19 May 2009

Joint Press Conference held by UN Secretary-General and World Health Organization Director-General, Margaret Chan

SG:: First of all, I want to thank Dr. Chan and her team at the WHO for organizing the World Health Assembly during these challenging times.

It's good to be back in Geneva. This morning I addressed the Conference on Disarmament, as it began its second session of this year. The Conference is at a critical juncture following a decade-long impasse. I am encouraged to note that we are seeing new momentum. There is a shift underway?from division to dialogue, from paralysis to progress.

I am particularly heartened that following the commitments of U.S. President Barack Obama and Russian President Igor Medvedev, both countries are now undertaking full-fledged negotiations in Moscow. We must capitalize on this emerging atmosphere of hope. Business-as-usual should not prevail in the Conference. I called upon its members to seize the moment and make much-needed progress this year.

Ladies and Gentlemen,

As you know, the bulk of my day has been devoted to global public health. I made global health one of my top priorities as Secretary-General, because health is fundamental to everything we do at the United Nations. Because we know that a healthier world is a better world, a safer world, a more just world.

The outbreak of the H1N1 virus is at the top of our list. In my many meetings today, three words shine through: Coordination. Solidarity. And vigilance.

The WHO under Dr. Chan's leadership has been guiding coordination efforts within the United Nations system.

I visited the JW Lee Strategic Health Operations Center otherwise known as the SHOC room. The SHOC is the nerve centre of WHO's global epidemic response to health crisis such as natural disaster, chemical emergencies, and of course, infectious disease outbreaks.

I also convened a productive meeting with representatives of about 30 vaccine producers. Our outreach this morning with the leaders was to discuss how best to ensure that vaccines get to those who need them.

I acknowledge the efforts made by vaccine manufacturers from developed and developing countries to work on new influenza vaccines in cooperation with the WHO. I appreciate the research, development and technology transfer already underway. I pledge to work with companies, governments and other partners to improve vaccine access in poor communities and countries. This will include work on vaccine pricing and distribution.

As I said in my address this afternoon, coordination is not an end in itself. The watchword is solidarity. Global solidarity. Above all, we must act in the interests of the poorest and most vulnerable. In addition to being noble, this is also in our self-interest given the nature of infectious diseases. And we must remain vigilant. We may be in a grace period with H1N1, but we are still in the danger zone.

Of course, this Assembly is about more than the immediate crisis. It is a time to focus on bigger picture health priorities. That is why I put a spotlight on maternal health. Maternal health is the mother of all health challenges. On the one hand, it is the slowest moving indicator of the Millennium Development Goals. On the other hand, it is the fastest way to build stronger health systems and a more secure world. Health begins at home and works its way up through society. Yet every minute of every day another mother loses her life giving life.

In an era of limited resources and growing demands, we must invest in areas that will reap the greatest dividends. Maternal health is a common sense investment for the common good. More than ever, we need to be imaginative about finding the resources to invest in the health and welfare of the world's people. In that regard, I am looking forward to meeting later today with the 8 initiatives principally responsible for providing innovative financing solutions for development. The I-8.

These are some of the leading creative thinkers in the world of development today. The aim is to share best practices, develop new ideas, and raise awareness about innovative finance as a key to achieving development goals. I look forward to hearing from them directly later today. With that, Ladies and Gentlemen, I will turn it over to Dr. Chan and then we will take your questions. Thank you very much.

The Director-General of WHO: Thank you very much, Mr. Secretary-General. It gives us great pleasure to have you to honour the World Health Assembly as our VIP guest speaker. Your commitment to global health is very much appreciated. Your commitment to achieving the Millennium Development Goals is most welcome and among all the goals as you have mentioned, the one that is lagging behind most is maternal mortality and we thank you for giving us your support. And of course, Mr. Secretary-General, your moral authority, your political influence, and your ability to mobilize resources, human, financial and also industry resources, is extremely vital in global health, and especially at this very critical time when the whole world is under the threat of an imminent pandemic caused by the new Influenza A H1N1. We very much appreciate your meeting with the CEOs and the heads of vaccine companies to encourage them to work with the global community to make sure that developing countries, poor nations, would not be left behind because of lack of means or because of the places where they were born. We are very committed to work with you and work with the international community, of course with the vaccine industry, to find solutions. And perhaps, Mr. Secretary-General, I will leave it at that and give more time to the media friends to ask questions.

Q: Good afternoon, Secretary-General. Nice to have you back in Geneva and it is much appreciated that you always find the time to talk to the press corps here. A warm welcome to Dr. Chan. I think this venue is preferable to the very comfortable annex next door to WHO Headquarters. My question, Sir, is specifically, what the United Nations is doing to help provide essential health for millions of people fleeing the conflict right now in Pakistan.

And I have a question for Dr. Chan. Your agency has just put an update in the website that after the initial year, perhaps you can produce up to 4.9 billion doses of vaccine, that is a radical revision upwards from the one to two billion we heard from Dr. Kieny two days ago, if you can elaborate on that, thank you.

The Secretary-General: In fact, this press conference is intended to focus on this virus and current public health issues. But since you have raised this issue, as you know, there are more than 1.2 million internally displaced persons because of this current situation in Pakistan. Just a few days ago, I had a meeting with President Zardari of Pakistan in New York and we discussed this issue. We are now mobilizing all necessary humanitarian agencies. The Office [for the Coordination] of Humanitarian Affairs is now taking charge of this. We have appealed urgently to the international community for the necessary humanitarian assistance. We will continue to do that. In fact, there are so many places at this time where people need urgent humanitarian assistance. Just be assured that the United Nations is doing all possible assistance, not only in Pakistan, but in Sudan, in Darfur, and elsewhere where they need our help. Thank you.

The Director-General of WHO: Yes, I think you are referring to the latest update and that is, those are recommendations coming from the SAGE Committee [Strategic Advisory Group of Experts (SAGE) on Immunization] to me and I accepted their recommendation. And of course, the world's influenza vaccine manufacturing capacity has tremendously increased in the last few years, thanks to the efforts of the industry and also government investments and that was part of the pandemic preparedness for the H5N1. Clearly we are reaping part of that benefit. At this point in time, the maximum production capacity of a trivalent seasonal influenza vaccine is about 900 million doses. Now, that is trivalent. It depends on whether indeed, if we are moving forward, we do need a pandemic influenza vaccine, if it is going to be monovalent, then clearly, that capacity would be increased by three times. And of course, you know whether or not the use of adjuvant would be considered, that is another factor which could also increase the production capacity by two to three times. Clearly, there are a lot of unanswered questions because we still have a lot of gaps in science. There are still uncertainties in science, but as we move forward, and we hope to be able to get more information to understand the virus itself and as well as to understand the full spectrum of the disease, and these would enable us to make more precise decisions as we move along. But John, I mean I have to say that is a very optimistic, you know, maximum capacity. It depends on how many doses, again, is required. Whether we need one dose or two doses, as in the case of H5N1, it was very clear that we need two doses in order to get the immunity. But for seasonal influenza vaccine, we need one dose. So a lot of factors need to be taken into account before we could tell you eventually what is the true capacity.

Q: Ma question sera dirigée vers Madame Chan. Madame Chan, actuellement, les autorités japonaises font part de cas de contamination hors communautaire, ce qui laisse penser qu'il y a un foyer de contamination autonome au Japon. Qu'attendez-vous pour demander au Comité d'urgence son avis sur un déclenchement de la phase 6?

The Director-General of WHO: Thank you for that very important question. What we are seeing is that, yes. I would like to thank the Government of Japan for their transparency and timely reporting of cases. Most of the cases we are seeing are, you know, cases in schools, happening in schools. To the extent we understand, most of the reported cases have contacts, either to students or family contacts. Yes we are now receiving information from the Government, and there may be some cases that they were not able to identify linkage with, you know, patients. But this is not unusual. This is also the situation we are seeing in the United Kingdom, and also, for a certain extent, at the early days, in New York in some schools. So we will continue to work with the Government and monitor the evolution of the situation. I know many of you are interested and watching very closely and would like to know when WHO is going to make the announcement of phase six. I would like to take this opportunity to share with you some of the reflections of my Member States during the World Health Assembly. It is important for us to remember the definition of the changes in phases in the current document by the name “Influenza Pandemic Preparedness and Response Plan”. The plan was constructed pretty much with H5N1 in mind. H5N1 has been threatening the world for many years and clearly that is a very toxic virus, the most toxic virus we have seen. For every 100 persons infected 50 to 60 of them died. And that has been, I mean, what is happening in the past few years. But the new influenza H1N1 virus we are dealing with is having a totally different clinical picture. We see outside of Mexico mostly very mild and self-limiting disease. We hope this will continue. Certainly, we do not want to see severe diseases. Another dimension my Member States have asked us to reflect and consider before we make the move to phase six. I need to be honest with you. I mean, you have been a very great partner, in the last three and a half weeks, to get the right information out. Phase six at this point in time, based on the document, is only considering geographical spread, and did not take into consideration other dimensions, whether or not the severity of the disease, whether or not the disease is causing disease in new population groups that the world is very concerned with. We are not seeing that. And if indeed we see some dangerous signals, of course, I will take into consideration and make the appropriate decision and make the appropriate announcement. But I must emphasize we are still in phase five.

Q: You talked about ensuring that poor countries also get access to vital medicines and vaccines. Can you tell us whether you are going to put in place any sort of vaccine purchasing mechanism that will allow that they have a minimum level of vaccines and anti-virals necessary. And for the Secretary-General, a quick question. One of the countries hardest hit by many health crises is Haiti. I believe that you are going to appoint former President Clinton as Special Envoy there today. Is that correct?

SG:: I'll answer your second question, yes that is correct. I have decided to appoint former President Bill Clinton as the Secretary-General's Special Envoy for the recovery of Haiti. As you may remember, I, together with President Bill Clinton, visited Haiti a couple of months ago. Both of us participated in the international donors conference which was held in Washington last month. The donor conference was a great success and my visit together with former President Bill Clinton was also very successful in a sense to raise the awareness of the international community and to keep this Haiti agenda high on the priority list. As you know, Haiti has been hit four times by very severe cyclones last year, which devastated completely the country. This country, which was just on the verge of trying to recover from their existing difficulties, had completely lost their capacity. Therefore, it would be very important to help this country. I have asked Professor Paul Collier, who is a very renowned person, to provide me [with] a report, and this international donors conference was based on Professor Paul Collier's report, who is the author of the “Bottom Billion”. I am going to continue to mobilize all international resources and I expect that President Clinton will lead this campaign. Thank you very much.

The WHO Director-General: Thank you very much, on the question of making sure that poor countries have access to drugs and vaccines, as you well know, WHO is not a funding agency, but it is, you know, I take it as part of my job to advocate for the poor. I am very happy to have the support of the Secretary-General. In the name of global solidarity, I have reached out to drug companies and vaccine companies and [will] start discussions with them. I would like to thank them for their cooperation. We will look at different mechanisms to ensure that poor countries are not left behind without access to both medicines, anti-virals as well as pandemic vaccine should that be required. Some companies have pledged donations and some companies have pledged to reserve a certain percentage of their production, and of course, for that, I need to get some resources through resource mobilization and also discuss with the vaccine companies. They agreed to a tier pricing so that reasonable and affordable price can be offered. The Secretary-General and I have a tough job. We need to find the money. We have reached out and talked to UNITAID, we talked to GAVI, we talked to the World Bank and some foundations. So far, in the name of global solidarity, I think the international community and donor partners are really coming along very nicely. Thank you.

SG:: I have a technical correction, it was not cyclone, but a hurricane in Haiti.

Q: Still, Mr. Ban Ki-moon on Haiti, how would the appointment of Mr. Clinton change for example the role of the troops on the ground, is there any change on that, especially regarding the commander's role. This is the first question regarding Haiti.

To Mrs. Chan, we heard today after the meeting that a network of laboratories from developing countries announced that they would reserve 10 per cent of their production of vaccine to WHO. How is this agreement exactly, if you can explain to us. Also, have you gotten any other examples such as this from the big pharmaceutical companies of reserving 10 per cent, 5 per cent, or giving a specific price. Otherwise, it looks a bit odd that you have your meeting, and actually the emerging countries are the ones offering the 10 per cent. Thank you.

SG:: Even with the appointment of a Special Envoy for the recovery of Haiti with President Bill Clinton, there will be no change in the United Nations commitment to help Haiti through the United Nations Stabilization Force in Haiti, known as MINUSTAH. MINUSTAH has been playing a crucially important role in restoring peace and stability. On the basis of restoration of peace and stability, Haiti could only be able to plan their national development strategy. They have their national development strategy very focused and prioritized, which has been very much welcomed and appreciated by the international community. On that basis, the international community pledged their financial and economic support and the United Nations will continue to use these two parallels, social economic development track as well as peace and stability track, in Haiti.

The WHO Director-General: This morning, as you well know, we met with about 30 CEOs of vaccine companies. These vaccine companies are from the developed as well as from the developing countries. I am sure you know it is not easy to have a cookie cutter approach with 30 companies. Each company needs to take into account their company objectives, but I can reassure you I have received very serious commitment to work with WHO from both vaccine companies in the north and in the south. Of course, different vaccine companies have different strategies. I promise to have follow-up meetings with them. As you well know, it is inappropriate to have a big roundtable discussion on a range of issues. I don't want them to get into trouble with (unclear).

SG:: I would like to say a few words about the situation in Sri Lanka, which may be of interest and concern to some of you. Over the past months, the situation in Sri Lanka has been a matter of grave and growing concern to me and the whole international community.

Hostilities appear now to have ended, and developments have entered a new phase.

I am relieved by the conclusion of the military operation, but I am deeply troubled by the loss of so many civilian lives. The task now facing the people of Sri Lanka is immense and requires all hands. It is most important that every effort be undertaken to begin a process of healing and national reconciliation. I listened very carefully to what President Rajapaksa said in his address to Parliament today. The legitimate concerns and aspirations of the Tamil people and other minorities must be fully addressed.

We must recognize the profound pain, particularly in communities affected by the conflict and among so many who lost loved ones to the violence. We urgently need to treat the wounds of a war that has alienated the communities in the Island for almost three decades.

To aid this endeavour, I will visit Sri Lanka this Friday, May 22 until Saturday, May 23. Mostly, I will be spending the whole day, Saturday 23 May, as I will be arriving almost at midnight on May 22, Friday. In particular, I will travel to hardest hit areas for a first-hand assessment of conditions on the ground. I remain concerned about the safety and welfare of the affected civilian population. That is why I am keen to visit the camps for the internally displaced. I will offer to the Government and people of Sri Lanka the partnership of the United Nations to address the huge challenges of early recovery, resettlement and rehabilitation of populations internally displaced by the conflict. I will also extend United Nations support in establishing the basic building blocks for peace through an inclusive political process.

Trust building must begin with putting in place international standards for the civilians in camps for internally displaced persons and reception centres under Government control.

A good start would be to provide the United Nations and its partners with full, unconditional access to all civilians. I will also urge the Government to expedite the screening and separation of former combatants from civilians and permit a more rapid release of IDPs from the camps. Families should be reunified on a much quicker basis.

As the displaced and long-suffering population strives to build a new life, serious steps must be taken to initiate early recovery as well as longer term reconciliation, rehabilitation and reconstruction. Efforts should necessarily be anchored on the Government's discussion with diverse Tamil groups and their representatives regarding the future political solution through a credible devolution of power.

In summary, progress must come in three critical areas. First, immediate humanitarian relief; Second, reintegration and reconstruction; Third, a sustainable and equitable political solution. Progress on all three of these fronts must move forward in parallel?and it must begin now. This will be my message in Sri Lanka. Thank you very much.

Q: Secretary-General, some UN officials accused the Government of Sri Lanka of causing a bloodbath, other officials of the UN said that they used heavy weapons and fired on civilians and this might constitute a war crime. Would you be prepared to ask for an independent investigation on these matters? Thank you.

SG:: It is true that, including myself, the United Nations system and senior advisors, wherever the opportunity arose, we have made this case very strongly. In my talks with President Rajapaksa in the past, over the last two months, we have made a very strong case to avoid civilian casualties and to not use heavy weaponry against the civilian population during their military operations. Wherever serious and credible allegations are made of grave and persistent violations of international humanitarian laws, these should be properly investigated. As you may know, the High Commissioner for Human Rights has already called for that investigation. I hope these allegations are handled through appropriate procedures.

Q: I wanted to ask a similar question as my colleague. The Secretary-General has mentioned that the international community is concerned, but the Human Rights Council here is Geneva has been unable to get the necessary number of votes of its members to convene a special session. So it seems that there is a bit of a lack of concern from the international community for what high-ranking UN officials have called killing fields and war crimes. Secondly, during your trip to Sri Lanka, will you try to gain access to this strip of land that your humanitarian staff has been blocked from in the last month? Thank you.

SG:: I expect that I will be able to visit the conflict zone, which the Sri Lankan Government officials told me had been liberated. I would like to have my first hand, on the spot, assessment of the situation myself. I am going to discuss this matter with President Rajapaksa. And for the procedures and handling these claims on the violation of international humanitarian laws in the Human Rights Council, that should be decided and determined by the members of the Human Rights Council.

Q: Secretary-General, I hope that in your term, you will come back to us and read a similar statement on the occupied Palestinian territories. My question is, what is your reaction to the meeting between President Obama and Prime Minister Netanyahu, and do you think there is any hope for a two-state solution, taking into account the OCHA report, the UN report on Gaza, the continued atrocities that were taking place, what is your hope, do you really have a realistic hope for a two-state solution? Thank you.

SG:: I am encouraged by the summit meeting between President Obama of the United States and Prime Minister Netanyahu of Israel. I also understand that President Obama will have a series of meetings with President Abbas of the Palestinian Authority. All these series of meetings, I hope will pave a good foundation for the continuing negotiations. The negotiations between Israel and the Palestinians and the Middle East peace process in general should begin from where they have left last time. This is the wish and aspiration of all the international community. Again there is a very important, fundamentally important wish and principle that there should be a two-state solution and there should be two countries living side by side in peace and security. That is what I am committed as Secretary-General to facilitate and push through a Quartet process and through my meetings with Arab and Israeli leaders in the future.

Q: Monsieur le Secrétaire général, j'ai une question. Peut-être que je me trompe. Est-ce que le fait d'aller tout juste après la fin de cette guerre, au Sri Lanka, ne donnerait pas une certaine crédibilité à ce Président qui quand même?ici à l'ONU, on a assisté à des civils qui ont crié - certains se sont immolés - pour demander votre aide? Et vous y allez tout de suite, maintenant: est-ce que ce n'est pas a posteriori donner un peu raison à ce Président qui a massacré pas mal de civils chez lui? Je vous remercie.

SG:: I hope there should be no misunderstandings whatsoever of the basic purpose of my visit to Sri Lanka. I made it quite clear I have three purposes in going to Sri Lanka. First and foremost, I will try to assess the situation of humanitarian conditions there and will try to mobilize humanitarian assistance to the needy people who need badly our assistance in sanitation, in health, in food and all other humanitarian aspects. Secondly, this integration and also development of the society damaged by this fighting. And thirdly, to help facilitate this political process through reconciliation, through dialogue, between the communities. This has short term and mid term and longer term purposes. As you may remember, over the last several months, I have been heavily and deeply engaged in promoting early resolution of these issues by dispatching my senior advisors, the Under-Secretary-General for Humanitarian Affairs twice, and I have dispatched my Chef de Cabinet twice already. My Chef de Cabinet is still in Sri Lanka. There is always opportune timing, and sometimes the visit myself at my level may be possible, may not be possible, depending upon the situation, how it develops. At this time, I think my visit would be able to create certain conditions where the United Nations can more engage in helping those people after this fighting is over. As we have been, even though we have been providing all necessary assistance, together with the ICRC. I will try to help the Sri Lankan people and Government so that all these political issues and reconciliation issues could be promoted as soon as possible. Thank you very much.