Director-General's Office

Meeting of the Chamber of Deputies’ Social Security and Family Commissions

Dr Tedros Adhanom Ghebreyesus
Director-General of the World Health Organization

Brasilia, Brazil
21 March 2018

Excellencies, ladies and gentlemen,

It’s a great honour for me to be here in the Chamber of Deputies. Thank you for the invitation to come and speak to you today.

Parliamentarians are so important for creating the legal environment in which health can flourish – not only in terms of providing health services, but for creating the social context for good health, from work conditions, to urban planning, road regulations, good sanitation, and so on.

It has now been almost 9 months since I started as Director-General of WHO. I’ve made a priority of visiting as many countries as I can to look for ways to strengthen our partnership and to ensure we are providing the best service possible.

But I’ve made a particular priority of visiting the BRICS countries, who will play a key role in realising our vision.

And I’m delighted to say that my visit here means that I have now been to each of the five BRICS countries in the past 9 months – perhaps I saved the best for last!

Brazil is a great partner to WHO, and a model of a large country with a strong health system, based on the principles of universality and equity.

You are leading the way on progress towards the Sustainable Development Goals. The National Commission on SDGs shows that you are taking your commitments seriously.

Your leadership in south-south cooperation through the Community of Portuguese-Speaking Countries is also very important.

The strength of your health system is not only that it ensures care for the day-to-day health needs of your population, it’s also your best defense against outbreaks.

We saw that very clearly in the case of the recent Yellow Fever outbreak. I congratulate the Government of Brazil for its swift response to that outbreak, which is saving many lives.

Not only that, Brazil is a major producer of Yellow Fever vaccines, which is a major contribution to keeping the world safe.

My first 9 months have been an intense but productive period. I would like to start by giving you just a few highlights.

My focus has been on laying the foundations for the next 5 years of our work.

The cornerstone is our General Programme of Work – our 5-year strategic plan. At its heart is a new mission: to promote health, to keep the world safe, and to serve the vulnerable.

Our Executive Board approved the plan last January.

To achieve our mission, we are setting ourselves three ambitious targets:

First, to see 1 billion more people enjoying the benefits of universal health coverage;

Second, to see 1 billion more people better protected from health emergencies;

And third, to see 1 billion more people enjoying better health and well-being.

They’re bold targets. But they must be. If we’re serious about keeping the promises we made in the SDGs, we cannot afford to aim low. We can’t afford the status quo.

We are making good progress towards each of these targets.

We’re seeing unprecedented political momentum for UHC. Countries all around the world, such as Kenya and India, have recently made bold commitments to expand health services to their populations.

We’ve introduced a new approach to our emergency operations, including establishing the WHO Health Security Council, which meets fortnightly to review the status of all health emergencies globally, and how WHO is responding to them.

We’ve established a new High-Level Global Commission on Noncommunicable Diseases, to be led by the President of Uruguay.

We’ve launched an initiative to help small island developing states adapt to the health effects of climate change.

And we continue to ring the alarm bell on antimicrobial resistance.

It’s also clear that to be the WHO the world needs, we must change. So I have launched a process of transforming WHO to make it more focused on delivering results where it matters – that is in countries.

I have also made a point of keeping my campaign promise to achieve gender parity in WHO’s senior leadership. In fact I’ve done even better. For the first time, women now outnumber men in our senior leadership team. But we have more work to do to achieve gender parity at all levels of the organization.

This year marks the 70th anniversary of WHO’s founding, although as you know, the Pan American Health Association was founded even earlier -- 116 years ago.

WHO was established on the conviction that health is a human right for all people, not a privilege for some.

Today, that conviction is stronger than ever.

And the evidence is stronger than ever that universal health coverage is not just a way of improving the health of populations. It can also lift people out of poverty by removing one of its causes; it creates jobs for health and care workers; it drives inclusive economic growth by ensuring people are healthy and able to work; and it promotes gender equality, because it is often women who miss out on health services.

Just as the right to health is enshrined in our constitution, so it is in yours, here in Brazil.

The Brazilian Unified Health System is a powerful force for equity. The fact that all services and products, including medicines and vaccines, are provided free of charge is a strong foundation not only for better health, but for development.

It’s also very impressive that ordinary citizens have a voice in shaping the health services that are delivered to them. The fact that community-based health councils are involved in approving health plans is a model for other countries to follow.

You are seeing some encouraging results. Premature deaths from noncommunicable diseases have dropped significantly. The action you have taken to reduce tobacco use is a major contributor to this success.

There is more you can do on this front. Brazil has signed the Protocol to Eliminate Illicit Trade in Tobacco Products, but not yet ratified it. I will be urging President Temer to do that when I meet him this afternoon.

I also congratulate Brazil for the action you are taking to address antimicrobial resistance. The National Plan on AMR Prevention developed last year lays a good foundation – now you must focus on implementing it.

Of course, no health system is perfect. There’s always room for improvement. Gains can be easily lost.

Brazil has made good progress in achieving an equitable distribution of health workers throughout the country. It’s important to sustain this.

In fact, there is no better investment a country can make than in expanding its health workforce. Having the right personnel, with the right skills, in the right places, is crucial to ensuring that people can access quality health services, where and when they need them.

Improvements can also be made in the quality of care that patients receive. The most important commodity in health care is trust, and if people are concerned that the care they receive may not be safe, or is low quality, they will stop seeking care.

There is also a need to increase access to testing and treatment for tuberculosis, especially among higher-risk groups such as children under 5, prisoners, homeless people, and people living with diabetes and HIV/ AIDS.

And as you know, there are persistent health inequalities throughout the country. The catch-cry of the SDGs, to leave no one behind, means that we must do our best to focus on delivering health services to the most vulnerable and disadvantaged.

This is one of many areas where WHO has resources that can help. We’ve developed a product called the Health Equity Assessment Toolkit – or HEAT – to help countries uncover inequalities, and to track progress towards reducing them.

For many countries with established health systems like Brazil’s, financial sustainability is also an issue.

No health system in the world can afford to offer every treatment to its citizens free of charge. No system has unlimited resources.

The challenge for Brazil, as for many other countries, is to make tough decisions about priorities, based on the most up-to-date evidence.

Again, WHO can help. Our experience and expertise can help countries make evidence-based decisions about which interventions will give them the most health for their money.

Ultimately, investments in the health sector are not just investments in health. They’re investments in economic growth, and a fairer and more prosperous future for all.

But they’re also investments in a safer future. Countries with strong health systems are better able to prevent, detect and respond to outbreaks.

The painful lesson of the 2014 Ebola epidemic is that a weak health system in one country can pose a risk to the entire world. Universal health coverage and health security are two sides of the same coin.

Seventy years since our founding, WHO is more committed than ever to realizing the vision of health for all.

Earlier this year, I issued a challenge to all countries to take three concrete steps towards UHC, and at this year’s World Health Assembly we are asking that as many countries as possible come to Geneva ready to make commitments about the actions they will take.

I am really glad to announce that Brazil is the first country to submit its ten commitments regarding universal health coverage. And I was really proud to receive the ten commitments from my brother, Minister Ricardo, this morning.

The commitment and support of the BRICS countries in achieving this vision is vital.

As I said at the beginning, as legislators you have a vital role to play in promoting health and preventing disease for all Brazilians.

But I encourage you to raise your sights even higher, and to think about the influence you can have on improving health globally.

Thank you once again for your leadership, and for your support for WHO. I look forward to strengthening our partnership as we work together towards a healthier, fairer, safer world.

Thank you so much. Obrigado.