Your Excellency Macky Sall, President of the Republic of Senegal,
Mr Abdoulaye Diouf, Minister of Health and Welfare,
Dr David Parirenyatwa, chair of the Regional Committee,
My sister Dr Tshidi Moeti, WHO Regional Director for Africa,
Excellencies, colleagues, friends,
It’s good to be home.
In the past year, I’ve had the privilege of traveling to every continent except Antarctica. But I always love coming home to Africa.
Africa is special to me, of course, because it is the continent of my birth. But it is also special to WHO because it’s here, more than anywhere else, that our mission to leave no one behind will be won or lost.
It’s here in Africa that the inequalities of our world are most painfully apparent.
And yet it’s here in Africa that our world’s future lies.
It’s Africa that is home to the world’s richest resources – not the minerals that lie buried under ground, but the hope and vitality of its young people.
Africa is home to the world’s youngest population and some of the world’s fastest-growing economies. It’s increasingly a hub of innovation, including in health.
It’s that Africa that brings us here. It’s that Africa that I am working for – that you are working for.
A lot has happened since I stood before you in Victoria Falls a year ago.
For the past year, we have been laying the foundations for the future.
At the World Health Assembly in May, you and all the Member States approved the General Programme of Work – our five-year strategic plan.
Let me remind you what we have committed to:
1 billion more people benefitting from universal health coverage;
1 billion more people better protected from health emergencies;
and 1 billion more people enjoying better health and well-being.
These are the targets we must achieve together by 2023 if we are to achieve the Sustainable Development Goals.
They are ambitious targets, and deliberately so. If we aim for mediocrity, we will certainly achieve it. But if we aim for what seems impossible, we will achieve more than we ever imagined we could.
But a plan on its own is not enough to succeed.
That’s why we’ve developed an investment case, to make sure we have the resources to succeed.
And it’s why we have built a strong leadership team, to make sure we have the people to succeed.
And it’s why we have begun a transformation project, to ensure we have the structures and processes to deliver results.
I know what many of you are asking: So now what?
Now we embark on the task of turning a plan into a reality. Now is the time to show that we are good to our word.
This is not a task for WHO alone. This is a task for all of us – the Member States, the Secretariat, donors, partners, civil society, academia and the private sector.
The people of the world deserve nothing less. The people of Africa deserve nothing less.
In the past year I have visited 13 of your countries. In each, there are achievements to celebrate, and challenges to address, for each of the three “triple billion” targets.
Many countries are taking bold steps towards universal health coverage.
For instance, in January this year I had the honour of travelling to Kenya to meet with President Kenyatta in Nairobi.
The President has made affordable healthcare one of the four pillars of his administration, and he has asked WHO for assistance. We have been working closely with the ministry to design a benefit package and provide policy advice on health financing.
South Africa is another example. It’s National Health Insurance bill, if it passes parliament next year, will help ensure that all South Africans get the health services they deserve.
Similar things are happening in many other countries. Some, like Madagascar, are at the beginning of their journey. Others like Rwanda started many years ago and have made enormous progress.
We are seeing encouraging signs. The number of people being pushed into extreme poverty by health spending is going down.
But there is an increase in those spending more than 10 percent of their household budget on health.
In other words, people are getting wealthier, but more and more of their income is being spent on health.
This forces them to make choices no one should have to make: between medicine and food; between surgery and school books; between investing in the future and just staying alive.
There’s a similar story to tell on service coverage.
For example, we estimate that without action, the world will face a shortfall of 18 million health workers by 2030. Six million of them will be in this region.
That shortfall not only leaves people without support for their everyday health needs, it leaves a huge hole in the region’s defences against outbreaks and other emergencies.
Investing in health workers is therefore not only an investment in a healthier Africa, it’s an investment in a safer Africa.
As you have heard me say many times before, universal health coverage and health security are two sides of the same coin.
It’s not either/or. We must do both – invest in strengthening the health systems that prevent and mitigate emergencies, even as we invest in preparedness and response.
Just as we see progress and challenges on UHC, we also see progress and challenges on our work on emergencies.
As Dr Moeti said, in the past four months we have responded to not one, but two Ebola outbreaks.
Both have put our preparedness and response systems to the test.
I visited DRC during both outbreaks. I’ll say more about my personal reflections later, but it’s clear that the hard work we have done is paying off.
Of course, Ebola is one of many emergencies WHO is responding to. In the coming months we will be focusing on preparedness and surveillance in fragile, conflict-affected and vulnerable states.
While outbreaks and other health emergencies capture global attention, individuals and families face their own emergencies every single day.
That’s why we have set a target for improving health and well-being.
Here also, we also see progress and challenges.
Life expectancy in Africa increased by 10 years since 2000 – that’s double the global average.
But there remains an 11-year discrepancy in life expectancy between this region and the global average.
That’s why we have included several platform initiatives in the GPW, to target the leading causes of death and disease.
We’ve introduced the 10 plus 1 initiative, to get the world back on track for the malaria targets – especially in Africa, which is home to 90% of the global malaria burden.
We’ve introduced new guidelines to treat multidrug-resistant tuberculosis.
We’ve committed to eliminating cervical cancer.
We established a commission on noncommunicable diseases and mental health, to accelerate action against what are now the leading causes of death in Africa.
We must fight all of these threats with the same urgency as we fight a sudden outbreak.
As I said at the World Health Assembly in May, I see three keys to success: political commitment, partnership, and a transformed WHO.
We are already seeing very positive signs of political commitment in some of the countries I have mentioned.
Ultimately, it is not the WHO Secretariat that will achieve the “triple billion” targets or the SDGs – it’s you.
It’s you as political leaders who are accountable for the decisions you make and the results you achieve.
WHO’s role is to give you the best support we can.
That’s why we have developed tools like Joint External Evaluations and multisectoral action plans for NCDs – to help you exercise that responsibility.
But we know that none of us can achieve anything on our own. To achieve the SDGs, we need innovative and dynamic partnerships – partnerships with a purpose.
As you know, earlier this year President Akufo-Addo of Ghana, Chancellor Merkel of Germany and Prime Minister Solberg of Norway wrote to WHO, asking us to develop a Global Action Plan on health and well-being.
They recognize that achieving SDG 3 will not happen by accident. It will not happen if all of us just do our own thing. It will not happen if fragmentation and duplication continue.
But it can happen if we work together. It can happen if the array of actors on the global health stage leverage their collective strength.
This can only happen with a change of mindset. Instead of competing for a bigger slice of the pie, we must all work together to make a bigger pie.
WHO is not in competition with any other agency or organization. We are in competition with anything and everything that threatens human health. We are in competition with disease. We’re in competition with insecurity. We’re in competition with inequality.
That is why it is essential that the global health community works together.
In the coming weeks and months, you will be hearing more about how WHO is transforming to put countries at the centre of everything we do.
But the clearest example is our budget for 2020 and 2021.
The budget has been developed based on country priorities. Its focus is on strengthening the capacity of our country offices to deliver impact.
You will hear that we are proposing an almost 30% increase in technical capacity for country offices, while the headquarters budget will stay flat.
And I’m pleased to say that AFRO is receiving the biggest share of this increased investment in country capacity.
This is what it means to put countries first. This is part of our commitment to leaving no one behind.
Of course, the African region is ahead of the curve on transformation. I especially want to thank and congratulate Dr Moeti for her leadership, and for the change she is delivering.
Of course, our own transformation is linked closely with the wider UN reforms.
Both the GPW and the new UN Resident Coordinator system will take effect as of the 1st of January next year.
This is a great opportunity for us to become more effective – to deliver as one.
We must break out of our silos and work together with colleagues from across government and across the UN family.
That is exactly what the Sustainable Development Goals demand of us.
Because if we succeed in achieving the ambitious targets of the GPW; if we succeed in achieving SDG 3, we will not only achieve better health and well-being for billions of people, we will drive progress towards ALL of the SDGs.
That’s why the best investments are in human capital – in people.
Universal health coverage helps lift people out of poverty by eliminating one of its causes. It enables children to learn. It gets people back on their feet and back to work. It unleashes human creativity. It powers economic growth. It’s the platform for individuals, families, communities and entire nations and continents to flourish.
With good health, anything is possible.
In the words of one of the great sons of Africa, Nelson Mandela: “Health cannot be a question of income; it is a fundamental human right.”
That is what the nations of the world affirmed when they established WHO 70 years ago.
It’s why WHO is still here, working every day to promote health, keep the world safe and serve the vulnerable.
Thank you so much. Merci beaucoup.