20 June 2005

Serious Efforts Needed to Build Health Systems with Universal Access in Developing Countries, Secretary-General Tells Doctors Awards Dinner

NEW YORK, 17 June (UN Headquarters) -- Following is the text of the remarks as prepared for delivery by United Nations Secretary-General Kofi Annan at the Doctors of the World Health and Human Rights Leadership Awards dinner in New York on 16 June:

It is a privilege and a pleasure to be here tonight. I am moved by the honour you have bestowed on me. Let me offer my congratulations to the other two awardees this evening. I am glad to be counted in their company.

Above all, let me pay tribute to Doctors of the World and their partners for the wonderful work they are doing around the globe, and offer my warmest wishes on this fifteenth anniversary. By focusing on places where health is endangered by human rights violations, by reaching out to the most vulnerable and marginalized populations, together with local partners, your work goes to the very heart of the ideals the United Nations stands for.

This is a special year for the United Nations. It not only marks our sixtieth anniversary. It is also a year in which we are thinking ahead, and engaging in a constructive debate about the future: how to defeat poverty and reach the Millennium Development Goals; how to build a collective security system able to meet our common threats; and how to increase respect for human rights in every land.

Health is essential to our mission in all its aspects. That is something I have been deeply conscious of ever since I first started my career in the UN family. Some of you may not know it, but my first job was in the World Health Organization -- back in the mists of time, just as the Salk oral vaccine against polio was being introduced, 18 years before smallpox was eradicated worldwide, and a good 20 years before the word AIDS entered our global vocabulary.

Over the decades that have passed since then, the connections between health, development and security have become increasingly clear. And it has become equally clear that health systems around the world are nowhere near equipped to deal with the challenges facing them.

The magnitude of the crisis is most severe in Africa. Today, a child born in some sub-Saharan countries cannot expect to live until the age of 40. Almost 11 million children die from preventable disease every year -- including 1 million a year from malaria. AIDS killed more people last year than ever before, and is taking a rising and disproportionate toll among women. It continues to wreak a path of destruction across the most affected countries, with a steady erosion of public services -- from police to education and local government, and, of course, public health.

But the challenges facing us in health are global, and they do not respect boundaries. Experiences in the past few years have forced Governments everywhere to accept that no country is immune.

SARS infected over 8,000 thousand people in 30 countries in the course of three months during 2003, and managed to compromise rudimentary and advanced health systems in both developing and developed countries.

Since then, bird flu has forced the slaughter of more than 100 million animals in Asia. Experts warn that we could be on the verge of a new global epidemic of influenza. The last one, which began in 1918, killed up to 50 million people -- and that was before the age of air travel. Experts agree that we are not much better prepared today than our grandparents were then.

The same or more dramatic consequences could result from an accidental or deliberate release of lethal biological agents. Those risks are bound to grow as advances in biotechnology continue to outstrip our capacity to establish necessary safeguards and regulations.

All those threats to our biological security, disparate as they may seem, are interconnected. We have no choice but to address them all.

That will require acting on a number of priorities:

First, we must disabuse ourselves of the notion that health is either exclusively a “development issue”, or exclusively a “security issue”. It transcends compartmentalized policies and responses. We must abandon traditional bureaucratic thinking, and work across ministries and departments to forge a holistic approach equal to such an all-encompassing challenge.

Second, we must devote greater resources to disease surveillance and response. I am heartened that, just last month, the World Health Assembly adopted newly revised International Health Regulations -- a bold and necessary step to improve global efforts to contain outbreaks. Governments must devote greater attention and resources to building local and national capacities. Donors -- if only out of self-interest -- must work with developing countries and assist them.

Third -- and most important -- we must make new and serious efforts to build health systems that afford universal access in developing countries. At the core of this challenge, we need to address the acute shortage of health workers in so many developing countries.

We must also move away from the kind of health interventions that I would liken to peacekeeping without peacebuilding: humane and essential, but all too often lacking the necessary longer-term effort to consolidate and make results sustainable.

Doctors of the World was founded by a group of volunteer physicians who were united by a common vision. I would especially like to remember one of them tonight: Dr. Jonathan Mann.

Until his tragic death in a plane crash in 1998, Jonathan Mann provided a strong and vital link between our two organizations. Not only did he help found Doctors of the World: he also created the first AIDS programme of the United Nations system.

If Dr. Mann had a motto, it was that the way you define a problem will determine what you do about it.

And as he sometimes said: “People say there is no use trying to change the world. But if we don’t try, will it change?”

That is the way I would like us to think about health in the twenty-first century. I am grateful to every one of you for your commitment to our shared mission.

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