Address by Dr Tedros Adhanom Ghebreyesus, WHO Director-General at the 69th session of the WHO Regional Committee for Europe
16 September 2019, Copenhagen, Denmark
Your Royal Highness, Crown Princess Mary,
Mr Magnus Heunicke, President of the 69th Session,
Mr Ioannis Baskozos, Executive President,
Dr Zsuzsanna Jakab, Regional Director,
Professor Ola Rosling,
Honourable ministers, distinguished heads of delegation,
Dear colleagues and friends,
God morgen. I’m delighted to be back in Copenhagen – a city with which I have a deep personal connection and very fond memories.
Actually, Copenhagen shaped me to believe in universal health coverage. This is the country where I had health insurance for the first time in my life, at age 23.
I was here for four months, but I got health insurance for one year. I was curious, because I thought if they’re covering their visitors, what does the health system look like for Danes?
Then I found out that all Danes are covered, and that influenced me to think that universal health coverage is possible, and has made me a strong advocate for UHC.
But not only Denmark. I did my Masters in the UK three years after that, in 1991, and I saw the NHS first-hand. I was surprised to learn when the NHS started in the UK, which was immediately after the Second World War, when the economy was on its knees.
That was a big lesson for me. As part of my PhD I studied in Sweden, which also reinforced my belief in UHC.
In Denmark I have even more memories – there were more bicycles than cars, and a separate lane for bicycles.
Thank you so much, Denmark, for influencing me to become a believer in universal health coverage.
Thank you, Your Royal Highness, for your support for WHO, your leadership in health and for your inspiring remarks this morning. Please accept my deepest thanks and respect and appreciation.
I’m also delighted to be here for my sister Zsuzsanna’s last Regional Committee meeting as Regional Director.
Under her leadership, the Region has made great progress over the past decade.
A key part of the Region’s work over the past 10 years has been Health 2020, the policy framework adopted by Member States to improve health outcomes and reduce health inequities.
There are many successes to celebrate, as you know.
Life expectancy in this region is increasing, and the gaps in life expectancy between countries and between men and women are narrowing.
Infant and maternal mortality have both fallen.
Premature mortality from noncommunicable diseases is declining, and you are on-track to reach the SDG target. This is very impressive. You are setting an example for the world and you should be proud.
Most countries now have a policy or strategy to address the determinants of health and inequalities in health.
The Regional Office has also been at the forefront of efforts to address the health of refugees and migrants, and to deal with the threat of antimicrobial resistance.
We should celebrate these achievements.
And yet significant challenges remain for the next Regional Director, and for you as Member States.
There are still large inequities within and between countries.
For example, there is a more than 10-year gap between the countries with the shortest and longest life expectancies.
Tobacco use remains unacceptably high and alcohol consumption is the highest in the world.
Overweight and obesity are rising.
Out-of-pocket health spending accounts for more than 30% of total health spending in more than 20 countries, due largely to the cost of medicines.
Vaccination rates are high across the region, but again, with significant variation.
Because of low coverage nationally or in pockets within countries, measles outbreaks are spreading rapidly.
Globally, the number of reported measles cases globally doubled last year from 2017, and the number of cases so far this year is already more than any year since 2006.
As you know, four European Member States recently lost their measles-free status. This is not acceptable.
The Vaccination Summit in Brussels last week was a timely opportunity to revitalize commitment for closing these gaps.
Once again, Your Royal Highness, we thank you for your invaluable support for immunization.
Health 2020 expires next year, but its goals are well-aligned with both the Sustainable Development Goals and WHO’s General Programme of Work.
As you know, the catch-cry of the SDGs is to leave no-one behind.
We cannot tolerate a world – or a region – where the rich get healthy and the poor get sick.
We are committed to health for all, not health for some.
The resolution before you on accelerating progress towards equity is therefore central to our mission.
Strong leadership in public health to reach our triple billion targets will also require your continued political commitment.
The health challenges you are facing have one thing in common: they all require a response that goes beyond the health sector.
Very often, by the time people present at our clinics and hospitals, the damage has been done.
To achieve a healthier Europe, we must go beyond the health sector to address the root causes of disease in the air we breathe, the food we eat, the water we drink and the conditions in which we live.
That is a key focus for WHO as part of our transformation and the “healthy populations” pillar we have established.
No country can afford simply to sit back and treat the effects of tobacco use, harmful alcohol consumption and unvaccinated children.
We must be relentless in our efforts to promote health and prevent disease.
This is the unfinished business of Health 2020, and you have to continue this work with determination – attacking the root cause of the problem. We cannot continue to manage diseases, we have to promote health.
Within the region, the regional collaboration for health with parliaments is especially important.
At the Interparliamentary Union meeting in Serbia next month, we are expecting a resolution on universal health coverage to pass.
Harnessing the support of parliaments is vital for creating the regulatory and policy environment for health.
In Astana last year, the world came together to recommit to primary health care as the foundation of universal health coverage.
The High-Level Meeting on Universal Health Coverage at the UN General Assembly next week will echo that call.
Secondary and tertiary health services are of course an important part of every health system, but the more we can prevent or delay the need for them, the better. Primary health care is central.
The agenda item on accelerating progress on primary health care is an excellent step towards translating political commitment into concrete policy ideas.
The 10 policy accelerators cover a wide range of evidence-based interventions that can improve the performance of health systems and health outcomes.
I’m very pleased to see that each of them also comes with specific “digital pointers” for using modern technologies to implement the accelerators.
Digital health is a key focus for WHO as part of our transformation.
We all know that the future of health is digital, and we want WHO to be ahead of the curve on that.
Artificial intelligence and digital technologies are changing the way health care is delivered right across the continuum of care.
WHO has a unique role to play in advising countries on how to maximize the opportunities of digital technologies, while avoiding the pitfalls with appropriate regulation.
That’s why WHO has created a new Department of Digital Health, to enhance our role in assessing digital technologies, and support countries to make decisions about how to prioritise, integrate and regulate them.
Harnessing the power of digital technologies for health is vitally important.
But the best asset we have for improving the health of people – is people.
People may only interact with the health system rarely. But every day, they make many decisions that affect their health in small ways.
We must empower people to become active participants in their own health, rather than simply passive recipients.
Progress can be made on many of the health challenges you are facing – tobacco and alcohol use and vaccination, for example – by arming people with the information they need to make healthy choices.
The European roadmap for implementation of health literacy is an excellent first step, and I look forward to seeing the action plan to be developed in the next phase. I commend you for this.
But Member States don’t need a roadmap or an action plan to take action.
The roadmap includes several examples of countries that have taken the initiative to improve health literacy.
WHO stands ready to work with all Member States to develop and implement initiatives that put people in charge of their own health. It has to be people-centred.
Your Royal Highness, Excellencies, colleagues and friends,
WHO is committed to a healthier, safer and more equitable Europe.
And we are committed to becoming the organization you need us to be.
Since we last met 12 months ago, the Regional Directors and I have been hard at work transforming WHO into an agile organization that works seamlessly across all 3 levels to deliver the Sustainable Development Goals. That’s why I poached Zsuzsanna from here!
We now have a new programme budget to support the General Programme of Work.
To build this new budget, we turned our planning process upside down, so that country needs drive the work of headquarters and the regions.
For the first time in our history, all three levels of the organization have worked together to define exactly what headquarters will produce in the coming biennium.
As a result, we now have a list of more than 300 specific “global public health goods” – the technical tools you need to make progress towards the “triple billion” targets. All these came from the grass-roots.
But we’re not just changing what we do, we’re also changing how we do it.
Our new operating model aligns the organization at all three levels and will enable us to work together more effectively and efficiently.
We are planning together how we can best support country priorities.
We are working hard to make the organization result-oriented and to achieve these results particularly at the country level.
One of our key priorities was to make sure every single WHO employee can connect their work to the corporate priorities.
Today, 75% of staff can link their day-to-day work to the General Programme of Work, compared with only 47% at the start of this year.
We are also committed to increasing diversity across the organization. We’ve already achieved several quick wins.
We have started rolling out 13 new or redesigned processes to harmonize and optimize the way we do business, from the way we develop norms and standards, to planning, monitoring implementation and results, recruitment, procurement, communications and more.
And we have announced plans for the WHO Academy, a major initiative to revolutionize health learning globally and train health workers to implement WHO norms and standards. The Academy, we believe, will be a game-changer in global health.
The agreement was signed with His Excellency President Macron, and the academy will be based in Lyon.
Excellencies, colleagues and friends,
I leave you with three challenges for the next year.
First, address the root causes of disease.
Our job as public health professionals is not simply to run a health system – it’s to build nations and communities in which health can flourish.
For that, we must engage actively with colleagues in finance, trade, agriculture, energy, transport, industry and more. We need to address the root causes and promote health. We shouldn’t continue to manage diseases.
Second, commit to strengthening health literacy.
As I said, our best asset for protecting the health of people – is people, and in that you’re in the right direction.
When they have accurate, reliable information, people can be empowered to make decisions that protect their own health, and that of their families and communities.
Third, prioritize primary health care.
Most of the challenges you are facing must be addressed at the primary level.
Primary health care is where health is promoted and diseases are prevented. When everyone in a population has access to quality primary health care services, inequalities are reduced and outcomes are improved.
As the Astana Declaration affirms, primary healthcare is the foundation for achieving universal health coverage.
The high-level meeting on universal health coverage in New York next week is a vital opportunity to catalyze political commitment for primary health care.
We look forward to having the support of as many of your Heads of State and Heads of Government as possible.
Finally, my sister Zsuzsanna, congratulations on 10 years of serving the people of Europe. You have much to be proud of, and you have left the Regional Office in good shape for your successor.
I very much enjoyed working with you in the Global Policy Group, and I’m delighted to be working with you now in your new role as my Deputy Director-General.
Europe’s loss is the world’s gain. I also know that the Member States shaped Zsuzsanna. She contributed, you contributed to what she is now.
I look forward to working with the next Regional Director. They have a hard act to follow!
My brother and sisters, thank you for your commitment and support.
I wish you a very productive meeting as we work together to promote health, keep the world safe and serve the vulnerable.
Thank you so much. Vielen Dank. Merci beaucoup. Spasiba. Muchas gracias. Tak skal du have.
