Commonwealth Health Ministers Meeting

Ministers, Excellencies, Ladies and Gentlemen – welcome to Geneva and to the Commonwealth Health Ministers’ Meeting, held as always on the eve of the World Health Assembly.

I sincerely thank all of you for being here – representatives of government, business, and civil society organisations both Commonwealth and otherwise. I thank our chair, the Honourable Jan McLucas of Australia, and I thank so many of you for the huge amounts of preparation that have gone into this meeting. I would like to acknowledge my own colleagues in the Commonwealth Secretariat, for their organisation and also for the substantive research and reporting they have done, to make today count.

I hardly need tell this audience of the scale of the health challenges we face in the Commonwealth. We are home to one third of the world’s population – yet two-thirds of its AIDS sufferers, its maternal deaths, its children under five years old suffering from malnutrition – and nearly half of its infant deaths.

It is only by partnership – between countries; and between governments, businesses and civil society organisations – that we can hope to confront these truly existential challenges.

And existential they are. I am aware that the issue that is occupying many of our thoughts at the moment is the transmission and control of H1N1 Influenza, and the need to strengthen health systems for an effective response. We are grateful for the leadership taken by the World Health Organisation on this, and there will be an opportunity to pose questions on the subject to the Director General, Margaret Chan, when she joins us this afternoon.

Responding to global pandemics demands effective, swift and cooperative actions, both at the national and the international level. Their potential threat is in large part attributable to our increasingly interconnected world – but so, too, does the solution lie in that same inter-connectedness, as we respond by international dialogue, and coherent and coordinated responses.

Another important concern for the international health community is the current global economic crisis, and its implications for health. Our fear is that our current financial woes can be expected to reduce funds available for health, at every level. This could have crucial implications for progress in international health, particularly the attainment of the Millennium Development Goals, and their deadline of 2015, in just over 5 years’ time.

This is a real and present danger. The World Bank tells us that the doleful roll call of infant deaths in developing countries may be 200-400,000 more each year between 2009 and 2015, than had there been no global economic crisis. We must try and ensure that – whilst cutbacks and improved efficiency may be required – we do not jeopardise progress in health.

Ministers, last year’s meeting, which focused on e-health, led to you giving us an important and innovative mandate to promote the use of Information and Communication Technology in the health sector. In the last 12 months we have delivered on this mandate, as you will see from the short briefing paper on your desks. We have done so by, amongst other things: convening a high-level dialogue in the East, Central and Southern Africa region; establishing a small technical working group on the topic; working closely with ICT suppliers; and developing a pilot initiative in conjunction with the Ministry of Health in Kenya.

But now in 2009, we turn to a new theme: that of climate change.

There is irrefutable evidence of global warming and climate change, and this will impact on human health. The facts are stark: around one fifth of the world’s population lives in coastal areas affected by rising seas and natural disasters. Earlier estimates of the potential for 200 million displaced persons are now seen as conservative.

According to the UN, some 200,000 deaths each year in the world’s low income countries can now be linked to the impact of climate change on health, through crop failure and malnutrition, diarrhoeal disease, malaria and flooding.
Here I pay particular tribute to the work carried out by The Lancet in cooperation with University College, London. Their new edition, published this week to coincide with this meeting, is an exceptional contribution to this debate. We in the Secretariat are already a strategic partner with UCL, and for the sake of this meeting we have produced short fact sheets summarising those arguments, which you will also have received.

Responding to climate change also demands concerted effort at a national and international level. But the responses are hampered by the fact that much damage done by climate change is incremental and – comparatively speaking – less visible. This presents a problem of prioritisation, as we often face competing, and more immediate demands on attention and resources.

I am glad, therefore, that in our meeting today we are taking a long-term view. What we bring to this challenge is our capacity for mutual cooperation and solidarity. With 32 small states in the Commonwealth, of which 27 are small island developing states, many of our members are particularly vulnerable to climate change, and they need to be part of an international network than can help and support them.

The Commonwealth Secretariat has been committed to working on climate change since the Lake Victoria Action Plan, which was agreed by our Heads of Government in November 2007. The Action Plan states that climate change can undermine our continuing efforts to achieve the Millennium Development Goals, and furthermore that the cost of inaction on adaptation and mitigation is far greater than the cost of early action.

We are therefore very pleased that in 2008 you, the Commonwealth Health Ministers, selected climate change and health as the topic for this meeting. You were far-sighted in doing so. How strange and ironic that the subject had not yet been broached. If we are to be able to save our planet, then surely we have to be healthy enough ourselves, in order to keep living on it.

There are also more practical arguments for the health sector to take a greater role in climate change debates. The introduction of greener transport will offer opportunities to improve health, for example, by reducing non-communicable diseases. And, in turn, the cost savings made by these health improvements could be re-directed to fund plans for dealing with climate change.

I am hopeful therefore that this meeting marks a step forward in the involvement of the health sector in climate change planning, at the international, national, and local levels.

A key concern in responding effectively to climate change is funding. Many of you said this to us in the Commonwealth Survey on Climate Change and Health. And, as I have said, the current economic crisis only makes the funding problem worse.

However, it is important to recognise that climate change is not a new disease, and need not, therefore, demand specific, new and expensive programmes. Climate change will mostly impact health through existing diseases and existing exposures, and therefore it will demand the strengthening of existing health systems.

Whilst funding will be required for some specific areas, investing in strengthening health systems in order to adapt to climate change will benefit health generally.

Responding to the health impacts of climate change therefore first demands that we continue and strengthen current health service delivery and existing health systems, and that we view this within the framework of climate change.

There are simple, practical things to do, like examining how climate change will impact upon existing vector control programmes, or considering the impacts of increased flooding on water and sanitation construction projects. Responding to the health impacts of climate change is therefore complementary to other primary health goals, such as the attainment of the MDGs.

Ladies and gentlemen, these are challenging times. We face both a troubling global financial climate, and the looming threat of climate change. Our focus here today – on health and climate change – demands timely and concerted action nationally and internationally.

As many of you will be aware, in November we will be hosting a Commonwealth Heads of Government Meeting, CHOGM, in Trinidad and Tobago. That meeting falls just before the Copenhagen Summit which will attempt a post-Kyoto global environmental agreement. Today, we have an opportunity to feed into that process, which we should seize, by putting health concerns firmly on the climate change agenda.

Thank you.