Address to the Committee on Foreign Affairs at the French National Assembly
Dr Tedros Adhanom Ghebreyesus
Chers dignitaires, chers amis,
Honourable members of the committee, ladies and gentlemen,
First of all, let me thank you for the honour of speaking to you today.
It’s truly a privilege to be here in Paris. France and WHO share many common values. Perhaps the most important is the value of égalité.
Like you, we are convinced that health is a human right for all people, not a privilege for those who can afford it.
That conviction was essential to our founding 70 years ago, and is still central to our identity.
France has long been at the forefront of global health.
The first International Sanitary Conference was hosted here in Paris in 1851.
The Office of International Public Hygiene was established in Paris in 1907, and was later incorporated into WHO.
And the International Health Regulations are largely coordinated through WHO’s office in Lyon, France.
Next month WHO will host the High-level Conference on Preparedness for Public Health Emergencies in Lyon.
Domestically, France’s health system is among the best in the world, and the envy of many other countries.
Long ago you put in place a system of universal health coverage, based on primary health care, which ensures that every citizen has access to quality services without fear of financial hardship.
France led the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Next year you will host the Global Fund’s replenishment and we know that you will do everything to make this event a success.
With Brazil, you created Unitaid, a truly innovative financing mechanism.
You have invested heavily in Gavi, the Vaccine Alliance.
French expertise in the development and manufacturing of vaccines has helped ensure the vaccination of nearly 170 million children against polio since the beginning of 2018 alone.
France has also been at the forefront of the response to climate change. The implementation of the Paris Agreement will have major benefits for health.
WHO has begun an initiative to address the health impacts of climate change in Small Island Developing States.
And just today we hosted the first WHO Global Conference on Air Pollution and Health in Geneva. I just came from that conference. Air pollution kills an estimated 7 million people every year, including 600,000 children. It’s a major cause of stroke, heart disease and cancer.
These are just some of the highlights of France’s contributions to health.
I was also delighted to see that health is one of your 5 strategic priorities for overseas development assistance.
This Assembly has played a critical role in making this happen.
Earlier this year, France and all of WHO’s Member States approved our new 5-year strategic plan.
At its heart are what we call the “triple billion” targets:
1 billion more people benefitting from universal health coverage;
1 billion more people better protected from health emergencies;
And 1 billion more people enjoying better health and well-being.
In one sense, these are not new targets – they are simply what we need to achieve together to stay on track for the Sustainable Development Goals. And as madam Chair says, half of the world’s population does not have access to basic health services and that is why we need to do everything in our power to achieve these goals.
Keeping the world safe is one of WHO’s top priorities. Responding to outbreaks and other emergencies is a key part of what we do all over the world. In global health security, we are only as strong as the weakest link. No one is safe until we are all safe.
As you know, the West African Ebola outbreak in 2014 and 15 was a wake-up call for the world, and for WHO.
Since becoming Director-General last year, I have built on the work started by my predecessor, Dr Margaret Chan, in making WHO much more agile in responding to emergencies.
I have made emergency preparedness a 24-7 around the clock business.
I now receive a daily briefing note on the status of all emergencies, and I have access to a dashboard with near real-time data.
And I have instituted the WHO Health Security Council, a fortnightly meeting that I co-chair to review all emergencies and our response to them.
In the past year, we have responded to 50 emergencies in 47 countries. We currently have more than 620 staff deployed all over the world responding to emergencies of different kinds.
Let me give you a brief update on just two of them – Yemen and the Democratic Republic of the Congo.
In Yemen, three years of crisis have resulted in the world’s worst humanitarian emergency, the largest food crisis, an unprecedented cholera epidemic, and the near collapse of the nation’s health system.
The humanitarian emergency remains extremely widespread and is deteriorating rapidly. More than 22 million people need humanitarian or protection assistance and more than 16 million people need healthcare services.
Health workers have not been paid since 2016. WHO and other partners in are increasingly being asked to pay salaries and buy medicines and medical supplies. We are trying our best to help the people and one of these successes was the first ever oral immunization campaign held in Yemen earlier this year.
In the Democratic Republic of the Congo, as of today there have been 274 confirmed and probable cases of Ebola virus disease, including 174 deaths.
What makes this outbreak even more challenging is that it is occurring in an active conflict zone. There are many armed groups operating in the area, which creates red zones that we cannot access.
A major security incident on 20 October suspended our operations and placed staff on lockdown in the town of Beni, which is the epicenter of the outbreak. But as you know, when we are in lockdown, Ebola is not. The virus gains an advantage.
Operations have since resumed and the situation is being monitored closely by WHO and our partners. WHO currently has 273 staff in the field to deal with this outbreak.
The other major difficulty we are facing is some community mistrust. Small but significant numbers of people refuse active follow-up, or refuse to be treated in the Ebola treatment units.
As you know, two weeks ago I convened a meeting of an Emergency Committee under the International Health Regulations. The committee recommended that at present, Ebola does not represent a Public Health Emergency of International Concern.
We have concluded that although the risk of regional spread is very high, the risk of spread beyond Africa remains low.
The good news is that we have new tools to fight the outbreak that are helping. So far we have vaccinated more than 24,000 people against Ebola, and more than 100 people have been treated with investigational therapeutics.
We’re also using community and religious leaders to dispel some of the myths and misinformation that are circulating. And we’re training community workers to do surveillance in the areas we can’t access with our staff.
But the situation is still extremely worrying. I have briefed the United Nations Security Council twice, and we have asked them for a resolution which was adopted unanimously just a couple of hours ago.
Next week I will be traveling to Beni with the Under-Secretary-General for Peacekeeping Operations, Jean-Pierre Lacroix – who you know very well – to review the security situation and see if we can identify ways to gain greater access to the red zones.
Ladies and gentlemen,
Effective international cooperation, partnership and leadership are helping us save lives.
But even better than responding quickly and effectively to emergencies is preventing them in the first place.
And the best way to do that is to invest in strong health systems. When people can access the health services they need, when and where they need them, without worrying about whether they can afford them, health emergencies can be prevented, or detected early and stopped.
The foundation of strong health systems is primary health care.
Last week I had the honour of attending the Global Conference on Primary Health Care in Astana, Kazakhstan.
Together we celebrated the 40th anniversary of the Alma-Ata declaration, but also signed a new declaration affirming primary health care as the fundamental platform for achieving universal health coverage and the Sustainable Development Goals.
The reality is that unless we invest in primary health care and health systems, we will miss many of the health-related targets in the SDGs.
At the current rate, we will miss the targets on maternal, child and neonatal mortality.
We will miss the targets on HIV, TB and malaria.
We will miss the targets on family planning, child stunting, universal health coverage and more.
Fragmentation, duplication and inefficiency are undermining progress.
That’s why just a few weeks ago we launched the first phase of the Global Action Plan for Healthy Lives and Well-Being.
This draft action plan is designed to get us back on track for the SDGs by working more closely together as a global health community.
The plan has been endorsed by the heads of 11 agencies, including the Global Fund, Gavi, UNICEF, UNFPA, GFF and others, who have committed to work together in dramatically different ways.
Together, we have committed to three key actions.
First, we have committed to align.
We all do a lot of the same things, but we do them in different ways – like resource mobilization, procurement, travel policies and other operational processes.
By harmonizing these processes and sharing information, we can generate tremendous synergies and spend more time on delivering results, instead of on administration.
Second, we have committed to accelerate. We are identifying areas in which we can join forces to drive faster progress in countries and move more quickly to achieve our shared goals.
These accelerators include working jointly with governments on sustainable financing, frontline health systems, data and digital health, research and development, community and civil society engagement, and more.
Third, we have committed to account. Countries, donors and partners expect results from the resources they entrust to us. So together we have agreed to strengthen our joint accountability.
We are developing common milestones for 2023 – which is halfway to 2030. Our aim is to develop a common results framework, against which investments can be calibrated.
Align. Accelerate. Account.
This is our commitment.
I ask for your support for this Global Action Plan and to join us in this work.
Thank you once again for the opportunity to speak to you today. Let me leave you with three requests.
First, we would love to see France playing a greater leadership role in global health. We urge you to use your enormous influence, particularly this year while you hold the presidency of the G7, to drive measurable commitments that can generate real progress towards universal health coverage, health security and the critical health issues of our time.
We know that you already have a “friends of global health” group here in the National Assembly – we urge you to strengthen it and to make advocating to the G7 part of its core business.
Second, to achieve the Sustainable Development Goals, we need an increase in funding for global health. Recently WHO launched our first investment case, which estimates what a fully-funded WHO would need to help us achieve our ambitious targets.
We estimate that over the next 5 years, WHO needs $14.1 billion to fund the programmes that will support countries to get on track for the SDGs and stay on track. That represents about a 14% increase in our base budget over 5 years.
We estimate that those resources could save up to 30 million lives, and add up to 100 million years of healthy living to the world’s population by 2023.
But third, it’s not just the quantity of funding that matters – it’s the quality.
In order to succeed, WHO needs reliable, multi-year financing. Our current funding model creates fragmentation, unpredictably and internal competition for funds that hinders progress.
A growing number of countries have started supporting WHO with more reliable financing. We encourage France to join that group, and to be vocal in encouraging others to follow suit.
I understand that the upcoming development bill to be debated in 2019 presents a key opportunity for you to push for the inclusion of development partners such as WHO.
I also urge you to ensure that financing for global health is predictable by promoting innovative mechanisms such as taxes on tobacco, alcohol and sugary drinks, or taxes on financial transactions or airlines, which France pioneered.
Thank you for your support and commitment. We look forward to deepening our relationship with France as we work together for a healthier, safer, fairer world.
La santé est un droit humain, pas un privilège.