Your Excellencies, distinguished guests, colleagues and friends,
ia Orana!
It’s a great honour to be here.
I feel like I am coming home and very special when I come to the Pacific.
I extend my deep gratitude to French Polynesia for hosting this meeting. Before coming here I had a great discussion with the President.
WHO is proud to support the new Health Sector Plan adopted here in French Polynesia, with its emphasis on primary health care.
I had the privilege of spending some time here in the Pacific during my campaign, and it’s wonderful to be back.
I was hoping to join you for the last Ministerial meeting in 2017, but as you know I had only just started my tenure as Director-General, so Dr Maria Neira joined the meeting in the Cook Islands. .
I’m glad we had the opportunity to meet during the WPRO Regional Committee meeting in Brisbane in 2017.
We’re also very proud to have Elizabeth Iro from Cook Islands as part of our senior leadership team in Geneva.
When I appointed Elizabeth, some people said to me, “A Chief Nursing Officer from the Cook Islands? Where is the Cook Islands anyway? Is it even a country?”
Elizabeth proves that talent is universal, but opportunity is not.
She’s doing a fantastic job. Elizabeth is leading preparations for the Year of the Nurse and Midwife next year, which will be a very important opportunity to highlight the vital role nurses and midwives play, especially in primary health care.
My message to you this morning is: WHO is committed to you and the people of the Pacific.
We have 194 Member States. Every single one is important, because every single person is important.
In the Sustainable Development Goals, we have committed to leave no one behind.
That is a promise that I take very seriously.
When I was last in the Pacific, I heard a recurring set of themes about the challenges you are facing.
Climate change.
Noncommunicable diseases.
Health security.
Weak primary health care.
Each of those challenges is addressed in the “triple billion” targets in WHO’s five-year strategic plan.
And I’m pleased to see each of those challenges reflected in your agenda this week.
One of the most important is the roadmap for implementation of the Pacific Islands Action Plan on Climate Change and Health.
Although you are the least responsible for climate change, you are among the most at risk.
Even as we sit here, the effects of climate change are lapping at the shores of this beautiful island.
The world is facing a climate crisis, and the Pacific is on the front line.
I believe strongly that to elicit the action we need, we must reframe climate change as a health issue.
The effects of climate change on the atmosphere, polar ice caps and sea levels are serious and significant, but for many people they aren’t close enough to home.
However, the effects of climate change on human health are much more immediate, including death and disease caused by extreme weather events, heat stress, waterborne and foodborne diseases, malnutrition and more.
This is especially true in the Pacific, where extreme weather events and environmental changes are increasingly common, and communities are more vulnerable.
When Tropical Cyclone Winston hit in 2016, 88 of 214 health facilities in Fiji were damaged. Seven of them were hit so badly that patients had to be relocated to get the health services they needed.
At the last Pacific Health Ministers Meeting in 2017, you called for a significant scale-up of efforts and increased investments to address the health impacts of climate change.
Soon after that, WHO established a special initiative on climate change and health in small island developing states.
We launched the initiative during COP23 in Bonn, in cooperation with UNFCCC and His Excellency Frank Bainimarama, the Prime Minister of Fiji, who was the President of COP23.
We held three consultations – one in Mauritius for the Indian Ocean states, one in Grenada for the Caribbean, and one in Fiji for the Pacific.
Following those consultations, we developed an action plan, based on regional plans including the Pacific Action Plan, which was endorsed during the World Health Assembly in May.
The implementation roadmap you are discussing this week identifies concrete actions for you and for WHO in the four strategic lines of action – empowerment, evidence, implementation and resources.
We are committed to those actions, and to working with you to implement the action plan as a matter of urgency. There is no time to lose.
Climate change also has consequences for another item on your agenda –health security.
Extreme weather events increase the risk of both natural disasters and emerging infectious diseases.
I’m pleased to see the progress you have made on keeping the region safe, especially in the area of emergency preparedness.
One of the tragic lessons the world is learning from the current Ebola outbreak in the Democratic Republic of the Congo is that we must fix the roof before the rain comes.
An emergency is the wrong time to discover you are unprepared. Investments in preparedness not only save lives, they save money.
I congratulate you all on the progress you have made to strengthen your core capacities under the International Health Regulations.
It’s also encouraging to see the development of new tools such as the ongoing trial of Wolbachia-carrying mosquitoes.
WHO is committed to working with you to further strengthen your defences and keep the region safe.
But although outbreaks and other emergencies capture headlines, there is a much more severe health crisis threatening the Pacific – the epidemic of noncommunicable diseases.
The NCDs is crisis even more dangerous than an emergency because it is not sudden or dramatic. It is slow and silent. And the impact in terms of morbidity, mortality and health spending will be just as bad, if not worse.
Again, you have made good progress. 14 of 21 Pacific island countries have a current and active national NCD strategy, and we are committed to supporting the remaining 7 countries to develop their strategies.
It’s also pleasing to see that most of your countries have increased taxes on tobacco, alcohol and foods high in salt, sugar and trans fats.
But much work remains to be done.
Too few countries – 5 out of 21 – have a functioning national multisectoral NCD task force.
Too few have legislation to prevent tobacco industry interference.
Too few have established the necessary policies to combat childhood obesity.
We simply cannot win the war against NCDs without closing these gaps, and we cannot do that without involving all sectors.
WHO recognizes the challenges and constraints you all face. We are ready to work with you to protect your children and your nations from NCDs.
But the key underlying factor in all of the issues you are discussing this week is the need for stronger health systems.
Many of your countries have a lot to be proud of, especially in terms of universal health coverage.
And it’s especially pleasing to see the emphasis you are putting on primary health care.
As the Declaration of Astana affirms, primary health care is the bedrock of universal health coverage.
There is perhaps nowhere on earth where primary health care is more important than here in the Pacific, where your populations are dispersed over many islands in a wide geographic area.
This is why primary health care is key for this region.
Large referral hospitals are always important, but we cannot expect people to travel miles by boat for services that could and should be provided locally.
The best effective and efficient investments are those that keep people out of hospitals, including immunization and WASH – two of the other items on your agenda.
Both are vital for preventing infections and saving lives.
Realizing the vision of primary health care will entail important changes inside and outside the health sector.
Within the health system, we must focus on strengthening and reorienting the health workforce to make sure we have the right staff with the right skills in the right places.
Outside the health system, it’s vital that governments adopt a health-in-all policies approach. Health promotion and disease prevention must start with addressing the root causes of ill health, in the air people breathe, the food they eat, the roads they drive on and the conditions in which they live.
These changes have the power not only to improve the health of populations, but to change the trajectory of nations.
My brothers and sisters,
I leave you with five requests.
First, I would like to propose that we continue meeting regularly, during the World Health Assembly each May. This meeting could be preceded by a meeting of experts to lay the groundwork for our discussions.
Second, I urge you not only to adopt the implementation roadmap for the Pacific Islands Action Plan on Climate Change and Health, but to find new and innovative ways of working. The White Paper is a very useful tool for that.
As I said, WHO is committed to our actions, and we look to each of your countries to carry out yours.
The United Nations Climate Action Summit during the UN General Assembly next month will highlight the enormous benefits that addressing climate change could bring, not only for the environment, but for economic growth, jobs and human health.
World leaders will be asked to make concrete commitments with tangible impacts on climate mitigation and adaptation.
WHO has been given the mandate to develop two health commitments.
First, commit to save lives, cut carbon emissions, clean our air.
Second, commit to invest in climate action, public health and sustainable development.
Each of these commitments comes with concrete actions for governments, development banks and funds, bilateral agencies, NGOs and the private sector.
We urge the Pacific Island countries and areas to make these commitments themselves, but also to promote them. We need as many national and subnational governments, mayors, donors and partners as possible to sign up in advance of the September summit.
My third request is that you continue to invest in emergency preparedness. Although your nations are geographically remote, in our global community you are still vulnerable.
We urge each of your states to ensure that your IHR National Focal Points have the resources they need, and that you work across sectors for emergency preparedness – these investments will save lives and save money in future.
Fourth, winning the war against noncommunicable diseases is not a job for the health sector alone. We need all hands on deck.
It is essential that you work with your colleagues across government to address the determinants of health.
I urge those of you who do not already have one to develop a functional, national multisectoral NCD task force as a matter of priority.
Fifth, investments in building a strong health workforce are also especially important.
The Year of the Nurse and Midwife next year is a great opportunity to ensure that nurses and midwives get the education, the training, the jobs, the conditions, the opportunities, the dignity and the respect they deserve.
As part of next year’s celebrations, we are proposing that every country bring one nurse and one midwife to the World Health Assembly next year.
We are also working on the first report on The State of the World’s Nursing, to present to the World Health Assembly.
We hope that countries, regions and partners will use the data from this report to engage in policy dialogue and make evidence-based decisions on how and where to invest in the nursing workforce.
We need your support to ensure contributions from every country, to make sure our snapshot is accurate and reliable and represents the world of nursing and midwives.
Only with a relentless commitment to primary health care can we promote health and prevent disease.
Thank you all for your commitment and dedication. I assure you of mine.
Together, we can create the healthier, safer and fairer Pacific we all want.
I thank you.