Statement by Federal Chancellor Angela Merkel at the 68th session of the WHO World Health Assembly
Ladies and gentlemen,
There’s an ancient proverb that says you should learn before you speak, and take care of yourself before you fall ill. Some words lose none of their wisdom even over thousands of years. Health is a human right. We are all working – now and in September – to ensure that the right to health is firmly anchored in the UN system as one of the new Sustainable Development Goals. The German G7 Presidency has also made health a priority issue, which we will address throughout our Presidency.
Why are we doing this? Firstly, because the human right to health can only be enforced if a sustainable health system is in place or is put in place in every country on Earth, and secondly, because globalisation is tangibly making us all more dependent on one another, so that increasingly the health of one person is also the health of others. In other words, the effectiveness of the health system in one country impacts on the health of other countries, and on security and stability. The responsibility of individual countries and global shared responsibility are two sides of one and the same coin.
Germany has put three health-related issues on the G7 agenda. First, in the light of current events, we are asking what lessons can be learned from the Ebola epidemic. Second, what can we do to better combat poverty-related neglected tropical diseases? And third, what can we do about the increasing resistance to antibiotics? This is an issue for industrialised and developing countries alike.
All three issues have one thing in common. They can only be successfully addressed if all countries are enabled to comply with the norms set for health systems. These International Health Regulations have been developed by the World Health Organization. Their implementation must be made compulsory for all. They are no mere recommendations. These Regulations are so good that they just have to be put into practice.
But why are the G7 nations now concerning themselves with something that has already been agreed on at international level? We’re picking up on it because we have strong economies, because we G7 states have a high level of scientific expertise, and because we share values that stress the indivisible nature of human dignity, a principle which should not be geographically confined to the G7 countries. I am thus glad that the German Health Minister and myself have been invited by the World Health Organization to report to you here today on our plans.
The disastrous outbreak of Ebola in West Africa made us painfully aware of how urgently the international community needs to act when crises strike. 26,000 people were infected by the virus, and more than 11,000 people died. The countries affected have been seriously destabilised. We can report some initial successes – Liberia is now an Ebola-free zone. We hope the same can soon be said of the other two countries affected. But the war will only have been won when there are no new infections. In fact, it will only really be won when we are properly equipped to face the next crisis – in other words, when we have learned from this crisis. One lesson that we all need to learn is that we should have reacted sooner. We thus have to ask: how we can do that?
We need some kind of global disaster response plan. And the World Health Organization must play a key part in this. But first of all we have to ask ourselves what we expect from the World Health Organization, what we think it should achieve and what its member states have to provide.
In my opinion, the WHO is the only international organisation that enjoys universal political legitimacy on global health matters. The aim now must therefore be to make its structures more efficient. It is, I am sure, an advantage for the World Health Organization to have 150 country offices and six regional offices in addition to its headquarters – a decentralised structure with strong local links is important. But let’s be honest. Decentralised structures can also impede decision-making and hinder good functioning. Therefore the advantages of having a decentralised organisation must be harnessed in a way that links the three levels on which the WHO operates through clear hierarchies, so that ultimately everyone knows who has the say in any given situation, who has reporting obligations and who has to carry out the work. This is, of course, easier said than done. But I think that right now, when we are trying to learn lessons, it is important for everybody to make a special effort, to accept this challenge, and thus together to come up with something better.
Notwithstanding its central health policy legitimacy, the WHO cannot be the only organisation involved in drawing up a global disaster response plan. We need to ensure that the WHO can work well together with the UN system as a whole and with the World Bank. The Norwegian Prime Minister, the Ghanaian President and myself asked the Secretary-General of the United Nations to appoint a high-level panel to examine the interaction between these organisations more closely. He has done so, and the panel has already started its work. It is chaired by President Kikwete of Tanzania, and is due to submit a report by the end of the year, specifying what we have to learn with regard to international organisations, what contributions can be made by which organisations, and how we can in future be better prepared for health emergencies, as we are for natural disasters. I am convinced that if we can respond more quickly, if we can act faster, if we have clear plans of action, then we will be able to fight a crisis such as the Ebola outbreak better next time.
But no matter how important international cooperation is, we must not lose sight of one thing. The starting point must be that every country should develop or be in a position to develop its own health system, designed to ensure maximum resilience. Building functioning health systems is a key task. Germany is ready to tackle it. This year and next year we will be providing affected countries with a total of 200 million euros. Of this sum, 70 million euros will be earmarked for West Africa, to help build sustainable structures. It should be seen as help towards self-help.
Ladies and gentlemen, the second item on our G7 agenda is neglected and poverty-related tropical diseases. Their prevalence is linked to the fact that many countries are simply too poor to roll out their own health systems, which is why we have to help them do it. About 1.4 billion people are affected by what are known as “neglected” tropical diseases. It is interesting to note that the suffering of hundreds of millions of people could be alleviated at relatively little material cost, in most cases at least. To this end what we need is firstly robust health systems, the establishment of which is a long-term task, secondly the right products from the pharmaceutical industry, and thirdly, the logistics to distribute these products. That is why it is very important to collaborate closely with the countries affected. For example, logistical capabilities vary widely across the African continent. We therefore not only have to develop health systems, but also appropriate administrative structures.
The third issue that Germany would like to address during its G7 Presidency is resistance to antibiotics. We have obtained the advice of the National Academies of Sciences on this issue – and indeed on the subject of neglected tropical diseases. I think this is an issue of crucial importance for the entire human race – for people in developed and less developed countries alike. We must ensure that existing antibiotics remain effective, and that they are used only when medically necessary – not only when treating humans, but animals as well. To this end we want to agree on the strictest standards possible at the G7 meeting, in particular for industrialised countries.
Antibiotics have to be used restrictively, because once pathogens have become resistant to them, it is much, much harder to develop new treatments – in contrast to the situation for example with neglected tropical diseases. The pharmaceutical industry is an important partner in the fight against disease, but it can only provide new products through research and development. I have been told how difficult it is to develop new varieties of antibiotics to replace the old ones. We must therefore tread carefully if we are to make progress. We must pursue a “one health” approach for both humans and animals.
I am delighted that the World Health Assembly has undertaken to draw up the first global action plan to address the problem of antimicrobial resistance. Every country should have a plan of this sort. Only a few days ago the German Cabinet adopted its own antimicrobial resistance strategy. It will require close cooperation in the fields of human and veterinary medicine.
Ladies and gentlemen, let me conclude by thanking all the WHO staff, as well as the representatives of other UN organisations, NGOs and foundations. The Ebola outbreak has once again highlighted the immense contribution made by NGOs and aid workers on the ground. I would like to give special mention to the International Red Cross and the Red Crescent, and likewise Doctors Without Borders – and also to the many, many others, who have worked tirelessly together with the staff of international organisations.
I would thus like to close my statement with an appeal – one which we will also make at the G7 Summit. Every single person is vitally needed to fight for the human right to health. The framework has changed over the past years. When the World Health Organization was established, it was the only organisation in the field. But now it shares the stage with various foundations and highly competent NGOs. Everyone who is working towards the same goal is equally important. Let us work together in a spirit of cooperation, and not seek to undermine each other’s deeds. The task is so immense and the endeavour so important that every helping hand is needed. Therefore may I say a final sincere thank you for your efforts to help humankind. During its G7 Presidency, Germany and the other G7 countries will endeavour to support and advance your work.
Thank you very much.