Dear colleagues and friends,

Thank you for the opportunity to address you today.

The first two decades of this century were a golden age for global health.

Backed by unprecedented political and financial commitment, and fueled by life-saving innovations, the world made incredible progress on many measures of global health.

Deaths from HIV dropped by two-thirds, deaths from malaria by one-third, and deaths from TB by half.

Maternal mortality fell by 40%, child mortality more than halved, and tobacco use dropped by 40%.

And many countries made progress towards universal health coverage: service coverage and financial protection have both improved by about one third globally.

But in the past five years, the golden age has ended, and an icy chill has set in.

Many of these indicators have either stalled or gone backwards.

The COVID-19 pandemic was one reason, causing severe disruptions to health systems and services in many countries.

Just as the world was starting to recover, sudden and severe cuts in foreign aid have once again hit the poorest and most vulnerable communities the hardest.

All of this comes against a backdrop of unprecedented challenges: 

Intractable conflicts, fast-moving geopolitical shifts and economic shocks;

The growing burden of noncommunicable diseases and mental health conditions, the steady march of antimicrobial resistance, the overshadowing threat of climate change and the ever-present danger of pandemics.

Many countries have had the aid rug pulled out from underneath them and are now facing an acute health financing crisis.

WHO is supporting countries to navigate this crisis and sustain the essential health services on which many countries depend.

At the same time, many countries are seeing this crisis as an opportunity - an opportunity to transition away from aid dependency towards self-reliance, based on domestic resources.

This is a transition that has long been called for; the financial crisis has shown why it must happen, and why it must happen now.

WHO is also supporting countries to make that transition.

In the short-term, we're helping them to develop affordable packages of essential health benefits;

We're advising them on how to introduce or increase health taxes on tobacco, alcohol and sugary drinks;

And we're supporting them to strengthen domestic manufacturing, pooled procurement and other initiatives.

In the longer term, countries can also strengthen risk-sharing mechanisms to improve financial protection, including through publicly-financed health insurance.

In addition, we're also supporting countries to make the digital health transformation, and to leverage the potential of AI in building resilient and future-ready health systems.

There is huge potential, but there are also risks to be navigated.

At the same time, WHO itself has also been affected, as you know.

But again, I see this crisis as an opportunity to build a WHO for the future that is leaner, more focused on its normative and technical work, more efficient and more effective.

That means we must also be an organization that is more independent and more financially secure.

In fact, this is not something we only realised last year. This is a journey we have been on for the past eight years.

When I began as Director-General in 2017, we identified WHO's over-reliance on a handful of donors as a major strategic risk, with the potential to compromise our independence, and to expose us to a financial shock like the one we had last year.

Over the past eight years, we have taken several steps to mitigate that risk, as part of a comprehensive set of reforms we call the WHO Transformation.

Most significantly, in 2022 our Member States approved a plan to progressively increase assessed contributions - which are the membership fees that countries pay - to 50% of our base budget by 2031, from just 14% at the time, in five installments.

The first two installments have already been made, and the remaining three are scheduled for 2027, 2029 and 2031.

The significance of this decision cannot be overstated. It is a major step toward securing the long-term stability and independence of WHO, and for preventing shocks like the one we experienced this year.

Although these efforts provided some protection from the current financial challenges, they could not insulate us fully.

But our experience of the past year shows why the reforms we have made are so important, and why we must continue on the path we are on.

All of us must recognize that there will be no going back to the way things were.

Parts of the global health architecture are being demolished and rebuilt around us.

But there can be no doubt that WHO is - and must continue to be - at the centre of that architecture.

Bilateral deals have their place, and always will. But there is no substitute for the multilateral platform that WHO provides - a meeting place for all 194 member states to find shared solutions to shared health threats.

The world needs a strong WHO now more than ever. But WHO is only as strong as its Member States make it.

At last year's World Health Assembly, Member States sent two very clear signals that they want - and need - a strong WHO.

First, they approved the next increase in assessed contributions - a powerful vote of confidence in WHO's long-term stability, security and independence.

And second, they adopted the WHO Pandemic Agreement, a truly generational achievement that will help to keep the world safer from future pandemics. The agreement's approval shows multilateralism is alive and well.

For three and a half years, our Member States engaged in difficult negotiations. There were times it seemed they were too far apart and would not be able to find common ground.

But in May last year, they did. They agreed and found a middle ground to agree on the Pandemic Agreement.

They are now negotiating an annex to that Agreement, the Pathogen Benefit and Access Sharing system - PABS - which aims to ensure faster sharing of pathogens with pandemic potential, and equitable access to the medical products needed to respond to them.

Likewise, the negotiations are not easy, and there are still differences to be resolved, but I am confident they will be concluded in time for next year's World Health Assembly in May.

After that, the Pandemic Agreement will be open for signature by countries, and for its ultimate entry into force as international law.

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Over the next five years, I see three critical priorities:

First, I call on countries to finalise the PABS negotiations in time for adoption at this year's World Health Assembly, and to make the Pandemic Agreement international law.

Second, countries must make the transition away from aid dependency to self-reliance, based on domestic resources. Donors must help them to make this transition, by aligning with national priorities.

And third, we must build a new global health architecture in which each actor plays its role and leverages its comparative advantage, avoiding overlaps and duplication, and delivering value for money and results where it matters most - in the countries and people we serve.

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There's no question that global health is passing through a significant crisis.

But we are passing through it, and we will come out the other side. There is always another side.

Albert Einstein said, "In the middle of adversity there is great opportunity."

That's how I choose to see it. And indeed, that's what led to the creation of WHO in the first place.

Like the UN of which we are part, WHO was born in the aftermath of the Second World War, and the realization that the only alternative to global conflict was global cooperation.

That remains more true today than ever.

Indeed, health is one area in which countries can work together across ideological and geopolitical divides to achieve common goals.

The WHO Constitution was the first instrument of international law to affirm that the highest attainable standard of health is a fundamental right for all people, without distinction.

Not health for some; not health for most; but health for all.

I thank you.