Secretary-General, in concluding remarks to forum, emphasizes importance of partnerships

 

in race to meet health-related Millennium Development Goals

 

Following are UN Secretary-General Ban Ki-moon’s concluding remarks to the Forum on Global Health today, 15 June:

I am very pleased to meet you again.  I know that you’ve had a good and rewarding meeting today.

First of all, I would like to thank you and congratulate you, for what has been a productive and challenging discussion.  I would like to especially thank the Rockefeller Foundation, the United Nations Foundation and the Government of Norway for supporting this forum today.

We started off today with a strong message from the World Health Organization:  we are in the midst of the greatest drive against poverty ever.  And the price of failure keeps getting higher.  The recent emergence of an influenza pandemic has brought this reality into the spotlight.

Improved health outcomes are certainly fundamental to our ability to reach the Millennium Development Goals.  This means we need to “up our game” because we don’t have much time left.  Yes, we live in the midst of crisis and uncertainty.  But this should only increase our resolve.  Now, more than ever, it is critical that we avoid any reversal or stagnation in the significant progress we have made in global health.

Over the course of the day, we have examined three overarching questions.  Together, these comprise an important agenda for our action going forward.  First, who do we need to reach and protect, as our first priority?  Second, how do we better define and build resilient, integrated systems to successfully deliver health services for all?  And finally, what are the opportunities and incentives we can build to enhance cooperation and foster partnerships that can deliver?

It is, of course, very easy to ask questions and even to propose what “should” be done.  But our meeting today has gone beyond that.  Together we have determined not only what must be done; in doing so we have also made concrete pledges of action.

Let’s take the issue of vulnerability.  We know that despite our progress, many people are being left behind.  Nowhere is this more evident than in the staggering number of women who suffer or die because of poor sexual and reproductive health, in pregnancy or during childbirth.

These women, often young, and their children make up a large proportion of our global community ‑‑ yet they are among the most marginalized and vulnerable.  Maternal mortality is the largest health inequity:  99 per cent of maternal deaths are in poor countries.  Half of all maternal deaths are in Africa.  As one panellist said so clearly, “geographic location of a woman shouldn’t determine whether she lives or dies when giving birth”.  We all agree.  We must tackle the gender inequalities head-on.

I announced this morning that Bill and Melinda Gates and I have agreed to jointly convene the major players on maternal and child health to increase attention, coordination and resources available for addressing this priority challenge.  One area for immediate focus is ensuring that we understand where the gaps are and where the system is failing to address critical barriers preventing women from getting the care they need.

Neglected tropical diseases also impact women and children the most ‑‑ and afflict the poorest in the developed and developing world alike.  Yet controlling them ranks among the most low-cost of all interventions.  Cancer, diabetes, heart diseases are no longer the diseases of the wealthy.  Today, they hamper the people and the economies of the poorest populations even more than infectious diseases.  This represents a public health emergency in slow motion.  The HIV epidemic continues to wreck people and societies ‑‑ we will look closely at the status of HIV/AIDS in the world in the General Assembly tomorrow.

As we have seen in the face of the H1N1 influenza pandemic, putting vulnerable communities and countries at the centre of our planning process produces results.  Pandemic preparedness also provides an example of successful cross-sectoral and intergovernmental cooperation.  We need to apply lessons not only as we move forward on H1N1, but also on a range of other health challenges.

We have the benefit of new technologies, which are already enabling us to achieve significant public health gains ‑‑ particularly in child health.  We must continue to remove the barriers preventing people from getting the existing vaccines, medicines and diagnostics they need.  But at the same time, we must invest ‑‑ from the point of discovery ‑‑ in technologies for the future.

I now turn to our second question:  how can we better define and build resilient, integrated health systems that work for the poor?  We must agree on what it means:  “strengthening health systems” and at the same time move beyond an academic debate.

We must train midwives, community health workers and health system managers.  We must integrate new and emerging technologies.  We must listen to those in need.  We must bring into this conversation decision makers beyond the health sector ‑‑ in noting the importance of multi-sector actors and approaches in preventing poor health.  The International Health Partnership provides a framework to support country-led comprehensive plans, country by country, under the stewardship of Governments.

We are beginning to prove that we can depart from “business as usual”, through better coordination.  And seeking results through performance-based financing and better use of information technology.  Indeed, the current financial climate reminds us of the cost-effectiveness of coordination; of rigorous searching for where we can provide better value for the precious dollars we spend.  While we focus on getting more for each dollar, we are clear that significant new funding is still required to meet the health Millennium Development Goals.  Innovative financing mechanisms can help fill these gaps.  Out-of-pocket expenditures are the worst way to fund health systems.  According to WHO, 100 million people become impoverished each year because of the need to spend on health.

We have moved beyond traditional “vertical” approaches.  I welcome the important new directions that UNAIDS and the Global Fund to fight AIDS, TB and Malaria are taking.  I urge you all to learn from their experience in confronting major diseases and use these lessons to build systems that work for all.  We heard today that the World Bank, GAVI and the Global Fund are already working to streamline their support for health systems strengthening.  This must continue.

We can expand our experience in fighting specific diseases into programmes to improve women’s health and reduce child mortality.  Where specific initiatives have been successful, our focus should now be on making the most of these successes.  On adapting and integrating where this makes sense.  Continued progress will be further catalysed by a focus on results.

Improved coherence calls for new ways of working, new strategic partnerships, and importantly, making the space for new actors.  Those of us here today come from a wide range of backgrounds and professions.  But we are united in a common goal.  We all have a stake.  The crisis reminds us that the response to global interdependence is, quite rightly, strategic partnerships ‑‑ that we have called enhanced multilateralism.

Success in reaching the Millennium Development Goals and ensuring that no Millennium Development Goal is “left behind”, particularly the health Millennium Development Goals, means that we have to be smart.  We need to recognize where existing partnerships ‑‑ for example with civil society and the private sector ‑‑ can be leveraged.  We must listen to what young people, the leadership of tomorrow ‑‑ might teach us.  The people affected must be at the heart of our collective efforts.  The AIDS response has demonstrated what is possible when this happens.  At the global, regional, national and community levels.

The explosion of mobile phone coverage in the developing world provides huge new opportunities, and is beginning to revolutionize medical communication.  But in order to take advantage of this we need interoperable e-health systems.  Early planning in this regard, and forging the right partnerships now, will save money and lives.

I want to challenge us to bring our partnerships to the next level.  Merely forming partnerships, regardless of their make-up, is not enough.  We must be strategic and accountable, under enlightened leaderships.  We need more complementary efforts and less duplication.

In closing, I hope that you all, like myself, will leave our meeting today with a clear sense of purpose.  Ensuring that we meet every one of the health Millennium Development Goals is not what we ought to do.  It is what we must do.  In short, we must make health the tie that binds our families, our societies and our world together.

Thank you very much for your commitment.

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For information media • not an official record