Mr Secretary-General,
Heads of Sister Agencies,
Excellencies,
Ladies and Gentlemen:

"Forgotten People", more and more numerous around the world, carry an unacceptable load in terms of burden of disease and poor access to health. Today’s "World Humanitarian Day" has a special significance for the World Health Organization.

The objective of the Consolidated Inter-Agency Appeal (CAP) is for the UN agencies to describe the activities needed to save lives during acute disasters; to help populations affected by war and natural disasters to move from extreme vulnerability to recovery and sustainability; to promote human rights, and to build peace. In this process, health is not only of central importance. It is also a highly sensitive indicator of both the performance of the overall humanitarian programme and of the rapid changes one sees during crises.

Let me give you two examples. In the countries of the Great Lakes, malaria rose from 1 million cases in 1989 to 4 million in 1995 as violence resulted in massive population displacement. In Somalia, the disintegration of health services resulted in a vaccination coverage below 35%. There, 12 000 new sputum positive TB cases occur every year, and only 25% are detected and treated.

Health is therefore central to the Consolidated Appeal process. As the UN technical agency specialising in health, WHO appeals for the survival of all the individuals trapped in deadly crises around the world.

In CAP countries, WHO appeals for the assessment of health risks. Indeed, knowing the levels and trends of morbidity and mortality, due to communicable diseases in particular, is essential to the planning and targeting of public health interventions undertaken by all actors in the health field. In these countries, WHO also strives to facilitate health coordination among inter-governmental, governmental and non-governmental partners. Finally, WHO aims at supporting the design, implementation and evaluation of selected public health interventions, particularly for the control of disease. Some examples illustrate the challenges to health confronting the 14 countries concerned with the Appeal:

• In Tajikistan, we are appealing to stabilize malaria and typhoid fever. Both diseases have killed thousands of people over the past three years. In fact, avoiding deadly epidemics is consistently at the top of WHO’s agenda in the 14 appeals that are launched today.
• In Afghanistan and Burundi, WHO appeals for safe motherhood and child survival initiatives: too many mothers are still dying when giving birth; too many children cannot overcome the health challenges of their first year. In Burundi, under-five mortality rates increased from 108 to 190/1000 between 1992 and 1998. Between 1989 and 1996, infection by the AIDS virus increased from 11 to 21% in cities and from 0.7 to 6% in rural areas.
• In the Democratic People’s Republic of Korea and Somalia we are committed, in close collaboration with UNICEF, to protecting children from measles and polio. War and conflict contribute powerfully to reducing the immunization coverage of millions of children.
• In the Balkans, access to primary health care continues to be denied to families who recently returned from exile. Affordable services avoid anyone seeking care arriving too late at the hospital for essential care.

Such examples of WHO’s interventions are the intrinsic elements of a "minimum health survival package" we include in appeal after appeal, and WHO’s voice is one advocating that minimum health standards for human development need to be met.

Mr Secretary-General, Ladies and Gentlemen,

WHO is a technical organization decentralized over the six regions and individually represented in almost two hundred nations. WHO is therefore very operational and addresses vital health needs as the core objective of a global agenda.

Our field offices enjoy the technical backup of technical specialized units in WHO Regional Offices, in our Headquarters and in our collaborating centres. WHO is mandated and structured to deliver this public health advisory and guiding function. This is WHO added value in the field.

WHO’s strong comparative advantages in humanitarian action lies in its long-term presence, its knowledge of the field, its ties and partnerships with local communities and national authorities. WHO’s technical cooperation and normative mandate bring public health knowledge and techniques wherever needed. WHO is an agency without exit strategies. We are in the country before, during and after the conflict. As such, WHO is a guarantee of ensuring integrating humanitarian action, post-conflict rehabilitation and long-term development in a continuum.

Regretfully, during 1999, our global humanitarian call did not receive much attention. Of the US$33.6 million that were requested by WHO for humanitarian health programmes, only 39.4% have been funded so far. Appeals for programmes in many of the countries were simply not funded at all.

Mr Secretary-General, Ladies and Gentlemen,

In spite of the poor funding result, WHO remains committed to the Consolidated Appeal Process for the year 2000.

In 14 countries today WHO proposes "Intensified Health Partnership for Emergencies".

In so doing, we need to take the lessons from the past and mobilize our initiatives to ensure that we will not have to fight illnesses alone in the DRC while the world is looking towards the Balkans.

As part of my commitment to this Health Partnership Initiative, during year 2000:

• I will visit various "CAP countries", and
• I am reviewing WHO programming at country level so that urgent needs in these countries can be met in a long-term perspective, from emergency relief to sustainable development.

WHO implements three humanitarian core functions:

• In Partnership for Health in Emergencies, WHO executes decentralized transfer of public health technologies as illustrated by our decentralised cooperation approach in the Balkans, our community-based mental health initiatives in Sierra Leone, Burundi and Uganda, and our pluri-coordinated expanded programme of immunization in the DRC and Afghanistan.
• With Health Intelligence and Rapid Assessment, WHO promotes an evidence-based advance planning and early response, as the currently acute context of the North Caucasus and Eastern-Timor illustrates.
• Through Capacity Building for Best Public Health Practices in Emergencies, WHO consolidates best practices and develops a body of knowledge that we are using for preparing and responding to epidemics in the 14 appealing countries.

Mr Secretary-General, Excellencies,

There needs to be a voice for health of a daily increasing number of "forgotten people". These population groups in extreme poverty are encountering the highest burden of deadly communicable diseases – but diseases for which highly cost effective preventive and curative measures do exist.

Several years ago a WHO Special Representative, when seeing the carnage in Bosnia, wrote: "This is a war on public health". Every war, ladies and gentlemen, every conflict, every one of these emergencies today, is a war on public health. I call on you to help us win this war.