Good morning, good afternoon and good evening,
First to Barbados, where last week, I had the honour to join leaders from Small Island Developing States in Barbados and agreed the 2023 Bridgetown Declaration on Noncommunicable Diseases and Mental Health.
Noncommunicable diseases such as cardiovascular disease, cancer and diabetes are responsible for more than 70% of all deaths globally.
Nowhere is the threat of NCDs felt more acutely than in small island states.
A new WHO report shows that 8 of the 15 countries with more than a 30% risk of premature death from cardiovascular disease, cancer, diabetes, or chronic respiratory disease are small island countries.
And the 10 countries with the highest obesity rates globally are all small islands in the Pacific, where over 45% of adults live with obesity.
Mental health conditions are also common in small island states.
The threat of NCDs is exacerbated by the climate crisis.
Small island states represent 1% of the world's population and economy and emit less than 1% of greenhouse gases, but are disproportionately and severely affected by climate change and natural disasters.
We cannot afford to ignore the crippling impact of these colliding threats.
The Bridgetown declaration is a collective call on all countries to support small island states to address the impact of NCDs and mental health.
And it is my call to all leaders and partners to extend their support to them.
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One of the main risk factors for NCDs is poor nutrition, especially in the earliest stages of life.
Inadequate breastfeeding increases the risks of childhood obesity, sudden unexplained infant death, leukaemia, and maternal diabetes and cancers.
WHO recommends exclusive breastfeeding for the first six months of life, and continued breastfeeding for two years or beyond.
In the decades following the Second World War, aggressive marketing of breastmilk substitutes led to significant reductions in rates of exclusive breastfeeding.
To respond to this threat, in 1981, WHO Member States adopted the International Code of Marketing of Breast-milk Substitutes.
The Code helps to protect health, nutrition, and development in the first years of life, so that parents and caregivers receive sound medical advice, untainted by commercial interests.
Since the Code was introduced more than forty years ago, there has been clear progress.
Over 70% of countries have enacted legislation that puts in place at least some of the Code’s provisions.
In the past decade, the prevalence of exclusive breastfeeding has increased globally by ten percentage points, reaching 48% of children under 6 months – the highest level since we started measuring it in the 1980s.
But many challenges remain.
Little progress has been made in high income countries, where the Code has not been made into effective legislation and, as a result, exclusive breastfeeding rates are stagnating.
Manufacturers of breastmilk substitutes are also using increasingly sophisticated marketing tactics, including targeted ads on pregnant mothers’ mobile phones, clandestine participation in online baby clubs, or coaxing mothers to market formula to one another.
Yesterday, experts from around the world met here at WHO headquarters in Geneva for the first Global Congress on the implementation of the International Code of Marketing of Breast-milk Substitutes.
The meeting is bringing together delegates from around 130 countries to discuss how to strengthen legislation to counteract industry tactics, and give more children the best start to life.
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Now to Sudan, where two months of violence have severely impacted the delivery of health services, leaving 11 million people in need of health assistance.
About two thirds of health facilities in affected areas are out of service. Repeated attacks on health facilities, medical warehouses, ambulances and health workers are preventing patients and health workers from reaching hospitals.
WHO has verified 46 attacks on health care since the start of the fighting.
Critical services have stopped, including for trauma and emergencies, mothers and children, survivors of gender-based violence, and malnutrition and non-communicable diseases.
There are significant challenges in controlling ongoing epidemics of measles, malaria and dengue in Sudan.
The risk of epidemics will only increase given the upcoming rainy season, limited access to safe water, population displacement, and limited capacity to detect outbreaks early.
Last week, WHO released a new funding appeal requesting 150 million U.S. dollars to meet increasing health needs of people affected by violence in Sudan, and those who have fled to the neighbouring Central African Republic, Chad, Egypt, Ethiopia and South Sudan.
I am deeply concerned for the health and well-being of the people of Sudan, and WHO is exploring all avenues for providing the support they need.
But we cannot do it alone. There is an urgent need for solidarity from the international community to enable WHO and our partners to continue providing lifesaving interventions over the next six months.
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Finally to Peru, which has declared a state of emergency over its worst recorded outbreak of dengue.
Since the beginning of this year, almost 150,000 suspected cases have been reported, more than half of which have been laboratory confirmed.
The number of cases reported so far this year is more than double those reported in the same period last year, and more than four times higher than the average of the last 5 years.
Although fewer than one percent of cases are of the life-threatening severe kind of dengue, these cases are putting a heavy burden on Peru’s health system.
In response, WHO is supporting Peru to strengthen vector control, surveillance and clinical management, through the training of more than 6000 health workers.
The incidence of dengue has grown dramatically around the world in recent decades, especially in the Americas, which reported 2.8 million cases and 1280 deaths last year.
WHO is preparing for the very high probability that 2023 and 2024 will be marked by an El Niño event, which could increase transmission of dengue and other so-called arboviruses such as Zika and chikungunya.
The effects of climate change are also fuelling mosquito breeding and the spread of these diseases.
To respond to this threat, WHO last year established the Global Arbovirus Initiative, which aims to strengthen the world’s ability to prevent, detect and respond to outbreaks of these diseases.
Many of the same capacities that countries established for COVID-19 can also be leveraged for dengue and other diseases.
And many of the actions that can prevent dengue are the same actions that can help to prevent so many other diseases, including climate action.
Fadéla, back to you.