Address to the Fiftieth Session of the WHO Regional Committee for the Eastern Mediterranean
Mr Chairman, Your Royal Highnesses, Honourable Ministers, Distinguished Representatives, Dr Gezairy, Colleagues,
I am honoured to be with you here in Cairo, and to join your discussions on our work in the countries of the Eastern Mediterranean Region. May I add my congratulations on this 50th Session of the Committee.
I feel a great responsibility being in charge of WHO, and I am grateful for all of your support and good wishes for success.
I would like to begin by paying tribute to our two WHO colleagues who died recently following bombings in Iraq, Nadia Younes was killed in the bombing of the United Nations Office, and Ahmad Shukri died from the injuries he sustained after the bombing of the Jordanian mission. Other UN colleagues also died and there were many injuries, including among our WHO staff.
Despite these terrible losses, we continue our mission to rebuild health services for the Iraqi people. I want to thank all of those involved, including our many national staff.
I would also like to offer my best wishes to our staff member, Dr Ala Alwan, our representative in Jordan, in his new responsibilities as Minister of Education in the Governing Council of Iraq.
Mr Chairman,
This year marks the 25th Anniversary of the Alma Ata Declaration on Primary Health Care, and it is good to remind ourselves that health is for all. Everyone equally needs health, and, when society fails to meet that need, it is in very serious trouble.
“Unequal development in different countries in the promotion of health and control of disease... is a common danger." These words are taken from our Constitution. In some countries, conditions associated with poverty are bringing life expectancy down to 40 years while, in others, increasing wealth and health technology are enabling it to rise towards 80. Inequality of this magnitude is not only a danger but an injustice to human well-being.
Though this region has largely been spared, the greatest health challenge facing us now is the catastrophe of HIV/AIDS. More than 42 million people in the world are HIV-positive. At the session on HIV/AIDS at the UN General Assembly in New York last week, I said that the lack of access to treatment for millions of people with AIDS in developing countries is a global health emergency.
I pledged WHO to respond rapidly and urgently to these needs. We are preparing to make available emergency response teams at the request of countries with high HIV/AIDS burden. The teams will work with those countries to find ways to deliver antiretroviral medicines to people who need them. WHO is working to produce simplified treatment guidelines and training materials. We are committed to increasing our support to countries in their struggle to respond to HIV/AIDS. We must deliver an integrated global HIV/AIDS strategy linking prevention, care and treatment.
We are working with local, national and international partners to design the necessary programmes to treat three million people with antiretrovirals by the end of 2005. "Three by five" will not solve the problem but it will mark the beginning of a solution, and be proof that it is possible. A comprehensive strategy for making this happen will be announced on the first of December, World AIDS Day, two months from now and our work with countries will be initiated immediately.
We are working with many partners, including UNAIDS and the Global Fund, to mobilize the resources to put these plans into action. Overall success will require the commitment of civil society, United Nations agencies, the private sector, and above all, Member States. It will require the commitment of each one of us here today.
2005 is the target date for control or elimination of several other important diseases. In this Region, as elsewhere in the world, TB remains a great threat. Your efforts to implement ‘DOTS All Over’ will ensure that those suffering from TB receive the effective DOTS treatment they need and the care that will cure them.
We must press home the hard won advantage that we are winning against polio in order to complete regional and global eradication. In doing so we will deliver substantial dividends for the health services of every country.
Malaria remains a titanic health problem in the world and in this Region. It will be vitally important to continue the regional work on this. The recent work to tackle cross-border control issues between Afghanistan, Pakistan and Iran was an innovative development.
The need for health care starts even before birth. Protection during pregnancy, childbearing and motherhood is at the heart of an effective health system. Yet half a million women die every year from giving birth. Skilled attendants are needed in pregnancy and childbirth, with access to emergency obstetric care when complications arise.
Despite the struggle of parents for their children's survival, 10 million children in low- and middle-income countries die every year before reaching the age of five. Seven million of those deaths are from five preventable and treatable conditions: pneumonia, diarrhoea, malaria, measles and malnutrition. We can reduce this toll substantially by working with countries to build up strategies such as Making Pregnancy Safer and Integrated Management of Childhood Illnesses. Reducing child mortality worldwide by two-thirds by 2015 is possible. But it will not happen without major rethinking and commitment.
Surveillance systems showed their effectiveness in the eradication of smallpox, and earlier this year in stopping the SARS epidemic. They are a key to success now, both for the eradication of polio and for the control of new and re-emerging infections. We also need to finalize the important work on the Revision of the International Health Regulations.
Meanwhile, noncommunicable diseases and injuries account for a growing share - now about 60% - of the burden of disease worldwide. Noncommunicable diseases are a growing problem in this region. In May the World Health Assembly adopted the Framework Convention on Tobacco Control. This was a global achievement in the fight against tobacco-related diseases. The Convention has now been signed by 69 countries, including seven in this region, and ratified by two, Norway and Malta. It will give the world the means to protect people from tobacco harm by banning advertising, preventing smuggling, raising tobacco taxes and enforcing warning notices on packages. We must do everything we can to speed the process to the ratification by 40 countries that will bring the Convention into force.
The unbalanced nutrition now affecting all societies, rich and poor, poses a major challenge for health. Our objective is integrated approaches that work against malnutrition - from deficiencies and excesses. WHO's Global Strategy on Diet, Physical Activity and Health will be presented to the World Health Assembly next May.
This year's Health Assembly reviewed the work of the Codex Alimentarius and concluded that the health sector should play a more prominent role in setting safety standards for food. The Health Assembly also stressed that developing countries should be given more support to participate fully in the process of international food standard-setting. In many cases this is a matter not just of food safety but of food security - of ensuring intake of the minimum calories essential for health and survival.
Every year, more than a million people die in traffic accidents around the world making it a leading cause of death in all regions. We must raise awareness and strengthen our response. World Health Day 2004 will therefore be dedicated to Road Safety.
Everything we are doing is about reinforcing national health systems. Our work everywhere is important, but the real centre of it has to be countries. We have to give our country offices more people, more realistic budgets, and more authority. At the same time, we also have to ensure sound management and financial practice as well as transparent budgeting.
At headquarters, all the Assistant Directors-General are looking at the global issues under their responsibility, to see which of their activities could be better carried out in regional and country offices. Overall, I want to see these changes completed for the 2006-2007 budget. Having worked for 20 years in WHO, I know that strengthening our work in countries is by far the most effective way to achieve our goals.
Health systems depend most of all on skilled and dedicated personnel, and here we face a major challenge: the brain drain. It is, above all, good health workers that will enable us to reach "3 by 5", and achieve the Millennium Development Goals, and everyone is short of human resources. We will be working closely with countries on innovative methods to train, deploy and supervise health workers, with particular emphasis on the community and primary health care level. That is where we can make the swiftest progress in getting results.
In many countries, the systems for providing reliable health information are also inadequate. This is one area in which the trend is on our side: the means for building effective information systems are becoming more powerful and more affordable all the time. We are therefore forming a health metrics network – an information partnership with Member States, foundations, the World Bank and UNICEF.
I also would like to refer to the resolution adopted at the last World Health Assembly entitled “Health Conditions of, and Assistance to, the Arab population in the occupied Arab territories, including Palestine”. The Health Assembly asked the Director-General and WHO to take a number of steps to continue to assist health programmes and projects in the territories. We continue to work with the Palestinian authorities to respond to the crisis to the extent that circumstances on the ground allow. Mental health was a particular focus recently. Information on the overall situation is published regularly on our web site.
Chair,
Over the years, WHO has built strong and effective working relations with governments, foundations, nongovernmental organizations, the private sector and fellow multilateral organizations. Our work depends on partnerships; some long-standing and some more recent. By combining our strengths we can do so much more, also in the occupied territories.
There is a commitment to partnership by global leaders on a scale we have not seen before. At the United Nations Millennium Summit in September 2000, the global community committed itself to eight goals. Three of them are directly related to health: to reduce child mortality, improve maternal health, and control major infectious diseases. The five others concern poverty, education, gender equality, the environment and global partnership. All these, as we have seen, have a bearing on health. We need to make the most of these opportunities.
Better health for all is our common goal. Let’s work to achieve this, in the Eastern Mediterranean Region, and globally.
Thank you.