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Mr
Chairman,
Distinguished
Representatives,
Ladies and
Gentlemen,
At the World Health Assembly four months ago, I
said that our fundamental challenge is to respond to the billions of
people whose potential is so cruelly extinguished by avoidable ill
health.
We are living in a world in which the divide
between the haves and the have-nots continues to widen; a world in
which only a privileged few have access to the fruits of the
technological revolution. Our challenge is to bridge that divide. We
can do it through improving access: Access to resources. Access to
commodities. Access to information and technology. Access to health
systems, together with infrastructure and institutions that make this
possible.
We in WHO are working with you as you address this
challenge in the Western Pacific Region.
We know that many national health systems are not
able to offer care that is as effective, responsive and fairly
financed as peoples and governments would wish. Technical advice and
well organized partnerships are necessary. But in poor countries they
are not sufficient. Health systems there will only work well if there
is a significant increase in available resources for health.
Within the last year, indeed since the Health
Assembly, we have seen growing global awareness of the need to invest
much more in people's health as a basis for broader social and
economic development.
I will soon receive the report of the Commission on
Macroeconomics and Health. I expect the Commissioners, led by
Professor Jeffrey Sachs, to call for a dramatic and rapid increase in
action for better health, based on their analysis of the crucial role
of good health, also in promoting economic development and poverty
reduction.
The international community is starting to respond,
building on efforts already underway in many nations. At the Health
Assembly, at the UN General Assembly Special Session on HIV/AIDS, and
at the G8 Summit, we heard commitments to increase resources for
global health. Public, voluntary and private sector bodies are already
making new commitments.
If the new resources are to be used effectively, a
number of individual actors in the international arena - governments,
research institutions, private sector companies and international
organizations - must work in concert along the same broad lines of
action. The work is intimately interlinked. Either of these actors
will only be able to work effectively if the others do their part.
We therefore need a framework for action, which
links the promise of new resources to the ways in which they are used.
This framework is built up by a number of key
elements. One of these is ensuring that essential global functions
take place, such as programmes of strategic research for, and
development of, necessary drugs and vaccines and strategic
partnerships to bring down medicine prices in order to improve access
in poorer communities.
But we also will need schemes for the efficient
purchase and equitable distribution of critical commodities, obviously
in ways that respect intellectual property, that build on existing
international trade agreements and that show how to take advantage of
the new advances in biotechnology.
Furthermore, we need an effective, fast mechanism
for moving money. This must be linked to ways of insuring the
independent authoritative monitoring and review of results. This is
crucial in order to sustain long-term involvement.
The Global AIDS and Health Fund will be one such
important mechanism. It is planned that the Fund be operational by the
end of the year. WHO sees the need for this Fund to live up to its
name and be a global fund. This means that it should bring
benefits to people in need within all regions, including this one.
Another element in this framework is innovative and
urgent action to secure the effective operation of health systems even
when they are seriously under-funded. This means improving the
capacity of a variety of different provider groups to deliver
essential services and goods through a diversity of private, voluntary
and public channels. The emphasis must be on stewardship by
governments, even in complex emergencies.
As part of the transitional working group designing
the Global Fund, WHO wants to be sure that it stimulates a build-up of
national health system capacity. We would like the Fund to help
governments and civil society to enhance health systems. This means
focusing on priorities, on the coverage and quality of interventions,
and on careful monitoring of what is achieved. The result should be
that health systems can use scarce resources more efficiently to
achieve better health outcomes for all.
The last key element of the framework for action
that I will mention is the need to catalyse intense and social
mobilization at country and global levels, through a credible and
upbeat programme of advocacy with political leaders and key public
figures. It would work through governments, NGOs, and the media. It
would be based on the theme of working together to "make the
forces of globalization work for the secure future of humanity".
The Global Alliance for Vaccines and Immunization
shows what can be achieved. The Alliance is two years old. It has
established a Vaccine Fund, which received a generous initial
contribution of US$750 million from the Bill and Melinda Gates
Foundation.
The Vaccine Fund provides resources for countries.
The members of the Alliance work with countries to strengthen the
performance of their health systems in immunizing children. WHO - as a
key member of this alliance - makes all of its technical expertise
available to help strengthen national vaccine programmes and introduce
new vaccines when needed.
GAVI responds to country-level priorities, working
with governments and civil society to make the best use of resources
available for health system action. Support has already reached
several countries in this region because the countries are committed
to improving their children’s access to vaccines.
As experience is gained, the GAVI Board reviews
lessons learned. Board members adjust the ways in which the Alliance
works to ensure flexible and effective responses to countries'
immunization needs. GAVI can act as a pathfinder for other health
actions too. In last month's Regional Committee meeting in Africa I
heard Ministers indicate how GAVI experience will inform their
contributions to the design of the new AIDS and Health Fund.
WHO’s network is supporting these and other
initiatives and partnerships.
Mr Chairman, Distinguished Representatives,
Understandably, much of the attention to HIV/AIDS
has been directed towards Africa. But we estimate that more than a
million people are living with HIV within the Western Pacific Region.
Although some countries have been able to reduce infection rates,
others are seeing rapid growth in the number of infections. The
overall trend gives reason for concern.
The UN General Assembly Special Session on HIV/AIDS
in July this year addresses the strategies and interventions that can
halt the spread of HIV infection. All of us are committed to
responding better - helping people prevent themselves from infection,
and increasing the proportions of HIV-affected people who can access
care for their illnesses.
As we have already experienced, it is not easy to
scale up our response to this unprecedented health crisis. It calls
for an extra-ordinary and courageous response. Experience shows how
hesitation and delay in the early stages of an HIV epidemic lead to
devastating consequences for the whole of society.
It is essential that we pursue the systematic and
coordinated intensification of prevention efforts and an improvement
of surveillance in this region. The alternative - an explosive
increase in the incidence of HIV infection and AIDS-related deaths -
is unacceptable.
We have good evidence that prevention works. Such
different countries as New Zealand and Cambodia have both shown that
effective prevention is possible and that the results of such work are
impressive.
I have directed that WHO scales up its contribution
to the struggle. Our goal is to help identify more effective responses
and implement them effectively in ways that take account of people's
cultural traditions and social realities.
Together with the other co-sponsors of UNAIDS, and
both government and non-governmental development partners, we are
working to adapt evidence-based practice to the needs of people. To
obtain evidence on what works, we coordinate and take forward
extensive research in the fields of diagnostics, spermicides, vaccine
development, operational research on care and support, and assessments
of programme effectiveness.
To this end, we have reorganized and substantially
increased WHO's contribution to HIV/AIDS action. We are now in a
better position to respond promptly - and effectively - to countries'
requests for assistance. We will continue to improve this response in
the time to come.
Mr Chairman,
This meeting is taking place as we mark an
impressive health achievement in the Western Pacific Region. Last
October, this region was certified as being polio free. Despite
neighbouring one of the last reservoirs of polio in the world, there
has been no report of any polio cases over the past year. This is a
sign of success of the region's policy of vigilance.
Globally, we are systematically pursuing the
eradication of polio. We are witnessing a public health sensation.
Millions of children have been immunized through repeated campaigns.
Surveillance has been built up to a level previously thought to be
impossible - often in countries torn by conflict. Hundreds of
thousands of volunteers have been mobilized. They have worked hard
under difficult conditions, especially in conflict-affected regions.
The efforts now made to ensure the eradication of
polio are among the largest and most impressive public health
interventions the world has witnessed. Last year alone, 550 million -
85 per cent - of the world’s children were immunized.
The Global Polio Eradication Initiative, has
reduced the number of cases by 99 per cent. 3,500 cases were reported
world-wide in the year 2000. So far this year, there were only 266
confirmed cases of polio globally. This means that three million
people in the developing world, who would have been paralyzed, are
walking today, due to our campaign that took off with UNICEF, Rotary
and CDC as main partners, in 1988.
Through the polio campaign, people are seeing how
health action brings results. In years to come, benefits of this
action will stretch beyond the eradication of polio. Health systems
will have been strengthened and made more effective. Public health
programmes will have a viable infrastructure. Thousands of health
personnel and volunteers will take on new tasks with pride and
commitment.
We are inspired by what has been achieved and we
move forward to address other health challenges in this region. The
tasks are daunting. How can we enable all people to access health
systems that are efficient, equitable, and respond well to their
health needs? How can we improve services for people who are the
hardest to access - whether because of their poverty, their location
or their gender? How can we better address communicable diseases,
challenges faced by pregnant women and children, the epidemics of
noncommunicable illness, and illness related to environmental issues?
My answers are straightforward. First, we need to
see a significant increase in available resources for health. Second,
we must ensure that these resources are used in ways that bring health
benefits to all.
WHO has a key role to play, not only by working
together, across the Organization to give the best possible support to
global health action and to country efforts. We should always also
have in mind that we make a difference through helping others achieve
the best results they can.
During the Meeting of Interested Parties held in
Geneva at the end of June, we heard how the WHO network is working
with others to help ensure that their actions - both within and
outside the health sector - make the greatest possible, and sustained,
improvements in health and health equity, in human well-being and
socio-economic development. The emphasis was on WHO as catalyst,
facilitator and supporter of the actions of others.
Another example of WHO facilitation was evident
this summer, as we presented a new access initiative to health
information. You may be aware that the Health Inter-Network was
launched by the Secretary-General as part of the Millennium plan. WHO
has helped to set up an agreement between some of the major
international publishers of biomedical literature to make around 1000
journals available free through the Health Inter-Network and thus
enable thousands of health professionals and researchers to access
vital information.
This initiative builds on the positive experience
of the SciELO project of the Pan American Health Organization and
similar initiatives. It has enormous potential for reducing the gap in
access to health information between rich and poor countries.
It is an example of the forces of globalization
helping to promote equity. Indeed, it will enable those who have
knowledge to communicate with an infinite variety of new people, to
relate with them, and to become more closely involved in their
realities.
It is yet another way WHO works to bridge the
health divide.
Mr Chairman,
The burden of mental ill health and brain disorders
is a serious global challenge. In most countries the resources and the
manpower available to tackle mental ill health are sparse. But new and
more effective means are now available to treat and prevent
brain disorders and mental illness. As a result, modern mental health
care is focusing more on supporting the family within the local
community. It is geared to prevention, early detection and treatment
and uses effective and relatively inexpensive medicines.
I am pleased to see that you are devoting a special
session to the issue of mental health and I am impressed with the
proposed regional strategy that is up for discussion. Both its key
principles - an intersectoral approach to mental health issues, and
the integration of treatment of mental disorders into general health
services - are important pillars for a modern, effective mental health
policy.
The forthcoming World Health Report, to be released
on 4 October, will focus on mental health. It provides a global
overview of the current and future burden of mental ill health and
their main contributing factors. It offers strategies for ensuring
that effective prevention and treatment are both put in place and
adequately funded.
Throughout this region, countries are working hard
to improve the overall effectiveness of their health systems. They
recognize the need for reliable information - both on the burden of
disease and on health system responses.
Policymakers and programme staff need to make
informed decisions about how best to allocate all resources for health
action. They need regular assessments of the status of their people's
health and the working of health systems. To this end, some countries
have initiated regular national health surveys. WHO is ready and keen
to help countries as they undertake these surveys.
Mr Chairman,
Tobacco is a tremendous threat to the health of
people throughout the nations of the Western Pacific Region. It has
the highest incidence of smoking men in the world, and the costs and
suffering from tobacco related diseases are growing rapidly. One in
four of all tobacco related deaths occurs in this region. Yet, tobacco
consumption continues to grow at an alarming rate.
Many of the region's countries are aware of the
dangers of spreading tobacco use. I am pleased that WHO has been able
to work with countries to implement responses helping to reduce the
number of young people who begin smoking, or help those who wish to
quit to do so. But much more needs to be done to curtail the efforts
of those who encourage tobacco use - and the resulting ill health.
That is why governments within the region are playing their part in
the negotiations of WHO's Framework Convention on Tobacco Control.
During the second round of negotiations in May, the
first draft of the Convention document was debated at length. The next
round of the negotiation process will take place in November. I am
confident that Member States will agree a Convention that really helps
countries to confront the threat of tobacco for their people. I stress
the need for countries to continue to be engaged until the convention
has been finalized - hopefully in 2003.
I am of course delighted that the Republic of Korea
and Japan have agreed the next year’s football World Cup will be
tobacco-free. That is the kind of message that needs to be heard all
over the world. It has my wholehearted support.
We are now confronted, each day, with controversies
about access to health care, and to the results of medical research.
Much bio-medical research is now carried out in the
industrialized world, and is primarily market-driven. This is
ethically unacceptable. Unless this pattern is changed, the knowledge
and technology gap between industrialized and developing countries
will widen. The health needs of poor nations will fail to get the
attention they deserve.
WHO’s research programmes help bridge this divide
through building international networks that involve researchers from
all over the world, working together in ways that maximize the
probability of success.
As we read of exciting new advances with real
potential to prolong life and improve well-being, in our daily work we
see the difficulties people face as they try to access inexpensive
care for malaria or TB that is already available and known to work.
Each day health professionals in this region make
difficult choices about how to allocate their resources. They wonder,
for example, when the results of recent advances in genetics will have
a positive impact on the health of ordinary people in the region.
WHO's Regional Offices and departments in
Headquarters are helping countries to start to handle complex ethical
issues - such as codes of conduct for research involving human
subjects. It is now time to draw together this work, providing Member
States with the opportunity to share experiences, establish consensus
and be in a better position to handle individual ethical challenges.
I therefore propose to establish a WHO-wide
initiative on health ethics which focuses on Ethics in Public
Health, Health Research Ethics and Biotechnology Ethics.
This will include ethical aspects of genome related work, stem cell
research, cloning and other ethical areas of biomedical science. The
initiative would be designed to help increase Member States'
capacities to handle ethical issues, and to provide support for
inter-governmental action on health and ethics issues.
The issue of genetically modified food is one area
where health, ethics and economics have come together, and there have
been some tensions. But genetically modified food crops are already in
widespread use. They have the potential to increase food production -
steeply. They can reduce levels of nutritional deficiency. But are
these products safe and beneficial for consumers?
Negative effects are possible, especially if such
products are too expensive for poorer people or have not been
adequately tested. It is thus vital that authorities with
responsibility for food standards and safety always focus primarily on
the well-being of consumers, and not on the profits of producers or
suppliers. WHO is stepping up its cooperation with FAO to help
countries answer questions about the safety of all foods - including
those that have been genetically modified.
I am pleased to see that the region is discussing a
comprehensive food safety strategy. In addition to health care costs
and productivity losses associated with foodborne illness, the
increased globalization of trade in food means that food safety is an
important element in global trade issues. The potential savings both
in money-terms and of human suffering through improved food safety are
enormous.
Mr Chairman,
All WHO's work is for countries, but only a
part of it is in countries. Country work, though, is critical,
and our country representatives are at the centre of all we seek to
do.
We are committed to improving the capacity of the
WHO teams within countries who need us the most, so that they are
better equipped to contribute to better and more equitable health
outcomes. WHO country representatives and Regional Offices will play a
central role in making this happen. They will build on our recent
experiences with establishing strategies for our cooperation with
individual countries.
The work of WHO's Regional Offices and departments
in Headquarters is summarized within the corporate strategy for WHO's
Secretariat that was agreed by Member States during 1999. This is the
basis of the General Programme of work for 2002 to 2005.
During 2000, the Secretariat established a
Strategic Programme Budget, identifying 35 areas of work across the
Organization. This formed the basis for the expected results,
milestones, activities and allocation of regular and extra-budgetary
resources for the 2002-2003 biennium.
I will be working with the Regional Directors over
the coming months to develop a proposed set of global priorities for
the next period, 2004-2005. We will draw on your deliberations at this
Regional Committee. My proposals will then be presented to the
Executive Board when it meets in Geneva in January 2002.
Mr Chairman, Distinguished Representatives,
As health professionals, we all face enormous
challenges. People's expectations are greater than ever. We respond to
their legitimate expectations in ways that promote equity of health
outcomes and contribute to reductions in levels of poverty.
These values underlie all our actions - as WHO
Member States and as the Secretariat.
Let us work together for a constructive and
successful meeting, and for effective health action throughout the
region in the coming year.
Thank you.
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