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Dr Shigeru Omi, WHO Regional Director for the Western Pacific, Talks at the Fifty-Sixth Session of the Regional Committee

Posted on: Monday, 19 September 2005, 06:00 CDT

NOUMEA, New Caledonia, Sept. 19 /Xinhua-PRNewswire/ -- The following is the speech of Dr Shigeru Omi, WHO Regional Director for the Western Pacific, who spoke at the Fifty-sixth Session of the Regional Committee on 19-23 September 2005 at Noumea, New Caledonia:

I would like to start today by discussing avian influenza A(H5N1) for obvious reasons. First of all, let me share a personal story.

Earlier this year, not long after the first human cases of avian influenza were reported in Cambodia, I travelled to Phnom Penh for discussions on this issue with the Prime Minister and the Minister of Health of Cambodia. The next morning, with a few hours to spare before my flight back to Manila, I decided to pay an unannounced visit to a poultry farm.

My WHO driver snaked his way along a series of twisting, unpaved roads, finally pulling up in front of a small farm.

This is the farm and the woman who owns it. She and I chatted for a while about her life and her farm.

She said: "I used to have so many chickens and ducks mingling together. But several months ago, all of a sudden, most of them died."

Pointing to the black chicken you see in the picture she said: "That's one of the few birds that survived."

After touring her farm, I thanked her for her time and then headed back to the main road to catch my plane.

By chance, we came across a speeding motorbike.

As you can see, there's a flock of live chickens tied across the back wheel. I became curious about their final destination. Although it was a bit dangerous, I told my WHO driver to pull up alongside the motorbike, roll down the window and ask the motorcyclist where he was going.

"The market," he shouted back. "About five kilometers away."

At the risk of missing my plane, I decided to follow him. After a bumpy ride down a few badly rutted roads, we arrived at the open-air market. I walked past vendors selling vegetables, fish and pork until I found a woman squatting on the cement floor of her vendor's stall.

Here's a picture of the woman. Working with her bare hands, she was plucking feathers and pulling out intestines. From the large bucket at her right, she scooped chicken blood into plastic bags for waiting customers.

If the birds she was handling had been infected with the avian influenza virus, I'm sure she would have picked up the infection.

She was a pleasant, hard-working woman. I asked if she knew anything about the recent outbreaks of avian influenza in neighbouring Thailand and Viet Nam. She said, "No."

My brief encounter in Cambodia illustrates the hard realities not only in Cambodia but throughout Asia and beyond. Recent outbreaks in Mongolia, Kazakstan and Russia have made it clear that avian influenza is not limited only to Asia but is spreading to the neighbouring region. All of this brings into sharper focus the great challenge we face as we gather here in Noumea.

We need to factor these hard realities in our discussions about strategies to combat avian influenza.

First, we need to keep in mind that in many of the rural settings in which poultry is raised there isn't sufficient capacity for proper surveillance.

Secondly, we need to realize that there is very little incentive for farmers to report suspected outbreaks. In fact, the fear that their flocks might be culled without compensation is a pretty strong disincentive to report an outbreak.

Thirdly, at the national level we need to improve further the capacity for surveillance and virological investigation. In addition, we need greater cooperation in sharing specimen samples.

Governments fighting avian influenza certainly have tried their best to tackle these problems. But we need more support from the international community to ensure we have sufficient human and financial resources to bolster surveillance, respond to outbreaks quickly, and to reduce transmission of the virus from poultry to humans, as well as prepare ourselves for a worst- case scenario.

As you may know, we took the initiative in setting up a meeting earlier this year in Kuala Lumpur with our colleagues from the Food and Agriculture Organization of the United Nations and the World Organization for Animal Health. This followed our participation in an earlier meeting in Ho Chi Minh City.

One issue that emerged at these meetings was the need for strong international support to help fight the disease. As a matter fact, I am pleased to report that U.S. President George Bush, speaking last week at the United Nations, announced a new International Partnership on Avian and Pandemic Influenza, which already has gained the support of a number of nations. As a result, donor countries are now better informed about the needs, and I hope the international community will offer ample assistance to the affected countries.

In addition, our office has developed, along with our colleagues at Headquarters and at the Regional Office for South-East Asia, an Asia Pacific Avian Influenza Action Plan.

As we discuss avian influenza, or think back to the 2002 outbreak of severe acute respiratory syndrome (SARS), we must keep in mind that we are likely to encounter in the coming years many other new emerging diseases.

At your direction, our office, in collaboration with the Regional Office for South-East Asia, has developed a biregional strategy for strengthening capacity for communicable disease surveillance and response. A final draft of the document, the Asia Pacific Strategy for Emerging Diseases, is on our agenda this week for your review and discussion.

And I'm sure this strategy will help our Member States strengthen their capacity to implement the revised International Health Regulations, which were adopted by the World Health Assembly in May of this year.

Let's move on to other communicable diseases.

The Regional Committee gave us a mandate some five years ago, asking that we reduce by one half the prevalence of tuberculosis and deaths due to disease by 2010. You also set interim targets for 2005 of 100% coverage for directly observed treatment, short course (DOTS), a case detection rate of 70%, and a treatment success rate of 85%. The Region is on track to meet the 2005 targets by year's end and its 2010 goals as mandated.

In the area of leprosy elimination, WHO is concentrating its efforts on a few endemic pockets and on post-elimination surveillance, with support from the Nippon Foundation.

The recent polio outbreak in Indonesia -- more than 200 cases over the summer months -- brought the disease back to the doorstep of the Western Pacific, which was declared polio-free in 2000. In order to maintain polio- free status in our Region, we have been working with Member States to strengthen the surveillance of acute flaccid paralysis and to increase polio immunization in areas identified as being at risk and vulnerable. Special focus has been placed on central and western China, Malaysia, Papua New Guinea and the Philippines.

The Regional Office also took the lead working with a donor Member State in our Region to provide $1.8 million in polio vaccine for Indonesia, a Member State of the South-East Asia Region.

In the area of immunization, the Western Pacific Region is entering an exciting new era. The Technical Advisory Group on the Expanded Programme on Immunization, which was the locomotive behind our successful effort to eradicate polio, has set ambitious goals for your consideration. The 15th TAG meeting held in Beijing in June of this year recommended not one, but two regional goals for 2012.

On one hand, it recommended the elimination of measles from our Region by that date.

On the other hand, it recommended a reduction in hepatitis B seroprevalence from its current level of between 8 and 10% to less than 2% by 2012. Our Region has the highest burden of hepatitis B, with more than 160 million chronic carriers and more than 350 000 annual deaths. With your approval, we will become the first WHO region to set a target date and a numerical goal for hepatitis B control.

HIV/AIDS continues to be a priority in our Region, where an estimated 1.5 million people were living with HIV/AIDS in 2004 and some 120 000 people are expected to die from AIDS this year. The "3 by 5 Initiative" has served as an important catalyst, energizing our international and regional partners and prompting most countries and areas to develop national treatment targets. We are still short of the goals laid out in the "3 by 5 Initiative", but our efforts to meet those targets have led to a marked increase in the number of people receiving antiretroviral therapy.

Prevention, however, continues to be a major priority. We must continue to promote the use of condoms in all situations in which high-risk sexual behaviour occurs and support harm-reduction programmes for injecting drug users, including needle exchanges and substitution treatments like methadone.

Let's move on to noncommunicable diseases, which continue to take an increasing toll on the people of the Western Pacific Region. These diseases - - such as diabetes, coronary heart disease and stroke -- have too often been regarded as issues of only personal responsibility rather than as public health problems. But we are slowly seeing change as more countries and areas in the Region develop policies for a national public health response.

For example, in Viet Nam, the Prime Minister has mandated a national NCD programme. A coalition of more than two-dozen government and nongovernmental agencies in the Philippines is working on NCD-related issues. Successive meetings of the Ministers of Health for the Pacific Island Countries have made NCD a top priority.

Also, for the first time in this Region, we are seeing a majority of countries and areas active in the collection of standardized data on NCD risk factors.

In the area of tobacco control, there is an overwhelming commitment in our Region to halt the deadly tobacco epidemic, demonstrated through the pledge of our Member States to implement the world's first tobacco control treaty. I'm pleased to report this year that 18 of 27 Member States have now ratified the WHO Framework Convention for Tobacco Control, with only nine more needed to reach 100% ratification. China was the most recent Member State to agree to ratify the Convention.

Some 3000 children under the age of five die every day in the Western Pacific Region from common neonatal conditions, pneumonia and diarrhoea. In my view, this is just unacceptable, especially since the majority of these child deaths could be avoided with readily available, cost-effective interventions. For many of these children, life hangs by a fragile thread. But their families simply don't have access to the most basic health services. Despite these alarming facts, child mortality receives little attention from policy-makers or in the media.

It is for this reason that child health is on our agenda this week as we look at the new Regional Child Survival Strategy, jointly developed by our office and UNICEF.

Health care financing is an important and complex issue in Asia and the Pacific, a region that contains more than one half of the 1.3 billion people in the world who live in absolute poverty. For these people, out-of-pocket total health payments are driving them even deeper into poverty. When out-of- pocket payments exceed 60%-70% of total health expenditures, as is the case in some of our Member States, there is a serious affect on equity and access.

To meet these challenges, WHO advocates in developing countries prepayment schemes through tax-based national health services and various health insurance mechanisms. This year, I'm happy to report that we have developed, in collaboration with the Regional Office for South-East Asia, a draft biregional strategy for health care financing for your consideration.

The migration of skilled health professionals is a major concern to a number of our Member States, particularly Pacific island countries and areas. Often, health professionals are trained in their home countries but soon accept higher-paying jobs abroad, leaving their local health systems short of critical personnel. The meeting of Ministers of Health for Pacific Island Countries held in Apia, Samoa, earlier this year recommended policy options and strategic actions to retain health personnel and manage migration, including the development of a Pacific Code of Practice for the recruitment of health personnel. WHO will help facilitate the development of the code of practice. Other areas of support to Member States will include support to strengthen the health workforce database, planning and management capacity, and research.

In the area of essential medicines, a Regional Rapid Alert System was launched in May of this year to combat counterfeit medicines by using the Internet to exchange information and coordinate action. It is the first system of its kind within WHO. Counterfeit medicines most severely impact the poor and those living in remote populations who are most at risk diseases and rely heavily on private pharmacies and drug sellers for their treatment. Recent investigations have found up to 90% of antimalaria drugs in some areas to be fakes.

Also for the first time, we are working with INTERPOL, the international police agency, and other law enforcement agencies to identify and close down counterfeiters. It is only through concerted action that we can stop counterfeit drugs from killing more innocent victims.

I'd like to briefly highlight one new project in our work. Last year, the Regional Committee asked that we produce, in collaboration with Member States and the Regional Office for South-East Asia, a draft policy framework reflecting the significance of psychosocial factors on health outcomes. We have started work on this policy and expect to have made significant progress before the next session of the Regional Committee.

You have likely taken note of the new format employed this year for the Regional Director's Report. This shorter, more reader friendly format was developed in response to your comments and recommendations at last year's session in Shanghai. In 2007, in collaboration with the Regional Office for South-East Asia, we will publish and update every four years a biregional reference work for health professionals, policy-makers, academics and others interested in the health in the Asia Pacific region.

Finally, I would like to thank all of you -- our Member States, Health Ministers and other government officials, our colleagues in our partner agencies and others too numerous to mention -- for your tireless efforts over this past year. Working together, we have made important progress on a very wide range of issues. So let us continue to get the job done together.

Request for interviews with Dr Shigeru Omi, can be forwarded to Ms Marilu Lingad, assistant/WHO public information office, at +68-7-951-636; email: lingadm@wpro.who.int; or to Mr Peter Cordingley, WHO public information officer/spokesman, at +68-7-951-635; email: cordingleyp@wpro.who.int.

Photo: NewsCom:http://www.newscom.com/cgi-bin/prnh/20040610/CNTH001LOGOAP Archive: http://photoarchive.ap.org/PRN Photo Desk, +1-888-776-6555 or +1-212-782-2840

World Health Organization

CONTACT: Ms Marilu Lingad of WHO, +68-7-951-636, orlingadm@wpro.who.int, or Mr Peter Cordingley, +68-7-951-635, orcordingleyp@wpro.who.int

Source: PRNewswire

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