Mr Chairperson;
Honourable ministers and representatives
from Member States and delegates from partner agencies;
Colleagues, ladies and gentlemen:
This is my sixth annual report to the Regional Committee for the Western Pacific, highlighting our work during the previous year and the challenges we face going forward.
One challenge I will discuss later that I know concerns all of you is Ebola and its potential impact on the Western Pacific Region.
But first let’s review the work we have undertaken in close collaboration with Member States over the past year — starting with progress on the Millennium Development Goals.
With the deadline fast approaching, I am happy to report that the Region as a whole is on track to achieve the MDG targets related to maternal and child health, HIV/AIDS, malaria and tuberculosis. But individually some countries and areas are likely to miss targets unless efforts are accelerated.
The hard work of WHO staff has played a critical role in the Region's progress.
Their efforts were exemplary during our response to Typhoon Haiyan in the Philippines last November – which was the first Grade 3 emergency under WHO's new Emergency Response Framework.
Our support underlines our special bond with the people of the Philippines, which has been our home for more than 60 years. Their hospitality and hard work in hosting this year's session of the Regional Committee is especially appreciated.
In the Philippines and in all our Member States, we are working harder than ever to tailor our support to your specific needs and priorities.
To sharpen our focus, we continue to review the support we provide to Member States.
Two external assessments have been conducted. One examined the quality of country support provided by the Regional Office. The other looked at WHO roles and functions in the Pacific.
We are now moving swiftly to implement the recommendations from these reviews.
We have made solid progress in the prevention and control of communicable disease.
The Western Pacific Region has maintained its polio-free status. We are doing our part to contribute to the global polio endgame strategy and a polio-free world.
All but three Member States in our Region have officially eliminated maternal and neonatal tetanus.
Together we can be proud of our achievements in reducing the rates of hepatitis B in children. Still, our Region bears a heavy chronic hepatitis B burden, with 350 000 lives lost every year.
We are working with Member States to address ongoing challenges.
Several Member States have introduced new vaccines into their routine schedules.
Last year, we worked closely with several Pacific countries to carry out supplemental immunization campaigns to combat measles outbreaks.
Cambodia, China, Fiji, Malaysia and Papua New Guinea have all adopted targets for the elimination of mother-to-child transmission of HIV.
Nearly all Member States now have national TB strategic plans. WHO supported activities to increase access to quality TB care, including intensified case-finding among high-risk groups.
We are also working to eliminate neglected tropical diseases.
Niue, Palau and Vanuatu are verifying the elimination of lymphatic filariasis.
Of the four schistosomiasis-endemic countries in the Region, Cambodia and the Lao People’s Democratic Republic have reported significant reductions in human infections. They are working towards elimination.
We still face difficult challenges — particularly artemisinin resistance in the fight against malaria.
With new foci of resistance detected in the Greater Mekong Subregion, our work is now more important than ever from the standpoint of global health security.
Emergencies and disasters represent a growing concern for Member States, and a constant threat to global health security. Ten of the 20 countries most exposed to natural disaster risks in the world are in our Region.
We are still on the scene in the Philippines, helping rebuild nearly a year after Typhoon Haiyan killed thousands of people and displaced millions more.
Our Organization-wide response has been unprecedented in terms of human resources, logistics and supplies.
We supported the Department of Health in coordinating the efforts of 150 foreign medical teams on the ground.
Likewise, we supported Solomon Island's health response, coordinating partners and deploying technical experts there when flash floods struck in April.
Over the past year, we have responded to many health security threats caused by emerging diseases — including outbreaks of dengue in the Lao People's Democratic Republic and the Pacific, and avian influenza in Cambodia and China.
We conducted risk assessments for H7N9, Middle East respiratory syndrome coronavirus — also known as MERS-CoV — and most recently the Ebola virus.
We continuously update these assessments, and assist Member States to meet the International Health Regulations, or IHR, core capacity requirements by the 2016 deadline.
Member States have made real improvements in national core capacities under IHR with the implementation of APSED, or the Asia Pacific Strategy for Emerging Diseases.
Five additional countries have fulfilled IHR requirements over the past year. Now rapid response teams for outbreaks exist in all but one country in the Region.
On the noncommunicable disease front, the news is less encouraging.
Lifestyles have changed dramatically in just a generation. From the food we eat to the air we breathe, we often face unhealthy and unsafe conditions that trigger NCDs and their risk factors.
In our Region: four out of five deaths are due to NCDs one in four people suffer from high blood pressure overall smoking rates are slowly dropping, but smoking among women and girls is increasing.
NCD statistics are especially alarming in the Pacific — 19 out of 20 men and nine out of 10 women have NCD risk factors in some Pacific communities, and one out of 10 diabetics eventually will face an amputation.
These problems require actions beyond the health sector. Healthy Islands, Healthy Cities and health-promoting schools show the potential of multisectoral initiatives.
Likewise, the WHO Package of Essential NCD Interventions, or PEN, is another example of innovation that works. PEN is making a real difference in Pacific island countries and areas.
Recently in Fiji, I saw first-hand the enthusiasm of health workers, as they used colour-coded charts and glucometers to assess cardiovascular risk.
On the tobacco front, Australia continues to be a world leader and an inspiration in the Region, since implementing plain packaging. Brunei Darussalam and Solomon Islands will now have large graphic health warnings on cigarette packaging. Last year, Viet Nam passed a comprehensive tobacco control law.
Among the 14 countries that raised tobacco taxes in recent years, several are already using the revenue for health promotion foundations, councils and boards.
Last year's declaration by Pacific health ministers of the goal of a Tobacco-Free Pacific by 2025 represented a landmark political commitment.
Countries will strain to cover the double burden of communicable and noncommunicable disease, as well as the growing needs of older people in the Region.
Over time, the need for universal health coverage, or UHC, will certainly grow.
We supported the development of a three-phase strategy for health sector reform in the Lao People’s Democratic Republic during the past year. We also held a roundtable discussion with The World Bank in China on public hospital reforms in the broader context of service delivery system change.
We may be a long way from making UHC a reality, but we are on the right track.
I was personally involved in Viet Nam's recent revision of its health insurance law. The Government introduced compulsory membership, mandatory family-based enrolment for the informal sector and expanded benefits for vulnerable groups. A cornerstone of UHC is human resources development and capacity-building.
Earlier this year, we re-launched the Global Health Learning Centre in the Regional Office, an initiative that was abandoned years ago. Fifteen fellows from five countries recently completed a six-month course in English and global public health at the centre.
Since 2012, more than 2500 health professionals in the Pacific island countries have taken advantage of another successful WHO training tool, the Pacific Open Learning Health Network, or POLHN. The distance learning courses allow professionals to build their skills while staying in their countries where they are needed.
CHALLENGES/FUTURE
Over the past year, I have focused on building the best team of public health experts in the Region.
I recruited two new directors from outside WHO, bringing fresh perspectives and enthusiasm.
I also rotated seven country representatives – which may well be unprecedented in WHO.
I am doing my best to put the right people in the right place to better serve you, our Member States.
I stress to staff that we must be willing to constantly reinvent ourselves to fulfil our mission of service to Member States as their health needs change.
To that end, four key principles will continue to guide our work through my second term:
One: WHO must be country-needs oriented and people centred by focusing on the most vulnerable populations within countries.
Two: WHO must build on successes, tackling emerging challenges while completing unfinished business.
Three: WHO must be flexible and adaptable as it continues to engage all actors in health and beyond health.
Four: WHO staff must be more effective managers – of both financial and human resources.
TO SUMMARIZE, we must focus not only on what Member States need now – but also anticipate their future public health needs.
Each year brings new challenges, and reaffirms the need to focus on prevention and preparedness – which brings me to the Ebola outbreak in West Africa.
It is an issue that concerns all of us.
EBOLA
In recent weeks, Ebola has dominated the news. You just heard the latest update from our Director-General.
The world is on high alert. The entire United Nations system has been mobilized.
This is the first time that the United Nations has established a mission for a public health emergency. It is called the United Nations Mission for Ebola Emergency Response. It brings together vast resources of UN agencies and other partners, providing urgently needed logistics capacity.
The mission also reinforces WHO's central role in leading public health efforts.
I will give you a brief update of the situation in our Region.
As of today, no confirmed cases of Ebola have been reported in the Western Pacific Region.
Several air travellers to our Region have been investigated, but all were confirmed to be negative. So far, our surveillance and response systems are doing their job.
But that does not mean our Region is safe.
As we have seen recently in the USA and Spain, the Ebola virus can be spread by international travel and by difficulties in the hands-on management of cases — even in advanced countries.
Ebola is not only a disease of the African continent. It is an international public health emergency with significant social, economic, humanitarian, political and security dimensions. The outbreak has quickly pushed some affected countries with fragile economies to the brink of collapse.
An imported case in our Region is certainly a possibility.
As this crisis developed, I asked my team: Are we prepared to detect and respond quickly to a case of Ebola, to prevent its spread?
The simple answer is yes. Let me explain.
If Ebola did hit the Region, the consequences could be huge. We would be under intense pressure to contain it immediately. As you know, the Western Pacific Region has long been a hotspot for many emerging diseases. We learnt a lot from the experience of managing SARS – the first major disease outbreak of the 21st century.
SARS taught us the need for strong leadership, effective surveillance systems, timely and accurate reporting, and rapid response. In the end, the SARS experience made us stronger.
I firmly believe that our Region is in a stronger position than ever before. Using APSED as a guide, our Member States have invested in preparedness and response measures as part of the core capacities under the International Health Regulations.
In June, the Regional Office hosted the first WHO global network meeting on preparedness, surveillance and response. We saw that our Region is better equipped than other regions to manage health security threats.
We have exclusive a team at the Regional Office – the Division of Health Security and Emergencies – that was created in 2010 to handle these threats.
The Division has been working around the clock to monitor and assess health security threats, including Ebola.
The Regional Office has an upgraded Emergency Operations Centre on high alert, working closely with Member States, country offices and headquarters to coordinate emergency response.
We continuously work with Member States to improve the readiness of their national public health systems. Just last week, we conducted a Region-wide Ebola simulation exercise to check the level of preparedness for a potential Ebola response in our Region.
Many countries have the laboratory capacity to detect Ebola, and infection prevention-and-control guidelines and training are being rolled out. Command-and-control operations centres exist in 85% of countries in the Region.
Despite our preparedness and experience in managing SARS, avian influenza and other outbreaks, Ebola poses a new threat to our Region — one with which we have little experience.
We must openly confront the challenges our Region faces to manage this threat effectively.
We are a diverse Region, with big and small countries and different levels of development. Our Region has huge transportation hubs, as well as vibrant trade and travel with countries worldwide, including West Africa.
We also have some countries that have not met core capacity requirements under the International Health Regulations. That means their surveillance and response systems are not yet strong enough to cope with such health security threats.
Only one half of the countries that responded to a recent survey by the Division of Health Security and Emergencies indicated that they have mechanisms to safely ship suspected Ebola virus specimens to reference laboratories.
Our Region has a tradition of self-reliance and cooperation in times of emergencies. Our Member States have worked hard to meet their obligations under the International Health Regulations and APSED.
And many Member States — including Australia, China, Japan, Malaysia, New Zealand, the Republic of Korea and Singapore — have shown solidarity with other regions by providing assistance to countries affected by Ebola.
But with global resources stretched thin, WHO in the Western Pacific Region must rely on the continued commitment of our Member States and partners.
We must constantly be improving preparedness, surveillance and response to ensure that we can manage any potential outbreak.
The Ebola crisis drives home a simple truth — investing in health security during so-called normal times is absolutely vital. Only be doing this will we be prepared for future crises — which may be beyond anything we have seen up to now. Thank you.