WHO Director-General's panel remarks - Trends for a Changing World: COVID-19 - the Importance of universal health coverage and primary health care

Your Excellency Raquel Pena, Vice President of the Dominican Republic,

Excellency Dr Lionel Fernandez, former President,

Excellencies, distinguished guests, dear colleagues and friends,

Buenos dias. I wish I was there with you in Santa Domingo - I have been there once and it's such a beautiful country but this is because we have a Special Session now of our Assembly. It's anyway it is an honour to join you today, and thank you for the opportunity to share some reflections with you.

As you may know, we are currently holding a Special Session of the World Health Assembly to discuss the potential for a new agreement, convention or other international instrument on pandemic preparedness and response.

One of the key lessons of the COVID-19 pandemic is that the best defence against disease outbreaks and other health emergencies is strong, resilient primary health care as the foundation of universal health coverage.

And at a time when faith in science and health institutions is being tested as never before, building strong, responsive health systems that have earned the trust of the public they serve is more important than ever.

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COVID-19 has now killed more than 5 million people. And they're just the reported deaths.

The excess deaths caused by the virus, and by disruption to essential health services, are far higher.

An unknown number of survivors live with post-COVID condition, or long-COVID, a condition we are only beginning to understand.

Health systems continue to be overwhelmed. Millions have missed out on essential life-saving health services including for noncommunicable diseases and mental health.

Progress against HIV, tuberculosis, malaria and many other diseases has stalled or gone backwards, as has access to reproductive health services and other critical services.

Millions of children have missed out on vaccinations for other life-threatening diseases, and months of education.

Millions of people have lost their jobs, or been plunged into poverty.

The global economy is still clawing its way out of recession.

Political divisions have deepened, nationally and globally.

Inequalities have widened.

And increases in domestic violence, child marriage, and unpaid work have been reported from around the world.

The pandemic is a powerful demonstration that when health is at risk, everything is at risk, which is why the task of supporting countries to progress towards universal health coverage is more urgent than ever.

Now is the time to reignite and intensify our work to reach WHO's goal of one billion more people benefitting from universal health coverage by 2025, and to reach the Sustainable Development Goals by 2030.

Universal health coverage is based on the principle of access to quality health services for everyone - the rich and the poor, the healthy and the sick, the young and the old - and everywhere, along the life course, without fear of financial hardship.

Health systems need to both be able to deliver routine health services and be able to respond to emergencies when they strike.

This was the theme of WHO's recent position paper on health systems resilience toward Universal Health Coverage and Health Security.

These efforts need to be tailored to the unique context of each country, fostering a whole-of-government and whole-of-society approach to address the social, environmental and economic determinants of health, including human rights, gender equality and the existential challenge of climate change.

Beyond the disease and death caused directly by COVID-19, the pandemic has severely disrupted the provision of many essential health services, and illustrated the inequities that lie at the root of so many of the world's health problems.

Currently, an estimated 3.6 billion people - nearly half the world's population - lack access to essential health services. Every year, 930 million people risk poverty because of out-of-pocket spending on health care.

The COVID-19 pandemic has only set us back further.

At the end of last year, WHO launched a Special Programme on Primary Health Care, to support countries to strengthen primary health care as the foundation of universal health coverage.

The programme is advancing evidence and measurement in primary health care, scaling-up innovation for greater impact, and promoting policy leadership, advocacy and strategic partnerships.

In times of emergency, primary health care can help to ensure the continuity of essential health services, while enhancing trust and confidence in health systems.

We have seen how countries that have invested adequately in primary health care have responded more effectively to COVID-19, thanks to the level of trust established over time between communities and the health system.

Such trust is crucial when it comes to vaccines and other preventive measures related to COVID-19 and other health emergencies.

WHO and partners are also working to implement a coherent, more efficient approach to health system strengthening by eliminating silos by disease, programme, care level or health priority.

As a leading member of the ACT Accelerator, we are working to urgently address health system bottlenecks that are impeding the use of COVID-19 vaccines, therapeutics, and diagnostics.

WHO also works at the regional and country level to promote infection prevention and control measures, and to minimize disruptions to essential health services.

Let me leave you with three priorities:

First, we have to end the acute stage of the pandemic, and the disruption it is causing to health systems, societies and economies.

Second, we must strengthen the global health architecture.

This includes the proposed international agreement on pandemic preparedness and response; as well as enhanced governance, financing, systems and tools, and a strengthened, empowered and sustainably financed WHO at the centre of the global health architecture.

During his visit we discussed this with former President Dr Fernandez, and we will collaborate with this foundation.

And third, we must refocus our efforts on the basics: strengthening health systems, prioritizing investment in government funded public health functions, and investing in primary health care as the foundation of universal health coverage.

This must also include well supported preparedness and response capability that includes a One Health approach to address the intersection of human, animal and environmental health.

The pandemic has highlighted that health is not a product of strong and prosperous nations; it is the means.

A healthy population is a secure, resilient and prosperous population.

And the best way to protect and promote the health of a population is to make sure all its people can access the health services they need, where and when they need them, without facing financial hardship.

Muchas gracias. I thank you.

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