Your Excellency President Mokgweetsi Masisi,
Your Excellency, First Lady Neo Masisi,
Honourable Minister Dr Edwin Dikoloti,
Honourable Minister of Health of the Republic of Togo, Professor
Moustafa Mijiyawa,
And representing him and the vice chair, Honourable Minister of Health of Uganda, Dr Jane Ruth Aceng,
UN Resident Coordinator Zia Choudhury,
Africa CDC Director-General, my brother, Dr Jean Kaseya,
My sister Regional Director Dr Tshidi Moeti,
Honourable Ministers and heads of delegation,
Dear colleagues and friends,
Dumelang, Good morning to you all;
I thank Your Excellency President Masisi, as well as the Government and people of Botswana, for your hospitality in hosting this meeting.
I also join my sister Dr Moeti, and of course my brother Jean, in congratulating you for your achievements in health here in Botswana in recent years, especially in your response to HIV. That comes from the strong commitment you have for Health for All. You see universal health coverage in action in Botswana. I visited yesterday the Julia Health Centre and of course I know about the health service delivery in Botswana and thank you so much for your commitment to universal health coverage.
In 2021, WHO certified Botswana for reaching the silver tier on the path to eliminating mother-to-child transmission of HIV, and in 2022 Botswana reached the 95-95-95 targets for testing, treatment and viral suppression of HIV - one of only five countries to do so.
In the fight against cervical cancer, Botswana was among the first countries in the region to introduce the HPV vaccine.
Botswana and South Africa were also the first countries to detect the Omicron variant of SARS-CoV-2 and to warn the world, even though some countries responded by imposing unjustified travel bans, which we all remember.
Following this morning's opening ceremony, I look forward to attending a signing ceremony to establish the Botswana National HIV Reference Laboratory, where Omicron was identified, as a WHO Collaborating Centre. And this in recognition of the excellence of the centre. And it will be one of the 25 centres that we have in the region, and 25 is very few. This is a recognition of the excellence of the centre, and we look forward to working closely with the centre. I know the world will benefit from the excellent service this centre has. This new collaborating centre is joining a global network to contribute globally.
I also offer my warm congratulations to all Botswana on the achievements of Letsile Tebogo at the World Athletics Championships in Budapest. I know this is a source of great national pride for you, and so it should be. I would like to use this opportunity also to congratulation my home country, and they think they have achieved a lot, and especially the current president of the federation is an amazing lady.
===
Excellencies,
As you know, in May this year I declared an end to both COVID-19 and mpox as public health emergencies of international concern.
Although neither represents a global health emergency, both continue to represent a threat to health.
In the past few weeks, I have issued standing recommendations to support countries to manage both diseases in the long-term.
I urge all Member States to implement those recommendations, and in particular to strengthen surveillance, sequencing and reporting so we can assess the risk of new variants of SARS-CoV-2.
Although data available to WHO continues to decline, we have seen increasing reports of hospitalizations, ICU admissions and deaths from COVID-19 in some countries.
And the risk remains of a new and more dangerous variant emerging that could cause a sudden increase in cases and deaths. So, we need to continue to be vigilant.
===
Excellencies,
Over the past six years, WHO has undergone the most significant transformation in its history.
We have made major changes to our processes, our operating model, our financing, our approach to partnerships, our workforce and our culture.
And it has all been grounded in a bold new strategy, the 13th General Programme of Work, based on the Sustainable Development Goals.
As you know, we are now working with Member States to develop the 14th General Programme of Work for 2025 to 2028, and I urge all Member States of the African Region to engage actively in this process.
In my address to the Regional Committee last year, I outlined five priorities - the "Five Ps" - which are now becoming the basis of GPW14: to promote, provide, protect, power and perform for health.
Allow me to take a few moments on each.
The first priority is to promote health and prevent disease by addressing its root causes.
That includes action to reduce tobacco use and harmful alcohol use;
To make diets healthier by reducing salt and sugar intake;
To increase physical activity;
To improve water, sanitation and hygiene;
And to address air pollution, and climate change.
I welcome the Regional multisectoral strategy to promote health and well-being, and the framework for implementing the global alcohol action plan, which you will consider this week.
I'm also pleased to note in the Regional Director's report that several Member States are making encouraging progress in these areas.
I congratulate Sierra Leone for passing a comprehensive tobacco control law, and Kenya, which has moved more than 2000 tobacco farmers to alternative livelihoods.
We also commend Eswatini for finalizing its road safety strategy, and Ethiopia, Ghana, Niger, Nigeria and Zambia for joining the Coalition of Action for Healthy Diets from Sustainable Food Systems.
I especially welcome the regional initiative to tackle the health impacts of climate change in Africa, which was launched at this year's World Health Assembly.
The climate crisis is a health crisis, which is why I encourage Member States to participate actively at COP28 in the United Arab Emirates, which will feature a day dedicated to health for the first time.
Health systems are increasingly dealing with the consequences of climate change, in terms of communicable and noncommunicable diseases, and the impacts of more frequent and more severe extreme weather events.
Even as we work to decarbonise health systems, at least 15% of health facilities in Sub-Saharan Africa have no access to electricity at all, and many more have unreliable access.
This means surgeries and births are done in the dark, vaccines cannot be stored safely, and that vital medical equipment cannot function.
The WHO Secretariat is supporting African Member States on electrification of health facilities through decentralized solar energy systems.
===
The second priority is to provide health, by radically reorienting health systems towards primary health care, as the foundation of universal health coverage.
Nowhere is this more important than here in our continent.
Across the region, hundreds of millions of people lack access to essential health services, or are pushed into poverty by catastrophic out-of-pocket spending.
Closing these gaps must be top of the to-do list for every Member State.
Maternal and child health also remains a major challenge in our continent.
Two-thirds of all maternal deaths occur in our continent, and the latest estimates indicate that the maternal mortality ratio in the region is more than seven times higher than the SDG target.
Yesterday I attended the meeting to launch a partnership between the Susan Thompson Buffet Foundation and the WHO Regional Office for Africa to strengthen primary health care and integrated health services, including for sexual and reproductive health. I thank the Buffet Foundation, especially Dr Senait, for its generous support in this area, and I asked Ministers yesterday to use this great opportunity that the Buffer Foundation is providing in partnership with our Regional Office and of course CDC Africa will be part of that partnership as well.
Despite the enormous challenges we face, there are also positive signs.
More than 1.5 million children have now received the RTS,S malaria vaccine, resulting in a 30% reduction in hospitalization due to severe malaria, and a 10% drop in mortality among vaccine-eligible children.
In the past year, seven countries eliminated at least one neglected tropical disease.
And I'm pleased to note that HPV coverage in the region increased from 26% in 2021 to 33% this year.
Still, persistent gaps in immunization coverage remain, and there is an urgent need to make up the ground we lost during the pandemic.
Together with UNICEF and Gavi, we have launched the "Big Catch Up" to support the most-affected countries to catch-up, recover, and strengthen their immunization infrastructure.
Of course, strengthening service coverage depends on strengthening the health systems that deliver those services.
So it's pleasing to see improvements in the region's health workforce, with the average regional density of nurses and midwives increasing by 40% since 2015.
The role of community health workers is especially important in reorienting health systems towards primary health care.
And we continue to see progress towards improved access to essential medical products and strengthened regulatory systems.
So far, 26 African Union member states have ratified the Africa Medicines Agency treaty, and we urge the remaining countries to follow suit.
There are many positive signs, but we all know we still have a long journey ahead of us on the road to universal health coverage.
So I welcome the framework for sustaining resilient health systems to achieve UHC and promote health security, which you will discuss this week, as well as the regional strategy on diagnostics and laboratory services and systems.
===
The third priority is to protect health, by preparing countries to mitigate health risks, and to rapidly detect and respond to both acute and protracted health emergencies.
We are all painfully aware of the burden of health emergencies this region bears.
More than 360 million people worldwide are currently in need of humanitarian assistance, many of them in our continent.
Meanwhile, the same vulnerabilities that COVID-19 exposed persist.
That is why WHO has developed a plan for a more equitable, inclusive and coherent global architecture for health emergency preparedness and response, with equity at its core.
Already, many of the parts of this architecture are being built.
With the World Bank we established the Pandemic Fund, and we have also launched the WHO Hub for Pandemic and Epidemic Intelligence; the WHO BioHub System; the Universal Health and Preparedness Review; the mRNA Technology Transfer Hub; the WHO Academy, and others.
We also have existing structures to build on, including the Global Outbreak Alert and Response Network, or GOARN, the Pandemic Influenza Preparedness Framework, the ACT Accelerator, the Research and Development Blueprint, and others.
Crucially, this new global architecture cannot be designed, built or managed by those with the most power, money and influence.
It must be designed, built and managed by all Member States and partners, in a truly inclusive process.
The International Health Regulations are the cornerstone of detecting and responding to diseases that spread internationally, but as the COVID-19 pandemic laid bare, there are serious gaps in compliance and implementation which must be addressed.
We need an IHR that is fit-for-purpose.
The proposed amendments now being discussed by Member States address many crucial areas, including compliance, cooperation, and more efficient communication.
We must learn the lesson of COVID-19, which is that global threats require a global response that is based on coherent mechanisms for cooperation, rooted in solidarity and equity.
That is what the pandemic accord, now being negotiated by the Intergovernmental Negotiating Body, is designed to achieve.
However, I am concerned that negotiations are moving too slowly, and that the accord may not be agreed in time for next year's World Health Assembly.
I urge all Member States to work with a sense of urgency, with a particular focus on resolving the most difficult and contentious issues. If we do that, there is time to finish the accord by May 2024.
This is a unique opportunity that we must not miss, to put in place a comprehensive accord that addresses all of the lessons learned during the pandemic, with a particular emphasis on equity.
This region has more to gain from a strong accord than any other. So I urge you to continue engaging actively in the negotiations, to make sure the needs and expectations of Africa are heard.
===
Promoting, providing and protecting health are proposed as the three key priorities for all Member States in the 14th General Programme of Work.
The other two Ps - powering and performing for health - are enablers of the first three.
Powering health means harnessing the power of science, research and development, data and digital technologies.
Digital technology, including artificial intelligence, holds great promise for improving health and narrowing the access gap.
But it also presents a challenge for ethics and equity, to prevent digital tools becoming another driver of inequality.
The WHO Global Strategy on Digital Health advocates for people-centred, evidence-based, and inclusive solutions that empower patients and support countries on the path to universal health coverage.
Just two weeks ago, WHO launched the Global Initiative on Digital Health, for coherent global standards, best practices and resources for digital health transformation, rooted in people-centred, evidence-based solutions.
===
And the final P, performing for health, is about the work we are doing as the Secretariat to support you better.
Already we have made major changes over the past six years as part of our transformation.
I also thank Dr Moeti for her leadership of the regional transformation.
We have come a long way. But we have more to do, at all three levels of the organization.
Sign up for free AllAfrica Newsletters
Get the latest in African news delivered straight to your inbox
In particular, one of my key focuses for the remainder of my second term is to strengthen our country offices, with a core country presence, delegation of authority, and adequate financial and human resources.
To support these efforts, I have squeezed US$ 100 million from our budget to allocate to country offices.
Our Programme Budget for the next biennium is also the first in which country offices will be allocated more than half of the total budget for the biennium.
Our work to strengthen country offices will benefit greatly from the 20% increase in assessed contributions, and by the Investment Round, both of which you approved at this year's World Health Assembly, and I would like to thank you for your support and for your level of confidence in WHO. This level of increase in assessed contribution is first in the history of the organization. So thank you so much.
We are also continuing our efforts to strengthen our workforce, to achieve gender equity at all levels, and to make zero tolerance for all forms of sexual misconduct a reality, and not merely a slogan.
===
Excellencies,
Let me finish by re-emphasising the five Ps, with specific requests for each.
First, I urge all Member States to take decisive action to promote health, through tobacco control, healthier diets, safer roads, and especially by taking action on climate change.
In particular, I encourage all Member States to participate in the dedicated health day at COP28 in the United Arab Emirates.
Second, I urge all Member States to take decisive action to provide health, by reorienting your health systems towards primary health as the foundation of universal health coverage.
In particular, I ask you to work with us on the "Big Catch Up", to close gaps in immunization coverage, and to reduce the unacceptably high burden of maternal mortality, by expanding access to services for sexual and reproductive health.
Third, I urge all Member States to take action to protect health, by strengthening your defences against health emergencies.
In particular, I ask you to engage actively in this once in a lifetime opportunity and deliver both the pandemic accord and the IHR reforms by May 2024, as a generational commitment that is grounded in equity and addresses the critical gaps in the global health architecture.
Fourth, I urge all Member States to take action to power health, by harnessing the power of science, research and development, data and digital technologies.
In particular, I ask all Member States to engage with the new Global Initiative on Digital Health, which holds enormous potential to support countries on their journey towards universal health coverage and the SDGs.
And fifth, I seek the commitment of all Member States to support your WHO to be the even more effective and efficient organization you need and deserve.
Specifically, I urge you to engage proactively in the development of the 14th General Programme of Work.
My thanks once again to you, Your Excellency President Masisi, for your hospitality, and for your leadership on health domestically, regionally and globally. I would like many to come and visit Botswana. Botswana is a model to show that anything is possible. Peace is possible, stability is possible, democracy is possible, growth is possible. It's the possibility of countries. Africa can grow, Africa can be stable. Africa can be in peace. Africa can be a democratic continent. You can see it here.
I think our youth should come and see that anything is possible in our continent.
I thank you.
