Best days for public health are ahead of us says WHO DirectorGeneral.docx

1、Best days for public health are ahead of us says WHO DirectorGeneral(WORDS:3611)Best days for public health are ahead of us, says WHO Director-GeneralDr Margaret ChanDirector-General of the World Health OrganizationAddress to the Sixty-fifth World Health AssemblyGeneva, Switzerland 21 May 2012Madam

2、President, excellencies, honourable ministers, distinguished delegates, ladies and gentlemen,This is the sixth time I have addressed the Health Assembly in my capacity as Director-General. I still get nervous. But I do have some important messages to convey.In public health, decades sometimes acquir

3、e labels. The 1970s were a decade of hope, culminating in the Health for All movement under Dr Mahlers leadership.That hope was quickly followed by an oil crisis, a debt crisis, an economic recession, and the imposition of structural adjustment programmes, which forced governments to cut budgets for

4、 social services, including health.The 1980s became known as the “lost decade for development”. After a long span of steady progress, large parts of the developing world slid back into deeper poverty. Health services, starved of funds, began to crumble.That damage was inherited by the next decade. W

5、ith few exceptions, progress in public health was slow during the 1990s, with health viewed as an expenditure rather than an investment.The first decade of the 21st century has also acquired a label. Many describe it as the “golden age for health development”. And rightly so.For the first time, heal

6、th moved to the top of the development agenda, thanks to the work of Dr Brundtland, including the report she commissioned on macroeconomics and health.At the start of the decade, the Millennium Development Goals showed how much the perception of health had changed, from a drain on resources to a dri

7、ver of socioeconomic progress.In that golden decade, governments, in both donor and recipient countries, made the health agenda a top priority. Money for health development more than tripled. Substantial results followed, with a particularly strong impact on deaths from HIV/AIDS, tuberculosis, malar

8、ia, and childhood illness.The Millennium Development Goals unleashed the best in human ingenuity and creativity, leaving a legacy of innovations.The list is long. It includes new vaccines, medicines, and diagnostics, new ways of stimulating R&D for diseases of the poor, and new ways of financing hea

9、lth development, like GAVI, the Global Fund, and UNITAID.The decade is over, and some observers will tell you that the golden age for health development has also come to an end.Bitter observers say what many suspect may be true. A financial crisis derailed the best chance ever to alleviate poverty a

10、nd give this lopsided world greater fairness and balance.I strongly disagree. I believe the best days for health are ahead of us, not behind us.It is true that money is tight and the future of the world economic situation looks uncertain. Health officials, development partners, and WHO are watching

11、money closely. Money is important, but many other factors drive progress in public health.During my recent visits to countries, I have seen inspiring examples of success. Striking achievements within countries make me optimistic.The unprecedented momentum for better health that marked the start of t

12、his century continues, though on a different footing, sometimes on an even surer footing.Ladies and gentlemen,Time and time again, we see the importance of national ownership and leadership. India would never have been able to dramatically change the prospects for polio eradication without full gove

13、rnment ownership of the programme.The government of India deserves our congratulations for this monumental achievement.Ghanas commitment to guinea worm eradication shrunk the map to its last outpost, in South Sudan. During the first quarter of 2012, cases of this disease dropped 67% compared with la

14、st year, and now number just over 100.I visited Namibia in April. That countrys minister of health, an expert in vector control, is leading a group of 8 neighbouring African countries in a joint effort to eliminate malaria within the next few years. WHO has produced a complete set of technical manua

15、ls, for testing, treating, and tracking, to guide them on their way.These countries are ambitious. They are determined. Their eyes are wide open to the challenge, but the chances of success are good.Last month, I also visited Oman, where I learned about the outcome of an EU/WHO initiative to build t

16、he countrys capacity to respond to outbreaks and natural disasters. This is a splendid example of a whole-of-government approach, with more than 30 government sectors and departments working together to build resilience.In its fight to wrap a deadly product in a plain package, Australia leads resist

17、ance to the tobacco industrys latest onslaught of aggressive tactics. No government seeking to introduce measures that protect the health of its citizens should be intimidated by an industry, especially by one with the reputation of Big Tobacco.During negotiations on pandemic influenza preparedness,

18、 Indonesia, joined by many others, pushed for a fairer and more equitable system that shares responsibilities and access to benefits, on an equal footing. The result is a pioneering framework that extends traditional cooperation in the health-related public sectors to include annual contributions an

19、d firm commitments from private industry, in the name of health.Given my commitment to women, I am grateful to the Nordic countries and Canada for their unwavering promotion of womens empowerment, gender equity, and human rights, and for leading by example.Several recent studies have advised the int

20、ernational community to look to BRICS countries, namely Brazil, the Russian Federation, India, China, and South Africa, as a way to maintain the momentum for better health.These countries have become the biggest suppliers of essential medicines, in affordable generic form, to the great benefit of th

21、e developing world. BRICS countries also offer an alternative model for health development, including technology transfer, based more on equal partnerships than on the traditional donor-recipient model.Some of these countries need support in upgrading quality standards and improving regulatory contr

22、ol. WHO is providing this support. Last year, after extensive technical collaboration, WHO prequalified Chinas State Food and Drug Administration.Once individual vaccines are prequalified by WHO, the countrys capacity to produce a large number of vaccines at very low prices will revolutionize vaccin

23、e supplies and their prices.I am further encouraged by the high place health is given in many regional political and economic unions, and by international organs.Last November, I addressed members of the UN Security Council. I drew their attention to the threat posed by emerging and epidemic-prone d

24、iseases, and reassured them.WHO uses a sophisticated electronic surveillance system to gather disease intelligence in real time. We are rarely taken by surprise.WHO can mount an international response within 24 hours. This is because of your support through the Global Outbreak Alert and Response Net

25、work, but also the capacity of our country offices to get visas, move supplies through customs, and coordinate every step of the way with the Ministry of Health.No other agency can do this.You have before you a report on progress in building the core capacities needed to implement the International

26、Health Regulations. I look to you for further guidance and advice as we work to see the IHR fully implemented.Ladies and gentlemen,We see WHO leadership at work, often bringing outsized results for small but smart investments.Africas new meningitis vaccine, developed in a project coordinated by WHO

27、and PATH, is being rolled out, promising to end seasonal epidemics in Africas meningitis belt. The payback will be enormous. A single case of meningitis can cost a household the equivalent of three to four months of income. Mounting an emergency immunization campaign to control an epidemic can absor

28、b as much as 5% of a countrys entire health budget.WHO leadership brought the neglected tropical diseases from obscurity into the limelight. These Cinderella diseases, long ignored and underappreciated, are a rags-to-riches story.In January, a pharmaceutical company pledged to step up its contributi

29、on of preventive treatments for schistosomiasis10-fold, reaching 100 million treatments per year by 2016.WHO administers the distribution of the majority of drugs donated to control the neglected tropical diseases. With the January commitment, WHO is now in a position to protect all school-age child

30、ren in Africa at risk of schistosomiasis.We can blanket this part of the world with medicines that rid every schoolchild of worms and eggs, parasites that interfere with their learning, impair cognitive development, and compromise their nutritional status.This is a gift to their health, but also to

31、the education and nutrition sectors.Last year, WHO recommended a ban on inaccurate and costly commercial blood tests for diagnosing active tuberculosis. Last week, the country with the largest use of these tests, especially by private practitioners, announced legislation banning the tests nationwide

32、.More than a million of these misleading blood tests are carried out each year, often at great danger and great cost to patients, who may have to pay up to $30 per test.Think of what we are saving.Following publication of the 2010 World Health Report on health system financing, more than 60 countries have approached WHO seeking technical support for their plans to move towards universal coverage.What we are seeing goes against the historical pattern, where social services shrink when money gets tight. I think this drive to expand coverage is a powerful signal. Despite