Dr Margaret Chan Director-General of the World Health Organization Gave a Keynote address at the Health consultation for the World Humanitarian Summit Geneva, Switzerland On 8 April 2016. Read the full Speech Below;
Sister UN agencies, officials from the European Commission, experts on humanitarian assistance, colleagues in public health, ladies and gentlemen,
Thank you for giving us your time and your expertise. WHO and UNICEF have jointly organized this meeting to gather your advice on how best to profile health needs during the May summit in Istanbul.
We also seek advice on how best to showcase the unique contribution that health can make when building a better architecture for international humanitarian assistance.
I thank UNICEF for using its communication for development strategy to map out a humanitarian system that genuinely engages, listens to, and responds to children.
We expect discussions during the first-ever World Humanitarian Summit to differ markedly from the past. Several recent assessments, including the Secretary-General’s “One humanity: shared responsibility” report, indicate that the world’s response to humanitarian crises is itself in a crisis.
Since the start of this century, the landscape of humanitarian needs has changed dramatically. Trends like high population mobility, climate change, and the rise of violent extremism and terrorism reshaped the landscape, making protracted crises the dominant humanitarian event.
Needs have risen exponentially. The traditional international system has not kept pace. The consequences are numerous and severe. The costs are unsustainable, as is the burden.
Aid agencies, established decades ago to deliver urgent life-saving assistance, are now being asked to provide a range of basic services, year after year, normally considered the responsibility of government.
In many ways, we have become the provider of last resort, doing what governments should be doing. How long can we continue doing this?
No systematic effort to achieve greater efficiency is readily apparent. The evidence needed to measure value for money is in short supply.
The wrong things are being measured. In this era of sustainable development, what matters most is not the number of projects initiated or staff deployed, or the size of shipments of medical supplies and food, but the impact these activities actually have on the lives of people.
These are people trapped in protracted crises or struggling to survive in the midst of armed conflicts that kill civilians, deliberately target health facilities and staff, and loot aid conveys.
I think we can agree on the need for an outcry in May against the flagrant disregard of international human rights and humanitarian law.
And there are other problems. The world humanitarian aid budget for 2014 was the largest ever, with the greatest shortfall ever.
In that year, humanitarian assistance became the UN’s most costly activity, surpassing peacekeeping operations by $2 billion. Protracted crises are the single biggest driver of these costs.
The lack of data on the real impact of assistance, on real lives, diminishes the credibility of funding appeals. The funding gap has become a credibility and accountability gap.
The aid architecture, characterized by a traditional divide between humanitarian and development work, has been rendered obsolete. Protracted crises blur the distinction between the humanitarian and development worlds, yet rigid mandates keep the worlds apart.
In a financial context that places a premium on efficiency, humanitarian and development agencies often operate side by side, in the same communities, with different goals, timeframes, reporting requirements, and ways of approaching the same problems.
All of these problems underscore one main conclusion. The international aid system urgently needs a fundamental overhaul. Many are looking to the World Humanitarian Summit to map out what needs to change, in what specific ways, and by which specific agencies.
Ladies and gentlemen,
I personally believe that the health sector is well-positioned, and well-equipped, to spearhead many of the changes called for in these hard-hitting reports.
A focus on health can help break down rigid territorial mandates. The protection of health is a central objective of all emergency operations, whether this involves the rapid treatment of injuries or the safe delivery of babies. The fact that the determinants of health are so broad automatically calls for a multisectoral cross-cutting approach. The provision of food, water, sanitation, and shelter contributes to the overarching goal of preventing disease, deaths, and mental distress.
A focus on health can improve the metrics. The health sector, with its well-established mechanisms and methodologies for conducting risk assessments and measuring results, can play a major role in meeting the call for better data on what donors are getting for their investments.
Pursuit of the health-related MDGs created a culture of measurement and left a legacy of independent monitoring, transparent reporting, and accountability for results.
A focus on health can help build resilience. WHO and its partners, including the International Health Partnership Plus, have long argued that the best aid is channelled through existing national infrastructures and systems in ways that build community resilience and capacity. Building national self-reliance is the best exit strategy for both humanitarian and development assistance.
A focus on health can improve efficiency. WHO has long experience with the provision of essentials, whether essential medicines, essential nutrients, essential services for water and sanitation, or essential interventions for preventing maternal and childhood deaths.
A focus on health helps bridge the humanitarian and development divide. The Ebola outbreak in West Africa illustrated what can happen when fundamental public health infrastructures and capabilities are fragile.
The Zika health emergency is illustrating a different set of vulnerabilities linked to inadequate health development. That is: poor access to reproductive and sexual health services, lack of piped water and sanitation in urban slums, and the worldwide collapse of programmes for mosquito control.
Finally, recent and ongoing WHO reforms were spurred by deficiencies in the initial Ebola response. With your support, we made important course corrections that spearheaded broader changes and have contributed to better preparedness and a more efficient response.
I want to thank Dr David Nabarro and the members of the Advisory Group for their advice on reforms.
WHO developed a common platform that took advantage of the unparalleled logistics of the World Food Programme. We drew on our long and fruitful relationship with UNICEF to improve supply chain efficiency. We welcome UNICEF’s new communication for emergencies strategy as yet another platform for efficient performance. We value our partnership with OCHA and UNDP.
In his report for the summit, the Secretary-General underscored how much the world needs a moral compass. I believe transformational changes in the international systems for humanitarian assistance and development can get that compass pointing in the right direction.