Director-General's Office

Opening speech at the Global Conference on Primary Health Care

Dr Tedros Adhanom Ghebreyesus

Astana, Kazakhstan
25 October 2018

Thank you Minister Birtanov,

Your Excellency, Prime Minister of Kazakhstan,

Excellency, Deputy Prime Minister of Nepal,

Executive Director of UNICEF,

Ministers, commissioner of EU

Excellencies, distinguished guests, ladies and gentlemen,

First of all, I would like to express how happy I am to be with you this morning.

I thank His Excellency the Prime Minister and the Government of Kazakhstan for your hospitality, and for hosting this very important meeting.

I would actually like to start by answering Yana Panfilova’s request. She said “We need universal health coverage with quality services.”

I fully agree with you Yana, and that is what we are saying here today.

The only thing we are stressing is universal health coverage, with primary health care as its foundation.

So we would like to assure you that we go for health for all, for universal health coverage and for quality.

And I will start by paying tribute to my predecessor, Halfdan Theodor Mahler, by the way whose middle name is the same as my name, who passed away just a couple of years ago.

In the history of public health, Dr Mahler is a giant.

And also I would like to recognise the presence of Dr Sharmanov, who was in 1978 the architect of primary health care.

I am glad to have someone in person to witness what it felt like 40 years ago.

We are here in large part because of the vision of these giants, and the vision of the other architects of the Alma-Ata declaration.

But we’re also here because we must acknowledge that we have not achieved that vision.

Instead of health for all, we have achieved health for some.

On one hand, we have made enormous progress.

In the past 40 years, life expectancy has increased dramatically;

we have reduced maternal mortality by almost half, and child mortality by more than half;

we’ve turned the tide on the HIV epidemic, malaria deaths have halved – and we could list many more successes.

But progress has been uneven and unfair, both between and within countries.

There is still a 31-year discrepancy between the countries with the shortest and longest life expectancies.

Some people enjoy the benefits of cutting edge medical technologies, while others don’t have the basics.

At least half the world’s population lacks access to essential health services.

And every year, almost 100 million people are pushed into extreme poverty by the costs of paying for care out of their own pockets.

In the forty years since Alma-Ata, we have allowed the vision of health for all to become too small, too diluted.

We have allowed ourselves to become too focused on fighting specific diseases, at the expense of strengthening health systems.

We have allowed ourselves to become too focused on treatment, at the expense of promoting health and preventing disease.

We’re here this week to do something about it.

We’re here to recommit to primary health care as the foundation of strong health systems and universal health coverage.

The declaration we’re endorsing commits us to putting people at the centre of health care, not diseases or conditions.

It commits us to empowering people to take care of their own health, and to advocate for it.

It commits us to taking action across sectors to address the social, economic and environmental determinants of health.

And it commits us to building sustainable primary care, with services that meet people’s needs, throughout their lives.

Excellencies, ladies and gentlemen,

On Friday last week I had the honour of having an audience with His Holiness Pope Francis at the Vatican.

I would like to use this opportunity to thank him for his statement through his ambassador here.

His Holiness affirmed to me what we all believe – that health is a human right for all people, not a privilege for those who can afford it.

The world has changed dramatically since 1978 – socially, economically, politically and in many other ways.

But the right to health has not changed.

We are one human race. We share the same blood, the same hopes and aspirations, the same DNA.

Some of us are born to privilege. Some are born to deprivation.

Some of us have big ambitions, big dreams. Some just dream of making it through the day, a matter of survival.

But the one hope we all share is to live a healthy life.

Health should not be the prize you win for climbing to the top of the pile.

It should be the gift we’re all given; the gift that enables us to realise our dreams and fulfil our potential.

Because it’s a fundamental human right.

Health is the foundation for individuals and families to flourish, communities to prosper and nations to thrive.

That’s why it is a fundamental human right.

And primary health care is the foundation of better health;

Health care that focuses on promoting health and preventing disease, as well as treating it;

Health care that empowers people to become active participants in their own health, instead of passive recipients.

Achieving health care like that is a political choice, but health is not a political toy.

Politics must always be a tool for advancing health, not for impeding it.

The question we all face is, can we realise that vision?

Can we succeed where we have failed before?

I believe the answer to that is a resounding yes, and I hope you will agree with me. Otherwise I would not be here today.

Today, I see three reasons for optimism.

First, I see I see a new era of cooperation to achieve the Sustainable Development Goals. In Berlin two weeks ago, we launched the Global Action Plan for Healthy Lives and Well-Being.

So far, 11 leaders of global health agencies – including Unicef and others in this room – have come together in support of the plan, to commit to working together in closer cooperation, instead of in a fragmented and disjointed way.

Second, I see new technologies that offer us the opportunity to reach everyone with health services and health information, from the biggest cities to the remotest villages.

And third, I see you. I see the people in this hall. I see us. I see the people I have met all over the world who share a singular commitment to achieving better health – for themselves, for their families, their communities, their nations and their planet.

You are our hope. No one else will achieve the ambitious vision of health for all. It’s up to us.

History will record us as the generation that was given a second chance of achieving health for all. Will it record that we wasted the opportunity? Or will it record that we made it happen?

Let’s start writing that history now. Let’s make it happen.

Yesterday we walked the talk for physical activity. Now we must walk the talk for primary health care as a foundation. And for universal health coverage, for true health for all.

Next year we will gather at the United Nations General Assembly for the High-Level Meeting on Universal Health Coverage.

This is a unique opportunity to rally world leaders in support of health for all.

I urge each of you to use your influence – however small or large it may be – to ensure your head of state or head of government is there.

But we don’t need to wait for next year. We can take action now. And we should start taking action now.

Each of us must do whatever we can to realise this vision in our own sphere of influence.

Together, we must learn from the mistakes of the past, embrace the opportunities of the present and shape the future we all want.

We must engage in open discussion.

We must listen to the voices of health professionals, nurses, midwives, doctors and carers.

We must allow the courage, ideas and innovations of patients and communities all over the world to inspire us.

Palpable change will come by empowering and enabling people to take ownership of their health and healthcare.

We must refocus our efforts to ensure that everyone everywhere is able to enjoy the highest attainable standard of health.

Excellencies, Ladies and gentlemen,

The human race is capable of amazing achievements and terrible deeds – from exploring the universe to waging destructive war.

Now is the time to change history. Now is the time act. Now is the time to achieve a healthier, safer, fairer world for all.

If we want it, what it takes is political commitment, it’s a political choice.

And it’s up to us.

I thank you. Rakmet.