May 22 2017

Extracted from the address to the Seventieth World Health Assembly

Dr Margaret Chan
Director-General of the World Health Organization

Geneva, Switzerland 
22 May 2017


Excellencies, ladies, and gentlemen,

As I speak to you, the political and economic outlook is much less optimistic than it was when I took office in 2007.

That was before the 2008 financial crisis changed the economic outlook from prosperity to austerity almost overnight, with effects on economies and health budgets that are still being felt.

That was before acts of international terrorism and violent extremism became commonplace, before the word “mega-disaster” entered the humanitarian vocabulary, before seemingly endless armed conflicts caused the largest population displacements and flights of refugees seen since the end of World War II.

That was before the alarming frequency of attacks on health facilities and aid convoys made a mockery of international humanitarian law. We condemn all these attacks on health care facilities and workers. According to reports consolidated by WHO, more than 300 attacks on health care facilities occurred in 2016 in 20 countries, with the majority documented in the Syrian Arab Republic. We are also seeing how a world full of threats can toss out deadly combinations, like the dual threats from drought and armed conflict that have brought famine to parts of Africa and the Middle East on a scale never experienced since the United Nations was founded in 1945.

The world was fortunate that the 2009 influenza pandemic was so mild. The world is fortunate that the new viruses that emerged to cause MERS in 2012 and human cases of H7N9 avian influenza in 2013 are not yet spreading easily from person to person. But they have the potential to do so and we dare not let down our guard.

The world was less fortunate with Zika, an outbreak that WHO continues to monitor closely. The world was not at all fortunate with the 2014 Ebola outbreak that utterly devastated the populations of Guinea, Liberia, and Sierra Leone. This was West Africa’s first experience with Ebola, and the outbreak took everyone, including WHO, by surprise.

WHO was too slow to recognize that the virus, during its first appearance in West Africa, would behave very differently than during past outbreaks in central Africa, where the virus was rare but familiar and containment measures were well-rehearsed.

But WHO made quick course corrections, brought the three outbreaks under control, and gave the world its first Ebola vaccine that confers substantial protection. This happened on my watch, and I am personally accountable.

I saw it as my duty, as your Director-General, to do everything possible to ensure that a tragedy on this scale will not happen again. History will judge whether the new emergencies programme has given the world a stronger level of protection.

Ultimately, health systems with International Health Regulations core capacities must be strengthened in your countries to detect unexplained deaths much earlier. This is critical for improving global health security to protect our common vulnerability.

Last week, the Democratic Republic of Congo confirmed a new Ebola outbreak near the border with the Central African Republic. This is the country’s eighth Ebola outbreak. In its last outbreak, which coincided with the West Africa outbreak, DRC interrupted transmission within six weeks. Despite enormous logistical challenges, discussions engaging DRC continue about possible use of the new vaccine to augment the response.

The Ebola outbreak in West Africa had a number of spillover effects which can be judged more immediately. During the outbreak, WHO acquired extensive experience in facilitating R&D for new medical products, but poor coordination lost too much time. To speed things up, WHO and its partners finalized an R&D blueprint in 2016.

By setting up collaborative models, standardized protocols for clinical trials, and pathways for accelerated regulatory approval in advance, the blueprint cut the time needed to develop and manufacture candidate products from years to months.

The expert consultations that designed the blueprint led to the establishment of the Coalition for Epidemic Preparedness Innovations, announced in January 2017 with initial funding of nearly $500 million.

The Coalition is building a new system to develop affordable vaccines for priority pathogens, identified by WHO, as a head-start for responding to the next inevitable outbreak.

The world is better prepared but not nearly well enough.

For the full address, click Here.