Monday, 3 February 2025

WHO Director-General's opening remarks at the 156th session of the Executive Board – 3 February 2025

https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-156th-session-of-the-executive-board-3-february-2025

Good morning, happy New Year, and welcome once again to your WHO headquarters.

As you know, for me 2024 ended with a narrow escape in Yemen, when the airport in Sana’a was attacked while I was there, waiting for my flight home.

I want to express my heartfelt gratitude to each of you who reached out with calls and messages of support. Your kindness provided comfort during such a frightening moment. I wanted to express my gratitude to you and also, I thank God for sparing me.

I was fortunate, but it was reminder of the threat that so many people live with every day in dangerous situations around the world, including many of my WHO colleagues, and humanitarians at large.

For them, and for WHO as a whole, 2024 was a year of significant challenges.

It was also a year of significant milestones.

At the World Health Assembly in May, Member States approved our new global health strategy, the 14th General Programme of Work, with an ambitious target to save 40 million lives over the next four years.

You also approved a historic package of amendments to the International Health Regulations;

And you agreed to conclude negotiations on the WHO Pandemic Agreement in time for the next World Health Assembly.

In November, we also concluded the first WHO Investment Round, which helped to mobilize half of the resources we need to implement GPW14 over the next four years;

And in December I joined President Macron to officially open the WHO Academy in Lyon, France – a major step towards making WHO an organization that delivers an impact in countries.

There were also many achievements to celebrate in our threefold mission to promote, provide and protect health.

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First, our mission to promote health and prevent disease, by addressing its root causes.

As you know, noncommunicable diseases account for seven of the top 10 causes of death globally, including cardiovascular disease, diabetes, cancer and chronic respiratory disease.

One of WHO’s key focuses is addressing the risk factors for NCDs in the food people eat; the air they breathe; the roads they use; and the products they consume, including tobacco – the world’s leading cause of preventable death.

This month marks the 20^th anniversary of the entering into force of the WHO Framework Convention on Tobacco Control.

Over the past two decades, thanks to the WHO FCTC and the MPOWER technical package that supports it, smoking prevalence has dropped by one-third globally.

Last year, Georgia, Lao PDR and Oman introduced plain packaging on tobacco products;

With WHO support, Viet Nam prohibited e-cigarettes and heated tobacco products;

And through our partnership in the Tobacco-Free Farms Initiative, we have supported more than 9000 tobacco farmers in Kenya and Zambia to shift away from growing tobacco to growing high-iron beans.

Another key focus is addressing the drivers of disease in the diets people eat.

In 2024, Lebanon, Mauritius and Nepal passed best practice policies on trans fat elimination;

Thirty-four countries have now joined the Acceleration Plan to stop obesity, representing one-third of the global population with obesity;

We published a new guideline on wasting, and supported 14 countries with the highest burden to implement it.

We’re also seeing progress in preventing deaths and injuries from drowning, road traffic crashes and violence;

We’re integrating behavioural science into more areas of our work;

And we continue to support countries to build climate-friendly and climate resilient health systems.

We have mobilized US$ 150 million to support low- and middle-income countries to protect the health of their people from climate risks;

And at COP29 in Azerbaijan, we signed an agreement to keep health at the heart of climate negotiations.

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Second, our mission to provide health, by expanding equitable access to health services.

As you know, more than half the world’s population lacks access to one or more essential health services.

And two billion people face financial hardship by paying for care out of their own pockets.

To address these gaps, we’re working through the UHC Partnership to support 125 countries in all six regions on the road towards universal health coverage.

Last year we provided support to 28 countries to develop packages of services for universal health coverage, including eight countries with humanitarian crises.

And we are supporting countries to expand health services to refugees and migrants.

Ireland and Panama integrated refugee and migrant health into national healthcare plans;

Uganda provided a comprehensive health package to 1.6 million refugees;

And Colombia issued health insurance cards to 1.5 million migrants.

Just as we work to expand access to health services, so we are working to expand access to medicines and health products, and to strengthen regulatory authorities around the world.

We recognized Egypt, India, Rwanda, Senegal and Zimbabwe for achieving or maintaining maturity level 3 for regulatory oversight of medicines and vaccines.

And we designated 33 regulators as WHO Listed Authorities, making them “regulators of reference” that meet internationally recognized standards and practices.

We have now listed 36 regulators since we launched the programme three years ago.

In 2024 we prequalified 87 medicines and other products, and performed more than 150 inspections of manufacturing sites.

We launched a new platform with information on 2000 types of medical devices, which countries are using to select devices for health interventions, procurement or national reference lists.

We issued five alerts on substandard and falsified medicines;

And we selected 481 nonproprietary names for active pharmaceutical ingredients.

The International Nonproprietary Name programme is one of those things that WHO does that no one else can do, and that very few people know about, but is relevant to all countries.

Standardized names for pharmaceutical ingredients are absolutely essential for patient safety, global trade, tracking and tracing medicines, combating counterfeits, increasing access, research and more.

It’s not glamorous, but someone has to do it, and that someone is WHO.

And it is helping to increase access to lifesaving tools, including vaccines.

On antimicrobial resistance, the UN High-Level Meeting on AMR resulted in strong commitments and targets.

The number of countries reporting data on antimicrobial use to WHO has tripled from 36 in 2021 to 98 in 2024;

And countries are adopting our AWaRe recommendations on antibiotics: Nepal, for example, has banned the use of antibiotic combinations that WHO classifies as not recommended.

We also supported full implementation of surveillance for antimicrobial resistant gonorrhoea in 13 countries.

In Cambodia, implementing WHO guidelines reduced gonorrhoea treatment failure from 11% to zero.

We also developed the first guidance on wastewater and solid waste management for manufacturing of antibiotics.

Already we have trained inspectors in 52 Member States, and the AMR Industry Alliance updated its standard to align with WHO guidance.

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Last year, we celebrated the 50^th anniversary of the Expanded Programme on Immunization.

When EPI was launched in 1974, less than 5% of the world’s children were immunized. Today, that figure stands at 83%.

EPI has been the single biggest contributor to infant and child survival globally, preventing 154 million deaths – an average of 8,000 a day for 50 years.

And we continue to support countries to introduce new vaccines to save lives.

In 2024, four new countries introduced HPV vaccines;

Niger and Nigeria became the first countries to implement the new Men5CV vaccine, a meningitis vaccine;

We prequalified a new vaccine against dengue;

And we supported the rollout of more than 12 million doses of malaria vaccine in 17 countries in Africa.

Meanwhile, we are living in a golden age of disease elimination, with more and more countries liberating their people from malaria, trachoma, leprosy, lymphatic filariasis, and more.

Last year we certified seven countries for the elimination of neglected tropical diseases: Brazil, Chad, India, Jordan, Pakistan, Timor Leste and Viet Nam;

And just last week, we certified Guinea for the elimination of human African trypanosomiasis, and Niger for the elimination of onchocerciasis.

Last year, only 11 human cases of Guinea worm disease were reported from just eight villages in Chad and South Sudan.

Ghana approved a new treatment for river blindness, which was developed through two decades of collaboration between TDR, researchers, WHO country offices, and Medicines Development for Global Health.

We also certified Cabo Verde and Egypt as malaria free, and already this year Georgia has reached the same status;

Belize, Jamaica and Saint Vincent and the Grenadines were validated for the elimination of mother-to-child transmission of HIV and syphilis;

And we validated Namibia for being on the path to elimination of mother-to-child transmission of HIV and hepatitis B.

For the first time, TB treatment coverage has now reached 75% globally, 79 countries have achieved at least a 20% reduction in incidence, and 43 countries have achieved at least a 35% reduction in TB deaths.

And on mental health, we’re working with UNICEF in 13 countries in all six regions, reaching 270,000 children, adolescents and caregivers with care services.

On maternal and child mortality, progress is less encouraging.

After substantial improvements during the MDG era, progress has stalled.

We continue to work with Member States to identify the barriers and to give them the tools to overcome them.

For example, to increase uptake of family planning practices we developed a protocol to rapidly assess bottlenecks, which 27 countries are now implementing.

We published a new guideline on neonatal sepsis, and we’re supporting countries to implement it.

And we launched a new guideline on midwifery models of care, which has been shown in a study in Ethiopia to reduce emergency caesarean sections, preterm birth rates and admissions to neonatal intensive care.

Over 40 countries have developed acceleration plans to reduce maternal and newborn mortality and prevent stillbirths.

Tanzania opened 30 new care units for newborns, while Pakistan, Ghana, Sierra Leone and Malawi are also making progress.

We have come a long way on maternal and child mortality, but we still have a long way to go to reach the SDG targets.

For World Health Day this year, we have chosen maternal health as our theme, to draw attention to the need for all countries and partners to work together and prevent these preventable deaths.

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Now to the third pillar of our mission, supporting countries to protect health by preventing and responding rapidly to health emergencies.

In 2024, we responded to 50 graded emergencies around the world: conflicts, outbreaks, natural disasters and more.

This included delivering US$ 48 million worth of supplies to 78 countries.

We helped to bring cholera outbreaks under control in 27 of 33 affected countries, leaving only six in an acute phase;

With WHO support, Rwanda controlled an outbreak of Marburg virus disease;

As we speak, we are responding to outbreaks of Marburg in Tanzania and Ebola in Uganda, where Deputy Director-General Mike Ryan has travelled to oversee the response;

And as you know, in August last year I declared a public health emergency of international concern over the outbreaks of mpox in the DRC and other countries in Africa.

Although the number of reported cases has been stabilizing in DRC, the worsening security situation has led to many patients leaving treatment centres, increasing the risks of transmission.

In response to the outbreak, WHO gave Emergency Use Listing to the first mpox vaccines and tests, and established an Access and Allocation Mechanism, which coordinated donations of six million vaccine doses across 15 countries.

About 500,000 doses have been delivered, and a further 1.7 million doses will soon be available. We also provided supplies to laboratories in 136 countries to quality-assure their capacity for diagnosing mpox.

About 70,000 people have been vaccinated, mainly in DRC. Resource limitations in the affected countries, which face multiple competing health priorities, have limited the speed and scale of vaccination.

The other main part of WHO’s emergency response work last year was responding to conflicts and insecurity in Gaza, Haiti, Lebanon, Sudan, Ukraine and elsewhere.

We are very pleased to see that the ceasefire agreement in Gaza is holding, and we very much hope it becomes a lasting peace.

Our priorities are to meet acute health needs, support the operation of hospitals and primary care facilities, and transport patients within and out of Gaza for specialised care.

Since the ceasefire began, WHO has sent 63 trucks with supplies, and 30 more should arrive in the coming days.

We provide 60% of all the medical supplies, and 100% of the fuel for hospitals and Emergency Medical Team facilities.

In total during the conflict, we coordinated the deployment of 52 emergency medical teams from 26 organizations, which conducted over 2.4 million medical consultations, performed more than 36,000 emergency surgeries, and treated almost 86,000 trauma cases.

And together with our partners, we negotiated a humanitarian pause and prevented a resurgence of polio by vaccinating more than 550,000 children.

We can only hope that 2025 also brings an end to the conflicts in Sudan and Ukraine.

In Sudan, an estimated 32,000 people have been killed, 30% of the population is displaced and 20 million people need humanitarian aid.

I visited Sudan in September, where I saw the effects of the civil war and met people who are paying the price.

The following week I was in Chad, where I travelled to the border town of Adré and met some of the 900,000 Sudanese refugees who have fled, seeking security and food.

And they are just a fraction of the 122 million people globally who have been forced to flee their homes.

In Gaza, Lebanon, Sudan, Ukraine and elsewhere, we continue to see attacks on health care, which are becoming a “new normal” of conflict.

Last year we verified more than 1500 attacks on health care in 15 countries and territories, with 932 deaths and 1767 injuries.

It’s frustrating that almost no one is ever held to account for these violations of international law.

So with our partners we launched a new report last year with nine recommendations for bringing to account those who perpetrate attacks on health care. We urge Member States to implement these recommendations.

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Of course, responding to emergencies is just one part of our work. In response to the lessons learned from COVID-19, WHO has strengthened its work in every dimension of emergency prevention, preparedness and response.

Every day, we scan the world for public health threats.

Last year, we assessed more than 1.2 million potential signals;

And through the WHO Hub for Pandemic and Epidemic Intelligence in Berlin, we are supporting countries to strengthen their capacities in genomic surveillance.

The International Pathogen Surveillance Network, established in 2023, now includes 230 organizations in 85 countries;

We supported 19 countries to complete Joint External Evaluations, with another 21 scheduled for this year.

And three countries completed pilot studies of the Universal Health and Preparedness Review.

In addition to these general preparedness activities, we’re also supporting countries to prepare for specific threats, including Ebola.

Ebola outbreaks are often fuelled by nosocomial transmission, so with Gavi, we vaccinated 150,000 health workers in six countries against Ebola, the first time this has happened outside of an outbreak response, to prevent any future outbreak.

We also supported the vaccination of 53 million people against Yellow Fever in five countries;

And we have monitored carefully the concerning spread of avian influenza among dairy cattle in the United States.

Through the Global Influenza Surveillance and Response System, GISRS, we facilitated sharing of more than 100 zoonotic flu samples with WHO Collaborating Centres last year, and uploaded 525 avian influenza genetic sequences to publicly available databases.

And we recommended nine new zoonotic candidate vaccine viruses, available globally to manufacturers to produce vaccines in case of an influenza pandemic.

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Honourable ministers, dear colleagues and friends,

All of this work to promote, provide and protect health is supported by our efforts at all three levels of the Organization on the fourth and fifth Ps of GPW14: to power and perform for health, through science, digital technologies, data and our ongoing Transformation.

Last year, we conducted a review of our Transformation, to see what has worked, and what has not.

Based on the review, we have reprioritised Transformation and aligned it with the priorities of GPW14.

One of the successes of Transformation has been the establishment of the Science Division.

WHO’s normative, standard-setting work is its bread and butter, and the Science Division is helping us make sure we give Member States the highest quality, evidence-based advice as fast as possible.

Last year there were 65 million downloads of WHO publications, guidance, and other materials.

We launched important new guidelines on avian influenza, artificial intelligence, tobacco cessation, Mpox diagnostics, and so much more.

Starting this year, we are aligning our guidelines and normative work with prequalification, meaning we will prequalify a product and issue guidelines on how to use it at the same time.

This will speed up equitable access to proven interventions and increase investments from the public and private sectors, as the systems will become more transparent and predictable, completed within a 12-month period.

The first product under this new process will be lenacapavir, an exciting new medicine for the treatment and prevention of HIV.

Although a true HIV vaccine remains elusive, lenacapavir is the nearest thing we have to it: a new injectable antiretroviral taken every six months that has been shown to prevent almost all HIV infections in those at risk.

We have initiated the guideline and prequalification processes in parallel, which will support the rapid rollout of this product, which we expect in the first half of this year.

Another success of Transformation has been our increased focus on digital health, which will underpin health systems in every country in the very near future.

Last year, the Global Digital Health Certification Network enabled Oman, Indonesia, and Malaysia to issue 250,000 international patient summaries for 2024 Hajj pilgrims, supporting emergency care for 78% of scanned records.

The Network now covers 82 countries, benefiting nearly two billion people. And I thank the EU for their support in this.

Another key element of our transformation has been our focus on data.

We created the World Health Data Hub to make health data available to anyone, anytime, using digital technologies including artificial intelligence.

Every country in the world now accesses the Hub, which is a secure and standardized pathway to increased transparency, accountability, and progress.

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Honourable ministers, dear colleagues and friends,

As you know, two weeks ago, President Donald Trump signed an Executive Order announcing his intention to withdraw the United States from WHO.

We regret the decision, and we hope the US will reconsider. We would welcome constructive dialogue to preserve and strengthen the historic relationship between WHO and the USA that helped bring significant impacts like the eradication of smallpox - I can give you a long list.

The Executive Order gave four reasons for the decision to withdraw from WHO.

First, it says that WHO has “failed to adopt urgently needed reforms”.

As this Board is aware, over the course of the past seven years, under the guidance and governance of Member States, WHO has implemented the deepest and most wide-ranging reforms in the Organization’s history.

The WHO Transformation has touched every part of our work: our strategy, operating model, processes, partnerships, financing, workforce and culture.

We have also taken action on the recommendations of the Agile Member States Task Group;

We have implemented 85 of the 97 reforms proposed in the Secretariat Implementation Plan on reform;

And we are implementing the recommendations of the Action for Results Group, led by WHO Representatives, to strengthen our country offices.

For us, change is a constant, and that's what our Member States told us when we started the reform, "change is a constant". We believe in continuous improvement, and we would welcome suggestions from the United States and all Member States for how we can serve you and the people of the world better. So, although we are doing a lot of reform, additional is welcome.

Second, the order says that WHO “demands unfairly onerous payments from the US, out of proportion with what other countries contribute”.

Member States understand how assessed contributions are calculated, and you know that some countries choose to make higher voluntary contributions than others.

Addressing the imbalance between assessed and voluntary contributions, and reducing WHO’s over-reliance on a handful of traditional donors, has been one of the major areas of our Transformation. Because when we started the Transformation, the reliance on a few traditional donors was identified as a risk. And we have decided then, seven years ago, to broaden the donor base.

Last week the PBAC recommended the next 20% increase in assessed contributions, and we ask this Board to endorse that recommendation.

This is a critical element of our long-term plan to broaden our donor base, and will over the long term reduce the burden of financing for traditional donors, including the U.S.

We therefore continue to seek the support and engagement of all Member States, including the U.S., for our shared vision to put WHO on a more sustainable financial footing.

Third, the order refers to WHO’s alleged “mishandling of the COVID-19 pandemic and other global health crises”.

Last week marked five years since I declared a public health emergency of international concern, on the 30^th of January 2020. At the time, outside of China there were fewer than 100 reported cases, and no reported deaths.

On New Year’s Eve 2019 and New Year’s Day 2020, when much of the world was on holiday, WHO was not.

From the moment we picked up the first signals of “viral pneumonia” in Wuhan, we asked for more information, activated our emergency incident management system, alerted the world, convened global experts, and published comprehensive guidance for countries on how to protect their populations and health systems – all before the first death from this new disease was reported in China on the 11th of January 2020.

Of course there would be challenges and weakness, and there have been multiple independent reviews of the global response to COVID-19, with more than 300 recommendations to address the challenges or the weaknesses.

In response to those recommendations, WHO and our Member States have taken many steps to strengthen global health security: the Pandemic Fund; the WHO Hub for Pandemic and Epidemic Intelligence; the mRNA Technology Transfer Hub; the Global Training Hub for Biomanufacturing; the Global Health Emergency Corps; the interim Medical Countermeasures Network, and more. So, all of this has been established based on the lessons learned.

And as I mentioned earlier, Member States have committed to concluding negotiations on the Pandemic Agreement in time for this year’s World Health Assembly.

Finally, the Executive Order says WHO has an “inability to demonstrate independence from the inappropriate political influence” of our Member States.

As a UN agency, WHO is impartial and exists to serve all countries and all people.

Our Member States ask us for many things, and we always try to help as much as we can.

But when what they ask is not supported by scientific evidence, or is contrary to our mission to support global health, we say no, politely. And you have seen me doing that many times.

As Member States know, that is what we have done on several occasions to countries of all income levels, in all regions.

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Honourable ministers, dear colleagues and friends,

Even before the US announcement, WHO was facing a shortfall due to the economic difficulties that many countries are facing.

For many months, the Regional Directors and I, with the support of senior management, had been working with twin strategic goals: to mobilize new resources; and to tighten our belts.

The U.S. announcement has made the situation more acute, and we have announced a set of measures with immediate effect to protect our work and workforce to the greatest extent possible:

We are conducting a strategic alignment of resources with activities;

We are freezing recruitment, except in the most critical areas;

We are significantly reducing travel expenditure;

And we are looking to renegotiate major procurement contracts and reduce capital investments.

More measures will be announced in due course.

Our main objective is to protect our most important asset: our people – the dedicated, talented professionals who today are working around the world to help the people we serve to breathe cleaner air, eat healthier diets, drink safer water and use safer roads;

They are working to help people get the safe, quality health services and products they need, where and when they need them, without worrying about what it will cost;

And they are working to stop outbreaks and deliver lifesaving care in the most difficult and dangerous situations.

In short, they are committed to promoting, providing and protecting health.

I am proud to call them my colleagues.

And together, we remain committed to the vision that you, our Member States had almost 77 years ago:

The highest attainable standard of health – not as a luxury for some, but a right for all.

I thank you.

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