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Mr
Chairman,
Honourable
Ministers,
Distinguished
Ambassadors and Delegates,
Thank you very much for inviting me to this yearly
event of the Commonwealth Health Ministers.
Tomorrow, the World Health Assembly convenes. We
will all feel that we have had a warm-up here in this room. Your
discussion this afternoon, covering the technical items, will serve as
an important preparation for the wide discussion later in the week.
The growing realization of health’s important
role for development, growth and progress means that there is more
interest, higher expectations and a heavier work load for all of this
year. There is a perception among world leaders that we have a window
of opportunity at the beginning of this decade to act decisively to
improve global health and reverse the growing divide between rich and
poor. Our actions this week will be important to help this process
gain momentum and move forward.
In my speech tomorrow, I will summarize some of the
main areas the Organization has focused on over the past three years
and outline some of the key challenges ahead.
Since I arrived here in Geneva I have said that the
global health agenda is too big for any one entity. To work
effectively, we need to pull together. Since then, we have reached out
to different parts of government, civil society, professional
associations, the research community, foundations and bilateral
agencies, encouraging intensive and focused partnerships.
Within any partnership WHO retains its core values
and its integrity. The goals are always the same: to improve health
outcomes and promote health equity. Seen as a whole, partnerships have
greatly enhanced our reach and ability to make a difference.
Among WHO’s main efforts is our work to reduce
the health divide. We can do it through improving access: Access to
resources. Access to commodities. Access to information and
technology.
There is growing impatience for more resources, and
for their effective use.
The call to action is clear. A massive effort is
needed. Step up the fight against devastation caused by malaria, HIV,
TB, maternal illness, tobacco. Broaden access to life-saving
medicines. Ensure that health systems perform as they should, are
responding to people's needs, increasing healthy life expectancy, and
are being financed fairly. Rolling back the illnesses that perpetuate
poverty by investing more, investing it well and tracking investments
with care.
We see a growing commitment to a new international
framework which links the availability of new resources to the ways in
which they are used. Tomorrow, I will outline this framework as I see
it.
There is much that can be done by increasing
investments through existing international channels. But we also
believe there is need for something new. I will therefore carry
forward the Secretary-General’s call for a fund that focuses on
tackling AIDS and other major health conditions associated with
poverty. It is important over the next week that Member States take
advantage of opportunities available in this Assembly to discuss the
mechanics of such a fund, focusing - perhaps - on the collection of
resources, the ways in which they are used, and means for monitoring
results that are obtained.
Madam Chair,
WHO will also intensify its support for Member
States as they scale up and streamline their health systems. We will
continue to draw on experience to date - including the Primary Health
Care and Health for All movements, as well as initiatives for health
sector reform and sector-wide approaches.
We anticipate that the opportunities posed by the 3rd
Conference on Least Developed Countries, as well as the upcoming UN
General Assembly Special Sessions, will encourage all sectors to
examine the extent to which their policies can help bridge the health
divide. This applies particularly to education, finance and
revenue, trade, environment, local government, and social development.
We will continue to encourage approaches that promote the realization
of all people's human rights.
I note you have chosen HIV/AIDS, the Framework
Convention on Tobacco Control and the Global Strategy on Infant and
Young Child Feeding. I hope, together with my colleagues from WHO, you
will be able to clarify many of the important issues on these key
items.
HIV is the biggest health challenge of our time. It
is vital that we work together to confront the epidemic effectively. A
much better response is needed. The world is listening and watching.
Indeed, we focus relentlessly on better health
outcomes. They are key to the fate of our peoples and the health of
our economies.
We are responding to the urgent calls for
intensified action, from Heads of State and the
UN Secretary-General, from civil society and the international
community.
- We concentrate mainly on the needs of young people, improving
their access to preventive measures - including condoms and
microbicides, information and services for other sexually
transmitted infections;
-
We do more to ensure prevention of
HIV transmission among mothers and their children;
-
We promote a comprehensive response by
increasing access to voluntary counselling, testing, blood safety
and safe injection practices, and better access to care and
support for those affected by HIV, including management of
opportunistic infections and of tuberculosis and treatment with
anti-retroviral compounds. We pay special attention to the needs
of health workers;
-
We invest widely in research to
establish the best options for prevention, diagnostics, care and
programme implementation;
-
We support communities who have
been devastated by HIV - particularly children who have been
orphaned.
Within WHO, our vital task is to establish the ways
in which the available interventions can be made as effective as
possible in different country settings. We want to help ensure that
all health systems everywhere are scaling up their efforts and
empowering people to better confront HIV. If the health systems
cannot do this, limiting the spread of HIV becomes virtually
impossible.
At the beginning of last year, I was outspoken
about inequities in people's access to life-prolonging therapies. I
asked why so many millions of people should be denied the hope that is
available to a fortunate few. The offer of treatment will
increase testing for HIV. Increased testing is essential for
prevention strategies to work. We must create a positive spiral of
hope.
In this effort, people with HIV are powerful
partners.
During the past year, the face of the epidemic has
changed, dramatically.
For many governments, the new reality raises
difficult challenges. Of priority setting. Of capacity. Of equity. Of
balancing public expectation with resources.
Many commentators have said publicly that the pace
of change over the last year has been too slow. But no-one will thank
us if - in our haste - we promote patterns of care that are unsafe -
or even dangerous.
We must be responsible and realistic, but that does
not mean we cannot begin improving access to treatment quickly. In
every country in the world, there is already the capacity to reach at
least some HIV-affected people with better medical care. As our
experience improves, we can expand.
We must also do what we can to establish consistent
funding: it would be a tragedy if people who start anti-retroviral
therapy are forced to quit because funds dry up. Good systems, and
sustained funding will create new market forces. I am sure that costs
of effective triple ARV therapy could still go much further down.
Madam Chair,
Another important innovation during the past three
years has been the process through which governments are negotiating a
Framework Convention on Tobacco Control. The second round of the
negotiation process was completed earlier this month under Ambassador
Amorim's excellent stewardship. His first draft was discussed and
debated at length. This is the normal negotiating process that will go
forward to the next session in November. I am confident that we will
end up with a strong and effective Convention – one that can help
countries confront the threat of tobacco to their people.
As we move forward, we must keep the alternative
firmly in mind: millions of needless and preventable deaths around the
world each year. Deaths caused not by microbes or virus – but by an
unhealthy hunt for profits. Profits for some which will burden
societies dearly through the cost of treatment and lost productivity.
Tobacco steals from society. It steals life and scarce resources. The
Framework Convention is an important tool to protect our societies –
and especially the poor ones – from this pillage.
Last year, I initiated work on a new global
strategy for infant and young child feeding to provide a framework for
intensifying action. The work has been guided by two principles: first
- the strategy should be focused on science and evidence, and second -
a broad range of interested parties should be involved in its
development. Consultations are under way within WHO's Regions, and six
more are due to take place between now and October. They will draw on
experiences of more than 100 Member States. We plan that the proposed
strategy will be presented to the Executive Board and the Health
Assembly in 2002.
Over a year ago, I commissioned a systematic
scientific review of all published literature on the optimal duration
of exclusive breast-feeding. The analytical work was examined at an
expert consultation here in Geneva at the end of March.
Based on this evidence I encourage Member States to
protect, promote and support exclusive breast-feeding for six months
as a global public health recommendation.
Of course, we must consider how health workers can
best respond to the specific needs of individual infants whose mothers
are unable to, or choose not to, breast feed for six months. Many
mothers need help to optimize their infants’ nutrition.
Madam Chair,
We will be addressing access to drugs under the
agenda item "Revised Drug Strategy". As you may know WHO and
WTO last month convened a workshop in Norway on differential pricing
and financing of essential drugs. Discussions showed how groups from
industrialized as well as developing countries, from both
research-based and generic pharmaceutical companies, and NGOs, could
find ways to work together and agree on the need for a
differential – or equity-based – pricing system for key drugs and
other pharmaceuticals.
The Norway workshop took place against the backdrop
of a legal dispute between a number of pharmaceutical companies and
the Government of South Africa on legal provisions for improving
access to essential life-saving medicines. I believe that there is
widespread relief after the settlement of a very controversial
struggle involving people’s lives and futures. WHO provided the
South African Government with technical information on the relevant
issues and is contributing to continued dialogue among all parties
within other fora.
The Round Tables this year will be on the topic of
mental health. It is also the topic of the World Health Report which
we will be launching in October.
Mental ill-health undermines the well-being of
populations and causes particular difficulties for the world's poor.
The round table discussions will be useful in broadening our knowledge
and experience around the challenges we are facing, and to increase
awareness about best practice.
This year's World Health Report will review 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
that effective prevention and treatment are put in place and funded.
I expect these efforts to take mental health
forward so that it is given the same priority and respect as physical
aspects of health.
In addition to the three agenda items you will
discuss this afternoon, we have several other important technical
items before the Assembly.
Global health security, health promotion and the
possible health effects of depleted uranium are all on the agenda.
Madam Chair,
A major issue will of course be the proposed budget
for the biennium 2002-03. I regard this budget as a key instrument in
the reform process towards One WHO, and one which will serve as the
underpinning for WHO’s business plans for the next biennium.
Over the last three years we have attempted to
increase the effectiveness and efficiency of WHO’s work with a
declining regular budget. We have made extensive savings, and
redirected resources to priority programmes. The demands on the
regular budget – for our administration, our core programmes, our
normative functions and our country programmes - are intense.
This year, we invite the Assembly to take account
of the net increases in our costs and consider a 1.9% increase in the
regular budget for the 2002-03 biennium – of US$16 million. We also
anticipate an amount of US$10 million resulting from the integration
of miscellaneous income into the budget and that this can be kept for
addressing priority needs.
I look forward to an interesting and productive
week, setting the agenda for important health action.
Thank you. |
