Honourable Minister of Finance Satsuki Katayama,
Honourable Minister of Health, Labour and Welfare Kenichiro Ueno,
President of the World Bank Group Ajay Banga,
Excellencies, dear colleagues and friends,
Konbanwa and good evening, it’s wonderful to be back in Japan for the UHC Forum and the launch of the UHC Knowledge Hub tomorrow.
I have been asked to discuss the challenges that we are facing in global health, and there are many, but I would like to begin by reflecting on our achievements.
We can often be so focused on the challenges that we forget just how far we have come.
Over the past 25 years, we have seen incredible achievements in global health.
Over 90 million deaths have been averted due to vaccination;
Maternal mortality has dropped by 40%, under-five mortality has decreased by more than half and stillbirths by more than a third;
Deaths from HIV have dropped by two-thirds, deaths from malaria by one-third, deaths from TB by half, and tobacco use by 40%.
These incredible results are thanks to the collective efforts of countries and communities, supported by an array of partners, donors, civil society, researchers and the private sector.
But as we all know, these gains – and the opportunity to drive further progress – are at risk.
We face the challenges of conflict and insecurity, outbreaks, inequality, the growing burden of noncommunicable diseases and mental health disorders, the steady march of antimicrobial resistance, the overshadowing threat of climate change, and the ever-present danger of pandemics.
And although we have seen significant advances since 2000 towards universal health coverage, progress on both service coverage and financial protection now appears to have stalled.
Severe cuts to international aid this year have also caused severe disruptions to health services in many countries.
But I am confident that in the crisis lies an opportunity – an opportunity to leave behind the era of aid dependency and embrace a new era of health sovereignty, based on domestic resources.
Likewise, although WHO and global health institutions in general are facing a significant reduction in funding, this is also an opportunity for us to recalibrate so we can support countries to make that transition to domestic funding for their health systems.
We must also recognize that the challenges we face now are different to those we faced when the global health architecture was built in the early years of this century.
Of course, many countries will continue to need bilateral and multilateral support. But we must be clear that external funds are to complement and not to replace domestic resources.
WHO is supporting countries to maintain essential health services, while making the transition to stronger, domestically and publicly-financed health systems.
In the short-term, WHO is supporting countries to develop affordable essential health benefit packages;
To introduce or increase health taxes on tobacco, alcohol and sugary drinks;
To strengthen domestic manufacturing, pooled procurement and other initiatives.
In the longer term, countries can strengthen risk-sharing mechanisms to improve financial protection, including through publicly-financed health insurance.
Earlier this month, WHO issued new guidance on how countries can implement immediate measures and longer-term shifts to manage the steep cuts in external funding and move to self-sufficiency.
Crucially, the global health architecture must evolve to align with domestic systems which are aligned with country needs.
It’s also more important than ever that we work together closely, leveraging our comparative advantages without duplicating efforts or mandates.
The launch of the UHC Hub here in Tokyo will also support capacity building, political commitment, and better data for decision-making. It will build bridges between Ministries of Health and Finance so they speak the same language and work together to boost domestic investment in health.
There is no better place for the UHC Hub to be than in Japan, which is a leading advocate for UHC, and one of the world’s leading examples of how to achieve it, through sustained political will and domestic investment.
For a long time, Keizo Takemi has been at the heart of this effort, supported by the Ministry of Health, Labour and Welfare, and the Ministry of Finance, in helping countries increase their fiscal space for health.
My thanks once again to Japan for its leadership and partnership as we work together to meet the challenges before us and realise the promise of UHC in all countries.
I was also impressed by the commitments made earlier today by the Japanese Prime Minister and former Prime Minister Shinzo Abe.
Arigato gozaimasu. I thank you.