WHO Director-General's opening remarks Global Health Landscape Symposium - 9 December 2021

Thank you so much Elisha, dear Madam President and Chief Executive Officer of the Global Health Council,

Dear colleagues and friends,

Thank you for the opportunity to share some thoughts with you today.

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Yesterday marked one year since the first administration of a COVID-19 vaccine.

We all believed and hoped at the time that a year later, we would be nearing the end of the pandemic.

Instead, as we enter the third year of the pandemic, the death toll has more than tripled, and the world remains in its grip.

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.

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

Progress against HIV, tuberculosis, malaria and many other diseases has stalled or gone backwards.

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.

Science has been undermined. Misinformation abounds.

And inequalities have widened.

And indeed, this is a pandemic of inequality.

Because while nobody is safe until everybody is safe, not everybody is equally at risk.

On one hand, the pandemic has exploited pre-existing inequities.

Infections, hospitalizations and deaths are grossly unequal between population groups within the same country.

Around the world, the risk of death from COVID-19 is as much as four times higher for low-income and marginalized people as for wealthy people living in the same city.

And one of the most basic protections, hand washing, is not available in one out of three health facilities globally; while one in four lack basic water services.

On the other hand, the pandemic has also exacerbated inequities.

Millions of people have been pushed deeper into poverty, particularly women, while massive disruptions to education have hurt poorer children the most.

Inequities such as these put people at risk not just for COVID-19, but for a range of health issues.

Even before COVID-19, the world was off-track for achieving the health-related targets in the SDGs. Now we're even further behind.

Of course, the greatest inequity has been in access to vaccines.

Since that first vaccination in the UK 12 months ago, more than 8 billion vaccines have been administered globally - the largest vaccination campaign in history.

As we began to see some countries striking bilateral deals with manufacturers, we warned that the poorest and most vulnerable would be trampled in the global stampede for vaccines.

And that is exactly what has happened.

More than 40% of the world's population is now fully vaccinated. But in Africa, it's just 8%.

At the beginning of June of this year, we issued a challenge to the world, to support all countries to vaccinate 40% of the population by the end of this year, and 70% by the middle of next year.

But more than 100 countries still have not reached the 40% target, and more than half of them are at risk of missing it, mainly because they cannot access the vaccines they need.

We understand and support every government's responsibility to protect its own people.

But vaccine equity is not charity; it's in every country's best interests.

We have often said that as long as vaccine inequity persists, the more opportunity the virus has to spread and mutate in ways no one can prevent or predict.

And so, we have Omicron, which threatens to unravel the gains we have made.

South Africa and Botswana should be thanked for rapidly detecting, sequencing and alerting the world to this new variant, not penalized for doing the right thing.

Indeed, the emergence of Omicron demonstrates why the world needs a new system for bringing countries together to respond to pandemics: our current system disincentivizes countries from alerting others to threats that will inevitably land on their shores.

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At its heart, the pandemic is a crisis of solidarity and sharing.

The lack of sharing of information and data by many countries in the early days of the pandemic hindered our collective ability to get a clear picture of its profile and trajectory.

The lack of sharing of biological samples hindered our collective ability to understand how the virus was evolving.

The lack of sharing of PPE, tests, vaccines, technology, know-how, intellectual property and other tools hindered our collective ability to prevent infections and save lives.

And the lack of a consistent and coherent global approach has resulted in a splintered and disjointed response, breeding misunderstanding, misinformation and above all mistrust.

COVID-19 has exposed and exacerbated fundamental weaknesses in the global architecture for pandemic preparedness and response:

Complex and fragmented governance;

Inadequate financing;

And insufficient systems and tools.

Voluntary mechanisms have not solved these challenges.

The best way we can address them is with a legally binding agreement between nations; an accord forged from the recognition that we have no future but a common future.

Global health security is too important to be left to chance, or goodwill, or shifting geopolitical currents, or the vested interests of companies and shareholders.

As you know, at a Special Session of the World Health Assembly last week, WHO's 194 Member States decided to negotiate a convention, agreement or other international instrument on pandemic prevention, preparedness, and response.

A new accord will not solve every problem. But it will provide the overarching framework to foster greater international cooperation, in four key ways:

First, better governance.

The governance of global health security is complex, fragmented and has failed to ensure effective collective action and equitable access to vaccines and other tools.

High-level threats need high-level political engagement, which is why WHO supports the idea of a heads of state council, anchored in WHO, to provide high-level political leadership for rapid and coordinated action.

Second, better financing.

Cycles of panic and neglect have created an unstable and unpredictable financing ecosystem for global health security.

Strengthening the world's defences demands financing that is truly additional, predictable, equitable, and aligned with national, regional and global priorities.

A mechanism funded solely from voluntary development assistance will only increase competition for already scarce resources.

WHO supports the idea of a financial intermediary fund supported by a Secretariat based at WHO, housed at the World Bank, and financed by countries and regional organizations on a burden-sharing basis.

Third, we need better systems and tools to predict, prevent, detect and respond rapidly to outbreaks with epidemic and pandemic potential.

In September, we opened the WHO Hub for Pandemic and Epidemic Intelligence in Berlin, a new centre designed to enhance global surveillance by harnessing the power of collaborative and artificial intelligence and other cutting-edge technologies. Collaborative initiatives are a new way and build trust.

Other initiatives are in development, including the WHO BioHub System, to provide a reliable, safe, predictable and transparent mechanism for countries to share novel biological materials.

Several countries are now piloting the Universal Health and Preparedness Review, a peer-review mechanism for enhancing national preparedness, modelled on the Universal Periodic Review used by the United Nations Human Rights Council.

And fourth, the world needs a strengthened, empowered and sustainably financed 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.

But over several decades, WHO has been weakened by a debilitating imbalance between assessed and voluntary, earmarked contributions that distorts our budget and constrains our ability to deliver and affects our independence.

One of the greatest risks to global health security now is to further weaken WHO or to further fragment the global health architecture.

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The COVID-19 pandemic demonstrates that when health is at risk, everything is at risk: the economy, jobs, trade, social cohesion, political stability and multilateralism.

That's why health cannot be seen as a luxury, but as a human right; not as a cost, but an investment; not simply as an outcome of development, but as the foundation of social, economic and political stability and security.

Health as a fundamental human right and foundation for development. That's why investment in health is the smartest thing to do for every nation.

And that's why WHO's top priority remains supporting all countries to strengthen primary health care as the foundation of universal health coverage.

Resilient health systems that provide access to the services people need, where and when they need them, without facing financial hardship, are the bedrock of global health security.

But we must recognize that a resilient health system is not the same thing as an advanced medical care system.

For too long, too many countries have invested heavily in advanced medical care, while under-investing in public health and primary health care. When COVID-19 hit, they were overwhelmed.

As the foundation of universal health coverage, primary health care is a vital first line of defence against disease outbreaks, but also for providing services for communicable and noncommunicable diseases, including mental health, and for preventing and mitigating the impacts of social, economic and environmental determinants of health, including climate change.

Ultimately, this pandemic will end, but we will still be left with many of the same challenges we had before: there is no vaccine for poverty, climate change, racism, inequality and many of the other shared threats we face.

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

Now is the time for all countries to make the choice to invest in a healthier, safer and fairer future.

I thank you.

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