Director-General of the World Health Organization Dr Margaret Chan, addressed the 23rd Forum on Global Issues in Berlin, Germany on 18 March 2009 in a speech titled
“The impact of global crises on health: money, weather and microbes.” We excerpt extended portions of the speech; the full text is available at the link below.
“…The financial crisis and climate change are not the only markers of bad policies and failed systems of governance. The gaps in health outcomes, seen within and between countries, are greater now than at any time in recent history. The difference in life expectancy between the richest and poorest countries now exceeds 40 years. Globally, annual government expenditure on health varies from as little as US$ 20 per person to well over US$ 6000.
Medicine has never before possessed such a sophisticated arsenal of tools and interventions for curing disease and prolonging life. Yet each year, nearly 10 million young children and pregnant women have their lives cut short by largely preventable causes.
Something has gone wrong.
Collectively, we have failed to give the systems that govern international relations a moral dimension. The values and concerns of society rarely shape the way these international systems operate. If businesses, like the pharmaceutical industry, are driven by the need to make a profit, how can we expect them to invest in R&D for diseases of the poor, who have no purchasing power?
In far too many cases, economic growth has been pursued, with single-minded purpose, as the be-all, end-all, cure-for-all. Economic growth, as many believed, would cure poverty and improve health. This did not happen.
Globalization was embraced as the rising tide that would lift all boats. This did not happen. Instead, wealth has come in waves that lift the big boats, but swamp or sink many smaller ones.
Greater market efficiency, it was thought, would work to achieve greater equity in health. This did not happen.
Trade liberalization was put forward as a sure route to prosperity for developing countries. But trade liberalization slashed tariff revenues and brought no alternative source of finances for public services, including health care. This has meant a disaster for health and social protection in the many countries where most labour is concentrated in the informal sector and the tax base is small.
User fees for health care were put forward as a way to recover costs and discourage the excessive use of health services and the over-consumption of care. This did not happen. Instead, user fees punished the poor.
WHO estimates that, each year, the costs of health care push around 100 million people below the poverty line. This is a bitter irony at a time when the international community is committed to poverty reduction. It is all the more bitter at a time of financial crisis…”
“…Let me turn to a third issue: global crises that arise from the constantly changing microbial world. This issue is different from the financial crisis and climate change.
It is different because the health sector is in the lead. The health sector makes the policy, and implements governance through the International Health Regulations. We do not have to compete against economic interests. In fact, the tables are turned.
Emerging and epidemic-prone diseases are considered threats to international security precisely because of the tremendous economic and social disruption they can cause.
Public health has very few estimates that come even close to the multi-billion dollar financial bailouts we seem to hear about every week. But according to the latest World Bank estimate, the next influenza pandemic could easily cost the global economy US$ 3 trillion.
World leaders tell us that the financial crisis is so severe and unpredictable because it is the first such event under the unique conditions of the 21st century.
SARS, which emerged in 2003, was the first severe new disease of the 21st century. Like the financial crisis, it emerged at a time of radically increased interdependence.
SARS was the first disease to move rapidly around the world along the routes of international air travel. It put every city with an international airport at risk. It closed airports, businesses, schools, and some borders. It paralysed economies, and paralysed the public with fear.
But never forget: the response to SARS was a deliberate effort to prevent this new disease from becoming permanently established in this world, to keep it from joining the league of killer diseases like AIDS, TB, and malaria.
This was one severe global contagion that was quickly ended. WHO and its partners stopped SARS, dead in its tracks, within four months.
The health sector was prepared. Surveillance, alert, and response mechanisms were in place. We managed the risks. And this crisis did not spiral out of control.
From the beginning of the outbreak, the world’s top scientists set aside competition and worked together, in a virtual laboratory, around the clock. They identified the virus within a month.
This is the brighter side of globalization. This is an example of collaboration and solidarity before a shared threat.
We see this same international solidarity in support for the drive to eradicate polio, including humanitarian support from Rotary International, and support from several enlightened governments, including Germany.
Concern for health can also motivate ethical behaviour in industry, as when pharmaceutical companies dramatically cut prices for AIDS medicines. Concern for health can persuade the international community to agree on the control of harmful, yet profitable products, like tobacco.
There is hope….”