SECRETARY-GENERAL, NOTING PROGRESS IN PUBLIC HEALTH DEVELOPMENTS, SAYS THERE REMAINS 'ENORMOUS BACKLOG OF HEALTH-RELATED DESPAIR' IN THE AMERICAS

SECRETARY-GENERAL, NOTING PROGRESS IN PUBLIC HEALTH DEVELOPMENTS, SAYS THERE

REMAINS 'ENORMOUS BACKLOG OF HEALTH-RELATED DESPAIR' IN THE AMERICAS

Centenary Address to Pan American Health Organization in Washington, D.C.

This is the text of an address by Secretary-General Kofi Annan in

Washington, D.C., last night (2 December) to the Pan American Health Organization (PAHO) on the occasion of the organization's 100^th anniversary:

We sometimes speak today as if globalization is new, or as if interdependence began with the Internet.  But in the last years of the nineteenth century, a group of scientists, doctors and public officials were well aware that disease recognizes no borders.  Even amid uncertainty about the precise ways in which sickness was transmitted, they knew that this was a peril capable of travelling anywhere, inflicting devastation that could hinder development and reverse hard-won improvements in living standards.  That insight, that foresight, that recognition of a collective challenge facing a largely unsuspecting hemisphere, led to the creation of the great and gallant institution whose centenary we celebrate tonight.

The Pan American Health Organization does indeed have much to celebrate.

Over the last century, life expectancy in the Americas has risen from 50

to 72.  Where once children died of preventable diseases, today many more survive because of immunizations and improved conditions and care.  Where once the risk of mothers dying in childbirth was immense, today virtually all countries have safe motherhood programmes.

Throughout the Americas, these and other advances have reduced misery, stimulated economic growth, built stronger societies and enabled the region to modernize and engage with the global marketplace.  The teamwork exhibited by PAHO and its partners has itself become a unifying, democratizing force, empowering women and communities and drawing countries closer together in networks of knowledge and mutual aid.  Where once fatalism reigned among the great mass of people, today there is hope -- more than ever before.  That is a record that PAHO can and should be proud of.

And yet, as this audience knows all too well, ill health is far too widespread in a world that boasts such material riches.  The Americas still face

an enormous backlog of health-related despair.  The Caribbean has one of the

highest HIV rates outside of Africa.  Violence, particularly against women and children, continues to be a leading cause of physical problems and mental trauma.

The same is true of the world in general.  A quarter of all children remain unprotected against six leading deadly diseases.  The AIDS epidemic is depleting countries of their most valuable and productive people, which in turn is undermining their abilities to deal with parallel catastrophes such as famine.  Diseases that disable rather than kill take a heavy toll.  Ill health creates and perpetuates poverty, which in its turn undermines the effectiveness of health systems.  And the challenges don’t cease:  we face new diseases such as AIDS,

re-emerging challenges such as drug-resistant TB and malaria, and the spread of existing problems to new population centres.

Far less than 10 per cent of global spending on health research is aimed at the health problems affecting 90 per cent of the world's population.  And let us not forget mental health, perpetually struggling to overcome stigma and neglect, especially in poor countries.  Let us remember, too, the so-called “life-style” health problems that afflict mainly middle and high-income countries -- obesity, high blood pressure and cholesterol, tobacco use and excessive alcohol consumption.

Just as peace is far more than the absence of war, so is health not merely the absence of disease or infirmity.  Our goal must be a world in which good health serves as a pillar of individual well-being, national progress, and international stability and peace.

This is an admittedly broad challenge.  Fortunately, the world has committed itself to meeting it.  The Millennium Declaration adopted at the Millennium Summit two years ago is not just another agreement among Member States.  It reflects unprecedented political consensus on the state of our world and the priorities ahead.  It sets out specific, time-bound and measurable goals for human progress.  Most importantly, those goals -– the Millennium Development Goals -– are achievable.

The health-related goals -- including reducing child mortality, improving maternal health and combating AIDS and other epidemic diseases -- are an end in themselves.  But they are also linked to the other goals.  We will not, for example, reduce child mortality unless we also eradicate hunger, provide access to safe water or increase access to education.  In some cases, the health goals are a means to achieving the other goals, such as environmental sustainability.  Yes, people’s health depends on sustainable agriculture; but agriculture in turn needs a healthy workforce.

Indeed, health was one of the five major priorities at the World Summit for Sustainable Development, alongside water and sanitation, energy, agriculture and biodiversity.  Leaders meeting in Johannesburg pledged to address the many linkages between health and the environment, including indoor air pollution, water-borne illnesses and uncontrolled urbanization.  And even earlier this year, leaders meeting at the International Conference on Financing for Development in Monterrey pledged to increase development assistance and take other steps towards

achieving another Millennium Development Goal:  creating a global partnership for development.

However, the list of unfulfilled commitments is also long, even though investments in health are known to be an important prerequisite for economic development.  Even modest interventions -– from hand-washing to insecticide-treated bed nets -– can save lives and improve health.  Such steps are particularly beneficial to the poor, who are largely dependent for their livelihoods on their own labour.

But cost-benefit analysis, proven technologies or promising research do not by themselves guarantee implementation.  More often, political, financial and other obstacles must be surmounted.  For that we shall need leadership.  I don’t think I will betray any confidences if I tell you that when I called to congratulate the newly elected President of Brazil, “Lula” told me his main concern was the war on ill-health, illiteracy, hunger and poverty.  As we have seen with AIDS, nothing can better raise awareness and rouse government machinery than committed, outspoken leadership from the top.

We will need the best possible science, and especially investments in research and development that will benefit the poor.  Diseases of great concern to developing countries -– including pneumonia, diarrhea, tuberculosis and malaria -- receive less than 1 per cent of global research budgets.

We will need more partnerships.  The Global Alliance for Vaccines and Immunization is a fine example of how the private sector can contribute.  The Mercosur Business Council and national business councils on AIDS have helped accelerate the response to the disease.  And I see Bill Leurs here, who has been doing quite a lot with his organization. Civil society has also mobilized, on AIDS and other issues.  We need many other initiatives of this sort.

We will need to do more, in particular with pharmaceutical companies, to secure wider access to affordable medicines.  As trade ministers themselves pledged last year in Doha, rules regulating intellectual property must not prevent developing countries from addressing their public health problems.

We will need to be creative.  The Health InterNetwork Access to Research Initiative -– HINARI -– is using information technology to narrow the information gap in health science.  Prompted by the World Health Organization, some 30 publishers of scientific journals are now providing 3,000 journals to thousands of institutions, free of charge or at a steep discount.  For the first time, a surgeon in Kampala or Dhaka can log on and read about the cutting-edge techniques developed in their fields.  Research institutions in Peru or Zambia can access the latest studies on their subjects.  The FAO is looking into using the same network to make agricultural journals more widely available.  The result is a real breakthrough in access to scientific knowledge.

Finally, of course, we will need money and there is always a need for money.  Even governments that are adopting sound policies and doing all the right things still receive far less aid than they need.  And if present trends continue it will be hard to meet our target of $10 billion annual spending on HIV/AIDS by 2005.

The Americas face a critical period ahead -– in continuing the century-long expansion of health and social services; in consolidating the democratic transformation of the past two decades; and in coping with the economic and financial crises of today.  The strong tradition of partnership in the Americas, of which PAHO is such a leading example, will need to deepen still further.

For children in the barrios and favelas; for stressed-out men and women juggling two jobs to make ends meet; to indigenous people subsisting in the farthest reaches of the hemisphere; for these and millions more of our fellow citizens, PAHO and the United Nations are joined in an urgent mission of health and well-being.  From Cape Horn to the Arctic Circle and beyond, let us work even more closely together so that the health of nations can become the wealth of nations.

Congratulations again on this milestone in PAHO’s history.  Thank you very much.  Muchas gracias, amigos.

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