Remarks at World Health Day and WHO 75th anniversary

Siyavusela Bekunene!

I am delighted to be part of the celebrations today to mark 75 years since the establishment of the World Health Organisation within the United Nations to advance health and well-being across our world.

This celebration provides an important moment for us to pause and look back at how far we have come since the need for an independent, science-led global health organization was recognised as the United Nations was being formed in 1945. Three years later, on 7 April 1948, the World Health Organization was born and has now grown to 194 Member States across 6 regions.

Throughout its history, WHO has served as a depository of scientific knowledge and good practices for health policies. It coordinates the actions of its individual Members and non-state actors on health.

Fortunately for WHO, we do not need to go back to all the 75 years of its existence to make the point of its importance:

If ever there was any doubt about the need for a global, professional, independent and scientific health organisation, that doubt was banished in 2020 when the world woke up to the COVID-19 pandemic.

The COVID-19 pandemic exposed the deep interconnections and strong interdependencies between countries and the shared fate among the peoples on our planet. It exposed our vulnerabilities and declining global solidarity just when it was most needed. 

It put immense pressure on the health systems of even the most economically developed countries and exposed the lack of global preparedness for such a public health emergency context. (Of course, it has to be remembered that WHO shares its responsibility with – and indeed depends on – Member States to ensure preparedness and response, including disclosures and quality of information).

Amid the initial shock, fear, misinformation, despondency and politicization of the disease and its response, WHO emerged as the authoritative voice for a coordinated response.

Who insisted on being guided by science and remained firmly rooted in the basic principles of the right to health and well-being for all people, as outlined in its 1948 Constitution. It therefore became a moral voice for the need to move together in solidarity because no country, rich or poor, could contain the pandemic on their own.

Allow me to therefore congratulate WHO and all Member States on the achievements over the last 75 years, including the great progress against several leading causes of death and disease. Early this year, we marked the growth of our global population to 8 billion human beings. This growth is attributable to improved health globally: Life expectancy has increased dramatically; infant and maternal mortality rates have declined; we’ve turned the tide on HIV and malaria deaths have halved. The number of childhood deaths has been cut in half.

This proves that it is possible to win the fight against almost every disease.

Your Excellency the Prime Minister, Honourable Minister, Excellencies, ladies and gentlemen:

I should also like to applaud HM’s Government for the great strides that the Kingdom has made in improving the health of its citizens. Eswatini has indeed emerged as good story in its pushback against HIV/AIDS. This success is a good demonstration of strong leadership at the highest level, policy-making and implementation, community engagement and strong international partnership. We must therefore celebrate the great effort of the Government and the solidarity of international partners, some of whom are in the room today.

Allow me to also applaud the strong relationship between the United Nations and Eswatini since the Kingdom became a member of the United Nations in September 1968.

As already pointed out, the theme of this year’s commemoration is “reflecting on the successes in advancing Health for the People of Eswatini”. According to WHO definition, Universal Health Coverage will be achieved when all people have access to the quality health services they need, including well trained health workers, safe treatment and access to medicines when and where they are , without facing financial hardship.

The sad reality is that the world is off-track on the global health targets under SDG 3. COVID-19 pandemic has exposed the many weaknesses and inequalities in our health systems and outcomes.

Progress has been uneven, both between and within countries, with a 31-year gap between the countries with the shortest and longest life expectancies.

In Eswatini, the Maternal Mortality Ratio which is one of the Key Performance Indicators of the SDGs has remained high at 452/100,000, according to WHO.

We note and commend that there has been some improvement on the under 5 Mortality Rate which declined from 104  per 1 000 live births to 74 per 1 000 live births in 2017.

Hon. Prime Minister, ladies and gentlemen:

Allow me to mention three messages for our reflection this morning. 

The first is the need to increase investments in people in order to make our health systems work. Improving health service coverage and realizing the right to the enjoyment of the highest attainable standard of health is dependent on the availability, accessibility and quality of health workers. Worldwide, WHO estimates a projected shortfall of 10 million health workers by 2030, mostly in low- and lower-middle income countries.

These shortages are made worse by under-investment in education and training of health workers in some countries and the mismatch between education and employment strategies in relation to health systems and population needs.

Another challenge is the increasing international migration of health workers, particularly in low- and lower-middle income countries like Eswatini. According to 2017 statistics, Eswatini is among countries with the lowest density of physicians at 0.16 per 1000 population.

We do need to invest in quality training and retention of skilled health workers who can educate and advocate for their patients.

The second point is about the need for a multi-sectoral, whole of society approach to health in order to respond to non-communicable disease. NCDs – primarily heart and lung diseases, cancers and diabetes – are the world’s largest killers.

WHO estimates that there are 41 million deaths attributed to non-communicable diseases (NCDs) annually; equivalent to 71% of all deaths globally.

The burden of NCDs falls mainly on developing countries, where 82% of premature deaths (deaths under 70 years of age) are linked with these diseases. More than a billion people worldwide are living with obesity. They are at higher risk of non-communicable diseases such as type 2 diabetes, cardiovascular disease, hypertension, stroke and cancer, and also more likely to experience mental health issues.

Tackling the risk factors through a comprehensive multisectoral response to NCDs will therefore not only save lives but will also provide a huge boost for the sustainable development in the race to 2030.

It will also need a coordinated campaign to empower individuals to care for themselves and their families.  Diets, nutrition, reducing tobacco consumption, physical activity – all these are within our means to achieve.

One of first groups I met when I arrived in Eswatini about a year ago was the Diabetes Association and they informed of the excellent programmes they have in schools and rural communities - in partnership with the Government and WHO – to raise awareness among young people on the importance of staying active in sports and other activities.

Finally, my third message is on transferring lessons from areas of success to address emerging threats. A key area requiring attention today is mental health which is becoming widespread globally and, sadly, mostly affecting our young people.

Mental health remains largely ununderstood and often stigmatized.

We are told that the impacts of the COVID-19 pandemic have included an increase in poverty, violence and worsening mental health for children across the globe. It is estimated that 10 percent more children were forced into poverty in 2022. Mental health helplines are said to have seen a demand surge by as much as 7,000 percent, according to a report by Save The Children. Eswatini is ranked among countries with the highest rates of suicide in Africa after Lesotho.

The message here is that we fought a gallant battle to destigmatize HIV/AIDS. We must do the same with mental health so as to gain a handle on how to support those unfortunate enough to suffer this illness, both you and old.

In conclusion, as we celebrate World Health Day and the 75th anniversary of the World Health Organisation, I invite us to uphold the vision of the right of all people to reach the highest possible standard of health.

I thank HM’s government for our continued partnership and reaffirm that the United Nations remains committed to harnessing the comparative advantages of the 17 UN agencies present in Eswatini to ensure a comprehensive, multi-sectoral and all-of-society approach to health for all.  

Siyabonga, I thank you.