global vulnerability calls for global response, Secretary-General stresses,

 

pointing to h1n1 flu pandemic while addressing health forum

 

Following are UN Secretary-General Ban Ki-moon’s remarks at the Forum on Global Health:  The Tie That Binds, today, 15 June:

We planned this meeting months ago, before anyone had ever heard the term “H1N1”.  Now, a strain of this virus is officially a global pandemic.  As someone recently told me, “add one more to your list of crises”.  As if the economic situation, food insecurity and climate change weren’t enough!

The declaration of the first influenza pandemic in over 40 years reminds us of our global vulnerability and the need for a global response.  We cannot protect ourselves by working in isolation.  This is as true for the recent outbreak as it is for the long-standing health challenges we face.  From the far-reaching problem of poor maternal health and weak health systems to the H1N1 flu, the current situation demands that we come together and strengthen our efforts.  This means mobilizing all constituencies, better coordinating our actions and giving priority to health issues that remain relatively orphaned.

As Dr. [Margaret] Chan has said, we are all in this together, and we can all get through this together.  But to succeed, we must strengthen the ties that bind us ‑‑ in communities, countries and the world.  No child in the twenty-first century should have to suffer this uncertainty.  At this time of global economic downturn, we face a crossroads.

We can cut back on health expenditures and incur massive losses in lives and fundamental capacity for growth. Or we can invest in health and spare both people and economies the high cost of inaction.  The cost of cutting back is just unthinkable.

I know that many in this audience do not need to be told about the significant returns we see from investing in health. Investments to scale up basic health services can bring a six-fold economic return.  Healthy people have improved life expectancy, go to school, are more productive, take fewer days off work, have lower birth rates and thus invest more in fewer children.

Across sub-Saharan Africa, controlling river blindness cost less than $1 per person but will ultimately deliver an estimated $3.7 billion in productivity.  Polio eradication would save Governments $1.5 billion annually in vaccines, treatment and rehabilitation costs.

In the United States, analysts say $1 invested in a vaccine can save up to $27 in health expenses.  In Ghana, Tanzania and Uganda, studies show that each dollar invested in contraceptive services can save up to $4 in expenditures on antenatal, maternal and newborn health care.  These impressive numbers do not even begin to measure the value of lives saved.

We know from previous economic crises that social outcomes are the first to suffer and the last to recover.  Even then, the statistics often obscure the day-to-day struggles of millions of women, men and children in the poorest countries.

Health is the tie that binds all of the Millennium Development Goals together.  If we fail to meet our targets on health, we will never overcome poverty, illiteracy, achieve universal education and meet the other Millennium Development Goal challenges.  I am most troubled by the costs of failed maternal and child health.  The global impact of maternal and newborn deaths has been estimated at $15 billion a year in lost productivity.

Birth, which should always be cause for celebration, too often brings mourning when mothers and their newborns die from a lack of adequate care.  And when I say too often, I mean once every minute.  Once every minute!  That is over half a million tragedies every year ‑‑ nearly all of them preventable.  Experts warn that an additional 200,000 to 400,000 more babies could die annually if the crisis continues.  This fact alone should shame us into action.

People often call an issue on which all can agree a “motherhood issue”.  Ironically, however, motherhood itself has not yet become a motherhood issue.  But it should be.  Safe motherhood is the ultimate tie that binds.  That binds families, communities, nations and our world.

Every woman has the right to be assured of the assistance and care she needs.  First, in making the decision to have a child and then, during the process of giving birth.  We owe this to women.  We owe it to our families.  We owe it to ourselves.  Women weave the fabric of society, building stable, peaceful and productive communities.  Let us make mothers the motherhood issue in our fight for global health.  We must use maternal health as a lens through which we decide and act on global health policies.  We must hold ourselves accountable to a rapid acceleration in progress on Millennium Development Goal 5 over the next five years.

Comprehensive sexual and reproductive health services for women must be integrated into global responses to specific diseases and interventions aimed at strengthening health systems.  The woman who receives prenatal care gets more than just a monthly exam ‑‑ she is better able to protect herself and her children from HIV, malaria and other diseases.  A clinic helps women through the challenge of childbirth and is well-placed to respond to the needs of her and her family.

The international community should apply its valuable experience of fighting AIDS and malaria to saving mothers’ lives.  We know that when Governments, United Nations entities, businesses and civil society leaders join forces, we can have a powerful impact.  We can drive down the stubborn and terrible statistics.  We can save lives.

I was pleased to see that at the World Health Assembly most statements included a reference, even a focus, on maternal and child health.  We are finally reaching a tipping point.  Now we need to translate commitments into action and operationalize our will to make measurable difference.  It is my great pleasure to announce that the Bill and Melinda Gates Foundation and I have agreed to jointly convene the major players on maternal and child health to leverage commitments to accelerate progress and address critical gaps.

Many of you in this room have contributed to the steady progress we have achieved on global health.  Official development assistance for health tripled in the last six years and new instruments ‑‑ including the Global Fund, GAVI and PEPFAR ‑‑ are showing that additional funds for health can be raised and disbursed in innovative, accountable, efficient and inclusive ways.  Progress has been possible also thanks to the engagement of philanthropic foundations, as well as private businesses, which have partnered with Governments and non-governmental organizations in health-care financing and service delivery.

These efforts are tremendous, but the needs are greater and growing.  An additional 50 to 90 million people in developing countries will be plunged into absolute poverty this year as a result of the crisis.  Inequities between rich and poor countries in access to health care are likely to increase, particularly where out-of-pocket expenses account for a large share of health spending.

Governments will face difficulties in maintaining budgets for all social services, but must resolve to honour their previous commitments to allocate adequate resources to health.  One billion people continue to suffer on a daily basis ‑‑ and often die ‑‑ of easy-to-control diseases that we continue to call “neglected tropical diseases”.  These are in fact diseases of the world’s poor.

Chronic conditions like heart disease and stroke have become the chief cause of death globally.  The AIDS epidemic is not over.  The broad mobilization of stakeholders has spearheaded remarkable results but the gains are fragile and must be protected and sustained.  Functioning, affordable and accessible health systems that work for the most vulnerable continue to remain a challenge.

These examples are but a few of the many hurdles we face together.  We must reverse the trend before millions more people fall ill, suffer and die from a lack of proper health care, and before economies buckle under this burden.  We have to move quickly.  The decisions we make in the next months will be critical to sustaining the gains we have made so far ‑‑ and to expanding programmes to cover all people in need.  This meeting is an important start, and the Economic and Social Council Annual Ministerial Review is the next major stepping stone on our road to success.

We have commitments from Gleneagles to Heilingendamm to Toyako to provide $60 billion to fight disease and strengthen health.  Decisions to honour past commitments are ultimately political and involve making choices.  I call on the G‑8 and the G‑20 leaders to stand by their promises and do what they know is right.

Sustainability is not just about securing predictable financial resources.  It is also about strengthening health systems while fighting disease, and using the extraordinary opportunities provided by disease programmes to deliver other health benefits.  It is about training and empowering the health workforce.  It is about drawing on the experience of the private sector to help us innovate and measure risk and results.  It is about strengthening the untapped capacity of communities.

I would like to close my remarks by posing a challenge to us all.  By the end of today, I would hope that we can agree on an agenda, our approach to achieving it and our commitment to seeing this through.  Countless lives hang in the balance.

In the twenty-first century, our fates are already intertwined.  Now we need to heed the call of our conscience, recognize that our interests are bound together, and act ‑‑ united ‑‑ with the urgency that the times demand.

I thank you very much for your participation and your commitment.

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For information media • not an official record