WHO Director-General Dr Tedros address to the 146th Session of the Executive Board
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Excellencies, distinguished members of the executive board. Dear colleagues and friends. First of all, I would like to say good morning and welcome once again and thank you for your moving tributes to our late friend and colleague, Dr. Pit's LMR, and for all those we have lost in the past year. It's clear from what you have said that he enjoyed as much trust and respect for member states as he did from his colleagues in the secretariat. I shared my reflections on Pete at the P.

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Buck. Many of you are here and I don't think it's necessary to repeat. Now, you have said it all, and I fully concur with all the things you said about it. The expressions of sorrow over the past week and of admiration for everything Pete did and everything he was saved on. We miss Pete now, and we will always miss him. And the other thing I'd like to share with you is the four days in bucardo, which I haven't said in my pinback meeting.

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They were killed in cold blood while saving lives. You know, they were facing Ebola and they were facing bullets. So bullets killed them. Immediately after the attack, I went to visit the wounded ones that were seven seriously wounded colleagues to. And the stories the wounded colleagues told me was very, very horrifying. And I just wanted you to imagine in what condition our colleagues are working, our responders are working not only from W.H.O. but all organizations, be it U.N.

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, the Civil Society NGO, but more importantly, including the government, because it's the strong governments leadership which is helping us to get get result. And many of the losses that, by the way, are from government. And working in that condition, as you know, is how difficult it is. And the story is very terrifying. But despite that, they went back again because they said. The deaths of their colleagues strengthened their resolve and that they will go back to finish their job.

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And that's why now Ebola is almost zero. The last 16 days or almost done. But we had one case again yesterday. But I hope we will finish it as soon as possible. But for the Ebola situation to be what it is now, we paid. And we have to give them all due respect. And thank you so my chair for for doing that. Excellencies, dear colleagues and friends, 20, 19 or their year of unprecedented challenges and present the precedented achievements, an unprecedented transformation.

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It was a very rewarding year and a very tough year as we pushed hard to finalize the design phase of transformation. We touched every corner of the organization while fighting emergencies, launching new initiatives and striving towards the triple billion targets. Allow me to summarize some of last year's key achievements according to each of those targets. First, 2019 or the year our new division of healthy populations was born, reflecting the new emphasis we are putting on health promotion and disease prevention by addressing the root causes of ill health.

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We reached a historic agreement with the International Food and Beverage Association, which has committed to eliminate industrially produced trans fat from the global food supply by twenty twenty three. Together with the Food and Agriculture Organization of the United Nations, we launched a new tool which allows countries to analyze the strengths and weaknesses of national food systems and prioritize interventions. We published new guidelines to help frontline frontline health workers to recognize children who have suffered sexual abuse and to provide Ebbert evidence based FirstLine support.

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We work with civil society and other partners to improve road safety. In Chile, Kazakhstan, Malaysia, Slovenia, Trinidad and Tobago and more. We established a new department on social determinants of health and convened a meeting of international experts to identify ways to strengthen and deepen W2s work in this area. Over the next four years, more than 80 cities in more than 50 countries have committed to W2s air quality guidelines, and we begun implementing the initiative on climate change and held in small island developing states following its approval at the World Health Assembly.

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Our vision is that by 2030, every island in the Pacific will have a health system that is resilient to climate change. The urgency of this challenge was brought home to me during my trip to Tahiti, Tonga, Tuvalu and Fiji. Last year in Tonga, I planted a mangrove in an area which used to be a rugby field where Tonga and Fiji played each other in nineteen twenty four. But it's now fully consumed by saltwater, and you can see the gravity of the problem.

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And Minister was with me and the great hospitality when I visited Tonga and the other islands, Tuvalu, Tahiti and Fiji. Now let me turn to progress on universal health coverage. We saw many countries making progress. South Africa and the Philippines both pass new laws on UHC, while Greece, India and Kenya rolled out ambitious programs to expand coverage. Our global monitoring report on you. She showed that while access to health services has expanded in all regions and across all income groups, we are going backwards on financial protection.

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In 2015, nine hundred thirty million people spend 10 percent or more of their household consumption on health. And we know that number is growing every year. This trend can be turned around. The world spends 10 percent of global GDP on health, but we could and should be getting much better value for money. Too many countries spend too much of their health budgets on managing disease, instead promoting health and preventing disease, which is far more cost effective. That's why W.H.O.

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is calling for all countries to increase public spending on primary health care by at least one person of GDP, either through new investments RIANNE allocation or both. As you have. Heard me say many times. Health is a political choice, but it's a choice. We see more and more countries making at the United Nations General Assembly last year. All 193 U.N. member states approved the political declaration on universal health coverage, the most comprehensive international health agreement in history.

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And thank you to you all for fighting to have that historic resolution. Then at the Inter-Parliamentary Union Congress in Belgrade, Serbia, legislators adopted a resolution on universal health coverage committing to leverage the power of parliament to translate political commitment into policies and the commitment of the m._p.s I met there was very, very strong and we hope we will get all the support we need from the MPE. They're very crucial and central in pushing the UHC agenda forward. As you know, and also my experience as a former member of parliament and just as countries are coming together, so the international health community is also coming together to support them.

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Together with eleven other global health agencies, W.H.O. launched the Global Action Plan for Healthy Lives and Well-Being for all the toilet. Signatory agencies are now moving from commitment to action, laying the foundation for the UN decade of action for the S.A.T.s and beginning to demonstrate the path to results in countries in four ways. We're engaging countries to identify priorities. We're working with Mali, for example, as it strives to provide free access 200 percent of its population through a package of essential services.

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We are establishing joint working groups to accelerate our support for countries, for example, to mobilize more resources for health in Ghana and to spend them better. We are aligning our ways of working by institutionalizing the plan within the agencies and becoming a Pathfinder for U.N. reform. And we're developing a joint monitoring framework to keep a count of progress with the first joint progress report to be presented around the World Health Assembly in May 20 20. But I'd like to use this opportunity to thank Germany, Norway and Ghana for being the pathfinders for this and for bringing the idea of the global action plan.

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And that culminated in the signing of the toiler agents is to work jointly. In addition to these significant milestones, w.h also signed a memorandum of understanding with the African Union to develop the African Medicines Agency and an agreement with France to establish the W.H.O. Academy. One of the most important issues for the light, for the realization of universal health coverage is improving the access, accessibility and affordability of medicines. For the first time last year, W.H.O. pre-qualified a biosimilar medicine, a cheaper version of the Breast Cancer Drug Trust to zoom up, tries to zoom up, making this lifesaving therapy more affordable for countries and more accessible for women who need it most.

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We expect to pre-qualify more and more of this very effective but very expensive medicines in the coming years. So we have started the first step. We will continue to invest on pre-qualifying biosimilar medicines that will increase access, ability and affordability. We also launched a pilot procedure for the pre-qualification of biosimilar human insulin, published a cancer a cancer medicines pricing report and held our second fair pricing forum than you can imagine when we do the human insulin, how it will benefit many of those who are using it regularly.

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In terms of affordability, as you know, health workers are also vital to achieving universal health coverage and especially nurses and midwives. The year of the nurse and the midwife gives us a wonderful opportunity to highlight the incredible role nurses and midwives play and to draw attention to the shortfall of 9 million nurses and midwives. The world is facing between now and 20 30. We are calling on all countries to invest in nurses and midwives as part of their commitment to universal health coverage.

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This year, W.H.O. will also publish its first report on the state of the world's nursing to provide a snapshot of the global nursing workforce. We hope that countries will use the data from this report to make evidence based decisions on how and where to invest in the nursing and midwifery workforce. But I assure you, many countries have serious challenges in this area and I hope the report will benefit them all non-communicable diseases. There is plenty of good news. Globally, the number of men using tobacco has finally started to decline.

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At the same time, we have seen growing evidence about the threat posed by e-cigarettes. This is an increasing area of focus for W.H.O.. Twelve countries scaled up. Hypertension management using the W.H.O. Hart's technical package and more than 700000 people globally are now on protocol based treatment. As a result, hypertension control has improved in all countries. And this is our priority because globally we have more than 1.2 billion people with hypertension and only 200 million of them managing it, a billion, as Tom Frieden calls them, walking bombs.

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This is serious. And that's why we have started to invest on this. And it's not too late. Please give it attention with the International Telecommunications Union. We launched Standard This for safe listening to reduce the risk of hearing loss among users of personal audio devices. This standard does have already been integrated in the helds application on iPhones. We launched the Global Initiative for Childhood Cancer in six countries and we have developed a draft strategy on eliminating cervical cancer, which you will consider at this executive board.

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We also launched the W.H.O. Special Initiative for Mental Health with the aim of increasing access to quality and affordable care for mental illness conditions. Two hundred million more people. We have held a consultation with the first six countries Bangladesh, Jordan, Paraguay, the Philippines, Ukraine and Zimbabwe. Thank you to Switzerland and the United States for their generous support for this program. We train 6000 health workers in Ghana on mental health through the quality, right? A training platform and we issued new guidelines on reducing the risk of dementia.

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The high level Commission on Non-communicable Diseases has also been working on the second phase of its work and I look forward to receiving its final report and recommendations on infectious diseases. There is more good good news. By the end of twenty nineteen seventy seven countries had national policies that support HIV self-testing, helping to reach people at higher risk from HIV, including those who are most marginalized and not accessing health services. Egypt, which has one of the world's highest burden of hepatitis C, is now on track to be one of the first countries to eliminate it.

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Beginning with strong political commitment, Egypt has provided screening for 60 million people and treatment for 3.7 million people, largely through primary health care, integrated with screening and care of non-communicable diseases such as hypertension and diabetes, along with a national initiative on cervical and but breast cancer. This is a truly stunning achievement and that could be a good lesson for other countries. Australia, France, Georgia and Mongolia are also moving towards Hepatitis-C elimination, enabled by dramatic reductions in the price of direct acting antivirals on malaria.

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The W.H.O. Strategy Advisory Group on Malaria Eradication and the Lancet Commission on Malaria Eradication both published their reports on what we need to do to realize our shared vision of a malaria free world. Argentina and Algeria were certified as malaria free, and we launched a pilot program for the world's first malaria vaccine in three countries Ghana, Malawi and Kenya. Despite these gains, we continue to see more than 200 million cases of malaria annually. More than 400000 people die each year from this preventable and treatable disease.

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In recent years, progress in reducing new malaria infections has leveled off. Most worrying of all, malaria is one. On the rise across many high burden countries in Africa, in response, W.H.O. and the IBM Partnership to End Malaria have launched hybrid than high impact. This is a targeted new approach to accelerate progress in the countries hit hardest by the disease. Eleven countries that carry 70 percent of the malaria burden globally. So we will have a focus on serious measures with W.H.O.

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support. These countries are pioneering smarter use of their data, which, when coupled with top quality guidance from W.H.O., will lead to a more targeted malaria response on tuberculosis. Seven million people were diagnosed and treated for TB in twenty eighteen, up from 6.4 million in 2017. Our aim for this year is 8 million. The W.H.O. Multi-sectoral Accountability Framework for TB was launched and is already being adopted and implemented in countries. W.H.O. has also developed new policies and guidelines to ensure better outcomes for those affected, including the strong recommendations for the first time for fully aurel regions for the treatment of multi-drug resistant TB on neglected tropical disease.

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Yemen and Kiribati eliminated lymphatic filariasis and Mexico eliminated rabies.

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And for the first time, the number of human African sleeping sickness cases reported globally fell below 1000 on anti-microbial resistance. One hundred seventy five countries have now developed multi-sectoral AMA national action plans. 90 countries have enrolled in Glass, the global surveillance platform that will provide that data for newly approved as DG Indicator on Emaar.

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159 countries have provided data to track progress in the implementation of their air mightve national action plans. We have established a standing tripartite joint secretariat to consolidate cooperation between W.H.O., F.L. and or i.e. the secretariat will facilitate the implementation of the recommendations of the UN Inter-Agency Coordination Group, whose report was submitted to the Secretary-General last April thanks to the support from the governments of Netherlands and Sweden. We have also launched the Multi Partner Trust Fund on a model to catalyze action in countries.

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One of the crucial barriers we are facing is the lack of new treatment options in the pipeline. Just last month, W.H.O. published a new report which shows that the 60 antimicrobials currently in development bring little benefit over existing treatments, and few target the most critical resistant bacteria to stimulate research and development into new and much needed medicines. We are working with the European Investment Bank on a new investment fund and we will have more news about that in the coming months.

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At the same time, we are striving to protect the antibiotics we have by working with countries to strengthen infection prevention, stewardship, hygiene, water and sanitation. W.H.O. continues to prioritize the health of those who are most disadvantaged, including women, children and adolescents. Last year, we revised our recommendations for contraceptive use by women at high risk of HIV and published new global estimates of maternal mortality. We have launched Survive and Thrive. A new report drawing attention to the plight of vulnerable newborns and identifying key interventions for transforming care for small and sick babies.

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Let me now turn to emergencies. As you know, it was an extremely busy year for W just emergences programs during 2090, W.H.O. responded to 58 emergencies in 50 countries. You only hear about the few of them fifty-eight emergencies. We must be honest, it was a difficult year in our fight to eradicate polio. There were 173 cases of wild polio virus last year, the most since 2014, and many outbreaks of vaccine derived polio virus mostly in Africa.

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But there were also several reasons for cheer. We certified the global eradication of wild polio virus type 3 and no wild polio virus has been detected in the African region for over three years. We also launched the new strategy for the Global Polio Eradication Initiative with $2.6 billion U.S. dollars pledged by donors at reaching the last mile forum in the UAE. Despite last year's setback, I'm confident that with a strong new strategy backed by strong financial support and strong political commitment in Pakistan and Afghanistan, we're on the right track for realizing our vision of a polio free world.

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Last July, I declared the Ebola outbreak in the Democratic Republic of Congo, a public health emergency of international concern. Since the outbreak began in August 28, in there have been three thousand four hundred twenty one cases and two thousand two hundred forty two does. But thanks to the incredible efforts of thousands of frontline responders and the solidarity of the international community and the leadership of the government, above all, the outbreak has been steadily declining. The rapid approval and pre-qualification of the Ebola vaccine after a trial involving 250000 people and the advent of experimental therapeutics have also helped us to save lives.

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This is an incredible public health triumph. Five years ago, we had no vaccine and not a RepuTex for Ebola. Now we can say Ebola is preventable and treatable. Last week, there were just five new cases. The smallest number since the beginning of the response. This is a very encouraging trend, but until we get to zero, there is always the risk that the outbreak could flare up again. The insecurity of the region continues to pose a threat to our ability to exert to anguish the outbreak.

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That's exactly what happened in November, when several security incidents undermine the progress we had made and the horror story I told you. And just in the last few days, more civilians were killed by armed rebels in the Beni region. That was on Thursday. W.H.O. currently has about six hundred thirty staff in the odyssey to support the Ebola response. And we will continue to work with full determination until we can celebrate the end of this outbreak. But even as we focus on ending this outbreak, we must also think beyond Ebola to strengthening the artist's weak health system.

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We have already prepared a roadmap with the government and are planning a meeting later this month with the president and senior ministers to identify how W.H.O. and others can support the DRC in this presence. This is beyond Ebola. Strengthening health systems in fragile and conflict afflicted states is something we must prioritize. If we are to achieve our 20 setti goals. As you know, last week I declared another public health emergency of international concern, this time over the outbreak of novel Corona virus.

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As of this morning, there are seventeen thousand two hundred thirty eight confirmed cases in China and three hundred sixty one. There's outside China that are one hundred fifty one confirmed cases in twenty three countries and wonders, which was reported from Philippines yesterday. During my visit to Beijing last week, I was so impressed in my meeting with President Xi at his detailed knowledge of the outbreak and for his personal leadership. But also at his commitment from the word, as he told me, I will share with you, we will take serious measures at the epicenter, at this source in order to protect our people and also to prevent the spread of the virus to other countries.

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We have the obligation to do that, and that's what we will do. And that's exactly the strategy we discussed with him. If we invest in fighting at the epicenter, at the source, then this spread to other countries is minimal and also slow if it's minimal and slow. What is going outside can also be controlled easily. So is the number of cases, for instance, we have now as we speak, 151. It's actually small and it's coming only slow so it can be managed.

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But when I say this, don't make a mistake, we can get even worse. But if we give it our best, the outcome could be better.

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And because of this strategy. And if it weren't for China's efforts, the number of cases outside China, outside China would have been very much higher and it could still be. But we have the opportunity now to work aggressively to prevent that from happening. The decision to declare a FICC was taken primarily because of the signs of human to human transmission outside China. And our concern of what might happen if the virus were to spread in in a country with a weaker health system.

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W.H.O. has made several recommendations for all countries to prevent and limit the further spread of the virus. First, there is no reason for measures. I would repeat this. These are the recommendations. First, there is no reason for measures that unnecessarily interfere with international travel and trade. We call on all countries to implement decisions that are evidence based and consistent. WTO stands ready to provide advice to any country that is considering which measures to take. Second, we must support countries with weaker health systems served.

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Accelerate the development of vaccines, therapeutics and diagnostics. Our global connectedness is a weakness in this outbreak, but it's also our greatest strengths. We need strong public private partnership to find solutions. For combat, the spread of rumors and misinformation. To that end, we have work with Google to make sure people searching for information about Corona virus S.W. join formation at the top of their search results. Don't worry, it's not caught on. Social media platforms, including Twitter, Facebook, 10-cent and Tick-Tock have also taken steps to limit the spread of misinformation theives, review preparedness plans, identify gaps and evaluate the resources needed to identify, isolate and care for cases and prevent transmission.

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6 We call on all countries to share data sequences, knowledge and experience with W.H.O. and the world and Severns. The only way we will defeat this outbreak is for all countries to work together in a spirit of solidarity and cooperation. We're all in this together and we can only stop it together. So the rule of the game is solidarity, solidarity, solidarity. But we see this missing in many corners and that has to be addressed. I'm taking advice from a wide range of experts in this field as a complement to the emergency committee to ensure we understand the evolution of this outbreak and respond accordingly.

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Both the Corona virus and Ebola outbreaks underscore once again the vital importance of all for all countries to invest in preparedness, not panic. So far, more than 1 billion U.S. dollars has been spent trying to stop Ebola outbreak in DRC. By comparison, just 18 million dollars was spent on preparedness in Uganda. But when Ebola did cross the border to Uganda, they were ready and stopped it. This must be a lesson for the rest of the world. Last year, the Global Preparedness Monitoring Board published its first report, which concluded the world remains dangerously unprepared for a global pandemic.

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For too long, the world has operated on a cycle of panic and neglect. We throw money at an outbreak and when it's over we forget about it and do nothing to prevent the next one, even in the context of the current Ebola outbreak. Although we now have sufficient funding for the response. Funding for preparedness in surrounding countries has remained grossly inadequate to outbreak. This is dangerously shortsighted and frankly difficult to understand. If we fail to prepare, we are preparing to fail.

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That's exactly why W.H.O. has established the new division of emergency preparedness in March. We will bring together ministers of health, finance and foreign affairs at the Marrakesh meeting on health diplomacy to discuss what can be done to improve preparedness globally with Ebola. And Corona virus also illustrate that the current binary fiqh or noffke system is too bland an instrument for dealing with complex emergencies. We have a green light and the red light and nothing in between. So we need to have a yellow light like the traffic light, maybe other mechanisms.

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But yes, no, binary is not released suitable for emergencies. It's too restrictive, too simplistic and not fit for purpose. So we need to change, improve it. We are therefore exploring options for tools that would allow us to signal an intermediate level of alert without reopening negotiations on the text of the international rules regulations. And we will seek your support. As you can see to enty 19 was an extremely challenging yet productive year. 2020 promises to be no different to maximise the opportunities and rise to the challenges before us.

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The world needs a WTO that is agile, responsive and fit for purpose. And in our era of fake news and misinformation, more than ever, the world needs a WTO that brings reliable science and evidence to bear on the decisions we make about help for each of the three million targets we need to invest in W8 just core business norms and standards. Our new science division at headquarters reflects our commitment to being at the forefront of science and producing the world class and evidence based norms and standards.

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The world expects of us. In the past year, this new division has convened expert advisory committees on human genome editing and digital health as part of our new process for assuring the quality, timeliness and impact of norms and standards. We have created a new quality assurance department to standardize and optimize the planning methods, design and dissemination of 100 normative products to keep us accountable for delivering the GP deblois. We are also creating a new delivery unit which will track progress.

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Tripple billion targets. That will help us to be accountable to you. As I say at the member state briefing last week, transformation is a journey. We have come to the end of one part of the journey. The design period. But we have not come to the end of the road. The road ahead is now to focus on the implementation and on delivering results in countries. As you know, transformation involves five major areas of work. A new strategy, new processes and new operating model.

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A new approach to partnerships and new culture. In addition, there are two cross-cutting areas of work that enable the other five sustainable financing and a fit for purpose workforce capacity building. As member states, you have been closely involved in shaping the first major area for what our new strategy, which is the foundation for everything else. You have also shape the programme budget and the results framework that are fundamental to its delivery. This is the first GP W by the impact and outcome based.

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The first DPW in the history of W.H.O.. The other areas of work flow from the strategy and reflect the internal work we need to do at the secretariat to deliver your priorities. So the plan. Just one phrase result at country level. That's it. Our new planning process is a perfect example. The new process has resulted in the development of W, which just first set of country support plans and our first list of global public goods. This is a set of more than 300 technical products distilled from more than 1000 proposals that W.H.O.

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will produce this year and next. Based on what countries told us they needed, we are already rolling out our new resource mobilization process. Building on the launch of w.h was first investment case. Our first partners forum in Sweden and our new resource mobilization strategy. You have often called us to diversity, to diversify our funding base, and we we're working hard to do that. Many other processes are now being rolled out, including for performance management, not standard discriminations, data, research and more.

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Our new operating model took full effect as of the first of January this year. It brings new clarity to the roles of each level of the organization, new alignment in our structures and new ways of working to help us operate as one W.H.O.. We have also introduced cross-cutting teams to break down silos and foster integrated delivery of results in key areas like primary healthcare and anti-microbial resistance. We have strengthened in the areas you asked us to strengthen in data, emergency preparedness norms and standards and signs.

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Our region's apple or all also announced new structures that reflect the four pillars of the operating model deep functional. Reviews have been conducted in 81 countries across four regions. Last year, we made real progress on implementing our new approach to partnerships. First, we strengthened our relationship with traditional partners through the Global Action Plan for Healthy Lives and Well-Being for all and our engagement with civil society. Second, we brought a new approach to building high level political commitment at international and national levels, for example, through the U.N.

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General Assembly and the G20 and G7 and said we embarked on innovative partnerships that can help us reach groups we haven't reached before. For example, with FIFA and Google Feet, we are also working with Facebook and Pinterest to ensure their billions of users get reliable information about vaccines and other health issues. And finally, we launched our New Values Charter, which defines five values that underpin and guide our day to day work trust, professionalism, integrity, collaboration and care.

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We are now working to embed these values into everything we do as member states. You will continue to be involved intimately in transformation by keeping us accountable for the results we deliver. Thank you for your hard work on the results framework. The balance of the scorecard is groundbreaking within the United Nations system. We have asked a lot of you, but that's because we are asking a lot of ourselves. We're holding ourselves to high standards, trying to do things that have never been done before at W.H.O.

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. We are committed to continued transparency and continued accountability as regional directors, and I worked together to realize the bold ambition of the triple billion targets. Excellencies, dear colleagues and friends, you'll have a full agenda this week. So it's time for me to stop and let you get on with your work. I look forward to answering your questions. All of the issues you're considering will contribute to our pursuit together of the £3 billion targets and the Sustainable Development Goals.

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I wish to thank all member states and all our other partners for your support for W.H.O.. As we work together to promote help, keep the world safe and serve the vulnerable. The most important thing, especially at these difficult times, is I will repeat solidarity. Solidarity, solidarity. I thank you. Boku Shukran. Zealand. Shishy Muchas gracias. This perceiver and yougotto. Thank you.