Statement – Sustainability of health care frameworks during the pandemic

Dr Hans Henri P. Kluge statement to the Virtual Symposium on the Impact of the COVID-19 Pandemic and HIV on SDG 3.3

organized by Dr Anna Popova, Head of the Federal Service for Surveillance on Consumer Rights Protection and Human Well-being – Chief State Sanitary Physician of the Russian Federation, and Winnie Byanyima, Executive Director of the Joint United Nations Programme on HIV/AIDS

28 July 2020

Dear Anna Yurievna, Mrs Byanyima, colleagues in public health, and friends,

First, allow me to thank Dr Anna Popova, our Russian Federation counterparts, and UNAIDS Executive Director Byanyima for organizing this virtual symposium.

As we speak, more than 3.2 million COVID-19 cases and 210 632 deaths are reported in the Region, with the eastern part of the Region being particularly affected at this moment. Our thoughts remain with those that have lost loved ones and community members over the past 6 months.

There are many lessons that will be taught as a result of the COVID-19 pandemic but we have already learnt one the hard way: Many health systems were not prepared, and even the strongest systems were overwhelmed and often unable to ensure care for people with other conditions such as HIV and immunization.

For this reason, as we look forward, health systems need to maintain what we at WHO call a dual track – which means to be on the alert to expand capacity to deal with a resurgence of COVID-19 and, at the same time, to maintain essential health services.

Ultimately, this will require far better integration between communities, primary care and hospitals, and placing health at the centre of an interconnected country political agenda.  This is the essence of the SDGs, and the opportunity that a sound COVID-19 recovery plan presents.

Currently, COVID-19 threatens the delivery of HIV services.

While we have made tremendous progress, particularly in eastern Europe and Central Asia, HIV services are still in great demand and, unfortunately, these are still out of reach for many.

In the last decade, incidence of HIV increased by 22% in the WHO European Region while, in 2018, half of those diagnosed with HIV were diagnosed in the late stages of infection.

In addition, coverage of antiretroviral (ARV) treatments remains low, and particularly in the eastern part of the Region, COVID-19 threatens to exacerbate this situation.

What we know now is that, due to COVID-19, seven countries in our Region have reported ARV disruptions. But we are yet to fully quantify the disruptive impact of COVID-19 on the overall HIV epidemic across the Region.

The good news is that there are also major lessons we can draw from this pandemic.

  1. International solidarity is an effective response – where it has failed, the response has failed. No one is safe until everyone is safe. And no one should be left behind!
  2. The debate between life and livelihood is a false debate. We have targeted policy recommendations for countries to maintain their economic and education systems while combatting community transmission of COVID-19.
  3. Health systems were not prepared for a pandemic of this scale and speed. We need strong health systems based on strong primary health care which integrate public health functions at the community level. And we need risk communication to engage the whole of society. In fact, what we need is the implementation of the Astana Declaration on Primary Health Care.

As we look forward, our health systems need sustainable investments and mechanisms to bridge health care services with communities to reach all populations, especially those most vulnerable. This is even more relevant when we talk about services for people living with HIV.

Let me be clear – our individual and collective response is a major opportunity not only to control and prevent COVID-19 in the future, but also to recover from it stronger, and to build the resilient health systems we need.

We are now before an unprecedented opportunity since strengthening the health system is now at the centre of global, national, political and financial agendas.

It must be our common calling to translate this opportunity into tangible gains in improved health and well-being on the ground for our people across the Region.

Ladies and gentlemen, colleagues,

We are in the position to strengthen and rebuild the health system of the future; one that is equitable, emphasized on the community, and anchored in a country’s economic and social agenda that leaves no one behind.

To make this transformational change, we need a collective effort. We need European and global leadership which is based on innovation, courage and collaboration. Last week, I participated at the meeting of the Ministers of Health of the Shanghai Cooperation Organization (SCO), chaired by the Minister of Health of the Russian Federation, Mihail Albertovich, to discuss COVID-19. I was very encouraged by the leadership of the SCO!

The SDG Forum planned to be hosted in October by the Russian Federation will set the stage for an even stronger partnership to achieve SDG 3.3 in our Region.

Achieving universal health coverage means ensuring equitable access to quality HIV services for people living with HIV in the Region.

My vision for the Region is to see a culture of health and an economy of well-being which puts its people in the centre; provides a safety net for everyone; contributes to environmental sustainability; safeguards livelihoods; and, importantly, leaves no one behind. This is at the heart of the WHO European Programme of Work, entitled “United Action for Better Health”.

I want to ensure you that, as the Regional Director for the WHO European Region, I will do my share to take into account the lessons learned from the COVID-19 pandemic, and transform our Regional Office in Copenhagen and our country offices into a modern organization that is agile, innovative, results-oriented, and digital – to better serve our Member States and their people with 2 goals:

  • to leave no one behind; and
  • to strengthen the leadership of health authorities.

But we can only do it together. You can count on me, and I will count on you.

Thank you.