WHO Director-General’s Opening Address at the World Health Assembly – African Business
The pandemic is not over. This virus has surprised us at every turn – a storm that has torn through communities again and again, and we still can’t predict its path, or its intensity. We must be vigilant.
Nearly one-third of the population in low-income countries is still unvaccinated. Only 57 countries have vaccinated 70% of their population – almost all of them high income. We must continue to support all nations to achieve 70% vaccination coverage as soon possible. This includes 100% of people over 60, 100% of health workers, and 100% of those with underlying diseases.
The pandemic does not represent the only problem facing the world. A formidable convergence of disease and drought, famine, and war is facing us, which is fueled by climate change, inequality, and geopolitical rivalry.
You have a full agenda this week – from designing the health workforce of the future, to finishing the eradication of polio, to building a new architecture for global health security; and renewing the drive towards universal health coverage. In a divided world, none of these things can be achieved. It will only succeed if countries are willing to overlook their differences and work together to find common ground.
Your Excellency Minister Dangmo President of the 774ThWorld Health Assembly
Excellency President Kenyatta,
Your Excellency President Masisi,
Excellency President Milanović,
Excellency President Abinader,
Excellency Vice-President Borrero,
Excellency Federal Counsellor Berset
Excellencies, dear friends and colleagues
Before I go on, I’d like to acknowledge the video message of President Macron, Prime Minister Hasina, and Secretary-General Guterres.
It’s good to see you. It’s been a while.
Technology has enabled us to meet and continue our work together for more than two decades.
There is no substitute for face-toface meetings.
I look forward this week to our conversations and to moving on to the next stage of the challenges we face.
Our world has been turned upside down by the COVID-19 pandemic. Our world has endured great suffering – and endures it still.
I am sorry for the difficulties you and your family have experienced over the past two years.
People have lost their homes, loved ones, and livelihoods.
The health system has been stretched to breaking point, and sometimes beyond.
Health workers have worked in extreme conditions. Some have paid the ultimate price and others have been affected by stress and depression.
Communities have been affected by severe disruptions to their lives. Schools and workplaces were closed and they have been left with isolation and anxiety.
You, as governments have been at center of the storm, faced multiple challenges
To ensure the rights and health of your populations.
To offer reassuring guidance in the face of uncertainty
To counteract misinformation, disinformation
To access vaccines or other tools
You were also confronted with so much more.
I want to thank you all for your efforts in protecting your communities and working with the WHO Secretariat, our partners, to protect others around this world.
Where are we now, more than two decades into the worst ever health crisis in a century?
WHO has reported more than 6,000,000 COVID-19 deaths. But as you know, our new estimates of excess mortality are much higher – almost 15 million deaths.
Since the Omicron wave peak in January this year, the number of reported cases has decreased significantly.
Reports of deaths have fallen to their lowest level since March 2020.
Many countries have lifted all restrictions and life is much the same as before the pandemic.
Is it over?
No, it’s most certainly not over.
I know that’s not the message you want to hear, and it’s definitely not the message I want to deliver.
There’s no question we have made progress, of course we have: 60% of the world’s population is vaccinated, helping to reduce hospitalizations and deaths, allowing health systems to cope, and societies to reopen.
But it’s not over anywhere until it’s over everywhere.
Reported cases are increasing in almost 70 countries in all regions – and this in a world in which testing rates have plummeted.
And reported deaths are rising in my continent – the continent with the lowest vaccination coverage.
This virus has surprised us at every turn – a storm that has torn through communities again and again, and we still can’t predict its path, or its intensity.
We are at our peril if we lower our guard.
Increased transmission means more deaths, particularly among the unvaccinated. There is also a greater risk of a new variant developing.
We are blinding our eyes to the evolution of the virus by not testing and sequencing.
Nearly one billion people live in countries with lower incomes and are still unvaccinated.
Only 57 countries have vaccinated 70% of their population – almost all of them high-income countries.
We must continue to support countries to achieve 70% vaccination coverage. This includes 100% for those over 60; 100% for health workers; and 100% for those with underlying conditions.
Although vaccine supply has improved, absorption has not.
We see insufficient political commitment in some countries to roll out vaccines. This was caused by the initial lack in political commitment to equitable access to vaccines. President Kenyatta explained.
We see some gaps in financial or operational capacity.
We see all of this because vaccine hesitancy is driven by misinformation.
WHO’s primary focus now is to support countries to turn vaccines into vaccinations as fast as possible.
We still see supply-side issues for therapeutics and tests, with insufficient funding and insufficient access.
The pandemic won’t magically disappear.
We can stop it. We have the knowledge. We have the knowledge. Science has given us the upperhand.
We urge all countries that have not reached 70% vaccination coverage to make a commitment to do so as soon as possible. We also encourage all health workers to prioritize the vaccinations of all people over 60 and those at higher risk.
We appeal to countries that have reached 70% to help those that haven’t.
We appeal to all countries for surveillance and sequencing.
We appeal to all countries to be open to reintroducing and adjusting public health and other social measures as required.
We appeal to all countries to restore as quickly as possible essential services.
We call on all countries and peoples to work together to build trust.
The pandemic isn’t the only crisis facing the world.
As we speak, Ebola in DRC, Monkeypox and Hepatitis of Unknown Cause are being addressed by our colleagues around the globe.
A formidable convergence of disease and drought, famine, and war is facing us, which is fueled by climate change, inequity, and geopolitical rivalry.
As you are aware, this Health Assembly marks my last term as Director-General. I am humbled by the Executive Board’s decision to nominate me for a second term.
When I looked back at the past five years, it became apparent that they had been bounded by two visits to warzones.
In July 2017, I made my first visit to Yemen as Director-General. Yemen was a country that was and still is mired in civil war.
While I was there, I met a mother and her malnourished child who had travelled for hours to reach the health centre I was visiting in Sana’a.
The woman was skin and bone, begging the medical staff for care – not for herself, but for her child.
Two weeks later, I was in Ukraine visiting bombed hospital and meeting health workers.
I visited a Polish refugee center, where I met another mother from the Mariupol region. She told me that her daughter was scared when the shelling started.
“Don’t worry,” her mother told her. “It’s just a thunderstorm. It will pass.”
At our warehouse in Lviv, I held a pediatric crutch that WHO was preparing to deliver – a crutch for children – a tool that children should only need if they are injured playing sport or climbing trees – children being children – not if they are hurt by bombs.
I met people who have lost loved ones; lost their homes; lost their sense of security – and yet somehow, have not lost hope.
Both in Ukraine and Yemen, and in other countries between, I witnessed the devastating consequences of conflict on the health systems and people they serve.
More than pandemics or pandemics combined, war shakes and destroys the foundations of previously stable societies.
It deprives entire communities of essential health services, leaving children at high risk of vaccine preventable diseases.
Women at greater risk of sexual violence against their partners
Expectant mothers at risk of having an unsafe birth
People who live with life-threatening diseases, such as communicable or noncommunicable ones, and are unable to access the lifesaving services and treatments they need.
It can leave psychological scars that can last for years or even decades.
For me, this is not hypothetical or abstract; it’s real, and it’s personal.
I am a child war.
The sound of gunfire and shells whistling through the air; the smell of smoke after they struck; tracer bullets in the night sky; the fear; the pain; the loss – these things have stayed with me throughout my life, because I was in the middle of war when I was very young.
Like the mothers I met in Yemen and Ukraine, my mother’s concern was to keep me and my sisters and brothers safe.
In the hope of protecting us from a shell falling on our house, my mother would make sure that we slept under the bed when we heard gunfire at nights.
In 1998, I felt the same fear as a parent when war returned to Ethiopia and my children had no choice but to hide in a bunker to escape the bombardment. That’s when I returned from Nottingham where I was doing my PhD, because I was worried about my family and the rest of the country. Maybe you are still able to recall what happened back in 1998.
I feel the same loss and pain now, with the return of war in my homeland. Not only am i a war child, but he is also my constant companion.
My story isn’t unique.
It is like so many others – the story of a family who did not start the war, who were not responsible for it, but suffered because of it.
War is enough. It is even worse because it creates conditions for disease spread.
War, hunger, and diseases are good friends.
More soldiers died from diseases in the American Civil War than in battle during the Napoleonic Wars and the American Civil War.
It was no coincidence that the 1918 influenza pandemic – the greatest pandemic – coincided with what was then the greatest war the world had known – the First World War.
It’s no coincidence that the final frontier for eradicating polio is in the most insecure regions of Afghanistan and Pakistan.
It’s no coincidence that in 2018, the Ebola outbreak in the relatively stable Equateur province of DRC took two months to control, while the outbreak in the insecure regions of North Kivu and Ituri took two years.
Hunger and disease follow quickly after war.
The COVID-19 Pandemic didn’t cause the war in Ukraine. They are now intertwined.
Ukraine was one of the countries that had made the greatest progress towards universal healthcare coverage up to this year.
We are deeply concerned by the effects of war on these gains.
Already, many hospitals and clinics have been closed, with health workers being displaced and services disrupted.
I visited a Makariv, west Kyiv, hospital. Its inpatient unit had been damaged by a missile attack, and its primary healthcare department was completely destroyed.
And it’s not just Ukraine.
WHO has confirmed 373 attacks on health in 14 territories and countries this year. This has resulted in the deaths of 154 health workers, and 131 injuries.
Even WHO is targeted.
Our Ebola-protecting colleagues Belinda Kasongo and Dr Richard Mouzoko were both killed in DRC in 2019.
Attacks on health workers or health facilities are an offense to international humanitarian law.
But they also represent an attack on the right to good health.
WHO is in conflict zones in Ethiopia and the Syrian Arab Republic, Ukraine, Yemen, and elsewhere. They provide technical advice, medicine, equipment, training, and support care to those who require it.
To treat the hurt
To provide safe and supportive birth conditions for pregnant women
To ensure routine vaccinations are given to children,
To support health workers who continue to provide life-saving services in the most difficult situations.
I was forced to travel to Afghanistan after the Taliban tookover. I met a group women nurses who said they hadn’t been paid in three years, but that they would continue to provide care for their patients.
WHO paid their salaries so that they could continue to provide the care that their communities require.
But ultimately, the one medicine that is most needed is the one that WHO can’t deliver – peace.
Peace is essential for good health.
During El Salvador’s Civil War, one-day ceasefires called “days of tranquillity” were declared three times a year, to allow the vaccination of children against polio, measles and more.
In 1990, 159 nations signed a declaration and plan of action endorsing the need for Days of Tranquillity, which have been used in Afghanistan, Côte d’Ivoire, Peru, Uganda and elsewhere.
Without peace, health is impossible.
However, peace is not possible without health.
This was something that the WHO Constitution authors knew. They wrote that the health and well-being of all peoples was essential to the attainment and maintenance of peace and security. It is dependent on the cooperation of all individuals and states.
Health can help to promote peace by providing services that are fair to all members of a society, particularly those who are disadvantaged.
This can be used to address conflict triggers, such as inequal access to healthcare, which can often lead people to feel excluded and resentful.
Equitable services in health can strengthen community trust and contribute to peace building and strengthening of health systems.
As an example, in Tunisia after the Arab Spring, a Societal Dialog for Health was set up to allow Tunisians to share their ideas and needs regarding health.
In Sri Lanka, WHO has supported a community-based psychosocial intervention called “Manohari”, aimed at violence reduction.
WHO-PAHO supported Colombian ex-combatants who had health expertise to reintegrate into the health system by providing medical training.
The resolution on Health and Peace that you will consider this week, if adopted, will further support the Secretariat’s efforts to deliver health programmes in conflict-affected areas – programmes that also help to build peace.
One of the few areas where nations can come together across ideologies to solve common problems and build bridges is health.
Excellencies, dear friends and colleagues
You have a full agenda this week – from designing the health workforce of the future, to finishing the eradication of polio, to building a new architecture for global health security; and renewing the drive towards universal health coverage.
In a divided world, however, none of this can really work.
It will only succeed if the countries work together to overcome their differences.
To find common ground when it is possible
To collaborate whenever possible
To compromise where necessary
To seek peace.
As John Lennon said, “You may say I’m a dreamer, but I’m not the only one.”
We will continue to wake up in this world unless we dream of better things.
If we don’t aim higher, we’ll land lower.
We will reap division if we don’t sow solidarity
We will not find peace if we don’t seek it.
Today, and every day, we have a choice – we make the choices.
Today, and every day, it is time to choose peace for health, and health for peace.
Peace, peace, peace.
Distributed by APO Group, World Health Organization (WHO).
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