The Honourable Stevenson Kuartei, Minister of Health, Palau, and President of Pacific Islands Health Officers Association;
Honourable Ministers, Secretaries and Directors of Health;
REPRESENTATIVES FROM THE UNITED STATES GOVERNMENT;
Colleagues from the Secretariat of the Pacific Community
MR Michael Epp, Executive Director. Pacific Islands Health Officers Association Secretariat;
Ladies and Gentlemen:
I am honoured to be here today to represent the World Health Organization in celebrating the 25th anniversary of the Pacific Islands Health Officers Association.
WHO has always considered the Pacific Island Health Officers Association, PIHOA, as a key partner in health—not just for the United States-affiliated Pacific Islands but also as a partner for promoting health across this very important and diverse region.
Our two organizations, PIHOA and WHO, have worked side by side to support our Member States since your organization was established 25 years ago.
I am pleased that you have invited me to attend this important 25th anniversary meeting and have given me the honour of addressing you.
Thank you.
Twenty-five years—two and a half decades—is a long time.
During this period some diseases in our Region, such as polio, have become a thing of the past. And other diseases, such as malaria, have—through hard work and determination—been pushed to the edge of elimination.
But the past 25 years have also seen some diseases, such leprosy and lymphatic filariasis, become "half" diseases – half forgotten and half cured.
In the last quarter century, WHO—with its many partners in the Pacific—has worked hard to support countries to address tuberculosis, vectorborne illnesses, HIV and rising rates of other sexually transmitted diseases.
WHO also has worked with its partners to develop effective vaccination programmes, to prepare for health emergencies and to strengthen health systems.
It is fair to say that the lion's share of our resources and our efforts over the last 25 years have been devoted to the fight against communicable diseases.
But a dramatic shift has occurred in this region during this time.
Noncommunicable diseases—such as cancer, diabetes and heart disease—have supplanted infectious diseases as the major causes of morbidity and mortality.
The rising tide of noncommunicable diseases—the focus of your discussions over the next few days—is now one of the most pressing public health challenges facing not only the U.S.-affiliated Pacific Islands, but the entire Western Pacific Region.
The speed with which these diseases are increasing and affecting all of our communities is unprecedented.
Throughout human history, changes in the ways we live, the foods we eat and the work we do have evolved slowly, allowing our bodies to adapt.
But changes over the past few decades—increasingly sedentary lifestyles and a rapid change to diets unnaturally high in fat, salt and sugar—have occurred so quickly that the human organism has not had time to adapt.
As a result, in the Western Pacific Region, noncommunicable diseases are now responsible for four out of every five deaths.
Nearly 30 000 people in our Region die every day due to diseases that can and should be prevented.
The U.S.-affiliated Pacific Islands have some of the highest rates of noncommunicable disease in the world.
American Samoa is ranked the highest in the world for obesity and ranks among the highest for adult diabetes.
The Commonwealth of the Northern Mariana Islands has one of the highest rates of type 2 diabetes in the world.
This rising tide of noncommunicable diseases is straining health systems in the Pacific.
Unlike communicable diseases that tend to affect people quickly, noncommunicable diseases generally progress much more slowly, creating complex health needs that are expensive to treat and can overwhelm already stressed health systems.
This rising disease burden is beginning to be seen at increasingly younger ages, depriving many people of their most productive years.
And it's usually the poorest people who have the highest burden of noncommunicable disease, as they often have greater exposure to risk factors and less access to preventive and therapeutic services.
Today, the Pacific Island Health Officers Association is in the forefront of the urgent battle against noncommunicable diseases, highlighted by your landmark declaration last year of a "regional state of health emergency".
Your fight against noncommunicable disease and your discussions over the next few days can help inform the United Nations General Assembly High-level Meeting on Noncommunicable Disease that will be held in New York this September.
We need to find solutions to these problems—solutions that will meet the unique needs of the Pacific. In other words, Pacific-specific solutions, developed by and for Pacific islanders.
The impact of noncommunicable diseases in the Pacific will be of a quite different dimension from the impact found elsewhere.
The prevalence of these diseases is already—already—much higher than virtually anywhere else in the world and is set to increase even more.
And the realities of trying to provide effective preventive and curative health care services in some of the most remote places in the world are already stretching capacities to the limit.
Solutions need to be found, but they need to be your solutions.
Solutions that respect the different Pacific cultures and, above all, solutions that engage everyone in society in tackling this rising tide of chronic and debilitating diseases.
When I assumed office as WHO Regional Director for the Western Pacific two years ago, I tried to spend a lot of time listening— listening to the concerns of Member States, and especially listening to my counterparts in the Pacific.
It quickly became clear to me that we, WHO, needed to have a stronger presence in this part of the Pacific.
So last August, I traveled to Pohnpei to open the WHO Country Liaison Office for Northern Micronesia to serve the Federated States of Micronesia, the Marshall Islands, Palau and other nearby areas.
That new office joined our four other WHO Country Liaison Offices situated in Kiribati, Solomon Islands, Tonga and Vanuatu, as well as larger WHO Representative Offices in Fiji and Samoa.
My listening also convinced me that we could better serve this region if there was a division focused on the needs of the Pacific, focused on working with public health experts to find those Pacific- specific solutions.
The Pacific Technical Support Division based in Fiji was inaugurated last year to help address the special health issues in the Pacific countries and areas we serve.
Noncommunicable diseases are a very high priority for WHO in the Western Pacific Region.
As Regional Director, I am also focused on assisting our Member States in their efforts to realize the health-related Millennium Development Goals.
And I am pleased to report that although there is still much work to be done, there has been considerable progress across the Pacific in these areas.
I've also prioritized support efforts to strengthen health systems and to improve health security.
And I've pledged to complete our unfinished business with leprosy, lymphatic filariasis, yaws and other neglected tropical diseases—the half-hidden, half-forgotten diseases that still linger in this region.
Last October, at the annual meeting of the WHO Regional Committee for the Western Pacific, our governing body, I made a personal commitment to see that leprosy is eliminated in the Pacific.
Since then, WHO experts have worked closely with health officials in the most-affected countries to assess the situation and develop strategies for moving forward.
WHO experts have visited each of the higher-burden countries, have visited tiny outposts and have had in-depth discussions with patients, their families and local health officials.
Leprosy is a terrible disease and it is still very much here in the Pacific.
The stigma associated with this disease steals a patient's confidence, confining them to a life of isolation.
The damage to nerves and the skin steals a patient's ability to function, limiting work and play, confining them again to a life of isolation and often poverty.
And yet this is a disease that can be cured. Diagnosis is relatively easy.
The drugs are effective—and available free of charge from WHO. So why is this disease still here in the Pacific?
We need to work together to build commitment to eliminate leprosy.
We need to work together to build the health systems that can provide the care and treatment these patients and their families need.
And we need to work together to make these investments truly worthwhile and sustainable.
Investing in leprosy is an investment people—some of the most disadvantaged people in our society.
It is an investment in hope.
Hope that if a disease like leprosy can be banished, then many other things can be achieved.
And an investment in leprosy is an investment in health systems—building our ability to reach patients and provide effective care and treatment for conditions that require long-term care in the community, such as TB, diabetes and heart disease, as well as many of the noncommunicable diseases that we are seeing rise day by day across the Pacific.
WHO has drafted a comprehensive Action Framework for Leprosy Control and Rehabilitation, with the goal of eliminating leprosy as a public health problem in Pacific island countries by 2015.
The success of this action framework will depend on your political commitment and resources. WHO stands ready to work with you and assist you in eliminating leprosy.
WHO stands ready because this disease, like lymphatic filariasis and many other half-neglected diseases, should simply no longer be here.
I wish to work with you to bring full attention to these diseases, and I have made it my personal commitment to see them banished from the Pacific by the end of my term in office.
Once again, I would like to thank you for the invitation to this important meeting.
I understand that the timing of the meeting was adjusted so that I could be here, and I really appreciate your willingness to have done this.
Twenty-five years is, as I said in the beginning, a long time.
Your organization has achieved a great deal over that time, and I congratulate you for your tireless commitment to public health and support you have given to the entire Pacific.
It is you who can make the changes that are need to address the rise of noncommunicable diseases, to banish the half-forgotten diseases that should not longer be here, and to build health systems that can treat and care for all those who need it.
WHO stands ready to support you and looks forward to working closely with you for the next 25 years—and celebrating with you achievements along the way.
Thank you for your untiring work on behalf of the health of the people of the Western Pacific, and best wishes with your discussions over the coming days.