Keynote Speech to the World Health Summit 2021 – 24 October 2021
UNICEF Executive Director Henrietta Fore
Excellencies, colleagues, friends … it is a pleasure to be with you here today for the World Health Summit.
I am honoured and inspired by the spirit of collaboration among experts in science, politics, business, government and civil society represented at this Summit.
On behalf of UNICEF, I am grateful for the opportunity to speak with you now at this critical moment in the global response to the COVID-19 pandemic – a pandemic which continues to impact so many aspects of our lives.
COVID-19 has hobbled economies, strained societies and undermined the prospects of the next generation. While children are not at greatest direct risk from the virus itself, they continue to suffer disproportionately from its socioeconomic consequences.
Almost two years into the pandemic, a generation of children are enduring prolonged school closures and ongoing disruptions to health, protection and education services.
That is why today I am here to discuss the health threats facing the 2.2 billion children around the world who UNICEF serves, and the opportunity we have to protect them.
Driven by new variants of concern, the virus continues to spread. While successful vaccination campaigns in the wealthy world have driven down rates of hospitalization and death, millions in low income countries await their first dose, and fragile health systems – on which children rely – are in jeopardy.
Yet the gap between those who have been offered vaccination against COVID-19 and those who have not is widening. While some countries have protected most of their populations, in others, less than 3 per cent of the population have had their first dose. Those going without vaccines include doctors, midwives, nurses, community health workers, teachers and social workers – the very people that children, mothers and families rely upon for the most essential services.
This is unacceptable. As a community of global health leaders, we have a choice. We can choose to act to reach more people with vaccines. This will keep people safe AND help to sustain critical services and systems for children.
Today, almost 7 billion doses of COVID-19 vaccine have been administered, less than a year since the first vaccine was approved. And we are now on track to produce enough vaccines to protect the majority of people around the world before the end of next year.
But will we protect everyone?
Will we send lifesaving, health-system-saving COVID-19 vaccines to the world’s doctors, nurses, and most at-risk populations?
Will donors continue to fund ACT-A and COVAX sufficiently to procure and successfully deploy the tests, treatments and vaccines needed to end the pandemic?
Or will the costs of in-country delivery fall on struggling economies so that they are forced to cut other lifesaving health programmes such as routine childhood vaccinations?
Will we stand by as the lowest-income countries, with the most fragile health systems, carry on unprotected – risking high death rates due to shortages of tests, treatments and vaccines? Or will we invest so that community health systems everywhere can withstand further waves of the virus, and bounce back from future shocks?
Will we allow new variants of the virus to flourish in countries with low vaccination rates? Or, will we reap the benefits of global cooperation to defeat this global problem, together?
The world has learned that financing for prevention, preparedness and response is insufficient and not adequately coordinated. And that is a vital lesson.
But even more fundamentally, we have learned that the underlying strength of the health sector in general is a critical factor in a country’s ability to weather a storm like COVID-19.
After all, what good are vaccines if there is no functioning public health system to deliver them?
How do we hope to contain outbreaks if there are not enough trained and paid healthcare workers?
This pandemic has been crippling for high income countries where average spending on healthcare per capita exceeds $5,000. So, it is hardly surprising that it is causing critical strain in lower-income countries where the average per capita expenditure on healthcare each year is less than $100.
The past 22 months have shown us that even as we battle immediate threats such as a pandemic, we must also ensure continuous access to essential health services. If we do not, there will be an indirect increase in morbidity and mortality.
As COVID-19 took hold of the world, healthcare workers serving pregnant mothers, babies and children faced unthinkable choices. As COVID patients gasped for breath, desperate for oxygen, mothers and babies needed it too. As wards filled up with virus victims, staff were not free to help the very young. As health budgets were stretched to the breaking point, routine healthcare began to go by the wayside.
These are some of the reasons why more than twice as many women and children have lost their lives for every COVID-19 death in many low and middle-income countries. Estimates from the Lancet suggest up to nearly 114,000 additional women and children died during this period.
I greatly fear that the pandemic’s impact on children’s health is only starting to be seen.
While the pandemic has underscored that vaccination is one of the most cost-effective public health interventions, we have already seen backsliding in routine immunization. In 2020, over 23 million children missed out on essential vaccines – an increase of nearly 4 million from 2019, with decades of progress tragically eroded.
Of these 23 million, 17 million of them did not receive any vaccines at all. These are the so-called zero-dose children, most of whom live in communities with multiple deprivations.
Here are some of the most urgent choices we could make to address these problems:
Governments can share COVID-19 doses with COVAX as a matter of absolute urgency and resist the temptation to stockpile supplies more than necessary.
Governments can also honour their commitments to equitable access and make space for COVAX and other parts of ACT-A at the front of the supply queue for tests, treatments, and vaccines as they roll off production lines.
Manufacturers can be more transparent about their production schedules and make greater efforts to facilitate and accelerate equitable access to products. This will help to ensure that COVAX and ACT-A get supplies faster.
Governments, development banks, business and philanthropy can target strategic, sustainable investments in building robust and resilient primary healthcare services – embedded in each and every community.
We can and we must choose a path ahead that is equitable, sustainable and rooted in the principle that every human being, young and old, rich and poor, has the right to good health.
And there is good reason to believe that now is the time to set ourselves upon that path.
A look back at history shows us that global threats and crises that challenge multiple interests and equities have a way of pulling together diverse partners to solve shared problems. Indeed, it is out of some of the most tragic crises that the world has found some of the best solutions.
I believe now is such a time. We have a historic opportunity to both end the COVID-19 pandemic and set out on the road towards eradicating preventable diseases, ending avoidable maternal, newborn and child deaths, and building a strong foundation for community health that will serve this generation and the next.
We can and we must seize this moment together.