Dear Mr President, my big brother Dr Tedros, Executive President, Deputy Executive President, Rapporteur, ministers, ladies and gentlemen.
As I was telling you this morning, this Regional Committee is a very special one for me. First and foremost, because I still cannot believe it is the first time we are gathering together under the same roof since I became the Regional Director. Second, because it is hosted by this beautiful country, Israel, whose innovations in science and health are increasingly being recognized on the global stage. And third, because this happens exactly midway through the mandate you entrusted to me in 2019.
My only wish for this Regional Committee is that it is a true pan-European one for all the 53 Member States, and particularly for all the health-care workers of the 53 Member States, who time and again gave the very best of themselves during these times of extreme tension.
We will very much need this pan-European unity to deal with what I call the new normal. The new normal is the theme of my presentation. They say you give a good presentation if the people go away with 1 take-home message. My take-home message is 2 words: dual track. The new normal is a dual track.
It means that all countries should be able to maintain constant readiness and be on alert, but without breaking routine disease prevention and control. I will try to demonstrate this dual track, based on the lessons learned from all 53 Member States, during my presentation in 3 parts. In the first part, I will speak about the current emergencies. In the second part, of where we are on health and well-being – our trajectory towards the Sustainable Development Goals (SDGs). And in the third part, I will look towards the future.
So, let's start with the current emergencies. When I became the Regional Director 2.5 years ago, this Region was almost crisis-free. Today, it hosts 4 events with global repercussions. First, a devastating war, which unfortunately does not show any signs of de-escalation. Second, a COVID-19 pandemic which keeps resurging. Third, a worrying monkeypox outbreak. And fourth, an increasing number of outbreaks of vaccine-derived poliovirus.
Let's start with the war in Ukraine. The United Nations estimates that 18 million people in Ukraine – more than one third of the population – are in dire need of humanitarian assistance. The Office of the United Nations High Commissioner for Human Rights records, as of now, 13 917 civilian casualties. Of these, 5817 people were killed. Of these, 372 children were killed.
Seven million people from Ukraine are registered in Europe alone as refugees, and another 7 million are forcibly displaced in the country. Dr Tedros was telling us how many attacks on health care have been recorded. Efforts to push back and to deal with the global climate emergency have been set back because of the revival of burning coal due to gas supply shortages, the devastation of natural resources and, recently, threats around nuclear hazards.
The war in Ukraine has worsened global food insecurity. The World Food Programme estimates that this year alone, 9 million more people have been pushed into food insecurity in the Horn of Africa, bringing the number of people in the Horn of Africa who day after day have to look for food to survive to 22 million. I appeal to all of you to stand in strong solidarity with our brothers and sisters in the Horn of Africa.
From the very first moment the war started, in WHO globally, I have taken personally the leadership of our response operations. Three times I went to Ukraine together with Minister of Health Dr Viktor Liashko, whose tireless leadership is to be commended. I’m preparing now to go again during the week of 10 October for the fourth time, including to Odessa and Dnipro.
We know that we have tremendous solidarity here. I also visited all neighbouring countries of Ukraine, and I would like to thank the governments of those countries. I have seen how people literally opened their hearts, their apartments and their homes for the people in Ukraine. I want in particular to thank you, Minister of Health of Poland Dr Adam Niedzielski, who very early on went to the border between Poland and Ukraine.
I saw for myself, in Rzeszów at the train station, when the people arrived, medical students were giving vaccinations. I went with the Minister of Health of the Republic of Moldova, my good old friend Dr Ala Nemerenco, to the settlements, and I saw in the dialysis centre how the people from Ukraine were linked together, brotherly and sisterly, with the people of Moldova.
And as we discussed with Her Excellency Maia Sandu, President of the Republic of Moldova, it's very important that countries increase the budget for support to Moldova, also to strengthen the health system first and foremost for the local host communities. It is, ladies and gentlemen, amazing that while the war is still raging, the Ukrainian Government has already pulled together the national recovery plan to build back smarter.
And Dr Liashko was very quick to lay out the health sector part, because it builds on the national health sector strategy until 2030. And let's not forget, it builds on the health system reform path, which had already started in 2016 with the strong support of WHO to convene development partners.
I'm very grateful to the President of Poland, His Excellency Andrzej Duda, who invited me with Dr Niedzielski to present a WHO publication, which we pulled off very fast. It set out principles to guide investment in the health system for recovery in Ukraine. From there, we took it to the big conference on recovery in Lugano, Switzerland. And there I would like to thank Ambassador Nora Kronig Romero, who helped us, along with the presidents of Switzerland and Ukraine. The WHO Regional Office for Europe was the only organization at this big conference talking about the importance of health and health systems in the recovery effort.
We will continue to advocate, together with my special representative Professor Mario Monti, for health, finance and sustainable development to put health systems at the heart of the recovery. Because if the people see that the health system is functioning, they will increase confidence in local communities, and in a democratic government that can deliver the people's expectations. The health sector reform has also been a very good example of an anticorruption measure through digital procurement and electronic medical prescriptions.
I would like to thank the Standing Committee of the Regional Committee (SCRC). You, dear Nora, and the World Health Assembly, have given me and my staff very strong support in our actions for the people in Ukraine and other countries affected by the war.
For the first time in 70 years, the Office organized a special session of the Regional Committee in less than 2 weeks. I want to thank my staff because it was a tour de force with a resolution. For me, the special session testified to the importance that this Region attaches to solidarity, peace and health for all. I gave a detailed report on the implementation of the resolution at the SCRC in June, which was open to all 53 Member States, and we will have a special session on Wednesday afternoon, after which we will be prepared for a consultation with all 53 Member States.
The point I would like to make here is that to implement the resolution, we will need understanding and support from Member States. At the same time, I note that the SCRC and its president, like me, would like to see that we keep the technical link and dialogue with every one of the 53 Member States.
I will turn now to the public health emergencies of international concern. COVID-19 is still with us. The virus keeps changing, it keeps taking lives unnecessarily. Last week alone, there were 3422 deaths in our Region. I myself, just before the summer, was knocked off my feet by COVID-19 for 3 days. I cannot remember the last time I was so sick. It took me the whole summer to get back to pre-COVID running shape. What I see is that people stabilize their lives, but without stabilizing the pandemic.
That's why as early as mid-July, our office published the COVID-19 autumn and winter strategy – not to tell what will be done in the autumn, but what should be done in the summer in order to avoid too many casualties during the winter. It is the first time that this document integrates under a single response framework new tools such as new vaccines, and new tactics such as multiple respiratory disease surveillance and addressing persistent system issues like burnout among our workforce.
It is absolutely necessary now, after the summer, to quickly relaunch vigilance. While I fully appreciate how politically difficult it is to promote public health measures to a tired population, I would say that the single most important measures are to strengthen surveillance to pick up on any new emerging variants (hopefully not, but we need to be ready), and to definitely encourage a second booster to our high-risk groups, along with targeted use of antivirals to keep people off ventilators. For the very vulnerable people in the population – if need be, wear masks and practise social distancing in crowded, nonventilated places.
On the topic of monkeypox, it seems that we are on a good trajectory, but we have to follow it very closely. As an infectious disease specialist myself, from the very beginning I kept in mind that we should never underestimate the ultimate impact of an emerging infectious disease about which there are many unanswered questions.
That's why, in mid-June, I sent a letter to all of you as if monkeypox were to be a regional emergency. Learning the lessons from the early days of transmission of HIV/AIDS, we immediately engaged with the LGBTQI+ community. We invited the organizer of the EuroPride event to do a press conference together with me and the European Centre for Disease Prevention and Control.
We need very close collaboration, because the biggest threats to the elimination of monkeypox are stigma and discrimination. I was talking to my sister, WHO Regional Director for Africa Dr Matshidiso Moeti – a great regional director – and I was saying: Dear sister, tell me which message do you want me to convey to my Member States at the Regional Committee? And she said: Hans, it's very tough to get diagnostic tools and vaccines. But the most important is to support capacity-strengthening of the vaccination system and training in different areas of pandemic preparedness and response to have a robust system to then deliver the vaccines.
This Friday, I will fly straight from Tel Aviv to Reykjavik, Iceland, upon the invitation of the President of Iceland, His Excellency Guðni Jóhannesson, and Ms Jennifer Jones, the first female to serve as President of Rotary International, to celebrate that this Region has been polio-free for 20 years.
At the same time, there is no room for complacency. We have seen an increasing number of outbreaks of vaccine-derived poliovirus. In the first week of August, I was again on a mission in Washington, United States of America, and Dr Anthony Fauci was telling me that the cases in New York are genetically linked to cases in our European Region, which are linked to cases in Afghanistan and Pakistan, where polio is endemic. It reminds us that a crisis anywhere quickly becomes a crisis everywhere.
We have to do everything possible to keep very high vaccination rates and surveillance to quickly detect and respond to polio outbreaks. And here I would like to make a pitch for environmental surveillance through wastewater, which can pick up viruses and variants very quickly, including COVID-19 and monkeypox, particularly where there is no broad testing any more.
Having said that, I'm optimistic. By nature, I'm an optimist. But I'm also optimistic if I look to the global health system crisis response. First, we have seen at the World Health Assembly a historic resolution to increase the assessed contributions from Member States. And I really have to thank Minister of Health Dr Karl Lauterbach and Mr Björn Kümmel for the incredible leadership by Germany to really get to that stage.
Second, as my big brother Dr Tedros was saying, there was the first meeting of the board of the Financial Intermediary Fund for Pandemic Prevention, Preparedness and Response, hosted by the World Bank with the technical leadership of WHO.
Third, you are revising the International Health Regulations, mandating WHO to have faster reporting and, very importantly, a stronger role for the WHO regional offices.
Fourth, there are mRNA hubs for vaccines being established globally, with much more sharing of knowledge and licensed technologies to enhance access to diagnostics, therapeutics and vaccines.
And fifth, as you know, there is now an intergovernmental negotiation on a new, legally binding pandemic framework. Please have delegates attend the session tomorrow – I am very, very honoured to have both co-chairs of the Intergovernmental Negotiating Body with us, Mr Roland Driece from the Netherlands and Dr Precious Matsoso from South Africa.
At the same time, let's also be honest – if we are going to continue at the same pace, I'm afraid we will have a number of pandemics on our heads before we have this international system to detect and manage pandemic threats.
We have to accelerate the initiative. And here, with the regional directors and Dr Tedros, we see an important role, if you wish, for the regional offices, because we are very close to the countries and have knowledge of the system. So, please come up with, if you wish, some concrete suggestions on how the WHO Regional Office for Europe can assist you to move faster towards a cohesive set of reforms addressing leadership and accountability, financing, equity, common global goods, and, very importantly, WHO independence and authority.
Let's not forget that these are all recommendations that were published for the first time by the call to action of the Pan-European Commission on Health and Sustainable Development chaired by Professor Mario Monti as early as March 2021. And I want to thank again Professor Monti for continuing to work with us. Grazie mille, caro Mario. In these times of crisis and war, we feel the need to remain faithful to the European values of solidarity, equity and universality.
In fact, leaving no one behind is not a mantra anymore. It's the reality we live in: day in, day out. With this, I will move to the second part. Remember dual track – 2 words: dual track. Constant readiness and alertness, but without breaking routine disease prevention and control.
So, where are we now in our trajectory towards the SDGs? This is very nicely visualized in the latest European Health Report, and we would like to invite you to have a look. It's available virtually and in hard copy. It's a very powerful tool for decision-makers. For the first time, it includes projections made together with the Institute for Health Metrics and Evaluation. For the sake of the presentation, I thought to present 2 representative samples. The first is on noncommunicable diseases.
No doubt COVID-19 is the most visible pandemic in our lifetime, but it is not the most deadly. It is not the most preventable. That distinction goes to the cardiovascular diseases pandemic. We estimated that during COVID-19, 5 times more people died at a younger average age due to cardiovascular diseases than COVID-19 at its worst.
The good news, ministers, is that we don't need heroic medical innovation to turn the tide here. We do have the public health tools. So, the question is, together, can we muster the political and societal will to use those public health tools?
The 3 main drivers – which are preventable – of strokes and heart attacks are tobacco use, hypertension and air pollution. The first priority is to finish the tobacco epidemic. The only thing which kills more people in our Region than tobacco is hypertension: 2.4 million people a year, or 1 out of 4 deaths in our Region. We are doing a terrible job at preventing and managing hypertension. The single most important measure is to reduce sodium intake in processed and packaged foods, because the salt we are adding at the table only amounts to about 10% of our intake.
Even if we do a better job at preventing high blood pressure, countries ought to scale up effective treatment, because we have hundreds of thousands of people in our Region with uncontrolled hypertension. Again, based on the COVID-19 lessons, we know what to do: scale up team-based care for outpatients, use multidisciplinary teams, and address the social determinants of health with patient support.
Of course, we know that hypertension is also linked with obesity. One out of every 4 children in primary school in our Region is living with overweight or obesity. I am very, very appreciative to the First Lady of Croatia, my colleague Professor Sanja Milanović, who is going to organize next year in beautiful Croatia the first WHO pan-European summit of first ladies and gentlemen to address childhood obesity.
Obviously, hypertension is also linked to alcohol consumption. No doubt we are the heaviest drinkers in the world. One out of every 3 deaths among young people is linked to alcohol. Women in our Region are not aware enough that from the first drop, drinking increases the chance for breast cancer. And how much domestic violence do we see due to alcohol?
I would like to commend my good friend Minister of Health of Lithuania Mr Arūnas Dulkys for having organized this year the Baltic policy dialogue with the 3 Baltic ministers of health to change the narrative from alcohol taxes to health taxes. Alcohol taxation is the most underused policy tool in lowering consumption in our Region. That's why I call upon all Member States to support the regional framework to address alcohol.
We have very good data from the International Agency for Research on Cancer (IARC), based in Lyon, France – and IARC Director Dr Elisabete Weiderpass is here with us – that basically there is no safe level of drinking.
The third big driver of strokes and heart attacks is air pollution. In our Region alone, air pollution kills 550 000 people a year, half due to cardiovascular diseases. And here I am very proud of our WHO European Centre for Environment and Health in Bonn, Germany, which produced the new WHO Global Air Quality Guidelines.
This is how I see our vision to provide the best available evidence to the world. Now, let's have a look at the chapter on HIV: SDG indicator 3.3.1. Our Region and the African Region are the only WHO regions where HIV is still on the rise.
In order to avoid the worst-case scenario, greater effort is needed to reach the key populations, which include prisoners, migrants, men having sex with men, transgender people, sex workers and the sexual partners in those groups. Frankly speaking, for some reason, we are the WHO region that is very slow to take up the most innovative diagnostic tools and treatments.
We need your political commitment and financing for HIV services, because the worst-case scenario still does not include the effects of the pandemic. We know that in a number of countries, up to 50% of HIV testing services were closed. Please do attend the ministerial lunch tomorrow on ending tuberculosis, HIV and hepatitis.
Where are we with the implementation of the European Programme of Work (EPW)? It's a bit too early to provide you with data. It takes about 2 years to collect and verify data. But I want to assure you that we're working very hard with your teams to implement the monitoring and measurement tools.
I thought I would give a short update on where we are with the 2 flagships that you approved last year. The first is the pan-European Mental Health Coalition, launched last year by Queen Mathilde of Belgium. We are very, very grateful. And the Coalition stresses time and again that stigma and discrimination surrounding mental health conditions contribute to low political appetite and financing to address mental health.
We know from the WHO Mental Health Atlas that only 1 in 3 countries in the Region has a national mental health strategy in line with human rights instruments. But the Coalition has been doing an awesome job. They pulled together a leadership programme to help leaders like you grasp the complexities of the mental health needs of the people.
They have also been working with youth. Youth get lost in this maze of mental health services. We all know the terrible stories of these long waiting times for children with mental health concerns – some of whom will die due to suicide before they even can get to the service.
Here, I really want to commend you, Professor Jerôme Solomon, for inviting me to the group Hospitalier Universitaire in Paris. This is a group of university hospitals working on neuroscience and psychiatry, where the staff showed us that they put in place new care pathways for children, drastically cutting the waiting times by spanning institutional borders. Merci beaucoup, Jerôme. You generously propose that every country can come to the hospital to learn from that, and it's very, very necessary.
You heard in the address of the Prime Minister of Greece his commitment through the WHO Athens Quality of Care Office. Now we have the human and financial resources to assist you and realize the potential you have to improve mental health.
At the same time, the Coalition works very hard with the elderly to create policies on a dementia-friendly environment and to address social isolation and loneliness. This, my friends, I cannot repeat enough: whether for young people or elderly people, loneliness is a killer in itself.
We are also trying to address mental health in the workforce. Thanks to the generous support of the European Commission for the development of a mental health data lab, because we lack good data and indicators, including on the performance of mental health services. Thank you so much to my good friend Director-General for Health and Food Safety Sandra Gallina for the support.
The second flagship you approved last year is the European Immunization Agenda 2030. This is a country-led policy framework with the overarching aim to reduce inequities and leave no one behind. Obviously, our main job has been to assist you to roll out the COVID-19 vaccinations. It's amazing – you have administered more than 1.6 billion doses of COVID-19 vaccine. Each time I knocked on the door of any of your countries, you opened the door, providing international solidarity. And I really want to thank you for that.
We're also learning lessons now with monkeypox vaccination – learning lessons from COVID-19. And here I really want to thank the Director-General of the European Commission’s Health Emergency Preparedness and Response Authority (HERA) Mr Pierre Delsaux. Thank you very much for a very close collaboration.
The European Union (EU) initiatives also spanned to the Western Balkans, the Eastern Partnership, because ultimately, we are one region. But as important as assisting you with the COVID-19 vaccinations was preventing further backsliding in routine immunization. In 2020 and 2021, 1.2 million children in the Region missed their first dose of measles vaccine and are unprotected.
Here, I want to thank my very good friend Minister of Health of Tajikistan Dr Abdullozoda Jamoliddin Abdullo, for tremendous success when the country had the first outbreak of vaccine-derived polio. Tajikistan mounted an immediate, comprehensive outbreak response and, globally, its outbreak was the first to be declared officially closed. I'm very much looking forward to personally awarding your President, His Excellency Emomali Rahmon.
What are the lessons we learned? As I was saying, I'm in the midst of the mandate, and we looked back to then look forward. We're always thinking: are we working well enough with you? Because the vision is to tailor our action to your specific country context. And we have a number of lessons here.
The first one is, in my view, nothing replaces direct country contact, which I have maintained, you remember, since my campaign. I met almost all 53 ministers of health during my 38 country missions in support of your leadership. I met 28 presidents and heads of government to help to elevate health in the political agenda, and this determination to tailor our actions to your country context is exactly what is underpinning our WHO Country Collaboration Strategy – the first in 20 years. We should develop it together with all of you, and I really need your support on Wednesday to approve it.
The other lesson is that partnership works best when you do it around concrete projects. Here, the subregional dimension is very important, as in the Roadmap for Health and Well-being in the Western Balkans, which we launched at the summit of the Central European Initiative. Thank you very much, Secretary General Roberto Antonione, for this.
Together with the prime ministers yesterday, here in Tel Aviv, we made a single roadmap with the 5 ministers of health of central Asia. Thank you very much to the President of Turkmenistan, His Excellency Serdar Berdimuhamedov, who convened a meeting on the eve of the World Health Assembly.
We had the eighth high-level meeting of the Small Countries Initiative. You know, I'm very committed to small countries. And thank you so much to my friend Dr Dragoslav Šćekić, Minister of Health of Montenegro, for really being a perfect host in Budva, Montenegro, to sign off on the Montenegro Declaration.
From the very beginning of our mandate, the partnership with the countries of the Commonwealth of Independent States (CIS) has been a priority for me, in line with the memorandum of understanding that I signed with Dr Dmitry Pinevich in November last year in Minsk, Belarus.
And I'm very much looking forward to accompanying Minister of Healthcare Dr Azhar Giniyat next week, on Friday, in Kazakhstan, under her leadership of the CIS Healthcare Cooperation Council of all the ministers. Thank you very much – рақмет – Minister.
And we also elaborated our partnership with the CIS Interparliamentary Assembly. We organized a big conference on universal health coverage and the SDGs in November last year in St Petersburg, Russian Federation, and we followed up in Almaty, Kazakhstan, on the 30th anniversary of the Council of the Interparliamentary Assembly, hosted by the Speaker of the Senate of Kazakhstan, His Excellency Maulen Ashimbayev, with whom we are going to meet again next week.
Yesterday, we signed a country workplan for the first time with the Eurasian Economic Commission. The partnership of the European Commission has been scaled up exponentially. I want to really thank the Slovenian, the French and the Czech EU presidencies for aligning the EPW priorities with the priorities of the EU presidency. There was a great conference chaired by Minister of Health of Czechia Professor Vlastimil Válek last year in the beautiful city of Brno, on modern cancer control through smart innovations.
I want to thank European Commissioner for Health and Food Safety Stella Kyriakides for working very closely together, particularly on mental health; and my very good friend Sandra Gallina for working on the Oslo Medicines Initiative; and for our friendship, Olivér Várhelyi, European Commissioner for Neighbourhood and Enlargement; and Vice-President of the European Commission Margaritis Schinas, who came to Istanbul, Türkiye, for the meeting on migrant health; and the High Representative of the EU for Foreign Affairs and Security Policy, His Excellency Josep Borrell, for all regular meetings, encouraging at the country level closer collaboration between the WHO country offices and the EU delegations.
The other lesson we learned on modus operandi is the importance of interregional collaboration, fully compliant, of course, with the global actions developed by WHO in Geneva, Switzerland. We launched 3 interregional initiatives this year alone.
The first is a tri-regional one with the WHO regional offices for the Eastern Mediterranean, Africa and Europe, with a great conference in Istanbul, Türkiye, hosted by my very good friend Minister of Health Dr Fahrettin Koca – teşekkür ederim – a fantastic host. And thank you, President Recep Tayyip Erdoğan, for opening a meeting to develop a new narrative between the regions on migrant health.
The second is a transatlantic partnership between the Pan American Health Organization, the WHO Regional Office for Europe and the United States Department of Health and Human Services on Preparedness 2.0 – Workforce for Tomorrow’s Emergencies, and the new collaboration on the Arctic Council – because both regions are bordering the Arctic. Here, I want to really thank Director General of the Danish Health Authority Dr Søren Brostrøm, my good friend from Denmark, for going together, as we discussed, to Greenland very soon as well.
And third, we launched an interregional partnership between the Western Pacific, the People's Republic of China and Japan on digital health.
On partnerships – finally – we had too many partnerships to list them all. But I want to assure you that this is a priority, and a particular commitment of mine is partnership with youth. On 25 to 27 October in Tirana, Albania, we will have the first Young People and Young Professionals Summit. And thank you so much, Minister of Health Ogerta Manastirliu, to you and your colleagues and your Prime Minister Edi Rama, for organizing that very important summit.
Another partnership was on the Oslo Medicines Initiative. Please do attend the ministerial lunch at midday – even our internal audit mechanisms in WHO were reporting the Oslo Medicines Initiative as a necessary, innovative partnership between the public and private sectors to assure sustainable access to affordable, innovative medicines.
And thank you so much, Your Excellency, Minister of Health and Care Services of Norway Ingvild Kjerkol; Bjorn-Inge Larsen and Audun Hågå, our Norwegian friends; and Nathalie Moll, Director-General of the European Federation of Pharmaceutical Industries and Associations.
The final lesson we learned, and maybe the first I spoke about this morning, is the importance of governing bodies. From the very beginning, I have been looking at the SCRC members as my advisers, as the first-level decision-makers.
I want to thank you again, dear Nora and the SCRC, for our joint commitment to increase transparency in WHO and WHO governance, including a recommendation for the global level. This was exemplified in an awesome retreat the first time we came together as the SCRC in Bern, Switzerland, hosted by Nora and the Swiss Federal Office of Public Health. Thank you very much, for this was a time when we came together for very friendly, frank and open discussions on what we can improve in transparency and accountability, and in the follow-up of Professor Monti’s Pan-European Commission.
Your support, dear Nora, has been invaluable to me. I always keep the SCRC members updated in real time on any political or humanitarian missions. For example, in the midst of the refugee crisis, after meeting with the leadership of Belarus, I went to the border in Belarus, to the logistical centre in Bruzgi, at the border crossing points close to Grodno city. Before I left the mission with Dr Dmitry Pinevich, toilets were being put in place, showers were being put in place, and a primary health-care centre was established. This is what we mean by “health is not political”.
Dear ministers, let me go to the last chapter, which is looking forward. What do we think, for your consultation, are the 3 priorities in line with the priorities Dr Tedros was mentioning, in order to have a dual track – to be able to detect and respond to emergencies but keep routine disease prevention and control?
Priority number 1: primary health-care movement. This is what you have been telling me, be it in Copenhagen or in Geneva – to have primary health care as the centre of the health system and the glue to bind better preparedness for emergencies, and communicable disease and noncommunicable disease prevention and control.
For this, we would need to see 3 trends accelerated: primary health care composed of multidisciplinary teams and networks rather than standalone mono-providers; investment in family medicine; and enhanced roles of nurses and midwives.
You know that I'm a great advocate for nurses and midwives – the biggest health workforce in the Region, but so underutilized. And thank you so much, Israel, for organizing the meeting this Thursday of all chief government nurses at the Sheba Medical Center. It will be an awesome event. Thank you so much, toda raba.
The second trend to accelerate primary health care is what I call multi-model. It means cleverly combining face-to-face consultations with digital consultations, combined with mobile teams entering the homes of the people.
And the third trend is to take advantage of the digital revolution, to identify and address the needs of the most vulnerable people, to leave no one behind – for example, focused mental health activities or friendly calls to the elderly people you think are lonely and isolated.
Thank you so much, Your Excellency Dr Azhar Giniyat, for your commitment to organize next year the 45th anniversary of the Declaration of Alma-Ata and the 5th anniversary of the Astana Declaration. And please, once you get the invitation of Dr Giniyat, please be present. It will be a great event.
Second priority: we will not be able to pull off this primary health-care movement without investment in the health workforce. This is, again, what almost all of you have told me. The COVID-19 pandemic showed both the fragility and the strength of our health workforce. Health workforce absenteeism has increased by two thirds since the COVID-19 pandemic. But we should also commend our health workforce: how innovative they have been to absorb, for example, digital tools. And many of you have also increased their salaries.
Please do attend on Wednesday at noon, when we will launch here in Tel Aviv the first pan-European report on the state of the health workforce in the Region, with data from all 53 Member States and with 10 very concrete actions – for example, needs assessments and national health workforce strategies – which you, Your Excellency, Deputy Prime Minister of Malta Dr Chris Fearne, have recently been doing very, very well. We can learn a lot from this.
And let's not forget that 89% of nurses are women, 98% of midwives are women and 49% of doctors are women. So, everything we do for the workforce is advancing gender equality. Here, I have to say multumesc to my good friend Professor Alexandru Rafila, who committed to organize a high-level regional meeting on the health workforce in Romania next year to chart the way forward.
Third priority: what I heard time and again is that WHO needs to strengthen WHO’s science and evidence. Everything we do in WHO should be based on scientific rigour and excellence. Straight after the Regional Committee, I will commission a report with the strong support of Professor Martin McKee of the London School of Hygiene and Tropical Medicine, Chief Adviser to me, on identifying gaps and advice on how to strengthen scientific quality horizon-scanning. What are the gaps in science communication and the thorny issue of ethical approval?
But, dear ministers, at the country level, we need your help. It is unacceptable that our scientists have to fear for their lives or the lives of their loved ones and/or be harassed on social media because they are putting science on the table. Abandoning science is a very slippery slope and we need the political leadership to put in place protective mechanisms to empower our scientists.
Dear ministers, I am concluding where I started. This is the midpoint of the mandate that you entrusted to me in 2019. I had no intention to take it easy. I knew this was going to be a challenging job. Actually, every Sunday morning while my lady still sleeps at home, I'm looking at this one. Some of you may remember it – my campaign book. And I'm very proud to tell you that I'm ahead of time to tick off all my 53 campaign commitments to you.
But I could never have done it without your strong support, and the support of my staff. I am very, very proud of my staff and all collaborators inside and outside the room. But I must admit, in transparency, there's one thing that I have to add. In all the years I used to work with Médecins Sans Frontières, I knew very well that all crises pass. But I underestimated that peaceful times can also pass very fast. And that's why we need the dual track.
I will finish with a quote in the beautiful Hebrew language from a famous singer in the country here, Arik Einstein, beloved both by the Jewish and the Arab communities. Ani ve'ata neshaneh et ha'olam. Together, you and I, we’ll change the world. Thank you. Toda raba.