Director General, Regional Director, Minister Heunicke, honourable ministers, distinguished guests, ladies and gentlemen.

I am honoured once again, to have the opportunity to speak to you at this, the 69th session of the WHO Regional Committee for Europe. Time goes by quickly and while preparing for this meeting I realized just how quick it goes by, as this is now my fifteenth year as Patron of the WHO Regional Office for Europe and for 10 of those years I have had the pleasure of working together with the Regional Director, Dr Zsuzsanna Jakab.

Impressive progress has been made in health and well-being across the Region over this time, and Health 2020 has proven to be a powerful tool to build political consensus and drive inter-sectoral action for health. Indeed, Health 2020 has placed the Region in an advantageous position to deliver on the 2030 Sustainable Development Agenda, and leave no one behind in health, or in life. 

The timeframe the world set of 15 years to reach the Sustainable Development Goals is ambitious, and time, as I’ve just said, moves quickly. This year, you will be discussing steps to strengthen health equity, which has the potential to accelerate progress towards health for all and remove unfair, avoidable differences in people’s circumstances that places limits on lives and prevents individuals from achieving their potential.

It is unacceptable that babies born in households and neighbourhoods with low levels of resources fail to thrive. It is intolerable that poverty, unsafe homes, social isolation, precarious work and limited access to quality, affordable health services shorten people’s lives. It is a tragedy that exposure to such inequalities can shorten a woman’s life expectancy by up to 7 years, and men’s by up to 15. 15 years - so much experience, opportunity, wisdom, laughter, love -  cut short.

We must improve health equity because as Professor Marmot says, “it is the right thing to do”. It is also the smart thing to do, because health inequity challenges fiscal sustainability, leads to labour market losses, a reduction to the tax base, and increasing pension and social welfare costs. And if further arguments were needed, I would add that it is the sustainable thing to do; strengthening Europe’s goals of prosperity and peace.

Last week in London, WHO launched its European Health Equity Status report, calling out the policy decisions that compound health inequities, and the five risk factors that are holding people back. A key finding that reducing inequities by 50% would produce financial benefits to countries of up to 4.3% of gross domestic product clearly supports the economic case for health equity. The report provides the data and tools that can guide member states in tackling health inequities and produce visible results in a short timeframe. I hope that your discussions in the coming days will also reflect on the experiences and solutions discussed in June at the Ljubljana Conference on Accelerating Progress for Health Equity.

The urgency of improving health equity becomes clearer when we recognize that while the European Region is on track to achieve the SDGs overall, the lack of progress on reducing health inequities means we are falling behind on SDG 10 (reduced inequalities) and SDG  3 (better health and well-being for all).

WHO’s current programme of work, “GPW13” goes to the heart of the issue, seeking to ensure that 1 billion more people benefit from Universal Health Coverage. This requires intensified efforts to provide accessible primary health care, covering such essential services as immunization and sexual and reproductive health and rights.

Throughout my years as Patron, advocating for immunization has been a priority, and a personal conviction.  Every child born deserves an equal opportunity to lead a healthy life, and this includes receiving all recommended vaccines. We have safe and effective means to eliminate many diseases, including measles and cervical cancer, thereby preventing suffering from diseases that can permanently alter or take lives.

The mere fact that children and adults in the WHO European Region are still suffering and dying from measles demonstrates that we need to work differently and do more to reach out to all corners of societies with fact-based information about vaccines and tailored services. With immunization playing such a key role in achieving 14 of the 17 Sustainable Development Goals and as a cornerstone of Universal Health Coverage and strong primary health care, it is crucial that we make the necessary investments in expanding access to immunization in every corner of every community.

Across the life-course, sexual and reproductive health services, delivered and integrated at the primary care level, also have the potential to dramatically improve lives. Yet the inclusion of such services across Europe is uneven and often fragmented. Unmet family planning needs range from 5% to nearly 23% across the Region, and are highest among those with low socio-economic status, migrant populations and adolescents.

In too many instances there is a failure to deliver quality and comprehensive access to information and services. Countries and health systems that do not prioritize sexual and reproductive health and rights, that do not empower girls or address gender equality, will struggle and likely fail to meet the SDG targets.

I urge you to intensify efforts to smooth the path towards expanding coverage and providing universal access to sexual and reproductive health services, so girls and women can contribute fully and equally to sustainable development and achieve their own full potential.

Poor-quality health care imposes additional expenditures on households and health systems - The Lancet recently reported that if high-quality health systems were in place in 137 low and middle-income countries, maternal deaths would decline by half. Ensuring access to quality of care for women not just during pregnancy and childbirth but, across the life-course will improve the health, well-being and future of children, families and countries.

Tackling the complexity of sexual and reproductive health and rights in constantly changing political contexts is far from easy. Yet we have excellent examples of countries in the Region that are implementing right based policies and it is important to learn from these countries and share best practices such as good conditions for parenthood and the efforts made in engaging men in developing the way forward. The WHO Europe Action Plan for Sexual and Reproductive Health is helping to accelerate progress here. 

In this context, I would like to draw your attention to the fact that 2019 marks the 25th anniversary of the Cairo International Conference on Population and Development, commonly known as the ICPD. The ICPD Programme of Action, endorsed by 179 Members States, marked a turning point by putting people’s rights and dignity at the very heart of sustainable development. It emphasizes that sexual and reproductive health is a fundamental human right and that empowering women and girls is one of the most effective ways to improve well-being for all.

In November this year, the governments of Kenya and Denmark together with UNFPA are co-convening the Nairobi Summit on ICPD25, Accelerating the Promise. This high-level conference seeks to mobilize the political will and financial commitments we urgently need to finally and fully implement the ICPD Programme of Action. These commitments focus on achieving zero unmet need for family planning information and services, zero preventable maternal deaths, and zero sexual and gender-based violence and harmful practices against women and girls. I look forward to seeing many European Member States represented in Nairobi.

Through implementing Health 2020; improving health equity and the wider conditions that influence health; and building effective, integrated primary health care covering immunization and sexual and reproductive services, I am certain you will indeed extend universal health coverage, deliver on GPW 13, and speed progress towards achieving the Sustainable Development Goals.

Ultimately, this means you will improve lives, hand-in-hand with the child, young person, woman or man who risk falling behind. You will enable people in the European Region to prosper and thrive.

Finally, I cannot conclude today without saying a few words about Dr Zsuzsanna Jakab. It has been a privilege and pleasure to work with her over the past 10 years in advocating for better health, for all, across the European Region. We have travelled widely together, visiting many of your countries, listening, learning and discussing.

Our shared aim has been to enhance action for better, more equitable and sustainable health and well-being in Europe and beyond. This has been a truly enriching experience for me; both personally and professionally. Under Zsuzsanna’s remarkable and inclusive leadership the European Region has made enormous progress and she has also paved the way for that progress to continue.

Thank you for your ceaseless energy, drive, commitment and care. Zsuszanna – you will be missed.  

Once again, you have an ambitious agenda for the coming days, and I wish you success in your discussions and deliberations.

Thank you.