Speech at World Health Assembly

Madam President, Director General, Honourable Ministers,
Excellencies, ladies and gentlemen,        

Seven years ago in New York, I had the privilege of signing the Millennium Declaration together with 189 other Heads of States or Government, 

That Declaration solemnly lays down 8 fundamental goals – the Millennium Development Goals – for human progress towards the year 2015. And I was humbled to set my name on it, not least because, with so few words, it implicitly told an epic story of how far we have come, as societies and human beings, in overcoming injustice and inhuman and degrading living conditions.

Implicitly, the Millennium Development Goals tell us that in fact, we have come quite far since we started to develop civilizations. 

Humankind started to use tool some 50 000 years ago.

Industrialization is about 200 years old.

Real anaesthetics are 150 years. 

Vaccines 100 years.

And antibiotics are a little more that 50 years old.

We have seen more advances in human health during the past 100 years than in all previous human history.

But in the year 2000, we believed and promised that we would be able to reduce child mortality by two-thirds within 15 years - by 2015 – which is the goal No.4.

And we believed and promised that in the same brief period we would reduce by half the proportion of people living on less than a dollar a day or who are suffering hunger!

We have tremendous means and resources, which can allow us to reach those goals in 8 years from now.  These goals are tremendously courageous.

But I have no doubt that this is possible.  We as countries and people can organize ourselves and pool our resources, and deliver on those promises.

I remember travelling home from the Millennium Summit knowing that I represented a country of 4 million people, but a fortunate and affluent country. Norway could not alone realize the goals. But we could make a substantial difference. And as Prime Minister I had then as I have now the privilege to influence my country’s long-term commitments.

Since then, Norway has been pursuing all Millennium Development Goals, but we have focussed in particular on No. 4 dealing with child mortality, and No5 on maternal health, since the two are so intertwined.

Today, I have come to tell you how I want to work with you.

And I hope that one day we will be able to look back and to say that we did save millions of little children, and their mothers,

so that millions of families can rejoice over their children growing up as strong and healthy members of their communities.

Honourable Ministers,

We are all privileged to be in key positions with regard to providing health services and making these key assets universally available.

You have come together this week to foster global solidarity for health.

The state of global health has a profound impact on all nations. No national asset has greater value than a healthy, educated population.

Few other investment yields higher rates of return than investment in health and education for all. 

And such policies will help lead countries where poverty and ill health is endemic out of the vicious circle and into a virtuous one.

We know that prosperity can bring better health. But we also now know that a healthy population is fundamental to economic growth.

You have the demanding task of providing the best possible health to the people of your nation.

The primary responsibility rests with national governments. Unless you deliver a workable health system, there is little the international community can do.

But you need the support of the entire cabinet, not least of ministers of finance, in your own country to deliver.

You need to build the case for domestic investment in health as priority expenditure.

And all your efforts must be shielded and supported by Prime Ministers and Presidents around the world who must ensure adequate health budgets for their citizens as a priority of the first order.

 

Honourable Ministers,

In a globalized world, disease pathogens, toxic substances as well as bad habits travel without passports and visa at unprecedented speed and scale.

HIV/Aids, drug resistant tuberculosis and new epidemics are a threat to us all.

Therefore the health of our people depends profoundly on what happens in the rest of the world.

This is why national and global health security has taken on new meaning. Global health security is only as strong as its weakest link. Critical capacity in each country is essential. The response must be a shared commitment to act together.

Global health and global health security today pose challenges that go way beyond the health sector.

My Foreign Minister has engaged in global health from a foreign policy perspective.

In March this year, a group of foreign ministers from around the world met in Oslo. They agreed that health is a pressing foreign policy issue of our time;

Because:

Health can threaten societies;

Health concerns is a key element of many trade arrangements

Protecting health in crises leads to swifter recovery;

Health can be a bridge to peace and reconciliation. 

They will now invite others to join in order to take the issues forward.

 

Honourable Ministers

There can be no health security without skilled health workers on the ground.

We can all do more to better use our own workforce. But we also need to collaborate in order to stem the flow of skilled workers from poorer to richer countries. My Government is committed to tackling this challenge in a global framework.

The WHO is a key member of the UN family. In a globalized world we need multilateralism and a strong UN, to address global challenges in an efficient and coordinated way.

We need a UN that

• delivers on the Millennium Development Goals,
• A UN that responds effectively to your needs,
• A UN that delivers as one, and achieves results, documented by independent assessment.

Together with Prime Minister Diogo of Mozambique and Prime Minister Aziz of Pakistan, I had the honour to chair the high level UN Panel on System-Wide Coherence.

To make the UN more efficient we recommended establishing One UN in each country. One leader, one programme, one budget framework and one office where feasible.

One reason for inefficiency is mission creep in many UN organizations. For example more that 16 different UN organisations are involved in water and sanitation.

Roles and responsibilities have become blurred at the expense of core functions.

We are very pleased that the WHO’s new Director General, Margaret Chan, is prepared to follow through on our recommendations. She has committed the WHO to focussing on its core functions. Also for that reason, Margaret Chan is truly an outstanding leader!

Every 3 seconds a child dies, and every minute a pregnant woman dies in our globalized world.  All together over 10 million deaths every year.

This is unacceptable. It is a moral imperative that we take corrective action as prescribed for us in the Millennium Development Goals.

The time is right:

• We are at the half way point between 2000 and 2015,
• Countries, with the support of the UN, have developed plans for reaching the goals on child and maternal health,
• We have a new Partnership for Maternal, Newborn and Child Health,

It is a big challenge but we are seeing progress in many areas.

Vaccination is important. Norway has supported the Global Alliance on Vaccines and Immunization from its inception in 2000:

• Over 150 million children have received new or old vaccines with GAVI support.  According to UNICEF and the WHO this has saved 2.3 million lives.
• GAVI results have provided a platform for generating more funds. New financial mechanisms such as the International financing facility for immunization and Advanced market commitments have been established. The resources for GAVI have tripled.

The Norwegian government is establishing partnerships with several large countries to facilitate their own plans to reach MDG 4&5. One example is our cooperation with India. The Indian Government under Prime Minister Singh, introduced a maternal benefits scheme two years ago. The number of mothers giving births in a health facility has more than doubled. This will be announced also by the Honourable Minister of Health India. His government is now building on this success by taking bold steps to extend this scheme to newborns. We are proud of being part of this effort.

What we need to do is to develop a plan for scaling up of the most cost-effective interventions that will save a great many lives at low costs. 

Since all resources are scarce, they must be managed prudently to yield the greatest effect. We must manage and measure our efforts, according to the best practices that we see today, and improve them further together.

That is why for some time now, we have worked with a number of partners to develop a “Global Business Plan”, to accelerate the progress towards Millennium Goals No 4 and 5.

 

Today I am pleased to announce that a draft concept for such a global plan will be made available to you shortly for your consideration.

My hope is to be able to launch the plan in New York in September.

My hope is further that the plan will help us mobilize additional resources that will help us successfully achieve the goals on child mortality and maternal health.

This plan will underscore

• Why we need to do more to fight maternal and child health.
• How we should better organize ourselves to meet these goals
• and outline what more is needed to attain the Millennium Goals 4 and 5.

The plan may provide the political impetus at the highest level to facilitate country led action. I am very pleased that

Presidents Yodhoyono of Indonesia, President Kikwete of Tanzania, and President Guebuza of Mozambique, - Chancellor Gordon Brown, Bill & Melinda Gates and Graca Machel have so far agreed to join in this effort as members of a network of global leaders.

The global health arena is becoming crowded with a multitude of initiatives. Therefore, in this effort we are proposing to focus on strengthening health services as measured by improvements in maternal and child mortality.

Thus we are proposing a results-based approach.

This approach will allow us to consolidate the international health architecture.

Ideally the international community should provide unified support to a single plan, the country’s own health plan.

The approach will strengthen coordination and reinforce core functions of international agencies in line with the UN reform agenda.

Moreover, a results-based strategy provides a good balance between flexibility and accountability:

It allows flexibility of resources at the local level where the needs are best understood.

It allows greater accountability by strengthening the reporting of outcomes.

Based on the Global Business plan we shall:

Build a strong advocacy and communication effort to facilitate government led action.

Mobilize additional financial resources for country support, research and innovation.

Honourable ministers,

This effort must be led by you. Only if you deliver can we deliver.

To save a mother’s life,
To save a child’s life,
is a gift to its family,
a gift to its nation,
a gift to the sustainable future of our planet.

Thank you very much!