Director-General's Office

Making the World Safe from the Threats of Emerging Infectious Diseases Prince Mahidol Award Conference, Bangkok, Thailand

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

Bangkok, Thailand
1 February 2018

Your Royal Highness Princess Maha Chakri Sirindhorn, Excellencies, ladies and gentlemen,

I would like to start by congratulating all laureates of PMAC who are with us today: Dr Eric Green, Professor Porter Anderson, Dr Rachel Schneerson, Dr John Robbins, and Professor Mathuram Santosham. I would like to really congratulate you. You’re going to change the future of health. You’re going to establish the future of health. That’s what I have seen, actually, from the presentation.

As Dr Green said, just the mapping took six to eight years, and now you’re able to do it in 1 to 3 days. It used to cost 1 million U.S. dollars, now it’s a matter of 1000 U.S. dollars. This is really amazing progress

I fully agree with what you said: the future of health begins with you. I look forward to working with you very closely, because in what we do, and what WHO does, I know your work will have a significant impact.

So to all laureates, please accept my greatest respect and appreciation for your dedication and commitment.

As you know, this year marks the 100th anniversary of Spanish flu, the deadliest outbreak in recorded history. Up to 50 million people were killed, more than the death toll from the First World War. The revised estimate actually is between 50 to 100 million people were killed.

Thankfully, we have not seen a public health emergency on that scale since then. But we may at any time. Outbreaks are as you know a fact of life, and we’re still in vulnerable.

You know that only too well. Even here in Thailand, you have experienced outbreaks of H5N1, SARS, dengue and more, just in the last few years, but you have responded effectively.

I would also like to commend Thailand in being a leader in supporting other countries in times of emergencies and outbreaks, as we have seen recently in Nepal and Sri Lanka.

Of course, none of us will ever forget the West African Ebola outbreak in 2014.

Apart from its terrible human cost, Ebola also had a devastating economic impact. The IMF reduced its growth projections for sub-Saharan Africa by 10%. Commodity prices plunged, while unemployment and fiscal deficits rose.

Ebola taught us a valuable lesson: global health security is only as strong as its weakest link. No-one is safe until everyone is safe.

As you know, WHO was sharply criticized for its performance during Ebola. Some of the criticism was fair, some was not.

But it did prompt us to overhaul the way we respond to emergencies.

This work began under my predecessor, Dr Margaret Chan, and since becoming Director-General last year, I have taken further steps to make our emergency operations more like a national security setup, because it’s a serious security issue.

I now receive a daily briefing note on the status of all ongoing emergencies globally, and we have also established the WHO Health Security Council, a fortnightly meeting co-chaired by me and my Deputy Director-General for Emergencies, Dr Peter Salama, to review all emergencies in detail.

Recently we also begun an exercise with the Wellcome Trust of mapping the capacities of all countries, developed and developing, to contribute to a global “health reserve force” or “health reserve army” that can be deployed anywhere in the world within 72 hours to respond to emergencies.

I would like to quote what Dr Eric Green said: not one life; all lives. Not one country; all countries. That’s why working together is very important, and we have started the mapping exercise to map the capacities we have globally in terms of research and development, and also the capacities we have in terms of emergency preparedness and response.

In the past six months, WHO has responded to 50 emergencies in 48 countries, including 9 grade 3 emergencies, which is the highest level in our grading system.

One of the most severe was the outbreak of plague in Madagascar last year that killed 207 people.

But it could have been much worse. Prompt action by the government, with support from WHO and other partners, meant that we were able to bring the outbreak under control very quickly.

I visited Madagascar just a few weeks ago to meet the President of the Republic, and we discussed the plague response, but also the need to take action to prevent the next outbreak now by taking action, especially on vector control.

The reality is that 70% of new pathogens come from animals.

Increasing demand for food and land, and the intensive farming and transport of animals, all increase the risk of diseases spreading from animals to humans.

So it’s obvious that we cannot address human health in isolation. We can only improve human health with a “One Health” approach that recognizes that the health of humans, animals and ecosystems are linked, as Her Royal Highness said in her speech.

This is especially true to address the growing threat of antimicrobial resistance.

On Monday here in Bangkok, WHO launched the first report from our new Global Antimicrobial Surveillance System (known as GLASS). The findings are alarming.

In some countries, up to 82% of bacterial infections are resistant to at least one of the most commonly-used antibiotics.

Resistance to ciprofloxacin is as high as 65% in some countries. For penicillin it’s 51%.

One of the most important actions for every country is to set up a robust surveillance system that can track and detect trends in drug-resistance.

I am encouraged to say that 52 countries are now enrolled in this system and more are on the way to joining.

But we also need to take cross-sectoral action to address the root causes of the problem.

Together with our friends at OIE and FAO, we have a tripartite agreement to work on One Health.

For example, together we are fostering research to understand how MERS is crossing from camels into humans. We also collaborate with the agriculture sector to detect, monitor and respond to influenza viruses with pandemic potential.

This cross-sectoral collaboration cannot only happen at the global level. It must also happen on the ground, which is why I’m very encouraged that here in Thailand you have worked successfully across sectors to develop a national strategic plan on antimicrobial resistance.

Your Highness, Excellencies, Ladies and gentlemen,

Keeping the world safe is one of WHO’s three top strategic priorities in our new five-year strategic plan, which was endorsed by the Executive Board of WHO last week.

We are setting ourselves a goal that over the next five years, 1 billion more people will be better protected from epidemics and other health emergencies. I was very happy when I saw “Making the World Safe” here. It exactly fits with what we have put in our strategic plan.

We are currently developing the tools to measure this, but we already know what we need to do to make people safe.

First, we must build and sustain resilient capacities at national, regional and global levels to prevent, detect and respond to outbreaks, in accordance with the International Health Regulations. As Her Highness also underlined, capacities and coordination. That’s how she summarized it.

And second, we must ensure that populations affected by emergencies have rapid access to essential life-saving health services, including medicines and vaccines.

That requires investments in the fabric of health systems, especially in people-centred primary care, to ensure that people can access the services they need, when and where they need them.

Ultimately, universal health coverage, and health security are two sides of the same coin. That’s why we say all roads should lead to universal health coverage, whose centre of gravity should be primary health care, back to the basics of health promotion and disease prevention, whose dividend is great, but which is neglected.

Outbreaks are inevitable, but epidemics are preventable. If epidemics happen, it’s our mistake.

This is not a job, of course, for WHO alone or for the health sector alone. In fact, we cannot succeed unless we all work together.

This is what I am seeking to do at WHO, with my colleagues. I look forward to your partnership as we work together to keep the world safe.

When Dr Green presented, he said imagination is sky high. I think with the advance we have seen, making the world safe is possible, especially if we keep our imagination high.

I really enjoyed his presentation. Not one life; all lives. Not one country; all countries. Not in isolation, but together we can make a big difference.

Thank you so much. Khob khun krab.