Verbal Statement by Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean at the 72nd Regional Committee for the Eastern Mediterranean

15 October 2025

Your Excellencies, Ministers of Health and Heads of Delegations,

Director-General,

Ladies and Gentlemen,

A warm welcome to you all.

Thank you for joining the 72^nd session of the Regional Committee-WHO's highest decision-making body in the Eastern Mediterranean Region.

As always, we gather to shape political commitments that improve health for the 750 million people of our Region.

But this year is different.

We meet amid profound uncertainty for our Region and for global health.

Wars, disasters, displacement, and declining aid are compounding one tragedy upon another.
We have all seen the reports.

Starving people killed as they seek food.

Women giving birth without safety or dignity.

Children left unprotected, without vaccines.

Medicines running out, hospitals overflowing, and infections spiralling.

Not only are we failing to provide health, but health itself is under attack.

Two-thirds of all global attacks on health care last year occurred in our Region.
Hospitals-once sanctuaries-are turning into sites of death.

If we do not change course, these will be remembered as dark times.

But there are those of us-including the people in this room-who still believe in the mandate of this Organization.

Who still believe in the right to health for all.

And we are many.

So, to the community workers on the frontlines of polio eradication in the far reaches of Pakistan and Afghanistan,

to the Sudanese physicians risking their lives to provide emergency care in El Fasher,

and to those safeguarding the treasured Marshlands of Iraq from climate shocks-

to them, I say:

we are with you, we support you, and we will do everything we can to enable your work.

And to you, Excellencies:
Your leadership made possible the historic WHO Pandemic Agreement,
and the 20 per cent increase in assessed contributions for two consecutive biennia.

Your countries' generous pledges to polio eradication efforts-Saudi Arabia, the UAE, Kuwait, Qatar-show that our Region is determined to deliver one of history's greatest public health milestones.

And regional solidarity goes well beyond polio. Voluntary contributions from Member States of our Region to the emergencies programme reached 87.5 million USD in 2024.

So yes-we are in crisis-but multilateralism is alive and well.

Excellencies,

Our Region has answered the call of this defining moment-rolling out the Regional Strategic Operational Plan and the three flagship initiatives you endorsed last year.

Today, I will share a snapshot of our progress.

I invite you to read my annual report for the full picture.

I begin with polio.

Wild poliovirus in Afghanistan and Pakistan is on the decline.

And vaccine-derived outbreaks have been contained in places like Gaza, and Egypt.

Political commitment remains strong.

Support from Member States and global partners is bringing eradication within reach.

The leadership of the Regional Sub-committee for Polio Eradication and Outbreaks has been critical to these efforts.

Access restrictions remain the main barrier to stopping polio in our Region.

Beyond polio, countries have made important gains against other communicable diseases.

Regionwide, 85 per cent of children have access to routine immunization services.

Over 30 million treatments have been delivered for neglected tropical diseases.

And Sudan became the first country in our Region to introduce the malaria vaccine.

Egypt controlled hepatitis B, was certified malaria-free, and-together with Bahrain, Iran, and Oman-eliminated measles and rubella.
Jordan became the first country worldwide verified for leprosy elimination.

While Pakistan launched a hepatitis C elimination programme, and was certified free of trachoma.

In total, 16 countries have achieved elimination targets for at least two diseases-a remarkable achievement, and we look forward to completing WHO certification together.

Progress also advanced on noncommunicable diseases and mental health.

Saudi Arabia and Oman were certified for eliminating harmful trans fats,

while 14 countries adopted NCD best-practice policies.

Tobacco control strengthened with plain packaging in Oman and Saudi Arabia,

graphic warnings in Tunisia and Iraq, a full advertising promotion and sponsorship ban in Morocco, and a tax increase in 6 countries.

Mental health services expanded in 14 countries, increasingly integrated into primary care.

While mental health and psychosocial support services were provided as part of emergency response efforts in Afghanistan, Lebanon, Palestine, Somalia, Syria and Sudan.

Over 150 cities are now monitoring air quality, just as seven countries integrate health into national climate change planning.

Countries strengthened health system resilience and equity-

developing and costing universal health coverage packages;

expanding primary health care-oriented models;

and adopting hospital strategies that embed resilience, sustainability, and fairness into service delivery.

We have supported Ministries of Health in Iraq, Sudan, Syria and Yemen through health system recovery processes.

And have prepared for long-term recovery in Gaza after the cessation of hostilities.

We also supported health systems reform in Djibouti.

Advancing the health of refugees, migrants, and displaced people remained a regional priority.

Member States were supported to ensure access to essential services.

A new joint initiative with IOM and UNDRR linked climate adaptation with disaster risk reduction.

And a cross-border simulation exercise was conducted to strengthen health care delivery along migration routes.

Countries across the Region are advancing national digital health strategies.

Our Regional Network of Institutions for Evidence and Data to Policy

is turning isolated data into shared intelligence.

Egypt established an exemplary national programme for clinical care and public health guidelines.

More countries are adopting ICD11, with Saudi Arabia receiving the 77^th World Health Assembly's Global Excellence Award for its national mortality data platform.

Afghanistan, Somalia, Yemen have enhanced their use of the DHIS2 health information system, and Iraq now uses it in nearly 1,900 facilities for reliable, real-time immunization data.

Across our Region, WHO CCs are supporting ethical, equitable and impactful policies, while WHO is building regional capacity for clinical research.

Our three flagships-on access to medicines, health workforce, and substance use-are already delivering measurable impact.

On access to medicines, countries are strengthening regulatory systems, with the ambition of attaining the next maturity level of the Global Benchmarking Tool as soon as possible.

This boosts regulatory credibility, market access, local manufacturing, and health security.

Saudi Arabia's regulatory authority has reached maturity level 4 for vaccines and medicines and is preparing to become the Region's first WHO-Listed Authority by 2026.

Egypt's regulatory authority has reached WHO maturity level 3, with Morocco, Pakistan and Tunisia close behind.

Many countries are enhancing their production capacities and raising manufacturing standards.

Supply systems are also improving through a new regional pooled procurement mechanism, and digitized warehousing.

And inter-regional collaboration is advancing through the North African Regulatory Harmonization initiative, which brings together Algeria, Egypt, Libya, Mauritania, Morocco and Tunisia to strengthen regulatory convergence.

On health workforce, the Region faces a projected shortage of 2.1 million health workers by 2030.

Countries are developing strategies to strengthen primary care, transform education, and enhance governance and regulation.

The Commission on Investing in Health Workforce will identify gaps and best practices and recommend further actions.

There are promising bilateral initiatives among our countries.

And regional dialogue and collaboration is being strengthened, including with the League of Arab States and the Arab Board of Health Specialties, as well as through the Regional Health Alliance.

On substance use, 6.7 per cent of people aged 15-64 in EMR have used drugs in the past year.

And age-standardized DALY rates from drug use disorders have increased by 20 per cent since 1990.

Thanks to our Region's advocacy, the 6^th Global Ministerial Mental Health Summit in Doha and the UNGA High-Level Meeting on NCDs and Mental Health last month addressed substance use for the first time.

Together with UNODC and the Regional Health Alliance, WHO is supporting countries to address this important public health challenge at the national level-by expanding treatment, integrating care into primary health services, and scaling up prevention efforts.

We have launched a Regional Coalition to engage civil society and people with lived experience of substance use, a research blueprint to set priorities, and a Strategic Advisory Group to support evidence-based policies and services.

Our network of WHO CCs for Substance Use is also growing:

the Abu Dhabi centre hosted the first regional policy dialogue to launch the flagship initiative, while the centre in Iran supports epidemiological research and global advisory work.

New tools-including the Substance Use Atlas, health worker trainings, and school-based programmes-are strengthening accountability and protecting young people.

Pakistan and Egypt have initiated opioid substitution treatment,

while Qatar, Somalia and Tunisia are developing multi-sectoral strategies.

Now on health emergencies.

In a Region bearing one third of the world's health emergencies, WHO remains indispensable-containing outbreaks, sustaining essential services, and delivering life-saving aid.

WHO's cholera control efforts have ensured that 8 out of 9 outbreaks last year maintained a case fatality rate below 1 per cent, aligning with international standards.

In 2024, the WHO Global Logistics Hub in Dubai shipped 34 million USD in supplies to 75 countries in all six WHO regions.

We assisted Iraq in reducing case fatality rates from Crimean-Congo Haemorrhagic Fever from 18 to 5 per cent within a year.

We delivered 60 per cent of all medical items entering the Gaza Strip-alongside fuel, treatments and surgeries-and supported more than 7,800 medical evacuations.

We helped Sudan sustain services in conflict-affected areas-supporting nutrition centres, and responding to cholera, measles, dengue, and malaria outbreaks.

We also supported seven countries in unlocking 128 million USD from the Pandemic Fund to strengthen preparedness and response capacities

through improved surveillance, laboratories, and workforce capacity.

Excellencies,

Despite abrupt funding cuts and shrinking fiscal space, we have continued to deliver.

Yet with one third of global health emergencies and six protracted crises in our Region, the impact of reduced funding has been severe.

Critical areas such as disease surveillance and control, outbreak and humanitarian response, and polio eradication have been among the hardest hit.

The loss is not only financial. The suspension of collaboration with the US CDC has further weakened outbreak surveillance.

The full effects may not yet be felt, but their consequences are already with us.

For example, more than 450 clinics have closed in Afghanistan, Sudan and Syria, leaving 2.5 million people without care.

Nutrition support has been slashed for displaced populations in seven countries.

And maternal and child health services have been disrupted in Afghanistan and Somalia, leaving women at greater risk.

In response to these realities, we have been working hard to increase voluntary contributions and tap into new funding sources.

In 2024 alone, we mobilized 1.4 billion USD for our Region, processed 200 funding opportunities, and forged 15 new partnerships.

A new Regional Health Financing Taskforce will help Member States

mobilize domestic resources, engage diaspora and philanthropy, strengthen budgeting and management, and advance financial protection.

And through the Regional Health Alliance and UN system, we continue to pool resources for maximum impact.

We are deeply grateful for the continued support of our partners.

Yet we remain mindful that international resources are likely to keep shrinking even as needs grow.

In recent months, our team joined the rest of WHO in downsizing and optimising expenditure. The result is a Regional structure that is leaner, more coherent, and better positioned to deliver.

The approved 2026-2027 budget offers a clear outlook, but 40 per cent-215 million USD-still needs to be mobilized for this Region to sustain core programmes.

Without predictable, adequate funding, the Region will face serious constraints in maintaining life-saving operations, preparedness capacities, and essential country programmes.

This makes regional solidarity, smart investments, and contributions from within and beyond the Region more critical than ever.

Excellencies,

I will be frank. Our current regional funding model is unsustainable.

We cannot build health systems dependent on the shifting priorities of others.

Regional solidarity is not optional-it is our only way forward.

Every country must strengthen domestic financing, ensure efficiency,

and invest in people-centred systems.

We must also support one another through pooled procurement, shared expertise, and innovative solutions.

And we ask all Member States who can, to consider increasing their voluntary support to WHO in our Region.

The health of our Region is a shared responsibility.

We must turn this crisis into an opportunity to build systems that are resilient, self-reliant, and worthy of our people.

Instead of war, peace.
Instead of despair, hope.
Instead of indifference, compassion.
Instead of sickness, health.