Your Excellency Filipe Nyusi, President of Mozambique,
Honourable Minister of Health Armindo Tiago,
Excellencies, dear colleagues and dear friends,
Bom dia!
Good morning. It’s an honour to be here in Maputo.
Thank you so much, Your Excellency, for inviting me to join you. Obrigado.
My thanks to you, Your Excellency, and to the government and people of Mozambique for your warm welcome and hospitality.
And my thanks to His Excellency President Nyusi and Minister Tiago for hosting this very important and timely conference, and also again for your kind invitation to join you. You have WHO’s full support.
This conference highlights the government’s commitment to universal health coverage, based on a primary health care approach, as a cornerstone of sustainable development.
I commend you for that commitment, and for the impressive progress you have made towards universal health coverage, in terms of both service coverage and financial protection.
This progress is delivering real results, as seen for example in the significant reduction in maternal, infant and neonatal mortality. Of course, you should do more.
I also commend you for rapidly achieving high immunization coverage against COVID-19, for rapidly detecting and responding to the re-emergence of wild polio virus last year, and for your response earlier this year to the largest outbreak of cholera in 20 years.
I commend Your Excellency especially for your leadership on malaria, by launching the Zero Malaria Starts With Me campaign at the Maputo Malaria Forum in 2018, and for continuing to champion malaria.
I am pleased to note that Mozambique will be among the countries to receive malaria vaccine starting in the first quarter of next year.
I also applaud the "One District; One Hospital” initiative that His Excellency the President launched in 2019, to solve critical challenges, rehabilitate health facilities and equipment, and expand the health workforce.
You have come a long way, but like so many countries on our great continent, you still have a long way to go on your journey towards universal health coverage.
WHO is, and remains, your steadfast partner on that journey.
As the world emerges from the COVID-19 pandemic, WHO has outlined five priorities for all countries: to promote, protect, provide, power and perform for health. Let me say a little about each one.
The first priority is to promote health, by making a paradigm shift to address the root causes of diseases and injuries.
We must recognize that health starts not in clinics or hospitals, but in homes, schools, streets, workplaces, supermarkets, cities, and in our environment.
Stopping tobacco use, reducing the consumption of alcohol, sugar and salt, and increasing physical activity can all prevent cardiovascular disease, diabetes, cancer and more, which are the causes of more than 75% of premature deaths globally;
Making roads safer and using helmets can prevent crashes and the lifelong injuries they cause;
Cleaner air can prevent respiratory diseases;
Better health literacy can prevent unwanted pregnancies, HIV and other sexually transmitted infections;
And addressing the drivers of climate change can help to improve health both now and in the future for a range of communicable and noncommunicable diseases.
This is especially significant for you here in Mozambique, with your vulnerability to the impacts of climate change, as Cyclone Freddy demonstrated just a few months ago.
Addressing these risk factors is essential for keeping people healthy and preventing disease, and the burden it creates for health systems.
Making this shift to a focus on promotion and prevention means that health cannot be just the business of the health ministry, but of the whole of government, and the whole of society.
The commitment we see in you, Your Excellency, is important to implement the whole-of-government and whole-of-society approach, because it comes from the highest level.
The second priority is to protect health, by strengthening the global architecture for health emergency preparedness and response.
Building on the lessons of the pandemic, WHO has made a set of key proposals for stronger governance, financing, and systems and tools for health security, under the umbrella of a new pandemic accord, which Member States are now negotiating.
We very much appreciate Mozambique’s support for the pandemic accord, and we seek your continued engagement in the negotiations for both the accord and the revisions to the International Health Regulations.
We also recognize Mozambique’s strong response to the COVID-19 pandemic, and to the outbreaks of wild polio virus and cholera, which I mentioned earlier.
The third priority is to provide health, by reorientating health systems toward primary health care.
Investments in primary health care are investments that pay a rich reward in terms of promoting health and preventing disease, through essential services like vaccination, reproductive, maternal and child care, and more.
As the eyes and ears of the health system, primary health care also plays a vital role in protecting health, by detecting outbreaks at the earliest opportunity.
The “One District, One Hospital” initiative is an excellent example of Your Excellency’s commitment to strengthening Mozambique’s health system.
We very much appreciate Your Excellency’s commitment to continuing to invest in health, even as we see a shift away from investment in health elsewhere.
Strong health systems, based on primary health care, are the vehicle that enable a country to promote, protect and provide health.
But that vehicle must be powered, which is why the fourth priority is to power health by harnessing science, research, innovation, data, digital technologies, artificial intelligence and partnership.
The pandemic demonstrated the incredible power of science, research and technology for health, with vaccines, tests and treatments developed in record time.
However, inequitable access to these tools cost lives – as you experienced yourself in Mozambique. We must all do more to make sure all people have equitable access to the fruits of science.
And the fifth priority is to perform for health, by building a stronger WHO that is better able to deliver an impact where it matters most: in healthier people, healthier families, healthier communities and healthier nations, including right here in Mozambique.
Ultimately, delivering an impact rests on the strength of local health systems, including the strength of the health workforce and health infrastructure.
WHO analysis shows that these two areas each account for more than one third of the investments needed to achieve the health-related targets in the Sustainable Development Goals.
Health workers are of course the backbone of every health system. And I am pleased to note that over the past seven years, Mozambique has almost doubled its density of health workers.
This is an encouraging trend. Nevertheless, we know that you continue to face health worker shortages, and we are committed to working with you to close these gaps.
We are now working with the Ministry of Health on a health labour market analysis, which will help to prioritise investment in health workforce development and employment.
But the ability of health workers to deliver quality health services also depends on the quality of health infrastructure.
Capital investments in facilities and equipment are essential to allow health workers to do their jobs.
These two priorities – health workers and health infrastructure – are inter-dependent. The best health worker cannot deliver the highest quality care if they are working in a health facility with no electricity or running water. Likewise, the best health facility is no use unless it is staffed by skilled health workers.
There is no getting around the fact that quality health care takes investment. But that’s how we must see it – as an investment to be nurtured, not a cost to be contained.
Health is an investment that pays a rich return in sustainable development, equity, and inclusive growth.
The bedrock of health financing for all countries must be domestic, public financing. The private sector has an important role to play, especially in providing health services and products, but as a complement to strong domestic financing, not as a replacement for it.
We recognize that many low-income countries also rely heavily on external resources to fund their health systems.
It’s essential that these external resources are aligned with the priorities and plans of countries, not the priorities and plans of donors.
Having one plan, with one budget and one report is essential, because it allows the government to use funds in alignment with its own priorities.
Multiple plans, budgets and reports lead to fragmentation, siloes and ultimately, to lower-quality care and poorer health outcomes.
Just last month, WHO and a group of multilateral development banks launched the Health Impact Investment Platform, which aims to attract investment by development banks to deliver country-led health projects, with technical support from WHO.
In short, it marries WHO’s technical expertise with the financial muscle of development banks to design and deliver health projects aligned with country priorities.
The Health Impact Investment Platform represents a unique opportunity to complement domestic investment with external funds to make more rapid progress towards universal health coverage and the other health-related SDG targets.
It gives countries an end-to-end service from needs analysis to capital assets solutions that optimise health projects over their life cycle.
And it gives development banks the confidence that their investments are technically sound and will deliver value for money.
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Your Excellency President Nyusi, Honourable Minister Tiago,
Let me leave you with three specific requests.
First, I urge you to focus on promoting health and preventing disease by addressing its root causes, through a whole-of-government and whole-of-society approach.
Second, I urge you to prioritise domestic investments in health workers and health infrastructure, and to take advantage of the new Health Impact Investment Platform, to complement those investments.
And third, I urge you to ensure that the government, donors, the private sector and all partners are aligned behind one plan, with one budget and one report, coordinated by the government.
Ultimately, health is not a cost to contain, it is an investment to be nurtured – an investment in sustainable development, and in the Mozambique of the future: a healthier, safer and fairer Mozambique.
Thank you once again for your hospitality and for your commitment to our shared vision of health – not as a luxury for the few, but as a human right for all.
Obrigado. Thank you very much.