WHO Director-General's opening remarks at the GLOBSEC Bratislava Forum – 3 June 2022

Excellencies, dear colleagues and friends,

I would like to start by saying, dobré ráno. Good morning to you all, it's an honour to be here, and I thank the Government of the Slovak Republic and Mr Róbert Vass and the organisers of the Bratislava Forum for their hospitality.

I was honoured yesterday to meet with His Excellency Ivan Korčok, Minister of Foreign and European Affairs, and His Excellency Vladimír Lengvarský, as well as to visit the National Oncology Institute.

After more than two years of virtual meetings, it's very nice to be able to meet in person once more.

COVID-19 is a brutal demonstration that a pandemic is so much more than a health crisis.

It touches every area of life: economics, education, families, employment, business, technology, trade, travel, tourism, politics, security - and so much more.

I think you will agree with me if I say that this little virus has taken the whole world hostage for two years.

When health is at risk, everything is at risk.

So, the question is, where do we stand, and where are we headed?

Many participants of this conference have asked me this question. Many many people, the same question.

Globally, reported cases and deaths are near their lowest levels since the beginning of the pandemic.

However, this trend should be interpreted with caution, because many countries have reduced the number of tests they do, which in turn reduces the number of cases they find.

And we do see concerning trends in several regions. Reported cases and deaths are increasing in the Americas, while deaths are also increasing in the Western Pacific region and in Africa.

Sixty percent of the world's population is now vaccinated, which is helping health systems to cope and societies and economies to reopen.

However, it is still far too early to say the pandemic is over. It's not over.

Increasing transmission, plus decreasing testing and sequencing, plus one billion people still unvaccinated, equals a dangerous situation.

There remains a real and present danger of a new and more virulent variant emerging that evades our vaccines.

WHO's primary focus now is supporting countries with the lowest vaccination rates to increase those rates as fast as possible, with a focus on health workers, older people and other at-risk groups.

Through the ACT Accelerator, that's what we're trying to do, and the co-chair, the former prime minister of Sweden Mr Carl Bildt is with us, and very honoured to have you sir.

How the virus will evolve is very difficult to predict. We know for certain that future variants will have to be more transmissible than existing variants to outcompete them. But we can't predict how severe they will be.

This virus has surprised us at every turn - a storm that has torn through communities again and again, and we still can't predict its path, or its intensity.

We must remain vigilant and on our guard.

Whatever scenario comes next, we are in much better shape than we were when the pandemic began. So, we are in better shape. Of course, there is progress. We know the virus better, and we have the tools to prevent, detect and treat it. Those tools can be recalibrated quickly if needed.

It's likely that we will be living with COVID for the foreseeable future, and dealing with its long-term consequences, including mental health problems and long-COVID, which we are only beginning to understand.

But living with COVID does not mean just giving up and doing nothing - we have to live with it responsibly, by managing it through a sustained and integrated system for acute respiratory diseases.

But even as we respond to the pandemic, we must learn the lessons it is teaching us, because history teaches us that it will not be the last one.

As we look to the future, I'd like to suggest three key areas in which I believe we need substantial change to make the world if not pandemic-proof, at least more pandemic-resilient.

First, we need a realization, globally, nationally and locally, that health is central to sustainable development.

For far too long, health has been compartmentalized and deprioritized, nationally and internationally.

In too many countries, health has been seen as a cost to be contained, rather than an investment to be nurtured - an investment in social and economic development and sustainability.

History teaches us that health is not an outcome of development; it is the means.

Both the UK and Japan, for example, began their journeys towards universal health coverage in the aftermath of the Second World War, not when they were economically strong, but when both countries had been impoverished by war.

And in both cases, universal health coverage has been one of the foundations for decades of stability and prosperity.

Importantly, it's not just the size of the investment that matters. It's where the investment is made.

Which leads me to my second shift: a greater emphasis on public health.

In recent years, many high-income countries have invested heavily in advanced medical care - hospitalization and specialization - but have neglected investments in public health.

As a result, they were overwhelmed when the pandemic struck. The most developed countries were surprised, as you know.

For example, contact tracing is one of the most simple but effective public health tools for responding to outbreaks - and yet this was a skill largely forgotten in most high-income countries.

By contrast, through their experience with previous outbreaks of infectious diseases, many lower-income countries have developed strong infrastructure and "muscle memory" for contact tracing, which helped them respond well in this pandemic. The Mekong region is the best example, and especially its experience and muscle memory from SARS-CoV-1, the first SARS.

The bedrock of public health is strong primary health care, which is the eyes and ears of every health system, helping to detect and respond to outbreaks at their earliest stages, at the community level.

Primary health care is also essential for promoting health and preventing disease.

I do not mean to downplay the importance of secondary and tertiary care, which are vital too.

But a strong primary health care system can help to prevent or delay the need for secondary or tertiary care, leading to better health outcomes for people and lower costs for health systems.

So, our shift in focus should be to keeping people healthy rather than managing disease, and which is cheaper also in terms of investment but its impact is higher.

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The third shift is the need for significant changes in the global health architecture for pandemic prevention, preparedness and response.

There have been multiple independent reviews of the COVID-19 pandemic, with more than 300 recommendations on how to make the world safer.

WHO has synthesised these recommendations into a proposal for a stronger global architecture for health emergency preparedness and response.

It makes recommendations for stronger governance that is coherent, inclusive and accountable;

Stronger systems and tools to prevent, detect and respond rapidly to health emergencies;

Stronger financing, domestically and internationally;

And a stronger and sustainably financed WHO at the centre of the global health architecture.

Overarching these recommendations is the proposal for a new international instrument, to provide the framework for closer cooperation and coordination between countries in the face of global threats.

At a Special Session of the World Health Assembly last year, WHO's 194 Member States decided to embark on the process of negotiating such an instrument.

If the nations of the world can come together to agree a common approach to the human-made threat of nuclear weapons, then it is common sense for countries to now agree on a common approach, with common rules for a common response, to threats arising from our relationship with nature-threats no human can entirely control.

The time to act is now. The history of epidemics and pandemics is a history of panic and neglect - the world throws money at a crisis, then when it subsides, attention is diverted, lessons go unlearned, and little is done to prevent the next health emergency.

After all, COVID-19 is not the only crisis competing for the attention of politicians and news editors.

Just three weeks ago I had the opportunity to visit Ukraine.

I visited bombed hospitals and met health workers who continue to serve their communities despite the circumstances. My feeling was so bad. I've said it before: I'm a war child, so I know what war means. I know the smell of war, the sound of war, and the image of war. So, my feeling was so bad and devastating. I can understand through what conditions the kids I met are passing through.

Prior to the conflict, WHO was working with Ukraine's Ministry of Health to prepare for the worst-case scenario.

Although we didn't believe - personally I didn't believe, as you know I used to be Foreign minister, that the Russian Federation would invade. When I was asked that questions, I said, 'no, I don't think so'. That was what I believed. But in the highly unlikely event we decided in WHO to preposition supplies inside Ukraine, in different parts of the country. This is before the invasion.

Then, when the invasion began, we were able to immediately deploy those supplies where they were needed, while shipping more from our logistics hub in Dubai. So, the prepositioning of supplies helped us to move quickly, as soon as the invasion happened, but the prepositioned supplies were not enough, so we moved quickly, from our hub in Dubai, more supplies.

In addition to our prepositioned supplies, we were the first humanitarian organization, as WHO, to reach Kyiv with new supplies from outside, from the Polish border through our warehouse in Lviv, immediately after the invasion.

So far, WHO and our partners have delivered more than 500 metric tonnes of medical supplies to the hardest hit areas in Ukraine - enough for almost 16 thousand surgeries and to provide care for 650 thousand people, plus diesel generators for hospitals and clinics, 20 ambulances, and tests and treatments for COVID-19. What is key here is the support we are giving them based on the need on the ground, and I have already seen it in person and saw it in action.

There is one thing I would like to share with you. I was inspecting the supplies we had in the warehouse in Lviv, and one of the supplies was a crutch for children. I was holding the crutch for children, and what I was imagining then, was that children should be children. We expect them to do silly things, and maybe fall from a tree or break their leg while playing soccer, and then of course they need crutches. But to prepare crutches and to supply crutches for children because of war casualties, is sad. I wanted to share how difficult this was, especially for children and women.

Until this year, Ukraine was among the countries making the most rapid progress towards universal health coverage.

We are deeply concerned about the impact of the war on these gains.

The disruption to health services is bad enough. Attacks on health are unconscionable.

Since the Russian Federation's invasion began almost 100 days ago, WHO has verified 269 attacks on health in Ukraine, killing 76 people and injuring 59, including health workers and patients.

Attacks on health care are a violation of international humanitarian law, as we all know.

And I continue to call on the Russian Federation to stop the war and give peace a chance.

Because there can be no health without peace.

Of course, the war in Ukraine is the worst problem the world is facing, maybe you can call it the mother of all problems, because it is bringing more challenges and needs our continued attention and focus on Ukraine. Because it is the mother of all problems now.

At the same time though, let's not forget the other crises we have: Yemen, Syria, Afghanistan, Ethiopia, Central African Republic. I can give you a long list. And especially Ethiopia - Tigray, where I come from. More than six million people have been sealed off from the rest of the world for 18 months. I have family there, I can't call them, I can never call them, because there is no telephone, it is cut by the government. No food, it is just trickling in now. No fuel. No banking service. I can't send money to those who are starving.

As we speak, that's the longest siege ever that's still running in the world. More than six million population, which is the equivalent of maybe Slovakia, the same population by the way, in terms of size. A full blockade by both Ethiopian and Eritrean forces for more than 18 months. So, let's also give attention to those places while the center of focus being Ukraine.

We have to address all the challenges we have, wherever they are. But you can understand that I am in constant pain, because this is happening on our watch.

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Excellencies, dear colleagues and friends,

A pandemic; war; drought; famine. Even more.

We face a formidable convergence of overlapping crises, fuelled by climate change, inequity and geopolitical rivalry.

The only way to meet this convergence is with a convergence of our own - a convergence of nations, working together to find shared solutions to shared problems. If there is a will there is a way.

Division and rivalry only breed suspicion, distrust, hate and enmity. What do you get out of hate? Destruction and endless war.

Solidarity builds respect, trust and friendship. As humans we have the capacity to come back to our senses and to commit to solidarity and to build respect, trust and friendship. Let's choose that.

The only way out of these troubled times is for nations to come together, to collaborate where possible, to compromise where needed, and to seek peace. To use the best in us, instead of the worst in us.

I thank you. Ďakujem. Thank you so much.

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