Director-General's Office

Meeting of the Tripartite Inter-Managers Committee meeting

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

Brasilia, Brazil
22 March 2018

Your Excellency Ricardo Barros, Minister of Health, secretaries, excellences, ladies and gentlemen,

First of all I’d like to thank you for the invitation to come and speak to you today.

I’m really honored and humbled. Our partnership with you is very critical to realizing our shared ambition of achieving better health for all people.

I’m very much impressed to learn that you make decisions by consultancy consensus in all levels instead of by vote. This is very important for making sure that your vision and decisions are shared, and that everyone is included.

I’m also impressed that this is an open meeting, and that the public are invited to come and see your decision-making processes. This makes it very unique, meaning there’s nothing to hide, in terms of your decisions, from the public.

Health is a rights issue, which is actually in your Constitution. That’s also another important issue that impressed me.

So these are three important elements. One, you decide by consensus. Two, your decisions are open to the public. It’s in your Constitution that health is a rights issue. These are really impressive. I know that you’ll keep them, because these will help in building your system.

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. And this is based on what your Constitution states.

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.

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.

Most importantly, the Brazilian health system is built on the foundation of primary care. This is the model that we want to see replicated all over the world. I had the chance to visit one primary health care unit. Thank you so much for your excellent guidance, Humberto. I was really impressed by what has been built in the past year, especially in that community. I could see the importance of primary care.

With ageing populations and the increasing burden of noncommunicable diseases, the most cost-effective investments are in population-level services that keep people out of care, such as road bumps, motorcycle helmets, smoking regulations and measures to promote breastfeeding.

By contrast, the most expensive services are often those that have the least benefit, such as tertiary care in referral hospitals.

Those services are of course important, and must be provided. But the point is that countries that invest in promoting health and preventing disease will make considerable savings further down the continuum of care. So you have to stick to your primary care, which will have a huge dividend.

Allow me to outline five building blocks for improving the quality of services.

As you know, of course, no health system is perfect. There’s always room for improvement. It’s something that you’re already doing. But just to stress the fact that these areas are important.

First, and most importantly, committed leadership is important. And that is what I see at every level of the health system, it’s vital to develop leaders who put patient safety and quality improvement at the apex of clinical care.

And this is what you're doing, especially with the commitment of all the leaders, at all levels.

Second, clear policies are important. Every health worker must know and understand the best practices, based on the best evidence, for keeping patients safe and providing the right care.

Third, data-driven improvements. Robust data systems are vital for tracking what’s working and what’s not, so that we can learn and make adjustments continuously. And that's why you're moving to the digital age, and I encourage you to really speed up the process.

Fourth, competent and compassionate health professionals, in sufficient numbers. This is vital. Policies and systems are important, but in the end, health services are delivered by people. We must therefore give all health workers the conditions, the skills, the training and the tools and the right mindset to do their jobs to the best of their ability.

And fifth, we must involve communities, patients and their families as true partners in care and services. Too often health services are delivered in a way that makes people passive recipients of their own care, instead of active participants. But it’s not only making communities active participants. Your primary care will only succeed if there is ownership by the communities. Governments alone cannot do it. It’s the genuine partnership between government and communities that can give you better results and dividends.

When people are empowered to take charge of their own care, when they are listened to, informed and consulted, when their needs and preferences are respected, errors are fewer and outcomes are better.

Ladies and gentlemen,

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.

That’s why universal health coverage and health security are two of the three pillars of WHO’s new Global 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.

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.

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.

Brazil has already done, not only three, but 10 commitments and the first country to make those commitments. Thank you so much, Your Excellency and my brother, Minister Ricardo.

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

This committee is a vital platform for making decisions that affect the health of millions of people. As health managers, you have the opportunity to ensure not only that people receive services are provided, but that the quality of those services is constantly improving.

WHO and PAHO are ready to support you with world-class technical know-how and the best evidence from around the world.

And I also encourage you to find ways to share your experiences with other countries in the region and globally.

Every country is responsible for its own health system. But every country has lessons it can learn from others, and every country has lessons to pass on.

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.