As the World Health Assembly draws to a close and the great and the good in global health head home, it's time to focus on some truths about health.

1. Technology is not the (only) answer

The World Health Organization tends to focus on scientific and technical matters, but is that enough?

Human beings are amazing, they really are. We have created antiretroviral drugs, we have devised methods to prevent malaria and we have invented a treatment for tuberculosis. The technology we have created is incredible, and for all the media attention given to technology as a means to solve all global ills, you would be forgiven for thinking it is a panacea as far as health is concerned.

But it's not. Of the 39million people living with HIV only eight million have access to antiretroviral drugs, 660,000 people died from malaria in 2010, and in 2011 8.7million people fell ill with tuberculosis. All of this despite comparatively easy technological fixes being available. So technology, it seems, is only one part of the puzzle.

2. We will not improve health if we do not tackle poverty

In my role as the director of an NGO that works to strengthen marginalised communities in their struggle for health, I am constantly reminded of the root causes of ill health; the social and economic reasons that people live unhealthy lives.

I have seen people benefit from technology by having one illness treated, only to die shortly afterwards from something else. If you're so poor you face a myriad of threats to your health, a technological fix for one will often do little more than change the cause of death. The average life expectancy for people living in a low income country is 60 years, and in the poorest areas it's very much lower that this, whereas those in high income countries can expect 80 years of life. Across the whole of Africa life expectancy has increased by only six years in the last 20. An extra six years is not to be sniffed at of course, but it hardly reflects the scale of technological gains that some of humanity's brilliant scientific minds have achieved.

Around the world, for millions of people, the cause of their illness is poverty; lack of nutritious food and clean water, poor sanitary conditions in which to live, and lack of education and employment. Poverty is the cause, and sickness is the result.

But of course we already knew that. Everyone knows that poverty and poor health are closely connected. Perhaps what we don't always remember quite so well is that it doesn't need to be this way.

3. Poverty is not inevitable

It's estimated that the wealthiest 0.1% of people in the world own 81% of the financial wealth in the world. In fact, the richest 300 individuals in the world have the same amount of wealth as the poorest 3billion.

It's so easy to be lulled into a belief that this appalling level of inequality is inevitable. But it simply isn't! This global imbalance in resources is an avoidable phenomenon. It has come about as a result of specific policies and decisions made by those who seek to extract wealth from others, those who are part of a poverty creation industry.

This industry, just like the global health sector, has developed its own 'technology' - technical tools to preserve inequality, and redistribute wealth from the poor to the rich. These tools include ingenius and highly technical practices related to tax havens, trade agreements, patent rules and other legal frameworks. It's a well-funded technology, supported by elite lobbyists, policymakers, lawyers, and resources to co-opt (or buy-off) elected officials.

And it's extremely efficient, so much so that the gap is widening even further and inequality is on the rise.

4. This is good news!

It may not seem like it, but yes, this is in fact good news. The fact that poverty is created by human tools and systems means humans have the ability to change it. We can create new tax laws that stop tax evasion so that the world's poorest countries can fund their health systems. We can redraft trade agreements so that they strengthen the most vulnerable traders rather than the most powerful ones. We can change patent rules and other agreements so that public health is placed above corporate profits.

The World Health Organization's scientific and technical work matters, but if the organisation is to fill its mandate it needs to focus much more on tackling the social and economic causes of poor health. We all do. We have the technical ability to do all these things. All we need to do is mobilise together to generate the political will.

And let's never, not for a single moment, believe that it's impossible. It isn't.

(source: www.huffingtonpost.co.uk)

 

In my UN Special Envoy positions I have had the honor to work with some of the best policy makers, researchers, and practitioners of global health. And I am always excited when my path crosses with Dr. Margaret Chan, the Director-General of the World Health Organization (WHO), and one of the brightest thinkers about the health challenges in front of us. Before her appointment as Director-General in 2006, Dr. Chan was WHO assistant director-general for Communicable Diseases and representative of the director-general for Pandemic Influenza. She also served as director of Health in Hong Kong for nine years where she successfully defeated the spate of severe acute respiratory syndrome in 2003. Dr. Chan also appears to be a big fan of the NBA (see photo below).

Dr. Chan is busy hosting the World Health Assembly in Geneva this week, but I had a moment to catch up with her recently to get a sense of the main topics on her mind:

Ray Chambers: WHO's 2013 World Health Statistics were released last week -- what can we take away from that report with respect to progress toward achieving the health related Millennium Development Goals?

Dr. Chan: As we near the 2015 deadline of the Millennium Development Goals, the report shows the world has made dramatic progress in improving health in some of the poorest countries, especially in reducing the deaths of children under the age of 5 and women, improving nutrition and reducing deaths and illness from HIV, tuberculosis and malaria. This is very encouraging; but it is not enough. With fewer than 1000 days left, we must ask ourselves the difficult questions: Have our efforts to reach the Millennium Development Goals reduced the unacceptable inequities between the richest and poorest countries enough?

Remember, the over-arching objective of the MDGs is reducing poverty. Progress is measured by how well the health of the poor improves. If we miss the poor, we miss the point. One of the biggest obstacles identified in reaching these goals is weak health systems. For example, a health system that lacks commodities for managing high-mortality infectious diseases and the main killers of mothers and young children will not have an adequate impact. We must have both.

Ray Chambers: What are some the specific trends you can share from the Report?

Dr. Chan. Significant progress has been made in reducing child deaths by 40% from nearly 12 million deaths in 1990 to less than 7 million in 2011. But still far too many children are dying simply because they are born too soon. Every year more than one million premature babies die. Three quarters of these babies' deaths can be prevented with simple and cost-effective interventions.

A disturbing trend is the increase in overweight children. In fact in many regions, more than 5% of children are overweight today, increasing their risk of diabetes and other health problems even before adulthood in some cases. Diabetes is also on the rise in adults. Today almost 10% of the world's adult population has diabetes, putting them at increased risk of heart disease and stroke. Diabetes increases the risk of amputation, renal failure, visual impairment and blindness. Making healthy foods more available, increasing physical activity and avoiding tobacco can help reduce these alarming trends.

Another concern: in far too many countries, the essential medicines for improving health are simply not available in the public sector, forcing people to the private sector where prices can be up to 16 times higher and thus out of reach.

Ray Chambers: What are the countries that are succeeding doing that other countries should follow?

Dr. Chan: There are many countries doing remarkable work to improve health with very few resources. Those that are making progress consistently think outside the box. For them, obstacles are just challenges to be overcome. Take Afghanistan, for example, where many women live so far from a health clinic they do not see a doctor even once during a pregnancy and often they deliver at home without a trained health worker. I will never forget meeting some women there who wanted to change that. They were not trained health workers, they could not even read or write. But they were so determined to help they volunteered their time using cards with visual images to monitor the progress of a woman's pregnancy and helping with deliveries in their communities. This is the type of innovative thinking that saves lives. This is the key to success.

(source: www.huffingtonpost.com)

 

The World Bank Group would help countries tackle two major challenges as they advance toward universal health coverage: to ensure no family is forced into poverty because of health care expenses, and to close the gap in access to health services and public health protection for the poorest 40% of the population in every country, the World Bank Group President, Jim Yong Kim has said.

He therefore called on countries gathered at the 66th World Health Assembly to ensure universal access to quality, affordable health services to help end extreme poverty by 2030 and boost shared prosperity.

In a press release issued May 21, 2013, it said worldwide estimates are that out-of-pocket health spending forces 100 million people into extreme poverty every year and inflicts severe financial hardship on another 150 million people.

"To free the world from absolute poverty by 2030, countries must ensure that all of their citizens have access to quality, affordable health services. "We have the opportunity to unite global health and the fight against poverty in action focused on clear goals," Kim said.

"Every country in the world can improve the performance of its health system in the three dimensions of universal coverage: access, quality, and affordability," he added.

(source: www.spyghana.com)

 

The World Health Assembly on Tuesday called on all member states to renew its momentum on universal health coverage.

Dr Margaret Chan, Director-General, World Health Organisation, while addressing the assembly, stressed the need for fairness, and equity in health care for the people.

She expressed concern over emergence of new disease and the effect of poverty in accessing quality health care.

Chan said everybody, irrespective of social or whatever status, had the right to good health care, adding that ''universal health coverage reflects the need to maximise health outcome for everyone.

''Everyone, irrespective of their ability to pay, whether they are human, where they live , where they are from, should have access to the quality health care without risking financial ruin.

''A focus on universal health coverage continues the strong emphasis on equity and social justice articulated in the Millennium Declaration and in the future we want.

''Public health looks more and more like a refuge, a safe harbour of hope that allows, and inspires, all countries to work together for the good of humanity.

''This is what we are doing, and we see the results, fear of new diseases can unite the world, and so can determination to relieve preventable human misery.

''This is what makes public health stand out from other areas of global engagement: the motives, the values, and the focus, '' she said.

She commended the growing commitment to universal health coverage and appreciated member states for caring so much about health, nationally, regionally, and internationally.

She encouraged members to keep doing the right things, on the right track and pledge to give her support.

In his remark, the Minister of Health, Prof. Onyebuchi Chukwu said Nigeria was implementing a number of strategies for the attainment of Universal Health Coverage.

Chukwu said health insurance coverage was being widened through the scale-up of the Community-based Health Insurance Scheme.

''The Act establishing the National Health Insurance Scheme is being reviewed with the intention of making health insurance mandatory and universal.

''The Midwives Service Scheme (MSS) which was introduced as a response to the shortage of skilled birth attendants especially in 'hard-to-reach' locations, has continued to grow.

''Today, a total of 6,520 midwives, 6,600 community health workers and 2,100 village health workers have been deployed to 1,500 health facilities spread across all the 36 states of the Federation and the Federal Capital Territory.''

The minister said the National Health Bill had been returned to the National Assembly following the resolution of some contentious issues.

According to him, the Assembly is currently revising the Bill and ''I am optimistic that it will be passed into law before the end of 2013''.

He explained that the National Health Act would provide additional fund for strengthening Primary Health Care.

The Permanent Secretary in the Ministry, Mrs Fatimah Bamidele, said Nigeria was making efforts to ensure that every Nigerian has access to quality health care.

She said the issue of universal health coverage would go a long way in addressing maternal and child mortality.

(source: leadership.ng)

The World Bank President Jim Yong Kim on Tuesday said universal health coverage could help achieve a goal of ending 'absolute poverty by 2030' and that the global lender would help countries to provide the coverage.

"Every country in the world can improve the performance of its health system in the three dimensions of universal coverage: access, quality, and affordability," he said while addressing World Health Organisation's key annual meeting, World Health Assembly, in Geneva.

He said priorities, strategies and implementation plans would "differ greatly from one country to another".

But in all cases, he said "countries need to tie their plans to tough, relevant metrics. And international partners must be ready to support you".

He, however, cautioned all to prevent 'universal coverage' from ending up "as a toothless slogan' that doesn't challenge us, force us to change, force us to get better every day".

The United Nations General Assembly last year adopted a resolution on affordable universal health care, urging countries to develop financing systems that avoid payment at the point-of-services.

"Anyone who has provided health care to poor people knows that even tiny out-of-pocket charges can drastically reduce their use of needed services."

"This is both unjust and unnecessary," he said and that "countries can replace point-of-service fees with a variety of forms of sustainable financing that don't risk putting poor people in this potentially fatal bind".

He said health spending forces about 100 million people into extreme poverty every year and inflicts severe financial hardship on a further 150 million.

Kim, a physician by training, is also a former director of WHO. He took over the charge of the global lender in July last year and set a target last month to cut extreme poverty –living on less than $1.25 a day –to less than 3 percent by 2030 from 21 percent in 2010.

To end poverty and boost shared prosperity, Kim on Tuesday said countries need robust, inclusive economic growth.

"And to drive growth, they need to build human capital through investments in health, education and social protection for all their citizens".

"Now is the time to act," he said, "we must be the generation that delivers universal health coverage".

Oxfam International lauded his call. Its Senior Health Policy Advisor Dr Mohga Kamal Yanni said "The World Bank is becoming a major champion on Universal Health Coverage and we applaud President Kim's leadership on this issue".

In its website post Oxfam said, "Universal coverage cannot happen without major, scaled up public investments in health, the Bank must now change the way it works to help countries achieve this.

"By working with the World Health Organisation, the Bank can support countries to ensure that every citizen gets access to the healthcare they need".

The Oxfam also welcomed the World Bank's support for countries to remove user fees which it said 'a major financial barrier' in achieving Universal Health Coverage, but said "fees must not be replaced by insurance".

(source: bdnews24.com)

 

We live in a world of extraordinary inequities. Poverty and inequity are the world's greatest killers. In the 20 years after the Cold War, 360 million people have died from hunger and treatable diseases - much more than from all 20th-century conflicts.

Inequities in health are among the most visible of all in a world in which the gap between the mean GDP of rich and poor countries more than doubled in the 25 years to 2005. The developing world bears an extraordinarily inequitable burden of infectious disease, 90 per cent of it, and yet these countries represent just 12 per cent of all health spending.

AIDS is a classic example. Of the 30 million AIDS deaths since the virus that causes the disease was identified 30 years ago this week, 90 per cent have occurred in Africa.

Yet, against such odds, the face of AIDS has changed from one of desolation to one of hope.

When AIDS was first identified in fewer than 20 patients in the US who presented with unusual symptoms in the early 1980s, millions of Africans were already infected, but there was no system in place to detect this. The sub-Saharan epidemic spread unchecked for another 20 years: while science rapidly responded in the global north, barely a single patient in the developing world had access to treatment from an international program until 2001.

What AIDS has since shown us is what can be achieved when the world resolves to fight a pandemic, when the right to health is aggressively asserted, when we see and act on medicine and health care as a ''global public good''.

The global effort to defeat AIDS over the past three decades has demonstrated a long-suspected truth: health should no more be seen as a consequence of economic growth.

In 2000, the world set itself the ambitious Millennium Development Goals, endorsing that change in paradigm about how health relates to development. Experience has validated the concept. In its last report, the United Nations Development Program showed that the countries that invested the most in health and education in 2000 are also those in which the Human Development Index has progressed the most in the past 10 years.

AIDS is perhaps the pre-eminent example of successful investment in health. Eight million people have gained access to antiretroviral treatment, compared to just a few tens of thousands 10 years ago. As a result of investments in HIV prevention and treatment, mortality from AIDS and the number of new infections have decreased worldwide by 25 per cent in just the past five years.

Several factors have been key to this remarkable progress.

First, one cannot underestimate the impact of activism and social mobilisation against the inequity of access to care, as exemplified by Justice Edwin Cameron of South Africa, himself living with HIV, in his call to action at the International AIDS Conference in 2000. ''I exist as a living embodiment of the inequity of drug availability in Africa,'' he said. ''I stand before you because I am able to purchase health and vigour. I am here because I can pay for life itself.''

This is an activism that began in the global north and has spread to nearly every country in the world. It is a movement that has grown beyond AIDS to a global movement of citizens who have brought new life to the idea of health as a human right and new pressure on governments to fulfil their responsibilities.

Another key factor has been the global political commitment to funding health, beginning with the G8 meeting in Okinawa in 2000 and continuing through key instruments such as the Abuja declaration in 2001 committing African heads of state to dedicate 15 per cent of their national budgets to health by 2010, the UN General Assembly special session on AIDS 2001 and the Gleneagles G8 commitment to providing universal access to HIV treatment.

A third factor is what I would call ''innovation'' in the way in which aid is provided through new global mechanisms and partnerships, and in the way it is accounted for - increasingly, based on performance of programs.

In the case of AIDS treatment, delivery of what was once seen as a very complex intervention is now largely governed by simplified algorithms for health workers and nurses. Many patients receive routine care and adherence support, and have their prescriptions refilled, without ever seeing a doctor.

What the World Health Organisation calls ''task-shifting'' and a ''public health approach'' to treatment and care was seen as revolutionary only a decade ago and has forever changed our thinking about what can be achieved in chronic care in resource-limited settings.

The question today is whether this remarkable progress can be sustained and amplified as 8 million people are still in urgent need of treatment - in a global context that has changed significantly from what it was 10 years ago.

The world is no longer a relatively simple configuration of the G8 powers and the rest, or a global north and global south. Rather, we live in a multipolar world in which Brazil and Latin America, China, Australia and Indonesia, India, Russia, Africa, Western Europe and the US interact in complex ways, so the concept of global solidarity becomes increasingly subordinate to national and regional agendas, especially since the global financial crisis.

And while inequities between countries have decreased, and the overall proportion of people in extreme poverty has decreased, the inequities within countries are now increasing everywhere, particularly in middle-income countries and emerging economies.

There are now nearly twice as many people living below the threshold of poverty in middle-income countries as in low-income countries. Emerging economies will have to redistribute large amounts of funds to the social sector and prioritise social investments. It will make some governments feel very uncomfortable.

But there is a way forward as AIDS has shown - take the rollout of antiretroviral drugs over the past decade as a piece of inspiration. What many of us working in the field considered to be utopia not so long ago has become an achievable global target.

Finally, let's not forget the end game: inequities in health also systematically put groups of people who are already socially disadvantaged (for example, by virtue of being poor, female, and/or members of a disenfranchised group) at further disadvantage. Health is essential to overcome the other effects of social disadvantage. AIDS has shown us there are no excuses not to do so.

(source: www.theage.com.au)

 

Dr Margaret Chan
Director-General of the World Health Organization

Address to the Sixty-sixth World Health Assembly
Geneva, Switzerland
20 May 2013

Mister President, Excellencies, honourable ministers, distinguished delegates, friends and colleagues, ladies and gentlemen,

Ten years ago, the World Health Assembly met under a cloud of anxiety. SARS, the first severe new disease of the 21st century, was spreading explosively along the routes of international air travel, placing any city with an international airport at risk of imported cases.

By early July of that year, less than four months after the first global alerts were issued, WHO could declare the outbreak over. Rarely has the world collaborated, on so many levels, with such a strong sense of shared purpose.

Experiences during the SARS outbreak sparked extensive revisions of the International Health Regulations. These revisions gave the world a greatly strengthened legal instrument for detecting and responding to public health emergencies, including those caused by a new disease.

We are dealing with two new diseases right now.

Human infections with a novel coronavirus, from the same family as SARS, were first detected last year in the Eastern Mediterranean Region. To date, 41 cases, including 20 deaths, have been reported.

Though the number of cases remains small, limited human-to-human transmission has occurred and health care workers have been infected.

At the end of March this year, China reported the first-ever human infections with the H7N9 avian influenza virus. Within three weeks, more than 100 additional cases were confirmed. Although the source of human infection with the virus is not yet fully understood, the number of new cases dropped dramatically following the closing of live bird markets.

I thank China for collecting and communicating such a wealth of information, and for collaborating so closely with WHO. Chinese officials have promptly traced, monitored, and tested thousands of patient contacts, including hundreds of health care workers.

At present, human-to-human transmission of the virus is negligible. However, influenza viruses constantly reinvent themselves. No one can predict the future course of this outbreak.

These two new diseases remind us that the threat from emerging and epidemic-prone diseases is ever-present. Constant mutation and adaptation are the survival mechanisms of the microbial world. It will always deliver surprises.

Going forward, we must maintain a high level of vigilance. I cannot overemphasize the importance of immediate and fully transparent reporting to WHO, and of strict adherence to your obligations set out in the International Health Regulations.

As was the case ten years ago, the current situation demands collaboration and cooperation from the entire world. A threat in one region can quickly become a threat to all.

Ladies and gentlemen,

The debate on the place of health in the post-2015 development agenda continues to intensify. The Millennium Development Goals strongly influenced resource flows. Competition among multiple sectors for a place in the new agenda is fierce – very fierce.

I ask Member States to do everything they can to ensure that health occupies a high place on the new development agenda.

Health contributes to and benefits from sustainable development and is a measurable indicator of the success of all other development policies. Investing in the health of people is a smart strategy for poverty alleviation. This calls for inclusion of noncommunicable diseases and for continued efforts to reach the health-related MDGs after 2015.

At the same time, I want to assure you that efforts to reach the health-related Millennium Development Goals have accelerated during these last thousand days.

This is especially true for women's and children's health, and this is especially encouraging. Accelerating efforts to reach these two goals means accelerating efforts to overcome some very long-standing barriers to service delivery.

A new Integrated global action plan for the prevention and control of pneumonia and diarrhoea was released by WHO and UNICEF last month. The plan focuses on the use of 15 highly effective interventions. Each one can save lives. When the 15 are put to work together, this is powerhouse that can revolutionize child survival.

The newest vaccines and best antibiotics are included, but so are some time-tested basics, like breastfeeding, good nutrition in the first 1000 days, soap, water disinfection, sanitation, and the trio of vitamin A, oral rehydration salts, and zinc.

Equally impressive are the ingenious delivery solutions, worked out by front-line workers, for reaching the poor and hungry children who are most at risk.

I find this integrated delivery approach an exciting way to move forward. The tremendous success in controlling the neglected tropical diseases clearly tells us that integrated strategies can stretch the impact of health investments. They can stretch the value of development dollars.

Ladies and gentlemen,

I am most pleased to inform you that well over 9 million people living with HIV in low- and middle-income countries are now seeing their lives improved and prolonged by antiretroviral therapy. This is up from 200,000 people just eleven years ago. This is the fastest scale-up of a life-saving intervention in history.

WHO progressively simplified testing and treatment approaches to make it possible to deliver high-quality care in some of the poorest settings in the world. Prices dropped dramatically. Treatment regimens became safer, simpler, and more effective. Sites for testing and treatment moved closer to people's homes, and they are trusted and used.

The value of HIV treatment is now well recognized. Where external funding has levelled off, domestic funding has stepped in to ensure continued scaling up of treatment. In June, WHO will simplify things further by issuing revised, consolidated guidelines for the use of antiretroviral drugs for both HIV treatment and prevention.

For tuberculosis and malaria, recent progress has been encouraging, but is increasingly threatened by the spread of resistance to mainstay medicines. If we are not careful, all the hard-won gains can go down the drain.

Efforts to stimulate the development of new medical products are critically important for every country in the world. The spread of antimicrobial resistance is rendering more and more first-line treatments useless.

Some observers say we are moving back to the pre-antibiotic era. No. With few replacements in the pipeline, medicine is moving towards a post-antibiotic era in which many common infections will once again kill.

Health care cannot afford a setback of this magnitude. We must recognize, and respond to, the very serious threat of antimicrobial resistance.

Last month, I attended the Vaccine Summit in Abu Dhabi. Participants explored how the Global Vaccine Action Plan can be used as a roadmap to save more than 20 million lives by 2020 by expanding access to ten existing vaccines.

Polio eradication was given special attention as a milestone in this visionary roadmap. A comprehensive eradication and endgame strategy was issued last month and discussed during the summit. Participants appreciated the strategy's many innovations and expressed the view that it has a very good chance of success.

I agree, but am fully aware of the challenges we face. Insecurity continues to compromise the eradication effort. We mourn the many polio workers who have lost their lives trying to deliver vaccines.

Importations continue to threaten polio-free countries. As we speak, we are responding to new outbreaks.

Ladies and gentlemen,

Research, evidence, and information are the foundation for sound health policies, for monitoring the impact, and for ensuring accountability. They keep us on track.

The World Health Statistics report, issued last week, brings some extremely good news. The past two decades have seen dramatic improvements in health in the world's poorest countries. Progress has been equally dramatic in narrowing the gaps between countries with the best and the worst health outcomes.

The Millennium Development Goals, with their emphasis on poverty alleviation, have unquestionably contributed to these encouraging trends.

We have a right to be proud of recent achievements, and also of the many innovative mechanisms and instruments that were created in the drive to reach the goals. They brought out the very best in human ingenuity and creativity.

At the same time, I need to remind you that what lies ahead, especially as we tackle noncommunicable diseases, is not going to be easy.

Today's health challenges are vastly different from those faced in the year 2000, when the Millennium Declaration was signed. Efforts to safeguard public health face opposition from a different set of extremely powerful forces.

Many of the risk factors for noncommunicable diseases are amplified by the products and practices of large and economically powerful forces. Market power readily translates into political power.

This power seldom impeded efforts to reach the MDGs.

No PR firms were hired to portray the delivery of medicines for HIV and TB as interference with personal liberties by the Nanny State, with WHO depicted as the Mother Superior of all Nannies. No lawsuits were filed to stop countries from reducing the risks for child mortality.

No research was funded by industry to cast doubt on the causes of maternal mortality. Mosquitoes do not have front groups, and mosquitoes do not have lobbies.

But the industries that contribute to the rise of NCDs do. When public health policies cross purposes with vested economic interests, we will face opposition, well-orchestrated opposition, and very well-funded opposition.

WHO will never be on speaking terms with the tobacco industry. At the same time, I do not exclude cooperation with other industries that have a role to play in reducing the risks for NCDs.

There are no safe tobacco products. There is no safe level of tobacco consumption. But there are healthier foods and beverages, and in some cultures, alcohol can be consumed at levels that do not harm health.

I am fully aware that conflicts of interest are inherent in any relationship between a public health agency, like WHO, and industry.

Conflict of interest safeguards are in place at WHO and have recently been strengthened. WHO intends to use these safeguards stringently in its interactions with the food, beverage, and alcohol industries to find acceptable public health solutions. WHO will continue to have no interactions whatsoever with the tobacco industry.

As I said, this is not an easy time ahead. As just one example, not one single country has managed to turn around its obesity epidemic in all age groups. Just this one example makes us reflect on the importance of adopting the right policy options.

The UN political declaration on NCDs clearly states that prevention must be the cornerstone of the global response. I agree. Yet even if prevention were perfect, we would still have clinical cases of heart disease, diabetes, cancer, and chronic respiratory disease.

The response to NCDs depends on prevention but also on clinical care which is cost-effective and financially sustainable. This is another challenge that lies ahead.

Ladies and gentlemen,

You will be considering three draft global action plans, for noncommunicable diseases, mental health, and the prevention of avoidable blindness and visual impairment.

All three plans call for a life-course approach, aim to achieve equity through universal health coverage, and stress the importance of prevention. All three give major emphasis to the benefits of integrated service delivery.

Global strategies and action plans make an important contribution to international coordination and promote a unified approach to shared problems.

But sound health policies at the national level matter most.

Public health has known for at least two decades that good health can be achieved at low cost, if the right policies are in place.

We know this from comparative studies of countries at the same level of economic development that reveal striking differences in health outcomes.

Last month, a study from the Rockefeller Foundation revisited this issue with new data from a number of countries. That study leads me to a positive conclusion.

Member States, we are doing a lot of things right, on the right track.

According to the study, factors that contribute to good health at low cost include a commitment to equity, effective governance systems, and context-specific programmes that address the wider social and environmental determinants of health. An ability to innovate is also important.

Specific policies that can make the greatest difference include a national medicines policy that makes maximum use of generic products, and a commitment to primary health care and the education and training of health care workers, which is fast becoming a top priority in many countries.

Above all, governments need to be committed and they need to have a vision set out in a plan.

This is also true for WHO.

The 12th General Programme of Work sets out a high-level strategic vision for WHO, with priorities and an overall direction. It aims to make the work of WHO more strategic, more selective, and more effective.

For the first time, the proposed Programme Budget provides a view of all financial resources, from all sources, thus giving Member States an opportunity to approve and monitor the budget in its entirety.

Ladies and gentlemen,

We are living in deeply troubled times.

These are times of financial insecurity, food insecurity, job insecurity, political insecurity, a changing climate, and a degraded environment that is asked to support more than it can bear.

These are times of armed conflict, hostile threats among nations, acts of terrorism and mass violence, and violence against women and children.

Large numbers of people are living on edge, fearing for their lives.

Insecurity and conflict mar several parts of the world, endangering the health of large populations.

WHO is aware of reports of assaults on health personnel and health care facilities in conflict situations.

We condemn these acts in the strongest possible terms. Conflict situations sharply increase the need for health care. I cannot emphasize this point enough.

The safety of facilities and of health care workers must be sacrosanct.

Ladies and gentlemen,

In these troubled times, public health looks more and more like a refuge, a safe harbor of hope that allows, and inspires, all countries to work together for the good of humanity.

This is what you are doing, and we see the results.

Fear of new diseases can unite the world, but so can determination to relieve preventable human misery.

This is what makes public health stand out from other areas of global engagement: the motives, the values, and the focus.

We know we have to influence people at the top, but it is people at the bottom who matter most.

Nothing reflects this spirit better than the growing commitment to universal health coverage.

Universal health coverage reflects the need to maximize health outcomes for everyone. Everyone, irrespective of their ability to pay, should have access to the quality health care they need, without risking financial ruin.

A focus on universal health coverage continues the strong emphasis on equity and social justice articulated in the Millennium Declaration and in The Future We Want, the outcome document of the UN Conference on Sustainable Development.

I am inspired by your commitment to universal coverage. Nothing gives me greater cause for optimism, or a greater sense of pride and privilege to work as the head of this agency.

I thank my staff for their dedication, wisdom, and experience. They are unbeatable.

I thank Member States for caring so much about health, nationally, regionally, and internationally.

I thank them for doing so much to improve the relevance, efficient performance, and measurable impact of the work of WHO, at all three levels.

We need to keep doing the right things, on the right track. The world's people depend on this Organization for so much.

And our work creates benefits that extend beyond health.

By increasing fairness in access to care and equity in health outcomes, our work contributes to social cohesion and stability, and these are assets that every single country in the world would like to have.

I encourage you to keep doing the right things, on the right track. It is my great privilege to support you.

Thank you.

 

www.who.int

Indonesia's pilot health insurance scheme, introduced in November last year, was a good effort to solve the health issues of over 5 million poor people residing there. Unfortunately, it didn't quite work.

What the state officials didn't prepare for, was a major kink in the plan –– with long queues forming at already crowded hospitals and healthcare centers with patients that were not even ill, and were merely seeking advantage of the health insurance, a sick baby was turned down by 10 hospitals, after which she succumbed to her respiratory complications.

Lisa Darawati, mother of Dera, who was merely one-week old and was born premature, sought medical help from 10 different hospitals in Jakarta, all of which were either too crowded, or lacked proper medical equipment to treat Dera. The death of Dera has now given rise to an outcry in the local media, with all the 10 hospitals being blamed.

"If Jakarta itself is not ready, I don't know how we can say other less advanced cities can be ready," Palmira Bachtiar, senior researcher at Indonesia's private SMERU Research Institute, said.

This scheme, which was actually planned to help save lives and provide proper medical care to the poverty-stricken and lower-income individuals in the area, has failed, as unexpectedly long queues and crowded hospitals became an every-day problem, with people coming in and trying to make use of the health insurance as far as possible.

"If we did not start in November, there would be 500,000 people sick, but at home," Jakarta governor Joko Widodo told Reuters during a recent interview.

The Jakarta pilot scheme, which was developed 'ideally', suggested that the patients go to a clinic first, get a referral from a physician if they actually require services from a hospital, and then visit the hospital. This pattern, if followed, may prevent overcrowding and help things move more smoothly, thus preventing many more tragic deaths like that of Dera.

More hospital beds are needed, according to Widodo, and with the number of patients in the hospitals jumping a whopping 70 percent of that before, this seems to be true.

"Universal healthcare is a game-changer ... and if companies are not prepared for that then they are going to lose out," Emmanuel Wehry, chief Indonesia marketing officer for French insurer AXA Financial said.

With a rough estimate of $13-$16 billion being used in this insurance scheme, if it is fully implemented, this healthcare program may prove to be quite useful, especially for those below the poverty line.

Most of the patients are being treated properly, health minister Dr. Nafisa Mboi claimed, even with the number of patients at Cipto jumping 25 percent since the introduction of the pilot program.

Seems like there's definitely a lot that the people of Indonesia can gain from this program. What it needs is some proper management.

(source: www.itechpost.com)