Your Excellencies Ministers of Health and Heads of Delegations,

Ladies and Gentlemen,

It is my honour and pleasure to present my report on WHO’s work in the Region.

The annual report publication that was shared with you provides extensive information about WHO’s activities and achievements during 2023.

It testifies to the hard work, dedication and tenacity of my revered predecessor, Dr Ahmed, and the fabulous team that I have inherited from him.

I commend the report to you.

In my speech today, I would like to focus on where we are now – and where we are going.

Ladies and Gentlemen,

The past nine months have been an astonishing journey for me.

I am from this Region and I have always had a strong connection to it.

But I have come to know it so much better since I became WHO Regional Director.

And I love it so much more.

I have already visited 11 Member States and I am looking forward to visiting and meeting people in every remaining country – starting with Djibouti very soon.

Let me share what I have learned so far.

Inevitably, I have seen more heartbreak than I thought possible.

When I took office, my colleagues, family and friends congratulated me, but also warned me that I would have to face some harsh realities.

They were so right.

I still remember the shock I felt during my first visit to Sudan.

I met exhausted health workers struggling to save lives without basic supplies.

Anxious mothers with malnourished babies.

Despite our best efforts, Sudan is now facing the world’s largest hunger crisis and the world’s largest displacement crisis.

The suffering is unimaginable.

And in Aleppo, in the Syrian Arab Republic, the destruction was beyond anything I had seen.

Years of war, the 2023 earthquake and ongoing insecurity have devastated the health system.

And sanctions are posing additional barriers to essential services.

I met patients in their 30s and 40s on dialysis, unable to afford their medicines.

In Gaza, the devastation has allowed polio come back after 25 years.

Visiting in July, I witnessed people living in conditions that no one should ever have to endure.

Beyond the physical toll, the emotional and psychological strain was palpable.

“Are we not human too?” one woman asked.

I could not find the words to reply.

In Afghanistan, the Islamic Republic of Iran and Syria, I saw the horrifying toll of substance use.

I met women and adolescents – yes, adolescents – struggling to break free of addiction and reclaim their lives.

And in so many other countries, too – in Lebanon, Libya, Somalia, Yemen – there are people facing tragic losses and struggling to survive.

We have to deal with these situations.

And we will never let the world ignore them.

But we cannot afford to lose sight of the positives.

Look at the emergency response in Palestine.

Look at how quickly WHO, the national authorities and our partners were able to vaccinate more than 560 000 children in Gaza in the most testing conditions imaginable.

And by the way, most vaccinators are the Gazan health workforce themselves – amazing, brave, resilient people.

Look at the solidarity from other countries.

Huge donations from Kuwait, Qatar, Saudi Arabia and the United Arab Emirates.

More than 33 million dollars’ worth of health supplies already procured, and more than 65% of them already despatched from WHO’s hub in Dubai.

Patients evacuated from Gaza to Egypt, Jordan, Oman, Qatar and the United Arab Emirates.

And from Sudan to Egypt and Libya.

So many countries working together to help those in need.

Welcoming patients and refugees despite the pressure on their health systems.

And of course, the achievements in our Region are not limited to emergency response.

Take Healthy Cities, for example – one of our key health promotion programmes.

We have come a long way since Sharjah became the Region’s first Healthy City in 2015.

Our network now includes 118 cities, stretching from Morocco across to Pakistan, and from Tunisia down to Sudan.

Of those cities, Jeddah alone covers nearly 4 million people.

Bahrain’s Capital Governorate has just become our first Healthy Governorate.

Oman has the first Healthy Island in our Region, Maseera.

Kuwait is pioneering the use of Healthy City indicators.

And every single municipality in Qatar is now a Healthy City.

We are seeing some stunning gains in communicable disease control.

Egypt is leading the world in hepatitis C elimination. And now they have eliminated malaria.

Jordan has become the world’s first country to eliminate leprosy.

And Pakistan has just eliminated trachoma.

And there are so many other standout stories, across so many different areas of public health.

In the Islamic Republic of Iran they have put family education at the core of public health efforts. They produce 96% of their medicines, and they are regional leaders in medical research.

Iraq is the first country in the world to complete polio transition.

Afghanistan and Pakistan are working closely together to finally end polio – and also now collaborating on many other health challenges, such as training and education.

And Syria is working to make services more accessible to people living in remote areas.

There are successes in every country.

Forgive me for not listing them all, but we would be here all day.

The point is: there is a lot of good work going on.

And there is the potential to do so much more.

And that brings me to my main topic today: where should we go next?

Your Excellencies,

Yesterday, we shared our plans for the coming four years – including our new regional strategic operational plan and three flagship initiatives.

Thank you all for an exceptionally rich discussion.

And thank you also for the invaluable bilateral meetings that I have enjoyed with so many of you since I assumed my role.

I am learning so much. 

WHO belongs to you.

Our plans are based on your input.

The strategic operational plan for the next four years is designed to meet YOUR priorities, as identified through the recent consultation.

And my choice of flagships was informed by my conversations with Your Excellencies.

We have discussed these plans in some detail.

Today, I would like to highlight three key elements: investment, collaboration and accountability.

Your Excellencies,

Too often in policy discussions, public health spending is spoken about as some kind of indulgence.

The idea seems to be that, for all its clear social benefits, health is not good for the economy – it is just a drain on resources.

We need to change the conversation.

The truth is, health is one of the best, shrewdest investments that any government can make.

Properly targeted and managed expenditure on health will repay itself many times over by freeing people to live healthier, happier, more productive lives.

That was the message of the landmark resolution on “The Economics of Health for All” that Your Excellencies endorsed at this year’s Health Assembly.

And it is a message that every minister of health needs to proclaim, again and again, to secure the health sector’s share of limited government budgets and mobilize multisectoral support for action on health.

Our new plans can support you in doing that.

Each of the three flagship initiatives will not only improve health and well-being across the Region, but also boost social and economic development.

We are spending billions of dollars every year on essential medicines, vaccines and medical products.

Let us focus on building up domestic manufacturing, supply chains and systems, so that more people get the products they need and we keep more of that money in our Region.

Let us scale up investment in our health workforce, making sure that it is targeted strategically to cover the most critical gaps in each country.

Every dollar you spend on your health workforce can generate as much as nine dollars in enhanced productivity over the long term.

And our initiative to tackle substance use may offer an even bigger payback.

Each dollar spent on treating substance use disorders brings a return to societies of up to 12 dollars.

So when we spend more on prevention, we will save a fortune on treatment.

The link between investment in health and economic growth has been proven before, and it is such a powerful argument.

In fact, we have supported many countries to develop investment cases on key challenges like NCDs, tobacco control and mental health. They are great advocacy tools.

All the plans that we are proposing for the next four years are based on the best scientific evidence available to us.

They are intended to support the most effective and the most cost-effective interventions to improve your country’s health outcomes, taking into account the regional context and uncertainties.

And to get even more value from the money and effort you invest, we will leverage partnerships.

Collaboration with other sectors including the private sector is a key feature of these plans.

For example, WHO will facilitate pooled procurement to strengthen countries’ collective buying power for medicines and vaccines.

We will encourage cooperation between Member States on health workforce, so that more of our skilled health professionals stay within their countries and in the Region.

And we will work with you to set up a network of centres of excellence on tackling substance use.

We will create new platforms for sharing knowledge and expertise.

And building on the fine work of my predecessor, Dr Ahmed, we will use existing platforms like the Regional Health Alliance to improve coordination between different United Nations agencies and other stakeholders.

We want every partner to contribute where they have a comparative advantage.

We want to make the most of all available resources.

And we want to maximize WHO’s convening power to make it easier for countries to support each other.

So that more countries can upgrade their national regulatory authorities for medicines.

More countries can improve training programmes and offer better careers to their health professionals.

More countries can integrate substance use treatment into primary health care.

Because when one country succeeds in one of these areas, that is already welcome progress.

But if several countries succeed in several areas, it will lift the whole Region.

Your Excellencies,

Ladies and gentlemen,

I hope you have all had a chance to study the strategic operational plan.

We have kept it as high-level as possible, but inevitably it is quite a complex document.

As my dear colleague and senior adviser Dr Jama noted yesterday, a key feature of the plan is the extensive results framework.

We intend to implement rigorous monitoring and evaluation.

As the saying goes, “what gets measured, gets done”. And we want to make sure we get our work done over the next four years.

We have chosen 77 outcome indicators from GPW 14 to cover all the agreed priority regional outcomes, and we have 107 output indicators aligned to those outcomes.

Wherever possible, we have specified a regional baseline and an end target for each of the output indicators.

In some cases, we do not have data available yet to give us a regional baseline.

We have noted all those gaps, and over the next couple of years we will work to improve the data and establish a baseline. 

We have also specified annual milestones for WHO’s contribution towards each target, so that we can see – and Your Excellencies can see – exactly what we need to achieve each year.

We are going to track our progress regularly and comprehensively.

I will personally chair a steering committee to oversee implementation of the strategic operational plan including the three flagship initiatives.

I will receive progress reports from WHO’s technical teams every quarter, and I will update this Committee on progress every year as part of my annual report.

Progress on the plan will also be tracked through programme budget monitoring mechanisms.

And there will be an independent evaluation of progress in 2027.

So…

You can expect full transparency in the delivery of these plans.

We will be able to detect bottlenecks and deal with them promptly.

And everyone will be accountable for their part of the plan.

Your Excellencies,

Achieving our goals will require concerted efforts from the WHO Secretariat and all Member States.

So let us remember what we are talking about here.

Implementing our plans successfully would mean millions more people in the Region getting the high-quality treatment they need.

It would mean many more of our brilliant, talented health professionals staying in the Region to develop their careers.

It would mean healing and freeing individuals, families and communities affected by substance use.

And it would prevent many more people from getting ill in the first place.

Together, we can make all this happen. We can change millions of lives for the better.

But I need your buy-in.

Please endorse the plans that are being presented to you.

And please work with us to make them a reality.

I don’t expect it to be easy.

There will be ups and downs on the way.

But together, we can succeed.

I thank you again for the trust you have placed in me.

I will do everything I can to repay your trust and support, and deliver on my mandate – for all the people of our Region.