Mr Chairman, Excellencies, honourable ministers, distinguished delegates, Dr Shin, ladies and gentlemen,
The world has changed dramatically since the start of this century, when the Millennium Development Goals became the focus of international efforts to reduce human misery.
At that time, human misery was thought to have a discrete set of principal causes, like poverty, hunger, poor water and sanitation, several infectious diseases, and lack of essential care during pregnancy, childbirth, and childhood.
The results of that focus, and all the energy, resources, and innovations it unleashed, exceeded the wildest dreams of many. It demonstrated the power of international solidarity and brought out the best in human nature.
Maternal and child mortality fell at the fastest rate in history, with some of the fastest drops recorded in sub-Saharan Africa. Each day, 17,000 fewer children die than in 1990. AIDS reached a tipping point in 2014 when the number of people newly receiving antiretroviral therapy surpassed the number of new infections.
Since the start of the century, an estimated 37 million lives were saved by effective diagnosis and treatment of tuberculosis. Over the same period, deaths from malaria declined by 60%. An estimated 6.2 million lives were saved.
Drug donations by the pharmaceutical industry allowed WHO to reach more than 800 million people each year with preventive therapy for the neglected topical diseases. These donations underpin the Region’s determination to stop leprosy and eliminate lymphatic filariasis.
By reaching so many of the world’s poorest people, such efforts pave the way for a mass exodus from poverty.
The Director-General congratulates the recipients of this year’s Nobel Prize in medicine. This is not only an honour for China, Ireland, and Japan, but also a tribute to the importance of treating diseases prevalent in extremely poor people. It is hard to think of them as neglected anymore.
Last month, the United Nations General Assembly finalized a new agenda for sustainable development. The number of goals has grown from 8 to 17, including one for health. The related targets increased 8-fold, from 21 to 169.
The factors that now govern the well-being of the human condition, and the planet that sustains it, are no longer so discrete. The new agenda will try to shape a very different world.
This is a world that is seeing not the best in human nature, but the worst: international terrorism, senseless mass shootings, bombings in markets and places of worship, ancient and priceless archaeological sites reduced to rubble, and the seemingly endless armed conflicts that have contributed to the worst refugee crisis since the end of the second World War.
Ladies and gentlemen,
Since the start of this century, newer threats to health have gained prominence. Like the other problems that cloud humanity’s prospects for a sustainable future, these newer threats to health are much bigger and more complex than the problems that dominated the health agenda 15 years ago.
NCDs have overtaken infectious diseases as the world’s biggest killers. As noted in your RD’s annual report, in some Pacific Island countries and areas, more than 75% of adults are obese, nearly 50% of young people smoke, and up to 40% of adults have elevated blood-glucose levels.
The world is ill-prepared to cope. Few health systems were built to manage chronic if not life-long conditions. Even fewer doctors were trained to prevent them. And ever fewer governments can afford to treat them.
In some countries, the costs of treating diabetes alone absorb from 25% to 50% of the entire health budget. Most new drugs approved in 2014 for various cancer indications cost more than $120,000 per patient per year.
The climate is changing, with consequences to health ranging from a wider geographical distribution of dengue to excess deaths from air pollution, heatwaves, and other extreme weather events. Pacific islands are already recording acute consequences that threaten their very survival.
In December, Paris will host the 21st Conference of the Parties of the UN Framework Convention on Climate Change. That event is regarded by many as the last chance to prevent our children from inheriting a ruined planet. As UN Secretary-General Ban Ki-moon has noted, there is no Plan B. There is no Planet B.
Antimicrobial resistance is now regarded as a major health and medical crisis. Highly resistant superbugs haunt emergency rooms and intensive care units around the world. Gonorrhoea is now resistant to multiple classes of drugs. Even with the best of care, only around half of all patients with multidrug-resistant tuberculosis can be cured.
No one working in public health should underestimate the challenges that lie ahead. These newer threats to health do not neatly fit the biomedical model that has historically guided public health responses. Their root causes lie outside the traditional domain of public health.
The health sector acting alone cannot protect children from the marketing of unhealthy foods and beverages, persuade countries to reduce their greenhouse gas emissions, or get industrialized food producers to reduce their massive use of antibiotics.
The newer threats to health also lie beyond the traditional domain of sovereign nations accustomed to governing what happens in their territories. In a world of radically increased interdependence, all are transboundary threats.
The globalized marketing of unhealthy products respects no borders. By definition, a changing climate affects the entire planet.
As sharply illustrated by malaria, tuberculosis, and bacteria carrying the NDM-1 enzyme, drug-resistant pathogens are notorious globe-trotters. They travel well in infected air passengers and through global trade in food.
We face other challenges. The poverty map has changed. Today, 70% of the world’s poor live in middle-income countries. This is a game-changing statistic. Growth in GDP has long been the yardstick for measuring national progress. If the economy is doing well, where is the incentive to invest in equitable health care? The world does not need any more rich countries full of poor people.
Our world is profoundly interconnected and this, too, has consequences. The refugee crisis in Europe shattered the notion that wars in faraway lands will stay remote. The Ebola outbreak shattered the notion that a disease of poor African nations will have no consequences elsewhere.
Ladies and gentlemen,
The Ebola outbreak in West Africa is not yet over, but we are very close. The response is in a phase where we can track the last chains of transmission, and break them. To get to this phase, WHO deployed more than 1000 staff to 68 field sites in the three countries.
Dr Chan thanks the Western Pacific Region Ebola Support Team, or WEST, for contributing to the international response that has brought us so far.
The outbreak also tells us something about the importance of the new agenda for sustainable development. Many of the new goals address the root causes of ill health. Pursuing them will lay the groundwork for a world that is fairer, and more stable and secure. This includes security against the infectious disease threat.
Last month, 267 prominent economists from 44 countries published a declaration in the Lancet. That declaration called on global leaders to prioritize a pro-poor pathway to universal health coverage as an essential pillar of sustainable development.
The economic arguments for doing so are compelling. UHC transforms livelihoods as well as lives, and works as a poverty-reduction strategy. The economic benefits of investing in UHC are estimated to be more than ten times greater than the costs.
UHC cushions shocks on communities when crises occur, whether these arise from a changing climate or a runaway virus. Under normal conditions, UHC builds cohesive and stable societies and underpins economic productivity. These are valued assets for every country in the world.
As the economists noted, the devastating effect of Ebola could have been mitigated by building up public health systems in the three countries at one-third of the cost of the Ebola response to date.
Thank you.