My friend Kamel Ghribi,
Excellencies, honourable ministers, dear colleagues and friends,
Thank you for the invitation to be with you today.
A few weeks ago I was in the Democratic Republic of the Congo, visiting communities affected by the Ebola epidemic in the northeastern province of Ituri.
At one meeting, a community leader asked me a question.
He said: Why does the world care so much when we die of Ebola, but not when we die of everything else?
He listed them. Malaria. Childbirth. Diarrhoea. Measles. Hunger. And conflict.
It’s a fair question. I did not have a comfortable answer for him.
For the people of that region, Ebola is one danger among many. And it is not the largest one.
This epidemic is unfolding in one of the most insecure parts of the African continent.
Armed groups operate across the region. Populations have been displaced repeatedly.
Health facilities have been damaged, looted and abandoned, and health workers have been threatened and killed.
And years of violence have produced something that is harder to see, and harder to repair: a deficit of trust.
When people have been failed repeatedly, they do not automatically believe what they are told.
So when responders arrive and ask families to change how they bury their dead, to send a relative to a treatment centre, or to participate in a clinical trial, some refuse.
That refusal is sometimes described as resistance. But it’s an entirely understandable response to experience.
The trust deficit makes the response slower, more dangerous and more expensive.
Insecurity does not simply coexist with the epidemic. It drives it.
It blocks access to affected areas. It interrupts contact tracing. It scatters populations, and the virus travels with them.
This is the clearest possible illustration of a principle written into the WHO Constitution eighty years ago:
The health of all peoples is fundamental to the attainment of peace and security.
There is no health without peace. And there is no peace without health.
This is not a new observation. But it is one the world keeps having to relearn.
It is no coincidence that the 1918 influenza pandemic erupted during the First World War.
It is no coincidence that polio re-emerged in Gaza, twenty-five years after the last case.
It is no coincidence that Sudan is experiencing outbreaks of measles, dengue, malaria, diphtheria and cholera simultaneously.
And it is no coincidence that the last strongholds of polio are in the most insecure regions of Afghanistan and Pakistan.
War and disease are old friends.
In the Napoleonic wars, and in the American Civil War, more soldiers died from disease than in battle.
Conflict causes direct injury and death. But its longer effect is systemic.
Health systems collapse. Immunisation stops. Surveillance goes dark. Supply chains break. Mental health deteriorates across entire populations.
And these effects persist long after the shooting stops.
There is also a newer and more troubling pattern:
The deliberate targeting of health workers and health facilities.
So far this year, WHO has verified 1178 attacks on health care in 20 countries and territories, causing 931 deaths and 1574 injuries among health workers and patients.
In Gaza, Sudan, Myanmar, Ukraine and elsewhere.
A hospital is not a military target. A nurse is not a combatant. An ambulance is not a weapon.
These are not aspirations. They are obligations under international humanitarian law.
In every one of these places, WHO works to relieve suffering.
But what those populations need most is not the aid we deliver. It is peace.
The best medicine is peace.
We will stop the Ebola outbreak in the DRC, just as we have stopped every previous Ebola outbreak.
But stopping an outbreak, and then doing nothing to prevent the next one, is not a strategy.
It is a habit. And it is an expensive one.
We call this the cycle of panic and neglect.
The world reacts to a crisis. Money appears. Attention arrives.
Then the crisis passes, attention moves elsewhere, and the lessons go unlearned.
We saw this after COVID-19, which killed an estimated 20 million people and wiped more than 10 trillion dollars from the global economy.
It is remarkable how quickly the world has moved on. The cycle of panic and neglect is repeating.
The way to break that cycle is to invest now in preventing and preparing for future emergencies.
Principally, that means investing in strong local and national health systems, based on primary health care.
The reason Ebola is dangerous in eastern DRC is not only the virus. It is the weakness of the health systems in the affected communities.
Part of the reason for the size of this outbreak is that it went undetected for months.
If a health centre can diagnose, isolate and report a case quickly, an outbreak can be prevented from becoming larger.
If it cannot, the world ends up spending vastly more, later, under far worse conditions.
Health systems are the foundation of health security. They are also, at present, one of the world's largest unaddressed vulnerabilities.
WHO estimates that more than half the world’s population lacks access to one or more essential health services, and 2 billion people face financial hardship from paying for care out of their own pockets.
In the past year, many countries have learned, painfully, that they cannot rely on international aid – in Africa in particular.
Development assistance for health has fallen sharply. Major replenishments have missed their targets. Programmes have been interrupted with very little notice.
For some countries, that meant clinics closing and treatment stopping.
This is not a temporary disruption. It is a structural shift, and it requires a structural response.
Something significant is emerging from that recognition.
Across Africa there is now a serious movement toward health sovereignty, built on domestic resources.
That is the spirit of the Accra Reset, led by His Excellency President John Mahama of Ghana.
The Accra Reset reframes health financing around country ownership, accountability and co-investment, rather than dependency.
No country can build a resilient health system on unpredictable external financing.
Sovereignty here does not mean isolation. It means countries controlling their own priorities, resources and delivery.
WHO is supporting that transition. We help countries strengthen public financial management, expand domestic revenue for health, and translate national health plans into credible investment propositions.
Just as countries are changing, so is WHO.
Over the past year, we have been through a difficult transition.
But let me say clearly: WHO is not an organization in crisis. We have stabilized and are moving forward.
We are emerging as a leaner organization, focused on our core mandate and comparative advantage.
But WHO is only one part of the wider global health architecture has served the world well, but must also change.
It is fragmented. Too many institutions, too many vertical programmes, too many separate reporting requirements, too many parallel systems.
Every one of them was created for good reasons, but the time for change has come.
A health minister should not spend more time managing partners than managing the health system.
The principle for reform is straightforward.
Countries set their priorities. Everyone else aligns behind them, in financing and in technical support.
That is not a new idea. But we have rarely honoured it in practice.
Excellencies,
The community leader who questioned me in DRC was asking whether the world sees him only when he becomes a threat to it.
Our answer has to be no.
Build systems that serve people in ordinary times, and they will protect all of us in extraordinary ones.
Thank you.