Good afternoon, good morning, good evening. We are linked directly to AFRO, EMRO; EURO and AMRO: a recording will be shown in WPRO and SEARO. A happy new year to you, wherever you are.

Colleagues,

It’s almost two and a half year since I talked to you here for the first time, presenting my ideas for taking forward the important work of WHO.

I proposed several distinct emphases:

• to build the credibility of our technical work, so that we make increasing use of evidence to decide our priorities and where our actions would have the most impact.

• to increase our focus on what is most important for the poorest part of the world’s population.

• to concentrate on the areas where we have a comparative advantage over others.

• to place health at the heart of the global political agenda and at the centre of the development process.

We are two and a half years on. I judge that we have made real progress. We have moved faster and further in some areas than in others, but all in all I would say we have achieved a lot.

This progress is the result of the hard an innovative work of you all. We do not all have the opportunity to speak too often. So let me now, at the beginning of 2001, say how much I appreciate the commitment, effort and productivity of all WHO staff. I know that sometimes the demands made on you all have presented you with really difficult challenges. I see the trouble taken to prepare for meetings and visits, the dedication to getting things right, and the hours some of you work. I see the names in the night and weekend book here in Geneva, and I note the time-line on e-mails my office receives.

There is a continuing need for all of us to focus on communicating with each other on plans, on progress and on issues we face. This should help us avoid the build up of unanswered questions about where we are heading, or misconceptions about our intentions.

My special thanks go to those of you who work hard but are seldom in the limelight - field staff under harsh conditions; staff in Country Offices; in Regions; or in Geneva - whether your task is making sure that our Offices are administered properly, keeping our core functions going, or translating, printing, managing people and money. I know of your dedication to the Organization and what it stands for. We depend on you: your work is vital, even if it is not spoken of as a priority, featuring in the news or on the agenda of our governing bodies.

We are a broad, immensely varied technical Organization with a mandate and an expertise to cover a tremendously wide range of issues. All that we do, contributes to our corporate strategy: it is all important and all of it must be done well.

The progress has been uneven. Not all fields have moved as fast as we had hoped. The focus and attention of myself, the Regional Directors and the Executive Directors have not reached over all the areas that need renewal or assistance. This is natural and inevitable, but it is not a permanent condition. We will do our utmost to help all of you to move ahead. Like you, we want to see excellent work in all the areas where we are expected to contribute, so that WHO increasingly will be seen as the true leader in public health.

Outside, we have met a lot of understanding and good will.

• There is strong and genuine appreciation among world leaders and health professionals for the energy and leadership WHO has exhibited in some key areas of public health, such as in global tobacco control, rolling back malaria, immunization and polio eradication. As one example, our new relationship with the European Union represents a real shift - tangible evidence of the value they give to working closely with WHO.

• We have shown our commitment to quality research - both basic and applied - as a vital platform for effective work at all levels. We are being asked to help bring together different groups within the health research community so as to enable them maximize their impact.

• We have built strong and effective relationships with development partners, too - in countries, at regional level and globally. I know the trouble you take to do this. It is worthwhile. It makes a real difference.

As a result of these efforts, we are well on the way to earning, or, in some cases, regaining, the position and role we should have.

In parallel with our own work, and, clearly, to some extent as a result of it, health has become an important global issue. Health issues have become the theme of everything from G8 leaders’ meetings to the latest John Le Carré novel. We currently have an unprecedented political environment for voicing our concerns and proposing ways to improve health for the world's poorest. It is an opportunity that we have been eager to exploit.

But as we have shown our direction and our resolve, and as we are presenting the way we intend to progress, there have also been voices of opposition and concern.

Some of it is technical, like when we go beyond our traditional epidemiological role of supplying health statistics, and start to evaluate the performance of health systems in order to provide decision makers with better tools to make improvements and policy decisions.

Some of it is political, such as when we suggest that improving health is a powerful tool to reduce poverty - rather than a by-product of poverty reduction.

And some reflect the threat we cause to those who set out to harm people's health - as when the tobacco companies and their supporters attack our efforts on global tobacco control.

Colleagues,

This year will be a challenging one. We have many balls to keep in the air. We have to deliver on many commitments. And we have increased our profile, so we are under close scrutiny by a number of players.

I would like to outline some of the areas that will dominate our attention in the months to come:

Mental health. As you all know, the theme for this year’s World Health Day will be mental health, as well as this year’s World Health Report.

Our advocacy effort will concentrate on reducing stigma associated with mental ill health and on raising awareness about the many effective, affordable treatments that are available but underused, both in developing and industrialized countries. The Noncommunicable Diseases and Mental Health Cluster has already produced a very good brochure on mental illness, which they are presenting to the media tomorrow.

I will mark the World Health Day twice this year; first in Nairobi on the fourth of April, as the Administrative Committee on Coordination of the UN meets there, hosted by UNEP, and then again here in this room on 6 April in what we hope will be a warm and forceful celebration of the benefits of inclusion and care - both for those who suffer from mental ill health and from all who do not.

The World Health Report will give a comprehensive review of what we know: about the current and future global burden of mental ill health and neurological disorders; about the effectiveness of prevention and the availability and restraints to treatment; and about the policies needed to ensure that stigma and discrimination is broken down and effective prevention and treatment are put in place and funded.

I hope our efforts this year will take mental health a large step forward towards equal priority and respect with physical aspects of health.

Our massive effort. This has been a buzz-word for a process that is now well-established. The focus is on scaling up efforts to address conditions that affect really poor people. People have - I hope - stopped seeing this as a "new disease control programme". It is not. We have worked hard to help countries and agencies increase the focus on the impact of health systems on poor people's health.

The work we did last year around the Massive Effort was untraditional. Regions were involved from the start. We worked with national governments, NGOs and other UN agencies. We saw lots of cross-cluster work, lots of brain-storming. We are working on a large scale - touching on the structure of international development assistance, on arrangements for financing health action, on political and structural issues that restrain nations in effectively employing health programmes, and on global decision-making. We consulted and collaborated with a number of partners, while at the same time trying to manage expectations and clarify intentions.

It was not easy. But it has been a good start to what will be a long and sustained job. Developing countries are requesting action on the diseases and conditions that keep them in poverty. We have showed that we have enough interventions that work so that the world effectively can invest money in scaling them up. And we have worked with the main purse-holders of this world and got their clear reassurance that they share our views on what needs to be done. I am particularly pleased with the new partnership that is being forged with the Economic Commission for Africa, the OAU, the European Union and several of the large international foundations.

Last year necessarily focused heavily on securing donor commitments to underwrite what is at least a $3-5 billion–a-year, 15-year commitment. This work will continue this year, in particular leading up to this year’s G8 leaders meeting in Genoa in July.

During the coming year, our Massive Effort will focus more on better ways to channel the money effectively, on improving the capacity of countries’ health systems to absorb funds and on yielding concrete results on the ground.

At the same time the work of the Commission on Macroeconomics and Health is going into its final year, and many of the findings of the Commission and its sub-committees will underline the economic justification for scaling up action to yield better health outcomes among poor people. When the Report is presented in December, we will hopefully have a clear and strong endorsement from some of the world’s top economists’ of the central role health plays in development. It will give a strong boost to all the work we do and help us argue our messages on all health issues for prime ministers and finance ministers world-wide.

Tobacco. This will be an important year for the negotiations of the International Framework Convention on Tobacco Control. The Intergovernmental Negotiating Body will meet again in late April. We expect that we will see some solid progress towards a strong Convention.

Let me remind you: With the International Framework Convention, WHO has taken on a for us new and uncharted role as a health body. It is the first time we have made use of our ability to create an international legal treaty to forward our work and it has required an entire new internal mechanism to handle this, which is having impact far beyond the NMH Cluster. Chaired by Ambassador Amorim from Brazil, the negotiations in the Intergovernmental Negotiating Body are the first such process driven by Member Sates outside the World Health Assembly process.

Preceding the INB negotiations last year were a set of unprecedented public hearings on the Framework Convention. It was a resounding success and it can function as a template for seeking inputs on other issues of a complex nature in the future.

The report into tobacco-industry manipulation of WHO work provided a number of recommendations that we have taken note of and changed our work accordingly, such as conflict of interest policies among our staff and our consultants. It was a sobering experience to see the influence one interest grouping could have on our work and it is a sharp reminder of our need for vigilance and the need to stand strong against pressure of any kind against our core values.

The polio eradication effort will continue with the same high intensity as last year. National and Region-wide immunization days are planned both in West and Central Africa and in the countries in the Eastern Mediterranean Region and South-East Asia which still have wild polio virus. We will also continue the campaign to ensure funding in order to complete this crucial process.

One of the other main issues of the past year was the work we did on assessing the performance of health systems. As you know, last year’s World Health Report created a big debate - which is what we hoped and believed it would. This debate continues, also at the upcoming Executive Board. So will the work to develop and improve these assessments.

This work lies at the core of our role as a useful instrument for Member States. Health professionals - whether practitioners or researchers - make use of our epidemiological statistics. But if WHO shall be of better use to decision makers in the efforts to improve health systems in their countries, they need more advanced data on performance in order to assess and compare the performance of health systems in different parts of their country. They may also find it useful to rate their health systems' performance against its full potential, and against the performance of other countries. Unless we are able to link the knowledge base of epidemiology with the tools of econometrics, we will be much less effective in pursuing the goals of Health-for-All.

Colleagues,

Last year, I spent a lot of time sharing our ideas with leaders and decision makers world-wide. I spoke about the need to control tobacco. I spoke about the need to continue our efforts to eradicate polio. About the need to fight the diseases that cause and perpetuate poverty, and about the need to build health systems that are more cost-effective, responsive and fair.

It meant I travelled a lot and it meant that not enough time could be spent here at home This year I will try to spend two-thirds of my time in the Office, and I will seek to meet more regularly with HQ clusters, as well as with staff from outside of Geneva when they are here or during my visits to Regional or Country Offices.

Several areas will be important as we take our work forward during the coming year:

We are continuing to learn to work as one Organization - but at the same time as an effective network that responds to the particular needs of each country and its people. WHO country teams are at the cutting edge. In many ways, they determine the extent to which we can make a difference. So, during the next year, we will increase the emphasis on ensuring that countries, and their people, are at the centre of all our work and our efforts.

We will all work together to maximize the support that inter-country units, regional departments and Geneva-based groups can provide to country teams. I know that many of you are already making regular use of the new opportunities for video-conferencing to ensure better links between different parts of our network and other UN system partners. Our new telephone and video systems make this possible - more easily and at lower cost than ever before. We are all grateful to the people whose hard work has made this connectivity possible.

The upcoming global meeting of WHO Representatives will also help in strengthening the work between Countries, Regions and Headquarters.

Now we are focusing on our internal systems - for managing our precious human resources, and our scarce finances, so that they can be used to best effect and yield the results which we have been looking for. This means putting the right tools into your hands, simplifying complex processes and adopting the same best-practices across the Organization. This will take commitment and cooperation but without it we cannot complete the important organizational changes already set in motion. If you are called on to participate I hope that you will rise to the challenge.

We will give high priority to improving our Information Technology, so that programme managers within countries, in the Regions or in Geneva can know where they stand, and achieve the best possible benefits from these resources.

Looking ahead, it seems inevitable that more and more of WHO's contribution to health issues - whether at country, regional or global levels - will be supported through funding additional to the assessed contributions of Member States.

The most important item on the agenda will be the draft programme budget for 2002-2003. It is a real road map for the next phase of our reform. I want to thank all of those in all our six Regions and Headquarters involved in its preparation. The new process of planning for each of the 35 areas of work through extensive consultations between HQ and Regions went extremely well. We have a set of expected results for our work that will truly make a difference in our contribution to world health outcomes.

As you have probably guessed already, we do not yet know whether our Member States will support any increase in the regular budget. I am presently sounding out opinions but it is unlikely that we will be clear on this until the World Health Assembly in May. We are forecasting a continued growth in our extrabudgetary resources; the estimate at present is for an increase of 15%. If we achieve this it will be very good for us, but as you all know there are many critical things for which the regular budget is our only source of support. I take every opportunity to remind governments of this.

This coming session of the Board will also consider a series of proposals arising from all of the work over the past year on human resources reform. My appreciation goes to all of those who worked so hard on this, including the staff representatives from all over the world. Workforce planning; improving gender and geographical balance; performance management; grievance procedures; a more supportive work environment; staff development and career management; ... a range of initiatives in all these areas will be taken forward. We have not yet settled on the right way forward for reforming our human resources contracts policy, but we do need to reach conclusions soon.

Colleagues,

We have an exciting year ahead of us. I will again wish that it will be a happy and fruitful one for all of you - and for WHO.