WPRlRC611SRJ1
SUMMARY RECORD OF THE FIRST MEETING (Putrajaya International Convention Centre, Unity Hall A2, and at Unity Hall AI, Concourse Level) Monday, 11 October 2010, at 10:20 and 14:00
CHAIRPERSON: Dr Lam Ping-yan (Hong Kong, [China]) later: Mr Liow Tiong Lai (Malaysia)
CONTENTS page 1.
Opening ceremony .................................................................................................. . Opening of the session ............................................................................................ . Address by the retiring Chairperson ....................................................................... . Election of new officers: Chairperson, Vice-Chairperson and Rapporteurs ........... . Adoption of the agenda ........................................................................................... . Address by the Director-General ............................................................................ . Address by and Report of the Regional Director .................................................... . ANNEX 1 ANNEX 2 Address by the Retiring Chairperson, Dr P. Y. Lam, at the opening ceremony .................................................................. . Address by the World Health Organization Regional Director for the Western Pacific, Dr Shin Young-soo, at the opening ceremony ................................................................. . Address by the Deputy Director-General of the World Health Organization, Dr A. Asamoa-Baah, at the opening ceremony ................................................................. .. Address by the Minister of Health of Malaysia, YB Dato' Sri Liow Tiong Lai, at the opening ceremony ................. . Address by the Prime Minister of Malaysia, Y.A.B. Dato' Sri Mohd Najib bin Hj Abdul Razak, at the opening ceremony ............................................................... .. Address by the Retiring Chairperson, Dr P.Y. Lam, at the opening session ..................................................................... . Address by the Director-General of the Health Organization, Dr Margaret Chan, at the opening session ........................................ . Address by the World Health Organization Regional Director for the Western Pacific, Dr Shin Young-soo, at the opening session ...................................................................... .
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2. 3. 4. 5.
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6.
7.
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ANNEX 3
71 73
ANNEX 4 ANNEX 5
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ANNEX 6
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ANNEX 7 ANNEX 8
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1.
OPENING CEREMONY
The opening ceremony was held at 10:20 at Unity Hall A2, Concourse Level, of the Putrajaya International Convention Centre. The CHAIRPERSON of the Regional Committee (sixtieth session), Dr LAM Ping-yan (Hong Kong [China]), thanked Malaysia for so graciously hosting the sixty-first session of the Regional Committee and recalled the two previous occasions on which the country had hosted the Committee; their third hosting was especially valuable as it presented an opportunity to learn from Malaysia'S successes in such areas as health care and health information systems. He noted that the global financial crisis and its impact on health systems had been an underlying concern in the previous session of the Regional Committee, which had led to the adoption of a resolution that urged pro-health and pro-poor policy-making based on primary health principles. Financing for health and ensuring that people had reasonable access to quality health care had been a challenge, but Member States had worked together to weather the crisis. They had again successfully stood up as a Region against pandemic influenza HINI (2009), led the fight against tobacco, and found innovative ways of promoting healthier lifestyles and protecting our health and the environment in a more sustainable and context-relevant manner. He thanked the Committee for their support during his term as Chairperson (Annex 1). The REGIONAL DIRECTOR, speaking on behalf of the WHO Member States in the Region and their representatives, expressed special appreciation to the Prime Minister and the Government of Malaysia for hosting the sixty-first session. The plan to host the session in Manila had had to be abandoned after a devastating typhoon caused damage to the facilities in the Regional Office. With time for preparations in Malaysia short, the arrangements had been excellent. With a background of 50 years of cooperation with Malaysia, WHO's global financial and administrative services were now based in the country. He mentioned Malaysia's salutary achievements in public health and economic progress, and credited those advances to the Government's well-considered policies. He called for renewed leadership in dealing with the issues on the agenda, particularly further actions to meet the commitments towards achieving the targets of the United Nations Millennium Development Goals (Annex 2). The DEPUTY DIRECTOR-GENERAL, speaking on behalf of WHO and the participants, thanked the Government of Malaysia for its hospitality and generosity and commended the commitment of the Prime Minister. He conveyed the apologies of the Director-General for her inability to attend the session. He mentioned the great foresight that had attended the establishment of the Regional Committee, with shared health concerns as its basis. Globalization, international travel, the Internet, and 24-hour news coverage had now made countries even more interconnected. As the most diversified of all the WHO regions, the Western Pacific was more representative of the world, and the Regional Committee's discussions were therefore of special importance (Annex 3).
Mr LIOW Tiong Lai, Minister of Health, Malaysia, welcomed the participants and offered the hospitality of the multicultural community of Malaysia. He highlighted the attendance of the Prime Minister of Malaysia at the opening ceremony as conveying the Government's commitment to WHO and to the Regional Committee. He expressed his hope that the meeting would be a productive and successful forum and looked forward to the outcome of the discussions (Annex 4).
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The Honourable MOHD NAJIB BIN TIJN ABDUL RAZAK, Prime Minister, Malaysia, welcomed the participants and expressed the honour his country felt at being chosen to host the sixty-first session of the Regional Committee. The Regional Committee was an important forum for health ministers and experts in the Region and the current session was particularly significant as it provided an opportunity to examine the response to and effects of pandemic influenza HINI (2009) and could give input into plans for future global action against pandemics and other trans-boundary diseases. Another health challenge was noncommunicable diseases, which were increasing at an alarming rate in Malaysia, as well as in other Member States of the Region. The Western Pacific was an important test area in that regard, being a populous region with countries at various levels of development. The importance of primary prevention had to be emphasized and individuals must be reminded of the importance of a healthy lifestyle. To overcome;: the noncommunicable diseases threat it was also necessary to strengthen health systems. Malaysia's current restructuring of its health system had been made necessary by changing demographics, escalating costs, overstretched resources and people's increased expectations. The blueprint was for an integrated public and private health system, with improved safety nets for vulnerable groups, community participation in health care, strengthening of the workforce (brain drain was an area that was being addressed), sustainability, upholding of government responsibility, better response, and better utilized services. With global warming projected to increase rapidly, countries must deal with climate change in partnership, with international leadership and coordination, and strong donor commitment. In that area, Malaysia and the World Food Programme had recently established the United Nations Humanitarian Response Depot at Subang for delivery of relief materials within 48 hours of a disaster striking. The regional working group coordinated by WHO must continue as an important focus of cooperation for initiatives in climate change. He expressed his hope that the sixty-first session of the Regional Committee would strengthen the cooperation and collaboration among Member States in the Region and wished the participants a successful meeting and an enjoyable stay in Malaysia. After completion of the opening ceremony, the participants reconvened at Unity Hall AI. 2. OPENING OF THE SESSION: Item I of the Provisional Agenda The retiring Chairperson, Dr LAM Ping-yan (Hong Kong [China]), declared open the sixty-first session of the Regional Committee for the Western Pacific. 3. ADDRESS BY THE RETIRING CHAIRPERSON: Item 2 of the Provisional Agenda The retiring Chairperson, Dr LAM (Hong Kong [China]), made a statement to the Committee (Annex 6).
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4. ELECTION OF NEW OFFICERS: CHAIRPERSON, VICE-CHAIRPERSON AND RAPPORTEURS: Item 3 of the Provisional Agenda. 4.1 Election of Chairperson
Mrs GatoloaifaanaAmatagaAiesana GIDLOW (Samoa) nominated Mr Liow Tiong Lai (Malaysia) as Chairperson; the nomination was seconded by Dr YIN Li (China). Decision: Mr LIOW Tiong Lai (Malaysia) was elected unanimously. Mr LIOW took the chair. 4.2 Election of Vice-Chairperson Dr Nicola ROXON (Australia) nominated MsAmenta Matthew (Marshall Islands) as Vice-Chairperson; the nomination was seconded by Dr Sasa ZIBE (Papua New Guinea). Decision: Ms Amenta MATTHEW (Marshall Islands) was elected unanimously. 4.3 Election of Rapporteurs
Dr Neil SHARMA (Fiji) nominated Mr Taniela Sunia Soakai (Nauru) as Rapporteur for the English language; the nomination was seconded by Dr LEE Jong-koo (Republic of Korea).
Mr Moses KAHU (Vanuatu) nominated Dr Bounpheng Philavong (Lao People's Democratic Republic) as Rapporteur for the French language; the nomination was seconded by Dr MAM Bun Heng (Cambodia). Decision: Mr Taniela SUNIA SOAKAl (Nauru) and Dr Bounpheng PHILAVONG (Lao People's Democratic Republic) were elected unanimously. 5. ADOPTION OF THE AGENDA: Item 5 of the Provisional Agenda The CHAIRPERSON proposed that, under item 18 of the Provisional Agenda, the two parts of document WPRlRC61113 "Coordination of the work of the World Health Assembly, the Executive Board and the Regional Committee", be considered in reverse order. "The future of financing for WHO" would thus be considered earlier in the week than the first part. Decision: The Agenda, as amended, was adopted. 6. ADDRESS BY THE DIRECTOR-GENERAL: Item 6 of the Agenda The DIRECTOR-GENERAL, in a video message, addressed the Committee (Annex 7). 7. ADDRESS BY AND REPORT OF THE REGIONAL DIRECTOR: Item 7 of the Agenda (Document WPRlRC6112) The REGIONAL DIRECTOR expressing his honour in addressing the sixty. first session of the Regional Committee and presenting the report on the work of WHO in the Western Pacific Region for the period from 1 July 2009 to 30 June 201O-a report that covered his first full year as Regional Director. He noted that, during the sixtieth session of the Regional Committee, he had highlighted four priority areas for action, and
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he updated the Committee on the key achievements and significant progress that had been made since that time. He then outlined his priorities for the coming year and assured Member States of his continued support in pursuit of health in the Region (Annex 8). Dr MAM (Cambodia) voiced his country's appreciation of WHO, one of many international agencies working to improve the well-being of citizens through equitable access to good, affordable health care. With the support of WHO, Cambodia had reduced infant and child mortality through high immunization coverage, as well as reducing morbidity and mortality caused by HIV/AlDS, malaria, tuberculosis and other communicable diseases. The Country Cooperation Strategy-part of ajoint effort to achieve the WHO strategic agenda-reflected the commitment of WHO to align with country strategies, in this case the National Health Strategic Plan. WHO had also assisted Cambodia in emergency preparedness, such as pandemic preparedness for HlNI and H5Nl influenza. He remarked on the progress that had been made since the Regional Director had taken office and thanked him for his support to the Region and to Cambodia, particularly for the "fasttrack initiative" to reduce maternal mortality. He called for further financial and technical support from WHO and other partners in pursuit of the Millennium Development Goals. Dr LEE (Republic of Korea) welcomed the report of the Regional Director, which set out the challenges to public health in the Region and the way forward. He thanked the Secretariat for the section of the report on "Combating Communicable Diseases". Such diseases had to be curbed at all costs, and the Regional Office should focus the capacities and efforts of the Region on reducing them in order to ensure progress toward the Millennium Development Goals. The Regional Office had expressed its commitment at the highest level to improving the situation and he fully supported the ambitious agenda. On "Health Security and Emergencies", he expressed his country's appreciation of the great efforts and competent leadership of the Regional Office from the outset of the HI NI pandemic in 2009. Communications between national focal points and the Regional Office had effectively channelled and disseminated information, while the Asia Pacific Strategy for Emerging Diseases (APSED) had guided the response to the pandemic. It was important for the Regional Office to continue to assess those tools and to deploy new strategies to
strengthen capacity for response. The Republic of Korea continued to support the food safety initiatives promoted by the Regional Office, especially the revised version of the Western Pacific Regional Strategy on Food Safety. He noted also the report on "Building Healthy Communities and Populations" and encouraged the Regional Office to highlight in international agendas the effect of climate change on public health. Although progress had been made on Millennium Development Goals 4 and 5, more work was needed. The Regional Office had to provide better preventive and clinical interventions and more resources for mother and child health and for adolescent health, at community and facility levels. WHO had a leading role to play in the monitoring and control of noncommunicable diseases and he welcomed Regional Office efforts to curb alcohol and tobacco consumption in Member States while respecting different traditions, in order to reduce the burden of noncommunicable diseases. The Regional Office should fortifY the health systems of vulnerable Member States by strategically mixing health service development, mobilizing resources and securing staff. Increased commitment to health
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sector development would reap great dividends in the future. The Republic of Korea had experience to share in that respect, having changed in four decades from aid recipient to donor. The country had focused on health system strengthening with the highest standards of effectiveness and efficiency. He praised the Regional Director's decision to discuss administration and finance, and was glad to hear that the Regional Office had adopted useful tools to enhance its accountability. He pledged the support of his country in all areas covered by the Report. Dr ISMAIL MERICAN (Malaysia) congratulated the Regional Director on his comprehensive report and his commitment to the four key priority areas, of which the prevention and control of noncommunicable diseases was ofparticular interest to his Government. Malaysia'S national Strategic Plan for Noncommunicable Diseases, which was in line with WHO resolutions and mandates, adopted a whole-of-government approach and focused on policy and regulatory interventions. His Government had accordingly pledged its support for the United Nations High-level Summit on Noncommunicable Diseases, scheduled to be held in New York in September 2011. It was vital to exploit the increasing attention being given to noncommunicable diseases at the global, regional and country levels to increase advocacy for their prevention. It would be necessary to establish strong partnerships with leaders and decision-makers outside the health sector and to engage all relevant stakeholders in shaping people's living environment. At the same time, it had to be admitted that current political and economic incentives often favoured industry and other interest groups over health. Despite the strong focus on economic development, prevention of noncommunicable diseases merited the same level of global attention and cooperation as that given to climate change or, more recently, to pandemic influenza. Mr KHAW Boon Wan (Singapore) observed that most leaders tended to enjoy a "honeymoon" period during their first year in office, yet that lUXUry had been denied the Regional Director, who had been forced to confront the twin challenges of the pandemic (HINI) 2009 virus and a global financial crisis that had diverted public finances from public health. The Regional Director had dealt with both crises competently and systematically. His Government shared the Regional Director's health care priorities, especially his commitment to the Healthy Islands programme. Over the years, his country had acquired some experience in community health education, specifically efforts to encourage young people to lead healthy lifestyles, and his Government was prepared to sponsor and organize a training course on community health promotion for Pacific Island countries. The HlNI pandemic had fortunately been less severe than at first thought, which had led some armchair critics to criticize WHO for "overkill" and "undue alarmism". Some countries that had stockpiled large quantities of vaccines had even experienced a political backlash. Yet the same critics would have been the first to criticize WHO actions as "too little, too late" had the virus proved lethal. Regional Committee members should take comfort from the fact that they had done their best to protect the public, and that it was better to be over-prepared than to be wrong-footed. Now that the global alert was over, however, it would be worthwhile reflecting on the decisions that had been taken in order to learn appropriate lessons, for example reviewing the WHO alert system or even the definition of a pandemic. In addition, the scramble by large developed countries to comer the limited production capacity of HI NI vaccine manufacturers to the detriment of many developing countries could be a lesson for policy-makers and health ministers. Although risk communications during the pandemic had vastly improved in comparison with the severe acute respiratory syndrome (SARS) crisis, it could have been even better. At a recent meeting of the
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Association of Southeast Asian Nations (ASEAN), a proposal had been made for the establishment of an ASEAN Risk Communication Resource Centre to provide research and training in risk communications for emerging communicable diseases, which could act as a reference for other regions. Finally, his Government was firmly in favour of greater collaboration between the human and animal health sectors in respect of zoonotic viruses, more effective cooperation between health and agricultural agencies, and the establishment of common platforms for the joint management of zoonotic diseases at the regional and global levels. Dr YIN (China) said that, in order to strengthen its leading role in global health, WHO should adapt to the constantly changing external environment and strengthen its internal management. His Government hoped that the Regional Office and the Country Offices could strengthen their studies of Member States in order better to understand their individual needs and priorities and thus offer more targeted technical services and guidance. Regional strategic plans would thus truly reflect the needs of Members States and programme budget implementation would be enhanced. The United Nations High-level Plenary Meeting on the Millennium Development Goals (MDG Summit) had recently concluded with a call for the redoubling of efforts to achieve the MDGs by the target date. Among the health-related MDGs, China had already achieved its child mortality goal and made significant progress in reducing maternal mortality and controlling major diseases such as HIV/AIDS. China was confident that, as a result of its health care reform, basic health services would become more affordable and accessible, thereby facilitating the accomplishment of the MDGs at the national level. His Government would be glad to share its experience. By promoting cooperation among Member States, and specifically by encouraging them to implement the International Health Regulations (lliR), WHO clearly had an indispensable role to play in the area of health security and emergencies, as the recent influenza pandemic had amply demonstrated. His Government noted that that a number of technical units at the Regional Office had recently been consolidated into the Division of Health Security and Emergencies, which he trusted would give the Office greater capacity to help Member States to deal with emergencies. The Healthy Cities initiative referred to in the Regional Director's report was a highly effective means of improving public health, which his Government fully endorsed. The initiative had been well-received by local authorities in China. Again, his Government was ready to share with others its positive experience in implementing the initiative. Mr SOAKAI (Nauru), said that, while the creation of the Pacific Technical Support Division was to be welcomed, at the previous session of the Regional Committee his Government had urged the Regional Director to ensure that Member States were included in any process of reform in order to guarantee that country realities were properly taken into account, because any process of change that bypassed consultations was not likely to succeed. His Government accordingly sought clarification as to how the working methods of the Pacific Technical Support Division would differ from current practices, and specifically how the reorganization would impact countries, such as Nauru, that lacked a WHO Country Office. Dr Teiji TAKEI (Japan) said that, although some progress had been made towards the achievement of the Millennium Development Goals in the Western Pacific Region, such as increased access to antiretroviral
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therapy and a decrease in tuberculosis prevalence and mortality, much remained to be done, specifically in the area of maternal and child health. In addition, there was a close interrelationship between the MDGs and the strengthening of health systems, which necessarily implied better training for health workers. In the context of emerging infectious diseases, such as pandemic (HI N I) 2009, the Asia Pacific Strategy for Emerging Diseases (APSED) had proved to be an invaluable resource. This year's session, the Regional Committee would be asked to review and consider endorsing an updated version of the strategy, APSED (2010), which the Japanese Government hoped would incorporate the experience and lessons learnt gained during the pandemic. Changing industrial structures and development driven by globalization were enabling countries to work together to tackle various health issues, such as noncommunicable diseases, through the strengthening of their health systems. Harmonization was another topic with various health ramifications, to which end the Japanese Government would be sponsoring a Global Forum on Harmonization and Health, to be held in November 2010 in Kobe, with input from the Regional Office. Dr Stevenson KUARTEI (Republic of Palau) said that the HINI pandemic had mobilized resources, expertise and commitment throughout the Region as never before. The growing burden of noncommunicable diseases, especially in Pacific island countries, was testimony to their significance as a public health issue. Noncommunicable diseases, while not targeted by the MDGs, placed a heavy strain on health finances and human resource capacity. It would be useful to explore whether the model of emergency response and preparedness could be applied to noncommunicable diseases, and the newly created Division of Health Security and Emergencies should also expanded to include noncommunicable as well as communicable diseases. Mrs GIDLOW (Samoa) endorsed the priority areas outlined by the Regional Director. Samoa looked to the Regional Office for continuing leadership and regional direction, while understanding that the Regional Office looked to the Member States for country-level perspectives and to provide more realistic and practical priorities. Given the increased prevalence of noncommunicable diseases in Samoa, her Government accordingly requested that more money be allocated in that area. Mr KAHU (Vanuatu), welcoming the full report, expressed appreciation for the continued support of the Regional Office. He commended in particular WHO's leadership in the organization of the First Pacific Food Summit (Port Vila, Vanuatu, 21-23 April 2010). His Government was committed to putting the ensuing Framework for Action on Food Security in the Pacific into practice. He further commended WHO's prompt response to the floods in Vanuatu earlier in the year. He acknowledged the Organization's commitment to malaria control and elimination in the context of revitalization of primary health care and health systems strengthening. Professor Eksavang VONGVICHIT (Lao People's Democratic Republic) acknowledged the reported successes over the past 12 months. He outlined his country's improvements in health care services in the context of its National Social Development Plan and Seventh Five-Year Health Sector Development Plan, both of which stressed prevention and primary health care. The Ministry of Health had, with WHO support, developed a strategy for maternal, neonatal and child health care, a skilled birth attendance plan, and a national nutrition policy and action plan (2009-2015). His Government was promoting the expansion of health insurance programmes and health equity funds. Such funds had been launched in several locations, and
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a pilot programme of free facility-based deliveries had been started in two districts. Another achievement had been the prompt and appropriate response to emerging diseases, such as pandemic influenza HINt (2009) against which the national surveillance and laboratory system had functioned well as part of a multisectoral approach to pandemic preparedness and response. Mr Charles SIGOTO (Solomon Islands) said that, based on the premise that health care was the right of
every citizen, health was a high priority in the policy statement released by the newly elected Government in his country the previous week. The policy sought to ensure easy access to high-quality health services in both the public and private sectors. Reform in the health system would include devolution of primary health care functions to provinces and communities, with central government providing coordination of both primary and secondary health care. The Ministry of Health aimed to reinvigorate the health sector, including promoting a general acceptance of primary health care programmes in work towards the Millennium Development Goals and extending health services deeper into the provinces and remote areas, where most of the population lived. Primary health care, revitalizing the Healthy Islands Initiative, and strengthening health systems would be central to the national strategic health plan 2011-2015, which was being drafted. Dr ADANAN YUSOF (Brunei Darussalam) remarked on the significant results that had been achieved in the Region and welcomed the proposed initiatives and action plans. He commended the selection of the four priority areas, which his Government would make central to its health strategies. Particular attention was being paid to the prevention and control of noncommunicable diseases as a long-term strategy and investment. Health promotion was also important in building an enabling structure for improving health and involved many sectors and levels, including communities. In seeking to build a nation that practised healthy lifestyles, he sought further guidance and technical support from WHO, especially in enhancing capacity for behavioural change and to reduce the burden of noncommunicable diseases. Dr CHOW Yat-ngok York (Hong Kong [China]) paid tribute to the Regional Director for executing and initiating much-needed strategies. He endorsed the Regional Office's proposed priority areas, notably the prevention of noncommunicable diseases, and welcomed the emphasis on the evaluation of health systems and the sharing of successful experiences. He strongly supported the reaching-out approach, especially given emerging problems such as zoonotic diseases and increasing reports of antibiotic-resistant microorganisms, the density of population, the frequency of inter- and intra-regional travel and "medical tourism"; the global risks to health and society should not be underestimated. He encouraged both WHO Headquarters and the Regional Office to assume leadership and undertake coordination in raising awareness of these threats and preparing guidelines for surveillance and response. He appealed to his fellow health ministers to monitor their domestic situations and report incidence and trends to WHO and each other; prevention was more effective and less costly than cure. Mrs O'love Tauveve JACOBSEN (Niue) expressed her gratitude for the support given to her very small country. Her ministry focused in particular on noncommunicable diseases, about which more education was needed. She welcomed the push-pull-reach concept but urged great efforts to reach the wealthy business sector that manufactured the products that underlay some of those diseases, for instance the tobacco industry; even despite raised taxes, people continued to smoke. Her Government had endorsed the focus on and activities for prevention and control of noncommunicable diseases. Efforts also continued to be concentrated on filariasis, hygiene, water and sanitation (a WHO-supported project had produced excellent results) and
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health promotion. Coverage with influenza HINI (2009) vaccine had reached 96% and there was vaccine to spare. The representative of the Union for International Cancer Control made a statement. The REGIONAL DIRECTOR thanked speakers for their comments, encouragement and guidance, which would all be taken into consideration. Specific issues would be dealt with in more detail later in the session. He greatly appreciated the regional spirit of cooperation and solidarity, which had given focus to his work.
The meeting rose at 17:00.
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ANNEX 1
ADDRESS BY TIIE RETIRING CHAIRPERSON, DR LAM PING-YAN, AT THE OPENING CEREMONY OF TIIE SIXTY-FIRST SESSION OF TIIE WHO REGIONAL COMMITTEE FOR TIIE WESTERN PACIFIC
It is a great pleasure to be here with you in Malaysia for the sixty-first session of the Regional Committee. As Chairperson of the sixtieth session of the Regional Committee, it is my great honour to thank the most honourable Prime Minister of Malaysia and your people for graciously hosting this session and for opening the doors to this wonderful country with her rich culture and history. We are most grateful for the warm hospitality and the excellent arrangements that we have been accorded with since our arrival in this beautiful country. You have heard that Malaysia had hosted Regional Committee meetings twice before, in 1974 and in 1994. At this third occasion, at a time when we are facing unprecedented health issues and needs in the Region and in our own countries and areas, I am sure that we will, as before, learn much from the experiences of Malaysia. For example, quality of health care and health information systems are just two of the many health development challenges in which Malaysia has demonstrated remarkable success. The sessions of the Regional Committee are important events for all of us. The sessions provide us with the opportunity to discuss current health issue, policies and actions in a collegial atmosphere. Our meetings take on a special significance when these are held outside of the WHO Regional Office in Manila. The value added being that we have an opportunity to learn more about one of our Member States. And I must say that we, in Hong Kong, did enjoy hosting the sixtieth session. When the Regional Committee met in Hong Kong last year, the world was facing a global financial crisis. Countries and areas in this Region were vulnerable, and remain so today, to the inimical effects on their very own economies and populations, especially as the robustness and resilience of their health systems are put to an acid test. The Committee then endorsed a resolution to address the crisis and its health impacts, urging Member States to strengthen and implement pro-health and pro-poor policies based on primary health care principles. The resolution also called on WHO to promote awareness of and share experience on the issues, and to provide support to countries in putting proper countermeasures in place. Financing for health and ensuring that people have reasonable access to quality health care has been a challenge to countries as well as to the global health community including our partners in health. This comes at the time when the world grapples with age-old health problems like malaria and tuberculosis, the growing burden of chronic and noncommunicable diseases and the challenges of new and reemerging infections and other public health emergencies. Many of our countries continue to struggle even just to keep mothers and children healthy. Notwithstanding the Region's great diversity, and inspired by Dr Shin Young-soo's fresh perspective and strong resolve to finding better ways of working, we have in solidarity worked together to weather the crisis. We have stood up as a Region to the Pandemic HI NI (2009), led the fight against tobacco and found innovative ways of promoting healthier lifestyles and protecting our health and the environment in a more sustainable and context-relevant marmer. We have good reason to be hopeful and expectant, and together look forward to hearing the experiences and progress of the last 12 months.
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Annex 1 Distinguished representatives, as I will shortly be handing over my responsibilities to a new Chairperson, let me thank you for your support. I am sure that we will all continue to make valuable contributions during the deliberations this week, as well as during implementation in our respective countries, as we get back to work to make good our commitments and make a real difference for health. Most honourable Prime Minister of Malaysia, let me once again thank you and the people of Malaysia for this wonderful opportunity to work and enjoy the sights and sounds of Malaysia. Terima Kasih.
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ANNEX 2 ADDRESS BY THE REGIONAL DIRECTOR, DR SHIN YOUNG-SOO, AT TIIE OPENING CEREMONY OF THE SIXTY-FIRST SESSION OF TIIE WHO REGIONAL COMMITTEE FOR TIIE WESTERN PACIFIC
On behalf of our Member States and the more than 150 representatives who are here in Putrajaya, Malaysia, to attend the WHO Regional Committee for the Western Pacific, I would like to express my sincere appreciation to the Prime Minister of Malaysia and his Government for hosting this sixty-first session of the WHO Regional Committee for the Western Pacific. At last year's session ofthe Regional Committee, we agreed to meet this year in Manila. But a devastating typhoon hit the Philippines just days after we made that decision, and it caused extensive damage to the Regional Office and its conference hall. Understanding the dilemma we faced, Malaysia stepped forward and offered to host this year's session, even though the Government would have less time than usual to organize the meeting. Once again, we thank our friends in Malaysia for so graciously hosting us on such short notice. WHO and the Government of Malaysia have been working together closely for the last 50 years. Today, Malaysia hosts WHO's Global Service Centre-the financial and administrative hub that serves WHO offices worldwide. Malaysia also is known throughout the Region for the great strides it has made in public health. Rates of maternal and child mortality have dropped sharply, and life expectancy has increased significantly during the last decade. Such progress isn't simply the result of the country's robust economic growth. Sound policy-making by the Government has been responsible for many of these health gains. We salute Malaysia for these impressive achievements. The Regional Committee for the Western Pacific, our governing body, has a full agenda this week. We will be reviewing our progress in achieving the United Nations Millennium Development Goals and determining what more we need to do if we are to meet the commitments world leaders made to tackle problems such as reducing maternal and child mortality and combating HIV and AIDS, malaria and tuberculosis. Many of the issues that we will be considering this week, demand multisectoral action. The health sector alone cannot solve these issues, but we must take the lead in coordinating action. In addition, complex issues such as women's health and health systems strengthening demand crosscutting strategies and solutions. We will be discussing fresh and innovative approaches in these areas later this week. We will also be looking at ways to make our Region safer by reaffirming our commitment to fight measles and other vaccine-preventable diseases and by upgrading our strategy to fight emerging diseases and other health emergencies. And all of our Member States will have an opportunity this week to offer their views on the global Framework for National Health Policies and Plans, as well as to ongoing discussions on the future financing of WHO.
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Annex 2
We will be very busy this week and I want to once again thank the Government and the people of Malaysia for the generosity and wannth they have shown in welcoming us to Putrajaya, as well as the excellent arrangements they have made for the sixty-first session of the Regional Committee for the Western Pacific.
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ANNEX 3 ADDRESS BY THE DEPUTY DIRECTOR-GENERAL OF TIIE WORLD HEALTH ORGANIZATION, DR ANARFI ASAMOA-BAAH, AT THE OPENING CEREMONY OF THE SIXTY-FIRST SESSION OF TIIE WHO REGIONAL COMMITTEE FOR TIIE WESTERN PACIFIC
It's great to be here in Malaysia. I have been here for only 24 hours and I already feel that I am in Paradise. Allow me, therefore, to express on behalf of the World Health Organization and all participants, our sincere gratitude to the Government and to the people of Malaysia for their generosity and hospitality. I wish to pay a special tribute to His Excellency the Prime Minister. Sir, we are greatly honoured by your presence. It confirms our belief that countries which make progress in health are countries that have not only excellent Health Ministers, but where every Cabinet Minister is a Health Minister, and where the Prime Minister is the First Health Minister. Your Excellencies and Distinguished Ladies and Gentlemen, I bring you special greetings from the Director-General, Dr Margaret Chan, who has asked me to apologize profusely for her inability to be here with you. In fact, she is also feeling sorry for herself, because as everyone knows the Western Pacific Regional Committee is perhaps the most well organized and the most entertaining. She was therefore looking forward to some good company, good food, singing and dancing. I am a poor substitute for her because I cannot sing and I cannot dance. Our forefathers (and foremothers) had great foresight when they conceived the idea of a Regional Committee. They recognized that the health of a nation depends not only on what happens within its borders, but what also happens in the neighbourhood. The rationale for the Regional Committee was to provide a platform for neighbours to be good neighbours. In these days of globalization, increased international travel, 24 hour news and Internet, everybody is a neighbour. We are all interconnected and that is why this Regional Committee is so important for global health. Not many people are aware that the Western Pacific Region is the most diversified Region of WHO. In this Region, there are small and large countries, and rich and poor countries. In many ways, you are more representative of the world than other regions. Your deliberations are therefore of special importance, not just to this Region, but to the rest of the world, and the rest of the world is eagerly awaiting what comes out of this Committee. I wish you a very successful Regional Committee meeting and look forward to very exciting and animated discussions.
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ANNEX 4 ADDRESS BY THE MINISTER OF HEALTH OF MALAYSIA, MR LIOW TIONG LA!, AT THE OPENING CEREMONY OF THE SIXTY-FIRST SESSION OF THE WHO REGIONAL COMMITTEE FOR THE WESTERN PACIFIC
Good morning and a warm welcome to the participants of the sixty-first session of the World Health Organization's Regional Committee for the Western Pacific to Putrajaya, Malaysia. First of ali, I would like to express my sincere appreciation to the Honourable Dato' Sri Najib bin Tun Abdul Razak, the Prime Minister of Malaysia, for taking time from his busy and schedule to grace us with his presence today. Sir, your presence and subsequent opening of this meeting show the strong co=itment of the Malaysian government to matters that pertain to health. Our Government is delighted to host this distinguished event as it gives us a platform to discuss
important health issues affecting the Region. In addition, it also allows us to showcase our warm hospitality and our multi-ethnic population comprising people from different cultural and religious backgrounds living and working together in harmony, as proud Malaysians. We hope you will feel at home here, and will also take time to visit our tourist spots and taste our multiethnic cuisine. All of us here today are united under the WHO Regional Office for the Western Pacific, to improve regional health and intensify cooperation between Member States. This year's session is particularly significant because it provides an opportunity for us and our experts to examine the responses and effects of the recent Pandemic HINI that we experienced about one year ago. In particular, Member States now have the opportunity to share their lessons learnt with regard to the implementation of their national strategic Influenza Pandemic Preparedness Plans and suggest improvements for the future. In addition, it is hoped that Member States can take the opportunity to discuss the "One Health Strategies" to ensure universal access to health care among the people and also the implementation of the International Health Regulations (IRR) 2005 especially with regard to issue of cross border co=unicable diseases. I am looking forward to greater cooperation and collaboration among member countries as an outcome of this meeting while we work together to share our experience and expertise for the co=on good of the people in the Region. Some of the areas of interest will be best practices with regard to the MDGs and noncommunicable diseases while Malaysia will be implementing the National Strategic Plan on NCDs. I am confident that this meeting will be a productive and successful forum and I look forward to fruitful deliberations during the sessions over the next five days. Thank you very much.
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ANNEX 5 ADDRESS BY THE PRlME MINISTER OF MALAYSIA, THE HONOURABLE MOHD NAJIB BIN TUN ABDUL RAZAK, AT THE OPENING CEREMONY OF THE WHO REGIONAL COMMITTEE FOR THE WESTERN PACIFIC
I wish to warmly bid "Selamat Datang" to your Excellencies, honourable ministers, distinguished delegates, ladies and gentlemen to Putrajaya Malaysia for this sixty-first session of the WHO Regional Committee for the Western Pacific. It is truly an honour and privilege for Malaysia to be chosen as the venue for your session this year. The WHO Regional Committee Meeting for the Western Pacific Region is an important forum for health ministers and experts throughout this Region and this year's session is particularly significant because, amongst other things, it provides an opportunity for the various experts to examine the response and effects of global Pandemic Influenza A (HINI) that we all experienced about a year ago. We are now in the post-pandemic phase of the HINI pandemic. Like most countries, we have followed the recommendations of the WHO with regards to our national influenza preparedness strategies. Truly, the HINI pandemic has been a baptism offire for us. We had to balance important public health considerations with the multitude of opinions, especially during the implementation of many of the containment phase strategies. The HINI pandemic tested our risk communication strategies in facilitating public vigilance and the avoidance of panic. One good case study is the immunization coverage that we recommended. As advised by WHO, we made the decision to provide enough vaccines for our front liners, i.e, health care workers, those providing essential services and high risk groups. But the pressure was on us to cover our entire population, just like what was being done then in developed nations which began ordering the vaccines early, as soon as they were available. Fortunately, the pandemic turned out to be a mild one and we were spared the dilemma of disposing vaccines that were not used. One wonders what would have happened if the pandemic evolved into a serious and severe pandemic? Any responsible government would do whatever it takes to protect its people, even if the costs are daunting. This is where we stand guided by international and reputable organizations like the WHO which must demonstrate strong and firm leadership backed by impeccable technical competency. Member States look towards the WHO in providing appropriate guidance and advice as such threats are often unprecedented. I believe this important conference can provide the input for future global action against pandemics and other trans-boundary diseases affecting all countries and communities, especially developing countries. Indeed, the HI NI pandemic represented the first major test on the efficiency and relevance of the International Health Regulations (IHR 2005). Let us learn from the HINI pandemic, evaluate the responses of the International System to the HINI pandemic and equip ourselves better in facing more challenging pandemics in the future.
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Another health challenge in our Region is noncommunicable diseases ofNCD. According to WHO, cardiovascular disease, cancers, chronic respiratory diseases and diabetes represent a leading threat to human health and development. These four disease are the world's biggest killers, causing an estimated 35 million deaths each year-60% of all deaths globally-with 80% in low- and middle-income countries. The prevalence of NCD and NCD risk factors in Malaysia, as well as in our Western Pacific Region, are increasing at an alarming rate. The staggering increase ofNCDs over the past two decades threatens the quality of life of those affected. In addition, it poses an unprecedented challenge to health care systems in the Region, many of which are unprepared and in transition. The Western Pacific Region can be viewed as a critical area for global public health as the majority of the global population now live in this region which is now one of the most populous and dynamic regions of the world. How we grapple with these NCDs challenges, will shape the future of this region and beyond. In developed countries, it is estimated that about half of the decline in NCDs mortality, is influenced by lifestyle changes and the other half by better treatment and care. Although we are making headway in the treatment of chronic diseases, we must emphasize the importance of primary prevention, early NCD risk factor identification and NCD risk factor intervention. Continuing health promotion, especially targeted towards younger persons, together with creating an environment that supports healthy living, are important in curbing and decreasing the prevalence of NCDs. Having said that, we can achieve a more immediate effect by targeting intervention at those with highest risks of developing NCDs. To stay healthy, individuals must embrace a healthy lifestyle. They must be constantly reminded that health is wealth, as the saying goes. It is an important and vital resource for living. Now is the time to give attention to the importance of a healthy lifestyle. They must be made to be responsible for their own health as they have the capacity to influence it. Amongst the things they must now focus on would include healthy eating choices, staying physically active and refraining from resorting to a sedentary lifestyle. Non smokers must maintain their status whilst most smokers must be persuaded to quit smoking. Recently, NCDs have garnered more political awareness and policy maker's attention. The recent adoption ofthe United Nations GeneralAssemblyresolution on the prevention and control ofnoncommunicable diseases is the manifestation of that political commitment at the highest level. It seeks to halt the increasing trends in premature deaths from noncommunicable diseases worldwide. To overcome NCDs threats, it is necessary to strengthen health systems. The health care delivery system must be re-engineered to provide quality care that is coordinated and cost-effective, rather than focusing on high-burden services and acute episodes. In order to do this, countries, especially the middle and lower-income countries of the region, would need a formidable health workforce. In Malaysia, the National Strategic Plan for NCD represents our approach to operationalize existing knowledge and current scientific evidence in reducing the burden of NCD. The Ministry of Health will continue to enhance smart partnerships with other government agencies and other stakeholders to further reinforce NCD prevention and control programmes in Malaysia.
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In our quest to become a developed high income nation, the Malaysian health care system will be transfonued into a more efficient and effective system in ensuring universal access to health care. The blueprint is currently being worked out to develop 1Care for 1Malaysia, a restructured health system that is responsive in meeting the health care of the population, provide choices of quality health care and ensuring universal coverage based on solidarity and equity. Malaysia has been cited by international bodies as being a good model in health care, especially in tenus of primary health care for the rural population. So some may ask why we need to change a model that has served us well for more than five decades. The reason is simple. We want to do better. Like other countries in the world, Malaysia has to grapple with challenges brought about by demographic transitions, overall health care cost escalation, increasing out of pocket spending, overstretched public facilities and increasing client expectations. The goals for restructuring are to enhance universal coverage in line with lMalaysia concept. We propose an integrated public and private health care delivery system; ensure that health care remains affordable and sustainable; improve equity in tenus of access and financing, ensure efficiency, quality of care and optimal health outcomes; improve effective safety nets for catastrophic payments; enhance responsiveness of the health care system; increase client satisfaction; increase provision of personalized and community care and reduce brain-drain especially to overseas markets. But as Malaysia continues its accelerated action towards universal access to primary health care and moves towards high income status, safety nets need to address the hard core poor and the vulnerable groups will still be given our foremost attention. The restructuring proposal includes establishing a sustainable health care financing system, with the government continuing to uphold its responsibility in maintaining a strong social safety net. Primary health care will remain the thrust of this transfonued health care delivery system in order to manage rising health care costs and ensure better equity in health, through better utilization of resources. This will be implemented without compromising on the universal coverage and ensuring services that are efficient, responsive and of good quality. With global warming projected to increase two to ten times greater than the last decade, we are indeed heading towards potentially disruptive and irreversible changes to the ecosystem, which will not only impact on human health and well being, and may even ultimately compromise human survival on this planet earth. Throughout the world, the prevalence of some diseases and other threats to human health depend largely on local climate. Extreme temperatures can lead directly to loss of life, while climate related disturbances in ecological systems, such as changes in the range of infective parasites and life cycle of vectors such as mosquito, can indirectly impact the incidence of serious infectious diseases. The Asia Pacific Region, in particular, has been subjected to challenging climate sensitive mosquito borne diseases and here I am referring to dengue. It is the fastest emerging viral infection and the maximum
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burden is borne by the countries in this region. It is estimated that out of the 2.5 billion people at risk of the infection globally, 1.8 billion or 70% reside in the Asia Pacific Region, mostly in the developing countries. Regional and international cooperation and collaboration is vital to mitigate the effects and reduce the impact of climate change. There is a need for stronger partnerships and international action in Asia and the Pacific Region, emphasizing that it is essential for the donor and international community, to maintain their commitments for aid and assistance during the crisis period. Towards this end, the Government of Malaysia has signed an agreement with the World Food Program to establish the first United Nations Humanitarian Response Depot (UNHRD) in Asia, based in Subang, Malaysia. The UNHRD in Subang, the fifth such hub in WFP's global emergency response arsenal, is designed to deliver humanitarian relief items within 48 hours of a crisis occurring. We are aware that a Regional Working Group on Protecting Health from Climate Change was established in 2008 to address climate change and health issues relevant to WHO programmes in the Region. This initiative should continue as the main platform to enhance regional cooperation and harmonization in addressing the challenges of climate change of our future generations. Ladies and Gentlemen, it is my sincere hope that the sixty-first session will strengthen cooperation and collaboration between Western Pacific countries, especially in exchanging information and ideas on health issues of common concern. Since we are all living in a global village, regional and international cooperation in public health administration remain the most essential weapon against the spread of infectious diseases across countries. Finally, I wish all delegates and participants a successful meeting and I hope all of you will have an enjoyable stay in Malaysia.
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ANNEX 6
ADDRESS BY THE RETIRING CHAIRPERSON, DR LAM PING-YAN, AT THE OPENING SESSION OF THE WHO REGIONAL COMMITTEE FOR THE WESTERN PACIFIC
I wish to once again express on behalf of the Committee, our sincere appreciation to the Government and people of Malaysia for the gracious welcome and world-class facilities accorded to us-Representatives to the sixty-first Regional Committee meeting. As I had previously mentioned, the rich history and culture of Malaysia, as well as its great strides in development, always afford visitors much enjoyment and learning. Just over a year ago in Hong Kong, many of us who are here now were among those privileged to hear Dr Shin Young-Soo address this Committee for the first time. He shared with us his vision and direction for a stronger and more responsive WHO, in exercising health leadership in the Region and beyond, and in supporting Member States. Being not of WHO as Dr Shin described himself, we all looked forward to some innovative approaches to leading the Organization to achieve its objectives. We therefore welcomed not only the new Regional Director, but also his move to introduce reforms in WHO Offices in the Region to make the Organization equipped to serve and support Member States better to attain the highest standard of health. We have come to appreciate the intended improvements in the way WHO delivers support to countries, and how it partners with other players in the Region, and beyond, to push health issues farther up the development agenda of Member States and others in the international community. We now have the opportunity to examine more closely and appreciate more fully the depth and breadth of the reforms that Dr Shin continues to pursue with vigour and determination. As I was preparing for what I was going to say to you today, I looked back to the long history of this Region and the previous sessions of the Regional Committee. I believe that this sixty first sOession that is being held here in Malaysia is significant. If I could borrow from what Dr Shin shared with us last year-he said something about the number 60 being regarded as "the completion of one life cycle and the beginning of the next". It struck me therefore that, as we meet today for the sixty first session, among the items on our agenda is Dr Shin's report on his first full year as Regional Director, and I am sure, on the progress of his reform agenda that was presented to this Committee last year. Many of you may not know it, but 16 years ago, at its forty-fifth session held in Kuala Lumpur, the Regional Committee had endorsed a similar move when it discussed the WHO response to global change. To ensure WHO's continued leadership in health in the face of a global sea-change, a resolution addressed then important issues that have remained relevant up to now: the essential role of a strong regional office in working effectively with Member States to fulfill the mandate of the Organization and to improve the health status of people; the complexity of the change process and the overriding need for effective leadership performance; and the need to continuously review methods of work in the light of changing circumstances and health needs in the Region. The holding of this sixty-first session in Malaysia marks the beginning of a new cycle for our Region. Distinguished Representatives, you will recall that during the sixtieth session, we endorsed five key guiding documents for the Region, namely: the 2010-2011 Programme Budget; the Health Financing Strategy for the Asia Pacific Region (2010-2015); the Regional Action Plan for the Tobacco Free Initiative
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Annex 6 in the Western Pacific (2010-2015); the Regional Action Plan for Malaria Control and Elimination in the Western Pacific (2010-2015); and the Asia Pacific Strategy for Strengthening Health Laboratory Services (2010-2015). With your support and cooperation, we can expect the Regional Director's report to reflect the progress made in these areas. Let me touch upon a number of developments over the past year. We were concerned about the global financial crisis and its potential health impacts in Asia and the Pacific. We saw the urgency of promoting awareness and advocating action at the highest political levels. The resolution that we passed called for the review and revision of health financing policies to improve access and the implementation of pro-poor and pro-health policies. For after all, how could we ever talk about quality of care if there is no, or limited, access in the first place. We emphasized the importance of monitoring health impacts and the sharing of evidence and lessons for us to be forewarned and forearmed should another crisis occur. We have reasons to celebrate. We have scored against many of the health challenges that have come upon us. We have made steady progress in our efforts to control Tuberculosis and Malaria, eliminate measles and reduce prevalence of chronic hepatitis B virus infection. There are some obstacles along the way towards achieving our goals but we continue to discuss these issues, and this week I hope the Committee will have agreed on the Regional approach to guide our actions on these remaining challenges. Our Region still experiences concentrated epidemics of HIV/AIDS that disproportionately affect groups including sex workers, injecting drug users, and men who have sex with men. But we continue to be vigilant. An important piece of work that looks at the priority interventions in health sector response to the emerging spread ofHIV among men who have sex with men was launched this year. This was developed by both the WHO Western Pacific and South East Asia Regional Offices together with other partners including UNDP, UNAIDS, and the Asia Pacific Coalition on Male Sexual Health, among others. The Department of Health, Hong Kong (China) is pleased to have been involved in this landmark work. At this meeting, we shall hear of some innovative approaches and encouraging examples of national actions to promote and protect health through Healthy Settings. I believe this Region has a wealth of experience and examples of good practices from which we could build upon in strengthening health promotion approaches. If I may share the experience in Hong Kong, the Healthy Cities project in Hong Kong was launched some 13 years ago in just one district. Since then the development of healthy cities has been rapid. Districts have become members of the Alliance for Healthy Cities, and to further promote the exchange of experience and enhance collaboration, the Hong Kong Chapter of the Alliance for Healthy Cities was established in September 2007. We have applied the settings approach in addressing a broad range of health concerns and we are pleased with the outcome. I believe that we should harness the potentials of this approach. Our collective health efforts over the years have brought us at the forefront of the fight against SARS and we have just come out of the dreaded Pandemic (HINl) 2009. Our recent experience with HINI only brought home the point that the pandemic knows no borders and that only a global concerted effort can guard and maintain international health security. Our experience underscored the importance of high level political commitment and leadership, proactive surveillance and rapid response. We learned a lot from each other;
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Annex 6 we saw the critical role of the media, of open communication and strategic collaboration both within and among countries. We thank WHO and our partners for supporting countries to develop and strengthen their capacities to respond to these challenges. But while important progress has been made, we should not let our guards down. On the contrary, we must continue our vigilance, reflect on our weaknesses and build on our successes to better equip us to confront emerging infectious diseases and other public health emergencies. The Asia Pacific Strategy for Emerging Diseases and the International Health Regulations (2005) had served us well and continues to guide national and international actions. But it is also about time that we reviewed and updated the strategy based on what we have learned and to respond to the continuously evolving situations. As I mentioned during the opening ceremony, our health systems have been tested to their limits. Population ageing, the increasing burden of chronic diseases; the health impacts of environmental degradation and climate change, not to mention emerging and reemerging diseases that give our health systems shocks and jolts, the rapid technological advances - all these, our fragile health systems have to cope with. In response to the Regional Committee's request two years ago, a regional strategy on health systems strengthening and primary health care has been formulated for consideration by this sixty-first session. Now is the time to get a good grip of how health systems can be designed to deliver sustainable, essential, appropriate and quality health care. I would like to acknowledge the efforts of WHO in the Region to improve the capacity to analyze country-specific health system challenges and assess performance through the Asia Pacific Observatory on Health Systems and Policies in collaboration with national and international partners. I was glad to note the enthusiasm shown by Member States and academic institutions in the stakeholder consultation on the proposed Asia Pacific Observatory organized by the WHO Regional Office in Hong Kong in June this year. I am optimistic that, given the commitment of both Member States and partners to this initiative, it wouldn't be long and we shall have established an Observatory for our Region.
An area that I think merits our attention is traditional medicine. WHO Western Pacific Region has made significant efforts to increase understanding and to promote the rational use of traditional medicine both regionally and globally. Substantial progress has been achieved but I believe that further work is needed to strengthen national policies and measures to promote best practices and to ensure the appropriate and effective use of traditional medicine. I look forward to the continued leadership of WHO in mobilizing all partners and stakeholders to collaborate in this effort. Our world is changing so rapidly and in more complex ways, and it is urgent that we unify behind the platform of reforms that will make WHO and its Member States real equalizers for the health of all our peoples in this Region. Each of us, given our own capacities and circumstances, can make a significant contribution. Honourable Ministers, distinguished Representatives. We will soon be electing our Chairperson for the sixty-first session of the Regional Committee. Before I finally tum over the task of Chairperson, I wish to thank all of you again for having given me the opportunity to serve as Chairperson of the sixtieth Session. We
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have good reasons to be proud. We have begun a "new cycle". Through his vision and leadership, Dr Shin brought the Region off to a good start towards giving our people the highest possible standard of health. We have all stood up to the challenge, as individual Member States and as a Region as a whole. This is a tribute to your commitment and the unwavering support of our many partners. I would like to express my appreciation to my fellow office-bearers who have worked hard and supported me all throughout. To our Vice Chairperson, Honourable Minister Kautu Tenaua; our able rapporteurs, Ms Cath Patterson and Dr Jean-Paul Grangeon, thank you very much. Distinguished Representatives, dear colleagues, let us all do our best to make this meeting a success. I wish everyone an enjoyable and memorable time in Putrajaya. Let us take advantage of the fact that we are ensconced within Malaysia's widely admired Multimedia Super Corridor. I also hope that we will continue to deepen and cultivate our social and professional networks as we explore new health horizons and savour the exquisite sounds and sights of our host country for the rest of the week.
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ANNEX 7
ADDRESS BY THE DIRECTOR-GENERAL OF THE WORLD HEALTH ORGANIZATION, DR MARGARET CHAN, AT THE OPENING SESSION OF THE SIXTY-FIRST SESSION OF THE WHO REGIONAL COMMITTEE FOR THE WESTERN PACIFIC
Excellencies, honourable ministers, distinguished delegates, Dr Shin, ladies and gentlemen, Due to a scheduling conflict, I am sorry that I cannot be with you today in what I always think of as my Home Region. I would like to offer some comments about the issues you will be discussing, also in the context of two recent events. At the end of September, the Review Committee, set up under the International Health Regulations, continued its evaluation of the 2009 influenza pandemic and the coordination of the response by WHO. Part of that session was devoted to interviews with WHO staff, myself included. WHO welcomes this review, which is focused on improvements for the future. Numerous precise recommendations are emerging. For example, some countries had problems with the definition of a pandemic and the phases leading to its declaration. Many felt that an indication of severity should be part of risk assessment at the international level and risk management within countries. The technology for producing influenza vaccines needs to be modernized. When vaccines arrived, we had difficulty countering perceptions that the pandemic was even milder than seasonal influenza. Many people decided to forego immunization, thinking vaccines were not needed or not safe. The committee is also looking at the functioning of the IHR, again with a view towards improving its performance in the future. I know that this region is also looking towards the future with the strengthened Asia Pacific strategy for emerging diseases. The fact that most national influenza centres in the Western Pacific could reliably detect a brand new virus speaks well for capacity in your countries. A week before the Review Committee, I attended the UN summit on the MDGs in New York, and participated in a number of events.
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The world received its report card. High marks go to initiatives that have brought significant reductions in deaths from AIDS, TB, malaria, and vaccine-preventable diseases. Immunization, in particular, has been a striking success. You will be discussing this Region's dramatic declines in measles deaths and in hepatitis B infection among children. This demonstrates the power, not only of partnerships, but also of strong national commitment. High marks go to aid that is building fundamental capacities and infrastructures, thus moving countries towards self-reliance. This is best done, as you will be discussing, when the countries themselves have strong national health strategies and plans. But low marks go to wealthy countries for failing to deliver on their promises and commitments, including financial ones. This is the big question, the big shadow that falls on any bright story of success. Can gains be sustained and progress further accelerated despite the current global economic downturn? New financial commitments were announced, especially for women's and children's health. But does this mean less money for AIDS, TB, and malaria, areas where we have seen progress, but by no means victory? Progress, everywhere, in every area, is fragile. This is evident in your proposed regional strategic plan for tuberculosis control. It rightly focuses on the need to do more to find and manage cases, and to prevent the development of drug-resistant TB. It also puts the agenda for strengthening health systems at the centre of the TB control strategy. Ladies and gentlemen, I warmly welcome your proposed strategy for strengthening health systems, guided by the values and principles of primary health care.
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Annex 7
Given the region's diversity, developing a platform of common aims, common values, and common approaches facilitates collaborative efforts for better health. As noted, the values underpinning good health systems are universal. They seek fairness in access,
equity in outcomes, and efficiency in the use of resources. You are keenly aware of the challenges. Like growing expectations for quality health care, an overemphasis on specialized care, and rapidly rising costs. These challenges come at a time of strong commitment to universal coverage. This year's World Health Report, on health systems financing, offers a menu of options for moving towards universal coverage. It points to ten specific areas where better policies and practices could increase the impact of health
expenditures, sometimes dramatically. At a time of financial austerity, cutting waste and inefficiency is a far better option than cutting health budgets. Your strategy on health systems goes hand-in-hand with the framework for national health policies, strategies and plans. This helps channel effective aid in ways that strengthen capacities Strong national strategies and plans are also the best way to ensure that health is viewed as the corporate business of government, engaging all sectors in a whole-of-government approach. Most of today's biggest health challenges arise from policies made outside the health sector. Most of today's biggest barriers to health are not technical. They are political and social. The items on your agenda, including the renewed commitment to women's health, healthy cities, and healthy islands, contribute to the achievement of the MDGs, and address the broader social determinants of health. Above all, they recognize the need for stronger health systems, based on the values and principles of primary health care. I wish you a most productive meeting.
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ANNEX 8
ADDRESS BY THE WORLD HEALTH ORGANIZATION REGIONAL DIRECTOR FOR THE WESTERN PACIFIC, DR SHIN YOUNG-SOO, AT THE OPENING SESSION OF THE SIXTY-FIRST SESSION OF THE WHO REGIONAL COMMITTEE FOR THE WESTERN PACIFIC
It is an honour to address you today and present my annual report of the work of WHO in the Western
Pacific Region-a report that covers my first full year as Regional Director. We have a full agenda this week. I look forward to discussing the issues with you and receiving your guidance on how best to move forward with our ambitious programme. But before we begin those discussions, I would like to take some time to update you on the significant progress that has been achieved over the past year and then turn my attention to what we wish to do this coming year. When I first addressed the Regional Committee last year, I highlighted four priority areas: • accelerating progress towards the achievement of the Millennium Development Goals-particularly MDGs 4, 5 and 6: reducing child and maternal mortality, and combating mv, malaria and TB; • strengthening capacity in the Region to respond to public health emergencies; • revitalizing our efforts to fight the rising tide of noncommunicable diseases; and • strengthening the health systems that underpin all our programmes. I set these priorities to ensure that these major areas would receive our full attention. A detailed summary of our progress can be found in our annual report which covers the period from 1 July 2009 until 30 June 2010. Just three weeks ago, the Director-General, Dr Margaret Chan, and I attended the United Nations MDG Summit and met with world leaders to review progress on the Millennium Development Goals. The conclusions from the Summit were simple. Much has been accomplished. Many lives have been saved, and many people have been lifted out of extreme poverty. But much more work is still needed between now and 2015-the target date for achieving these goals. Here in the Western Pacific Region, we can take pride in the fact that overall our Region is performing better than any other WHO Region. We are on track to meet, or even exceed, the health-related goals. But with one exception-maternal mortality.
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Annex 8 I find it shameful that women are still dying in child birth. As we all know, most of these deaths are preventable. So during the past year, I have paid special attention to this issue. Among our Member States, Cambodia, the Lao People's Democratic Republic and Papua New Guinea are facing particular challenges but their govermnents are taking strides to address this issue. I have visited each of these countries at least twice since I took office. Each time I have worked closely with the Ministries of Health to support programmes to reduce maternal mortality. Last February, I stood proudly by the side of the Minister of Health in Cambodia as he opened the National Maternal Death Surveillance Room. Using mobile phones accessible in virtually every village in Cambodia, one day soon every single maternal death will be reported directly to the Surveillance Room. The Minister of Health will be able to track progress and, most importantly, use this information to strengthen responses and target interventions to where they are most needed. During my visits to the Lao People's Democratic Republic, I learnt about a community-based programme that trains voluntary health workers to become community watchdogs--collecting health data and providing basic health education to villagers. Most importantly they also support pregnant women to have their babies in health facilities and supply basic hygiene kits to women who deliver at home. This life-saving programme will be rolled out across the country with support from WHO and other partners.
In Papua New Guinea, I was honoured to speak at the launch of the new 1O-year National Health Plan. I was pleased to see that this plan places a high emphasis on reducing maternal mortality by creating a govermnent-led Maternal Health Taskforce. I truly hope that these, and the many other Initiatives that are now in place in our Region, will have a significant impact on reducing maternal mortality.
In terms of MDG 4--reducing child mortality-the integrated management of childhood illness is making a substantial impact in many countries.
In Mongolia, for example, its successful implementation has led to a dramatic reduction in the infant mortality rate.
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Much progress has also been made with MDG 6. Compared with 10 years ago, TB prevalence in the Western Pacific Region has been halved, the number of malaria deaths has been cut by over 50%, and the mv epidemic, which once threatened to explode in this Region, has been contained and even reduced in some countries. With malaria, we are now at a point where elimination is being discussed in some countries. I would like to thank the Government of Vanuatu for the opportunity to see for myself how their ambitious elimination programme on Tanna Island is progressing and observe how an integrated health systems approach in such programmes could also help address other major public health problems. My second priority area was strengthening the capacity in the Region to respond to disease outbreaks and public health emergencies. The framework provided by the Asia Pacific Strategy for Emerging Diseases has proven useful in guiding our joint work on strengthening early detection and response capacities. The HINI pandemic presented the first real test of the International Health Regulations (2005)--and a test of our readiness. Responding to pandemic influenza, as we all experienced, was not always easy. Calibrating the response, dealing with uncertainty, communicating effectively, managing complex logistics-all of these posed challenges. But despite this, we, as a Region, came through this together. The pandemic response demonstrated the value of our investment in capacity-building. Information was shared between Member States in an open and timely manner. Vaccine was donated and deployed to all 16 countries in the Region that requested it, and travel and trade disruptions were kept to a minimum. The third priority area I highlighted last year was the urgent need to address the rising tide of noncommunicable diseases. We know that tackling this issue is not easy and will take some time. However, I believe that over the past year we have moved forward in building a solid platform that will serve us well in the future. Let me give you a few examples.
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When the Regional Committee met last year in Hong Kong, you agreed to set clear targets for tobacco control and committed to working towards a 10% reduction in tobacco use over the next five years. An action plan to achieve this target has been aggressively pursued this year. We are particularly pleased with the work this year that Samoa and Viet Nam are undertaking to explore the use of tobacco taxation revenue to fund health promotion foundations. We are also delighted by the initiatives being explored in Australia, such as further significant increases in tobacco taxation and the plain packaging of cigarettes by 2012. Hong Kong (China) and Singapore are both working on stronger regulations. These countries are trailblazers in tobacco control, not just in the Region but in the world. We know that these types of initiatives save lives. Access to good food and good nutrition in the Pacific are now critical issues that are directly affecting the health, security and long-term well-being of Pacific islanders. I was pleased that WHO was able to work with Member States in the Pacific to host the Pacific Food Summit in Vanuatu in April of this year. The Summit brought together three ministries from each pacific island country-they were Health, Trade and Agriculture. Also present were representatives from the food industry, nongovernmental organizations and other international agencies involved in the production and distribution of food. The Framework of Action that was endorsed by the Ministers marks in my view an important step forward in acknowledging that food security is an urgent multisectoral issue. Another approach to tackling noncommunicable diseases is the healthy settings approach-particularly Healthy Cities and Healthy Islands. By focusing on a "setting" rather than just a disease, we can push policy-making upstream and focus more on prevention and strategies to support healthy living. We can also invite non-health sectors to join us in tackling life- style-related issues and addressing the harmful environmental conditions that are contributing to the rise in noncommunicable diseases. We will have an opportunity to discuss this healthy settings approach in more detail later this week. I look forward to the discussion. And finally, we have renewed our focus on strengthening health systems, the fourth priority area I highlighted last year.
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With the endorsement of the Regional Committee and the support of our Member States, we launched two key initiatives this year-a Health Financing Strategy that provides guidance on ways to increase health coverage for all our people, and a Laboratory Strengthening Strategy that emphasizes quality and building lab capacity across all programmes. Other important initiatives have also been scaled up, including improving access to essential medicines, combating counterfeit drugs and strengthening the evidence base for the use of traditional medicine. WHO has also re-engaged in supporting the national teacher training programme in the Region. This programme improves the quality of medical and nursing education by, quite simply, teaching teachers how to teach. This flagship WHO programme has been dormant for a number of years. As a beneficiary of this programme myself when I was a professor, I am very pleased to report that we have revitalised this work and that national teacher training centres are now in the process of being established in some of our Mekong countries. Finally in the area of health systems, I am pleased to report that the task to establish an Asia Pacific Observatory on Health Systems and Policies is well advanced. The Observatory is a biregional initiative with the WHO South-East Asia Region. It will build a solid knowledge-base on health systems in the Asia Pacific region. When we met last year in Hong Kong, I talked about the organizational reforms intended to strengthen our ability to serve Member States and to respond to emerging challenges. All of the major areas of reforms have now been implemented and are becoming part of our daily life. Some of the reforms have been structural, others technical, and a significant number have focused on human resource development. A key structural change has been the reduction in the number technical units in the Western Pacific Regional Office from 31 units to 17 integrated teams.
In addition, the resources used to support the health needs of people living in the Pacific have been brought together through the formation of a new Division-the Division of Pacific Technical Support. The Director of the Pacific Technical Support Division also serves as the WHO Representative for the South Pacific. The Director works closely with the WHO Representative in Samoa and the five Country Liaison Offices to ensure that our support can be better tailored to meet the specific and often unique health needs of people living in the Pacific.
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As an additional step to improve our services in the Pacific, the previous medical officer position in Pohnpei has been upgraded and expanded to create a new Country Liaison Office for Northern Micronesia, serving Palau, the Marshall Islands and the Federated States of Micronesia.
In our Regional Office the three emergency preparedness and response units-emerging diseases, food safety and emergency health action-have also been brought together to form a new Division-the Division of Health Security and Emergencies. During the restructuring, we were careful not to increase the size or cost of the Organization. We remain the same size-just a different shape that is better tailored to meet the needs of our Member States. And the structural changes have had only a negligible impact on costs. Throughout the last year, we have invested significant financial resources to develop a comprehensive staff development and learning programme. An in-depth analysis of the skills needed by staff in different positions and at different stages in their careers was undertaken. The results have formed the basis of a learning programme developed and implemented by us in this Region. This programme is designed to meet the needs of each and every member of staff. I am also pleased to report to you that the Western Pacific Region is the first WHO Region to implement a comprehensive staff rotation policy. Under this programme, professional staff will move to different positions within the Organization approximately every five years. Rotation will bring fresh ideas and will enhance opportunities for learning. Last year, distinguished delegates, you raised concerns about how our Regional and Country Office workplans are integrated and about our ability to realistically measure and demonstrate the impact our work. I can tell you that we shared your concerns and have made some significant changes. Following our meeting in Hong Kong, we embarked on a cross-cutting project to develop what we are now calling Technical and Country Strategic Frameworks. You will have an opportunity to learn more about these strategic tools during the budget-related agenda items tomorrow. You will hear how these tools have improved our ability to plan in a coordinated manner and to monitor the impact of our work. Distinguished delegates, I have provided you with an overview of some of the technical and organizational progress over the past year.
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More detail, as I mentioned earlier, can be found in our annual report and members of staff from the Regional Office who are here this week will be able to respond to questions you might have. I would now like to turn to what we propose to do this coming year. Over the past year, I travelled extensively to get a first-hand look at the public health situation in many of our Members States. Looking out in this conference hall, I recognize many people I met during my country visits, and I thank you all for your generous hospitality and kind attention during my travels. It is from these visits that I have drawn inspiration for my ideas for the coming year.
Next year I would like our Organization to do three things-to push, to pull and to reach out. Let me explain. First, we need to push forward with the priorities from last year. I want to ensure that we push forward to achieve and exceed the Millennium Development Goals. I want to push forward by making the Region a safer place by learning from the experience of the HINI pandemic. I want to push forward with the range of programmes that are needed to address the rising tide of noncommunicable diseases. And I want to use the momentum that has been created to push forward in strengthening our health systems. At the same time I want to address "old-fashioned" diseases-diseases that once attracted attention but have for a number of years been neglected. I want to pull them back into the limelight. We have unfinished business with leprosy, with lymphatic filariasis and with yaws. Although most countries in the Region have eliminated leprosy, a few Pacific island countries are still reporting new cases. The same goes for lymphatic filariasis. There have been many success stories, but lymphatic filariasis still remains a public health issue in a few of the countries in our Region. And yaws-a disease we thought we had eliminated from this Region back in the 1960s-is still causing disfigurement and suffering in some remote island populations.
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I will be making it my personal mission to see that leprosy is eliminated from this Region before my term of office ends. And I want to see lymphatic filariasis and yaws banished from the Pacific. And then there is dengue-an old disease that we have been struggling with for many years. It is now the most rapidly growing mosquito-borne disease in the world.
Outbreaks are occurring in many countries in our Region, and the disease is spreading. We have to think about new approaches and work much harder to confront this disease. And lastly I want to see the Organization reaching out-reaching out more to sectors beyond health. So many issues, from antimicrobial resistance and emergency preparedness to noncommunicable diseases and the potential impact of climate change, cannot be tackled by the health sector alone. We must take the lead in advocating for and supporting a multi sectoral approach. I wish, finally, to highlight the need for us to work closely together if we are to achieve the results we want. We all know that it will not be easy to face the many challenges ahead of us. But we also know that if work together, we can achieve a great deal. I look forward, therefore, to listening to your advice and comments on the agenda items we have before us at this, the 6lst session of the Regional Committee for the Western Pacific. But I also look forward to having you telling us what more we can do ensure that we work together to achieve our ultimate goal of better health for all the people of the Western Pacific Region. I would like to close by assuring you that I remain committed to you, our Member States, and to the people of this Region who deserve the highest level of health possible. Thank you very much.