding we receive, the more we can increase that amount and continue to strengthen our country offices.
Our work to strengthen country offices will benefit greatly from the 20% increase in assessed contributions, and by the proposal for an Investment Round, both of which you approved at this year’s World Health Assembly. Thank you so much for that support.
We are also continuing our efforts to strengthen our workforce, to achieve gender equity at all levels, and to make zero tolerance for all forms of sexual misconduct a reality, and not merely a slogan. By the way, we have achieved gender parity this year, overall, on the average, but we need to continue to work, especially in high level positions like country office heads and director level, where parity has still not been achieved.
Excellencies,
Thank you all once again for your continued commitment to promoting, providing, protecting, powering and performing for health in Europe.
I wish you all a very productive and successful regional conference.
And to our hosts, Minister Giniyat, and for tomorrow's Republic's Day, we congratulate you.
I thank you. Rakhmet!