WHO Director-General's Report to the 77th World Health Assembly

Monday, 27 May 2024

Dear journalists,

Please find the report that will be given by the WHO Director-General at the 77^th World Health Assembly today. It is subject to change-please check against delivery.

WHO Media team

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Honourable Dr Edwin Dikoloti, President of the 77^th World Health Assembly,

Excellencies, dear colleagues and friends,

Good afternoon.

I am pleased to present to you my report on your Organization’s work last year.

2023 was a year of many challenges, but also of many achievements.

These achievements are captured in the WHO Results Report, a comprehensive and interactive report available on the WHO website.

It provides a detailed overview of the Secretariat’s work, supported with data, charts, maps, country stories and more.

The report shows where our funding comes from, where it’s going, and what it’s doing. I commend it to you.

Today I can only offer a few highlights, according to each of the “triple billion” targets of the 13^th General Programme of Work.

First, healthier populations.

This is the only one of the three targets that we estimate will be met, with 1.5 billion people expected to be enjoying better health and well-being by 2025.

This has been achieved by Member States working across sectors to address the root causes of ill health: unclean air, unhealthy diets, unsafe water, polluted environments, and products that harm health.

Tobacco use is declining in 150 countries, and there are now 19 million fewer smokers globally than there were two years ago.

More than 90 countries increased their tobacco excise tax between 2020 and 2022.

In December, WHO published a call to action to prevent the uptake of e-cigarettes, along with a technical note on the evidence of the harm they do.

We also see positive trends in our efforts to improve nutrition and healthy diets.

Last year, another 13 countries passed or implemented best-practice policies to eliminate trans fat from their food supply;

Almost half the world’s population is now protected by such policies, compared with just 7% in 2018, when we launched the WHO call for action.

We estimate these policies have cut the number of annual deaths caused by trans fats by two thirds.

With support from WHO, more and more countries are taking action to tackle obesity and child wasting, and to scale up breastfeeding;

And 28 countries increased taxes on alcohol, tobacco or sugary drinks.

We’re also working to make the world’s roads safer.

Over the past decade, 45 countries have reduced road traffic deaths by at least 30%;

And 10 have achieved a reduction of 50% or more: Belarus, Brunei Darussalam, Denmark, Japan, Lithuania, Norway, the Russian Federation, Trinidad and Tobago, the United Arab Emirates and Venezuela.

And we’re increasing our work on behavioural science, to understand better why people make decisions about their health.

Following the Health Assembly’s adoption last year of a resolution on behavioural science, we worked with the World Bank to produce a new report showing that while some countries are using behavioural science in policies and planning, it is often fragmented, ad-hoc, and not connected to national health strategies.

While health is a state of complete physical, mental and social well-being, social health has received little attention.

I have therefore launched a Commission on Social Connection to highlight the impact of social isolation and advise me and the world on how to address it.

So there are many reasons for optimism in our work against the determinants of health, even though much more work is required.

Perhaps the greatest threat to health of our time comes from our changing climate.

At COP28 in the UAE last year, an entire day of the programme was dedicated to health for the first time. My thanks to the UAE for its leadership.

149 countries signed the COP28 declaration on climate change and health, and donors committed more than 1 billion US dollars to address the health impacts of climate change.

WHO and the global health community also played a part in keeping a commitment to transition away from fossil fuels in the final agreement.

Meanwhile, we are supporting countries to build more climate-resilient and climate-friendly health systems.

Last year, we supported the electrification of health facilities with solar energy in Somalia, and with UNICEF and Gavi, we started supporting other countries including Uganda, Ethiopia, Zambia, Pakistan and Yemen.

We are also continuing to work with our partners in the Quadripartite to support countries to translate a One Health approach into policy and action.

And at least 63 countries are making progress in the delivery of care to refugees and migrants, and tackling the root causes of ill-health.

For example, Colombia has enacted policies that have enabled 3.5 million migrants to receive health services.

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Now to the second of the “triple billion” targets: to see one billion more people benefiting from universal health coverage.

Here, the news is less encouraging.

We estimate that 585 million more people will be covered by essential health services without catastrophic health spending by 2025 – only a little over halfway towards our target of 1 billion.

Although 30% of countries have made progress since 2000 on both service coverage and financial protection, at the global level we’re going backwards on financial protection.

2 billion people face financial hardship due to out-of-pocket health spending.

And half the world’s population is not fully covered by essential health services.

At the second High-Level Meeting on UHC at the UN General Assembly, countries made more than 50 commitments to progressively expand access to essential health services, and to improve financial protection.

To support countries to realise those commitments, WHO is working in more than 120 countries through the UHC Partnership.

We also joined a consortium of multilateral development banks to launch the Health Impact Investment Platform, with funds of 1.5 billion euros to support primary health care projects in countries.

We aim to start making disbursements from September.

Last year, we supported 23 countries to strengthen their health and care workforce.

For example, we are preparing to train nurses and midwives to use of a set of basic emergency care tools that can reduce hospital mortality by up to half.

And with support from WHO, 95 countries made significant progress on infection prevention and control last year, with exceptional examples in Azerbaijan, Kazakhstan, Somalia and Ukraine.

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2023 was a productive year in WHO’s work supporting access to medicines and other health products.

We prequalified 120 medicines, vaccines, diagnostics and other products last year for HIV, malaria, multidrug-resistant TB, Ebola, polio and COVID-19, as well as the first long-acting insulin analogues;

We issued 8 alerts for substandard or falsified medical products;

And we standardized nomenclature for more than 300 cell and gene therapies – it sounds boring, but it’s one of those things that WHO does that no one notices, but which makes a huge difference to researchers, manufacturers and prescribers.

We also continue to support Member States to strengthen their regulatory systems.

We recognized Türkiye’s system as having achieved maturity level 3, and Saudi Arabia’s as level 4.

Singapore, the Republic of Korea and Switzerland were the first three countries to become WHO-Listed Regulatory Authorities, making them “regulators of reference”.

And just last week we listed a further 33 national and regional regulators.

With WHO leadership, opportunities for technology transfer and geographically diversified manufacturing continue to expand.

15 partners joined the mRNA Technology Transfer Programme, and with WHO support, have started expanding the technology pipeline to include new vaccines of regional and global interest

We also established the Global Traditional Medicine Centre in India, and hosted the first global summit on traditional medicine.

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One of the biggest disruptions caused by the COVID-19 pandemic was to routine immunization programmes in many countries, resulting in backsliding coverage and outbreaks of measles, diphtheria, polio, yellow fever and more.

In April last year, we launched “The Big Catch Up” with UNICEF and Gavi, to support countries to shut down outbreaks and restore immunization programmes at least to pre-pandemic levels.

This year, most of the 20 countries with the most children who missed out completely on vaccines during the pandemic are launching and implementing their plans to reach those children.

Meanwhile, the Strategic Advisory Group of Experts on Immunization, SAGE, last year recommended new vaccines for dengue, meningitis, and a second vaccine for malaria, the R21-Matrix M vaccine.

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On maternal, newborn and child care, we have supported 43 countries to develop acceleration plans to reduce mortality;

At the other end of life, we supported 18 countries to strengthen care for older people;

And 20 more countries adopted legislation on various aspects of age-related health issues

On sexual and reproductive health, we supported 23 priority countries to facilitate access to quality, survivor-centered services for sexual violence.

And we published a new report that shows that globally, 1 in 6 people of reproductive age suffer from infertility.

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Of course, the point of all this work to strengthen health systems is to improve health outcomes – and on that score that is plenty of reason for cheer.

Last year was particularly significant for our fight against malaria.

Azerbaijan, Belize and Tajikistan were certified as malaria free, and Cabo Verde joined that list earlier this year.

More than 2 million children in Ghana, Kenya and Malawi have received the first malaria vaccine, RTS,S, resulting in a drop of 13% in all-cause mortality among children.

At least 30 countries intend to introduce the vaccine, and 22 have already been approved for Gavi support and plan to roll it out this year or next.

However, demand far outstrips supply, so the approval of the new R21 vaccine will help to close that gap, and could save tens of thousands of young lives, especially in Africa.

Just this past Friday, the first shipment of the new R21 malaria vaccine was made to the Central African Republic, and preparations are underway for shipments to seven more countries.

On tuberculosis, about 8 million people – more than ever before – received access to diagnosis and treatment last year.

Since 2015, 47 countries, mostly in Africa in Europe, have reduced TB deaths by more than a third.

In addition, the UN General Assembly High-Level Meeting agreed new targets to end TB, and we launched the TB Vaccine Accelerator Council, to facilitate the development, licensing and equitable use of new TB vaccines.

On HIV, more than 75% of people living with HIV globally are now receiving antiretroviral therapy, and almost all of those on treatment are achieving viral suppression, which means they cannot infect others.

19 countries have been certified for the elimination of mother-to-child transmission of HIV and/or syphilis

And Egypt became the first country to achieve "gold tier” status on the path to elimination of hepatitis C.

Six countries eliminated one or more neglected tropical disease last year:

Benin, Iraq and Mali eliminated trachoma; Ghana eliminated African trypanosomiasis; and Bangladesh and Lao PDR eliminated lymphatic filariasis.

Bangladesh also became the first country in the world to eliminate visceral leishmaniasis, thanks to a collaboration between many partners, including WHO and the Special Programme for Research and Training in Tropical Diseases.

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There is also much to be proud of in our work on noncommunicable diseases, including on hypertension – a major cause of premature mortality that demands attention in all countries.

Last year, 10 new countries implemented the HEARTS package on hypertension, covering 7 million more people.

We published our first global report on hypertension, which estimates the disease affects 1 in 3 adults globally, but 4 in 5 are not adequately treated.

The Global Initiative for Childhood Cancer is now active in 76 countries in all regions, providing technical and financial support to improve service delivery in dozens of pediatric cancer centres.

11 more countries introduced the HPV vaccine for cervical cancer last year.

We supported more than 80 countries to integrate services for NCDs into their health systems.

And just two months ago, partners pledged almost 600 million US dollars to eliminate cervical cancer.

Tthrough the WHO Special Initiative for Mental Health, we supported 9 countries to expand access to mental health services for almost 20 million more people.

And 12 countries with complex emergencies received deployments of mental health and psychosocial support experts.

We updated our guidelines on mental, neurological, and substance use disorders, which more than 100 low- and middle-countries are using to scale up provision of mental health care at primary health care level.

Meanwhile, we continue to support countries to respond to the growing crisis of antimicrobial resistance, which kills at least 1.3 million people every year.

Since 2016, the number of countries reporting data on bacterial infections to the Global Antimicrobial Resistance and Use Surveillance System has more than tripled.

And with WHO support, 11 more countries developed multisectoral national action plans on AMR last year, bringing the total to 178, and we supported countries to secure new funding for AMR from the Pandemic Fund and the Global Fund.

This week you will consider an important resolution on AMR;

And this year’s UN General Assembly high-level meeting on antimicrobial resistance will be another important opportunity to secure concrete commitments for this urgent global threat.

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Now to the third of the “triple billion” targets, emergencies.

On current trends, we estimate that 777 million people will be better protected from health emergencies by 2025, three-quarters of the way to our target of 1 billion.

Of course, “better protected” does not mean completely protected, and as the COVID-19 pandemic demonstrated, all Member States have much work to do, individually and together.

In May last year, I declared an end to both COVID-19 and mpox as global health emergencies.

We continue to call on all countries to maintain and reinforce the capacities for surveillance, detection and response that they built during the pandemic. These investments must not go to waste.

COVAX, which closed at the end of last year, played a vital role, delivering nearly two billion doses and saving an estimated 2.7 million lives in lower-income countries.

In all, WHO responded to 65 graded emergencies last year:

Earthquakes in Türkiye and the Syrian Arab Republic;

Conflict and insecurity in the Democratic Republic of the Congo, Ethiopia, Gaza; Haiti, Myanmar, Sudan and Ukraine;

Outbreaks of cholera, dengue, diphtheria, hepatitis E, Marburg, measles, mpox and more;

While the global spread of avian influenza in new animal species remains a constant threat.

In response, WHO supported dozens of countries to access vaccines and treatments.

For the first time, we supported the deployment of a new vaccine against five strains of meningitis in response to a large outbreak in West Africa.

And we helped to protect 60 million people against yellow fever for life, including high-risk groups such as forest workers in Central African Republic.

Emergency medical teams played a vital role in our response to 19 emergencies around the world, including in Gaza.

Made up of health professionals from around the world, we have supported the deployment of 18 teams in Gaza, who have provided almost 400 thousand consultations, performed more than 18 thousand surgeries, and added more than 500 additional hospital beds.

They are working at all levels of care, in the north and south, providing trauma stabilisation, delivering babies, supporting early warning for disease outbreaks, and so much more.

In addition, WHO and our partners have carried out missions to support patient transfers;

And we have delivered 15 million US dollars of food, water, and medical supplies to health facilities, with another 13 million dollars of supplies on the way.

WHO was in Gaza before the conflict began, and will stay to support the health system until this conflict ends, and to help rebuild it afterwards.

In Sudan, more than a year of fighting has left almost 15 million people in need of health assistance.

More than three-quarters of hospitals, and almost 90% of primary care facilities are not functioning.

WHO has delivered 19 million US dollars of supplies to support continuity of health services for those most in need, and to prevent and respond to outbreaks.

In Ukraine, we continue to support the health system, which has remained resilient but faces continued challenges.

An estimated 7.8 million people will require health assistance in 2024.

In all three situations – and others - we continue to see attacks on health care.

Last year, WHO verified 1,510 attacks on health care in 19 countries, with 749 deaths and more than 1200 injuries.

Attacking or militarizing health care is a violation of international humanitarian law.

And in all three situations, the only solution is peace.

We call for a ceasefire in Gaza; a ceasefire in Sudan; and a ceasefire in Urkaine. Now.

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We continue to move towards our goal of eradicating polio.

Last year, six cases of wild poliovirus were reported in Pakistan and six in Afghanistan, the second-lowest number of cases reported in a calendar year.

So far this year, three cases have been reported in Afghanistan, and two in Pakistan.

We have intensified our efforts to reach unvaccinated children in a handful of districts in both countries, and we welcome the recent restart of house-to-house immunization in southern Afghanistan after almost six years.

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While our work responding to emergencies often makes the headlines, our work supporting countries to prevent and prepare for emergencies is less visible, but equally important.

For example, the Pandemic Fund is now up and running, and the demand is huge.

For its first round, the Fund made disbursements of 338 million US dollars to 37 countries – but received applications from over 120 countries, with requests for financing of over 2 billion U.S. dollars.

The application for the second round has just closed, and demand remains strong.

We continue to support many Member States to strengthen their core health emergency capabilities – including laboratory capacity, with support from our office in Lyon.

We also launched i-MCM-net, an interim coordination mechanism to facilitate timely and equitable global access to quality, safe, effective and affordable medical countermeasures;

The WHO Hub for Pandemic and Epidemic Intelligence launched the International Pathogen Surveillance Network, which has expanded to 94 organizations in 43 countries.

The WHO BioHub System now houses 30 biological samples, and more than 100 materials have been exchanged between Member States.

After the successful pilot phase of the Universal Health and Preparedness Review, 10 countries in five regions have enrolled for the next phase

We also launched the Preparedness and Resilience for Emerging Threats Initiative, an integrated approach to pandemic planning.

And we’ve been supporting France and the International Olympic Committee to prepare for this year’s Olympic Games in Paris.

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The fourth pillar of GPW13 is to build a more effective and efficient WHO, including through science, data, research and digital technologies.

Since last year’s Assembly, we have published over 8,000 new publications and documents;

Quality assured about 500 normative technical products;

Approved 28 new evidence-informed clinical and public health guidelines;

Supported 26 countries to put in place mechanisms to adapt and implement our guidelines, norms, and standards.

And supported 50 countries with a data-driven “Delivery for Impact” approach to implementation.

In addition, the World Health Data Hub now includes the world’s largest databases on inequality and mortality;

More than 120 countries have now implemented ICD-11;

We launched the Global Digital Health Certification Network, the Global Initiative on Digital Health, and issued guidance on artificial intelligence for health;

The Council on the Economics of Health for All delivered its final report;

And in October this year, the WHO Academy campus in Lyon will open, marking the start of a new era.

I thank France for its continued support, and I welcome the launch of a Group of Friends of the WHO Academy.

All of this is supported by our continued implementation of the WHO Transformation, as I described this morning

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Excellencies, dear colleagues and friends,

I have given you a long list, but as always, it doesn’t even begin to do justice to the breadth and depth of work that your WHO is doing all over the world.

Some of it makes the headlines; most of it doesn’t.

Some of it attracts the attention of donors; and some of it doesn’t.

As we approach the end of the 13^th General Programme of Work, we have much to be proud of, but we face mounting challenges.

I and my colleagues remain committed to serving you as best we can, as we work together for a healthier, safer, fairer world.

I thank you.

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