Florence
11 November 2001

Executive Board "Retreat" 

Madame Chair,

Colleagues,

Welcome to the beautiful city of Florence and to the fourth of the WHO Executive Board retreats.

On behalf of us all, I thank Dr Marta di Gennaro, the authorities in Tuscany, and the Government of Italy for making this important event possible. The contribution of the host nation is essential to enable us to have these get-togethers.

Each of the last three retreats have given us an opportunity to work together in ways that make us more effective in executing our roles in governing the World Health Organization. I am delighted that the Regional Directors have been able to join me for this session, and that a number of the Executive Directors are coming from Geneva.

The term "retreat" gives the notion of people hiding away in quiet - even solitary - contemplation. Given the urgency of the problems we face, and the ever-changing nature of our membership, it really would not be a good idea for us to use this precious time in that way.

This event is, first and foremost, a re-union, bringing together a group who last met in May of this year. A great deal has happened in the intervening months, and together, we shall take stock of some key issues in international health.

This event is also an opportunity for engagement - for Executive Board members to examine, and become involved in, a number of issues that have critical importance to our Member States.

Most importantly, it is an opportunity for constructive interaction - among Executive Board and senior secretariat staff.. We can expect to interact in ways that are focused, with clear purpose. We are all committed to an effective response to the health challenges which face our world. We all seek ways for WHO to make a better contribution to people's health. And we will focus, particularly, on the health and well-being of those who are poor.

Indeed, the next three days will be more like a workshop. We will be comparing experiences and personal perspectives, and looking hard at the ways in which WHO responds to them. Our challenge is - how can we best make a difference?

Together, over the last three years, we have defined the functions in which we have a comparative advantage -

• The setting of standards and guidance based on evidence;

• Managing the knowledge that gives us this evidence;

• Backing for research to help develop guidance and new products;

• Support for alliances to take forward global and country action;

• Technical assistance with individual Member States; and

• Global advocacy around critical health issues.

We have focused our efforts on the specific health issues that concern most of our Member States. The broad directions for this focus are contained within our corporate strategy and are threaded into most of our work.

1. We concentrate on an effective response to the issues that particularly affect the well-being of the world's poorest people;

2. We are examining and helping all with an interest to address, both long-standing and emerging risks to people's health;

3. We are working with countries to see how best we can help them to improve system performance;

4. We are attempting to strengthen global action for health within the context of other international development strategies;

We have sought to ensure that health issues receive the highest priority by Governments and others with influence. Good health is definitely central to a healthy and prosperous life;

There has been a change in the global attitude to international health issues. I sense that the change will be sustained despite the events of 11 September. During the last three years we have seen human health become one of the central priorities for both international and national action - as one of the essential keys to unlock well-being and prosperity for millions. Put simply, re-evaluations of evidence available over the years show that the world has seriously under-invested in health and health equity. The consequences have reached deeply into the social, economic, human and environmental dimensions of people's livelihoods.

WHO is expected, by its Member States, to respond to this new interest through health stewardship on a global scale. We are helping to show the way forward, encouraging effective action and monitoring results - all with a view to continuous improvements in health outcomes. It is not easy. We work with Member States whose governments are stable and secure, and those that are destabilised by conflicts - sometimes over many years. We work with Member States whose per person GNP figures differ by a factor of nearly 100.

But, whatever the setting, we call for strategic and evidence-based investment in the promotion of health. We deploy staff to obtain reliable and enlightened assessments of different aspects of the health situation. We encourage the formation of work through alliances - including public, private and NGO bodies - bringing together a range of interested parties under one strategy and plan of action. We measure progress and impact, reflecting the realities of local settings.

The institutional context within which we work is changing too. Plans for a new global funding mechanism are taking shape, and WHO is involved in (but does not itself direct) several well established new alliances - like GAVI, Roll Back Malaria, Making Pregnancy Safer and Stop TB - for country level action, and for research.

We know that blanket prescriptions to all nations are unlikely to be useful. Advice has to be tailored to the specific circumstances of each country. Nevertheless -

• We expect to maintain our overarching emphasis on support for the scaling up of the collective efforts to confront the priority health conditions that cause such high loss of life at this time.

• We will do more to ensure that the whole of WHO contributes fully to the effectiveness of all action for health - whoever undertakes it - within the individual Member States that we serve.

• To this end, we want to be certain that all of us within the secretariat use the resources available to us - whatever their source - as efficiently and effectively as possible, and

• We are due to tune up our systems for managing information, people, funds and interactions throughout the organization with a view to continuous improvements in our performance and contribution to World Health.

Colleagues,

I have discussed the shape and content of this workshop with the Chair. We all know that it is not a formal EB meeting - not an occasion for formal statements and decision-making. But our work this week should better prepare us for making decisions when the time comes - in January and May next year. We have kept the number of issues on the programme down so that there is sufficient space for proper dialogue.

We start, tomorrow, reviewing our perspectives and experiences on improving access to medicines. Professor Sallam asked that we do this, and this seems appropriate given the high level of international attention to this important issue, and as countries are meeting in Doha. We will have the opportunity to work on this in small groups.

Another area of interest to Executive Board members is the interaction between public and private sectors in health action. It happens everywhere, and Executive Board members may wish to express views on their experiences in this area, and their perspectives on how WHO should be responding to public-private interactions.

At the last meeting of the Executive Board we agreed that we would bring ourselves up-to-date on the Global AIDS and Health Fund (now renamed as the Global Fund to fight AIDS, TB and Malaria). So we have made space to discuss the Fund. I have also been asked to describe progress on our work on health systems performance assessment - a matter that led to extensive discussion both at the Weggis retreat last year, and at the first EB meeting this year.

We are continuing to intensify the secretariat's work on ethics and health: I have announced that we will establish a new initiative to bring together existing work and intensify its contribution. I value the opportunity to receive your comments on this.

Thank you.