WHO Director-General's remarks at Columbia University World Leaders Forum: Centennial Anniversary of the Mailman School of Public Health

President Lee Bollinger,

Dean Linda Fried,

Dear faculty, staff, students, alumni, colleagues and friends,

Good morning, and good afternoon from Geneva.

It is truly an honour to join you in celebrating the centenary of the Mailman School of Public Health.

When your forebears at Columbia University made the decision in 1914 to formalize the science, education and practice of public health, they cannot have known that a global influenza pandemic was just around the corner.

Some of you may remember the last time I had the privilege of addressing the World Leaders Forum, in 2017 - that was my first speech as WHO Director-General - I told the story of the 1918 pandemic, without knowing the COVID-19 pandemic was around the corner.

And I said that despite our more recent experiences with SARS, H1N1 and Ebola, the world was still unprepared for another pandemic.

Although much has changed since 1918, much hasn't.

People then were having many of the same debates that have been had around the world in the past year, including whether to keep schools open during the pandemic.

New York's director of public health for schools was Dr S. Josephine Baker, and she made the case for keeping students in school, as many students lived in crowded tenement conditions with poor ventilation and little access to health care.

In school, they would be in a healthier environment, could be monitored for illness, and if necessary be given free medical care.

Dr Baker convinced Dr Royal Copeland, the head of the city's health department, which enjoyed public trust from its handling of cholera and TB epidemics in years past.

It worked. New York fared better than other large cities that kept their schools closed.

I'm not saying whether I think schools should be open or closed now - that depends on the local situation, based on a careful risk assessment.

The point is, that's exactly what Baker and Copeland did; they made a risk assessment based on the data they had, and the measures they took were successful in part because of the level of public trust they enjoyed.

Columbia's own public health historian, Professor David Rosner, said this:

"With no ability to see the virus and no vaccines available to prevent it's spread, the public health community's ability to fight the epidemic depended on its moral, political, and legal authority".

That was 1918.

One hundred years later, we might have vaccines, but a lack of moral, political and legal authority has fuelled the COVID-19 pandemic.

Even some of the world's wealthiest countries, with the most advanced medical systems, have been overwhelmed;

Trust in science and scientific institutions has been frayed by years of politically motivated attacks;

Geopolitical fault lines have been exposed and widened;

And the inequalities and inequities that lie at the root of so many public health challenges have fanned the flames of the pandemic.

The global vaccine crisis is exhibit A.

More than 6 billion vaccine doses have now been administered globally, and almost one-third of the world's population is fully vaccinated against COVID-19.

But those numbers mask a horrifying inequity.

More than 75% of vaccines have gone to high- and upper-middle income countries.

Low-income countries have received less than half of one percent of the world's vaccines. In Africa, just 4% of people are fully vaccinated.

WHO's targets are to vaccinate 40% of the population of every country by the end of this year, and 70% by the middle of next year.

These targets are eminently achievable, but only if the countries and companies that control the global vaccine supply do their part.

We need a global realization that no country can vaccinate its way out of this pandemic in isolation from the rest of the world.

The longer vaccine inequity persists, the longer the social and economic turmoil will continue, and the more opportunity the virus has to circulate and change into more dangerous variants.

It was in my speech at the World Leaders Forum in 2017 that I first said, "No one is safe until we are all safe."

It was true then, and it's even more true now.

We're grateful that high-income countries have pledged to donate more than 1 billion doses, but so far, less than 15% of those doses have materialised.

We call on the countries and companies that control the global supply of vaccines to swap their near-term vaccine deliveries with COVAX and AVAT; to fulfil their dose-sharing pledges immediately; and to facilitate the immediate sharing of technology, know-how and intellectual property for local production.

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Even as we work to stop transmission, save lives and end the pandemic, we must learn the lessons it is teaching us.

As you know, there have been several reviews of the global response to the pandemic, and of WHO's performance, with many recommendations for making the world safer.

As we have studied these reviews, we see four key areas for action.

First, we need better global governance. The existing global health security architecture is complex and fragmented, and voluntary mechanisms have not worked.

A treaty or other international instrument on pandemic preparedness and response will provide a much-needed overarching framework for global cooperation, setting the rules of the game, and enhancing solidarity among nations.

This will be the subject of a Special Session of the World Health Assembly in November. Your voice in supporting a pandemic treaty or agreement will be very important.

Second, we need better financing for national and global preparedness and response.

That includes a substantial increase in domestic investment, as well as in international financing to support low- and lower-middle income countries, for surveillance, laboratories, risk communication and contact tracing, preparedness systems using a "One Health" approach.

Crucially, we need to recognize that global health security begins with local health security, which means we need investments in strong primary health care as the foundation of universal health coverage.

That means a well-paid and well-trained health workforce, with adequate protective equipment and supplies, and facilities for hand hygiene.

And it means a health system that has earned the trust of the communities it serves, including in disadvantaged urban and rural areas.

Strong primary health care is an essential first line of defence against outbreaks, but also against other communicable and non-communicable diseases, and for the health impacts of pollution and climate change.

Third, we need better systems and tools, to detect, prevent, prepare for and respond rapidly to outbreaks.

Already, WHO and our partners are putting many of those tools in place.

Earlier this month, I was honoured to join German Chancellor Angela Merkel to open the WHO Hub for Pandemic and Epidemic Intelligence in Berlin, a new centre designed to foster greater sharing of data and information between countries, and to improve global surveillance for epidemics and pandemics. This will be a very important early warning system.

Other initiatives are in development, including the WHO BioHub, a new facility in Switzerland for storing and sharing pathogens, and the Universal Health and Preparedness Review, a new peer-review mechanism for enhancing national preparedness.

Recently, WHO also announced the establishment of a permanent International Scientific Advisory Group for Origins of Novel Pathogens, or SAGO, to establish a more systematic way of identifying the source of new outbreaks.

And just this week I was honoured to join President Emmanuel Macron for a groundbreaking ceremony for the new WHO Academy in Lyon, which will use state-of-the-art technologies to expand worldwide access to lifelong learning for health workers and public health professionals all over the world, with a global simulation centre for emergency preparedness and response.

Fourth, and underpinning all of these, we need a stronger, sustainably financed and empowered WHO at the centre of the global health architecture.

With 194 Member States and 152 country offices, WHO has unique expertise, a unique global mandate, unique global reach and unique global legitimacy.

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In the coming months and years, other crises will demand our attention, and distract us from the urgency of taking action now.

If the world continues down the same path, it will continue to get the same result, which is a world that is less healthy, less safe and less fair.

100 years since the founding of what is now the Mailman School of Public Health, the research you do and the education you provide are more important than ever - for New York City, the United States and the world.

Because above all, the pandemic has taught us that health is not a luxury, but the foundation of social, economic and political stability;

Health is not a cost to be contained, but an investment to be nurtured;

And health is not a privilege; but a fundamental human right.

I wish everyone at the Mailman School of Public Health a very happy birthday.

May the next 100 years be even more productive as we work together in solidarity for a healthier, safer and fairer future for everyone, everywhere.

Thank you very much for your contribution and dedication, not only to the United States but to the world.

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