At the upcoming Executive Board, we will discuss the new terms of reference for the Meetings of Interested Parties. Let me just say here that I find these meetings an excellent opportunity to exchange views with a wide range of our partners, non-governmental organizations, the research community, the private sector as well as our multilateral and bilateral collaborators. In this fashion, they complement the other existing mechanisms for information and dialogue among partners.

When we met a year ago, I spoke at length about the reform process here at WHO. Over the past year, we have been able to shift our attention towards our priorities. The new structure we put in place in 1998 and the first few months of 1999 has been serving us well, allowing us to work more effectively and more focused.

In the field of Health Technology and Pharmaceuticals, we already have results to show for this work. Over the past year, the Global Alliance for Vaccines and Immunizations has been created. We have entered the final stage of polio eradication. We have passed a revised drug strategy and begun a concerted effort to widen access to essential drugs. And last Friday – on World Health Day – we launched a five-year programme for strengthening national programmes on blood safety.

When listed like this, these can sound like WHO achievements. They are not. They are achievements of partnerships.

I believe that WHO’s greatest contribution to world health is working alongside others, supporting them all as they do important things, trying to contribute where we have the most to offer and helping them with tricky issues.

"Partners" is a wide concept. It includes the private sector, foundations, non-governmental organizations, other international organizations and national governments. The MIP provides us all with an opportunity for the wider community to exchange views on the big challenges. It gives us a chance to learn lessons from the past, and - particularly - to consider how WHO can make the best possible contribution to the overall effort.

Let me restate the fundamentals. WHO has a strong value base for its work. A set of values based on our responsibility to fight poverty and inequity and to strive for the goals of health for all. We will keep these values alive and present as we progress in our technical work. This fully applies to our approach to drug and vaccination policies and to other health technologies.

Another core value is that of ethics, not only for biomedical research but also in terms of services and commitment to society. We must have the independence and courage to speak out for the disadvantaged, to argue against unethical practice and to advocate the cost-effective use of resources.

WHO delivers a global public good. There can be no compromise in the quality of that good. We need to ask for excellence at all levels. Our meetings with you - our partners and contributors - help us achieve that goal.

We are facing big and difficult issues, and to play our part well, we need help and advice. There are many other issues, on which we need to tune our activities. But the overarching intention is to consider how best we can contribute, in a sustainable way, to the four strategic directions which capture the current priorities in International Health, and which reflect the interests of our member states and their peoples.

• By increasing access to essential drugs, vaccines and safe blood, HTP can contribute to reducing the excess mortality of poor and marginalized populations.
• By creating a safe environment for vaccines and drug use, HTP can contribute to reducing the leading risk factors to human health.
• By building sustainable management capacity in heath technologies, as fundamental components of functional and reliable health systems, HTP can contribute to developing sustainable health systems.
• By developing national drug and blood policies with all, HTP can contribute to promoting an effective health dimension to social, economic and development policy.

During the next two days, we shall be reporting on how we are meeting these challenges, both globally and nationally. We shall also spell out what resources are needed for future action.

Let me visit two of the main partnerships that stand central in our work.

The first is polio eradication. Our efforts are on the right track. We are getting close to the target date for eradication, which is by the end of this year. The world is likely to be certified as polio free by 2005. But it is important to stress that we are entering a period of more – not less – intense vaccination effort as we turn from the eradication to the follow-up and certification phase. We currently have a shortfall in resources for this year of $300 million globally. We also must stress that if funding for polio eradication dwindles in the next few years, our whole twelve-year effort may be in danger.

Then there is the Global Alliance for Vaccines and Immunizations. Over the past year, we have come together with important partners to create GAVI. The Alliance is now operational. It has a separate secretariat, but administration is minimal, which means that the partners are closely involved in its daily activities. The technical co-operation is taking place within the HTP Cluster.

The prospects for GAVI are exciting. We now believe we may be able to reach half of the children that currently are not vaccinated within five years. To do this, we need at least another billion dollars in funds. But we also need technical assistance, guidance and advice. This means reaching out to all our collaborators.

Ladies and gentlemen,

Essential drugs and vaccines are one of the most cost-effective elements in modern health care. Their potential health impact is remarkable. Immunization, for instance, has helped avoid over 5 million deaths in 1998 alone. Yet lack of essential drugs and vaccines, irrational use of drugs, and poor quality remain serious global health problems.

I would like to briefly elaborate on the two key concepts: access and quality.

First access. We have the vaccines to prevent several million deaths each year. We have the medicines to save millions from dying from tuberculosis, malaria, and a number of other infectious diseases. Potentially, we have the blood that could save millions of lives of women in childbirth or people on operating tables. Yet millions continue to die each year due to lack of access.

It is almost without exception the poor who die from lack of essential drugs, vaccines or blood. In that sense this is a question of equity. At the beginning of the 21^st century, one-third of the world’s population still lacks access to the essential drugs it needs for good health. In the poorest parts of Africa and Asia, over 50% of the population do not have access to the most vital drugs.

Yet, we know that rectifying this is more than a question of bridging the gap between rich and poor..

We need to build new bridges between offer and demand. To succeed we will need broad partnerships between governments in developing and industrialised countries, financial institutions and the pharmaceutical industry. We will need to build on an emerging consensus on the needs of the poor and the basic requirements for improving their access to life saving drugs. We need to gain acceptance for the concept of equity pricing.

There will be no quick fix. A single focus on prices will miss two other crucial factors which prevent medicines from reaching those who need them; namely adequate financing and reliable supply systems. Sustainable access will require progress on all three dimensions. Making a specific drug massively available for a time limited period – without a system on the ground able to manage and distribute the drugs and follow up the patients may even be counterproductive.

Our polio eradication campaign has shown us that effective delivery of vaccines means strengthening the entire health system. Improving access to safe blood means creating a legal and administrative environment which ensures the availability and safety of blood products while keeping costs low.

Our Blood Safety and Clinical Technology Department has started to define requirements and organize evaluation of existing technologies in order to support developing countries and, as in the case of HIV antibody test kit, organize bulk purchase in the interest of developing countries

That leads to the other guiding concept: quality. As important as the work to improve access for the widest possible populations, is the work to ensure that what they gain access to is of a quality that satisfies both safety and ethical standards.

Quality means more than making sure that existing drugs, vaccines and blood products hold satisfying standards. It also means doing research to develop new drugs and vaccines.

Together with partners and collaborating centres, we facilitates the international research agenda by bringing all players around one table and acting as an advocate for developing country public health needs.

It also establishes international vaccine research networks and strengthens local research capacity, in particular capacity to appropriately plan and perform clinical trials. It explores and promotes innovative ways of financing the development of new vaccines against diseases that are absent from the countries of the North through public-private partnership, virtual companies and through technology transfer to developing country vaccine producers.

In house, Health Technology and Pharmaceuticals, together with the Communicable Diseases cluster, has launched the Inter-Cluster Vaccine Initiative, bringing together all of WHO’s vaccine research initiatives under one umbrella. One component of this vaccine network is the HIV Vaccine Research Initiative, a new partnership between WHO and UNAIDS. This network truly is a model for cross-cluster activity within WHO and sets the stage for strengthening of our vaccine research capacity. It will, among other things, enable WHO to play a stronger role in helping the international community set vaccine research priorities.

The last years have seen important technological achievements to improve quality of blood and blood products. These are exciting, but they are or will be expensive and the price of blood is rising. There is a growing gap between developed and developing countries. This is a concern for WHO.

However we believe that technology will benefit developing countries possibly with "technological leaps" when there is a well organized transfusion service.

Let me conclude by reminding us all that the people of our world do not need to bear the present burden of illness. Most of the severe illness that affects the health and well-being of the poorer people of our world could be prevented. But first, those at risk need to be able to access health care - including essential medicines, vaccines and technologies. Millions cannot - they cannot get the help they need, when they need it. As a result they suffer unnecessarily, become poorer and may die young.

A country's health service cannot respond to people's needs unless it enables people to access essential drugs of assured quality. Indeed, this access represents a very important measure of the quality of the health service. It is one of the key indicators of equity and social justice.

I invite you in your discussions today and tomorrow to identify additional ways in which WHO can help tackling the challenges ahead. We count on you, our partners, to share your experience and to guide us in our programme planning.

May thank you for your considerable contributions to our joint work in these important areas over the years. I hope that you will give the WHO's contribution a vote of confidence by continuing and - if possible - increasing your support. Together we really are making a difference - where it matters the most.