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Brazil's National Plan for the Elimination of Socially Determined Diseases [1]
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Date: 2024-02
Your Excellency Minister Nisia Trindade, my sister,
Excellencies, Ministers, Honourable Members of Parliament, heads of agencies, civil society leaders, private sector leaders,
And of course, I would like to recognize my Regional Director and my brother, Jarbas Barbosa,
And especially, someone who touched me by speaking now, Adijeane Oliveira. Thank you very much.
I can understand how it feels to live with disability. I just recovered from a broken foot.
As soon as my foot was broken, I had to be in a wheelchair, and I started to feel irritated.
Normally people tell me, “You’re calm”. But when I was put in a wheelchair, I was starting to show some new behaviors and irritation.
I could not believe actually, for myself, how difficult it is, even if you try it for just a few weeks.
Then you saw me with a cane, and now with trainer shoes, so I am getting better.
But I think very often some problems like Adijeane has, and many others, it is when we face it, when we experience it, that we understand even better what it really means. So, I fully understand, Adijeane.
The other thing that impressed me, which is going to be very good support for the initiative we are launching today, are all the movements she mentioned: HIV, TB, Hansen’s or leprosy, hepatitis, chagas, HTLV, and all the movements that are in the room. I think that will give energy to the 12-disease elimination plan.
And of course, thank you for your work so far. I think it is your advocacy also that convinced the government to come up with this package of diseases.
It cannot be done be done just by the government. I think the movements are going to help realize the goals that are set by the government.
And then there is one other recognition. This is an autistic artist from Brazil. His name is João Pedro de Oliveira Merces.
We became friends on Twitter. He's a very good artist and representing Brazil very well, it's just amazing.
I had a plan to see him in person, but he lives in Bahia state, so he is a bit far away from here. I am coming back for the G20 meeting, so we have agreed with João Pedro to meet him then.
I wanted to use this opportunity to recognize his work, as an autistic artist. Incredible work he does.
Disability, they say, is another form of ability. And if people can really recognize their potential, disability cannot limit them. But at the same time, there are many social inequalities and stigma, and the society should also help them. So, I wanted to use this opportunity to say to my friend, hello, and bom dia. I hope to see you soon my friend, João Pedro de Oliveira Merces.
It’s such a great honour to be here in Brasilia for this important moment.
I thank His Excellency, President Lula, and my sister, Minister Nisia Trindade, and the Government and people of Brazil for their hospitality, but more importantly, for their commitment to promoting and protecting the health of Brazil’s people.
Brazil’s leadership on health is especially important this year as you assume the presidency of the G20, and I look forward to coming back to Brazil during the course of the year.
It’s for that reason that I am very encouraged by Brazil’s National Plan for the Elimination of Socially Determined Diseases.
This plan is a bold statement of intent. Truly bold. It’s my favourite kind of plan: ambitious, but achievable. But at the same time, it’s going to address the roots of the problem, the social determinants. As Madame Oliveira said, the inequalities.
And it should be ambitious, because what’s at stake is the most precious thing of all: human life.
But Brazil's work is not starting today. Brazil has already taken several big strides down this road.
In particular, I welcome Brazil’s commitment to end TB by 2030, five years ahead of schedule. The Stop TB Partnership is here holding its board meeting, and they are very happy with this news, because they want to accelerate things.
WHO was also pleased to receive Brazil’s dossier for the elimination of lymphatic filariasis at the end of last year, as the Secretary of Health said earlier in her speech;
And we welcome the national HIV elimination plan that you are announcing this week.
I also greatly appreciate Minister Nisia Trindade’s agreement to co-chair the WHO TB Vaccine Accelerator Council, which we launched last year.
By the way, Minister Budi, who is the other co-chair of the Accelerator, is also a member of the Stop TB Partnership. So, we are trying to align, and I think it will have a big impact.
The success of the vaccine for TB will be a game changer, and I am very glad that this very important discussion is happening in Brazil, which is the right place, given the strong commitment of the government to eliminate TB.
And although it is not one of the 12 diseases in this plan, I also commend Brazil for its commitment to cervical cancer elimination, with the launch of its national elimination plan just last year.
These commitments build on Brazil’s significant achievements in recent decades.
Since the turn of the century, Brazil has achieved a significant reduction in preventable premature mortality, and infant mortality has more than halved.
Brazil also has a proud track record in responding to outbreaks of infectious diseases including Zika, dengue and influenza.
These achievements are built on a strong health system, from primary care to specialised clinics and referral hospitals, with one of the strongest surveillance systems in the world.
In FIOCRUZ, Brazil is also home to one of the world’s leading public health research institutions. By the way, I have been working with FIOCRUZ for many years, since I was Ethiopian Minister of Health. It is such a great institution that Brazil has.
And of course, Bio-Manguinhos is one of 15 vaccine manufacturers that is participating in the WHO mRNA Technology Transfer Hub. On capacity building, on vaccines, as you know we work very closely with Gavi, and I am very happy to have with us the Board Chair of Gavi, my good friend, José Barroso, the former EU Commission President. And the former Gavi CEO is also here, Seth Berkley. Sania is not here, she is just starting, but I think through the chair we have the commitment. Working with Brazil, especially on vaccines, will be important since Brazil has a huge capacity.
WHO is also working with Butantan to explore a new collaboration to accelerate local production of new and advanced vaccines in Brazil.
But like many countries, Brazil also faces significant challenges from both noncommunicable and communicable diseases, including the current outbreak of dengue, which is being fueled by the El Nino phenomenon.
In fact, this outbreak is part of a global upsurge in dengue, with more than five million cases and more than 5000 deaths reported last year, from 80 countries in every region of the world.
I commend Brazil for its response to the outbreak, and for its leadership in introducing the new dengue vaccine in more than 500 municipalities.
The outbreak demonstrates the need to continue strengthening the health system and epidemic and pandemic preparedness and response.
It also demonstrates that we cannot properly address the health of populations one disease at a time.
We need a holistic response that puts people at the centre of health systems and services, not diseases.
By the way, I am really glad also that the African Union is represented. My sister Ambassador Minata Samate is here. The experience in Brazil will also help Africa, the South-South cooperation, because there are many things that we share.
And the holistic approach is what this plan is all about. And that will be a model for many countries, for the African Union and for many countries in the South. And for WHO it’s an opportunity, because we can share the experiences here, the best practices, with other countries.
Eliminating a disease is one of the greatest gifts a government can give to its people.
Not every disease can be eliminated, but the 12 diseases you have chosen can be.
We have the tools; we have the know-how.
The reasons these diseases are not eliminated are largely social, not scientific.
They’re about the conditions in which people live and work, their gender, the risks to which they’re exposed, stigma and discrimination and more.
In fact, these 12 diseases have a symbiotic relationship with poverty and inequity. I think that Madame Oliveira has said it very well.
They feed on it, and they fuel it. They feed on poverty and inequity, and they fuel it also.
These diseases are emblematic of inequity.
In recent decades we have made incredible progress against many of these diseases.
But more recently, progress has stalled – in part due to the disruption caused by COVID-19.
The pandemic laid bare many of the same underlying inequities that fuel these 12 diseases and hinder their elimination.
This plan recognizes that many of the same diseases afflict the same communities because they suffer from the same inequalities.
But it also recognizes that while disease-specific interventions are important and necessary, many of these diseases can be prevented and managed at the primary health care level, with common tools.
The same clinic that provides services for HIV can and should provide services for syphilis;
The same health worker who recognizes the symptoms of trachoma can be trained to identify the symptoms of tuberculosis;
The same lab that processes tests for malaria can process tests for hepatitis;
And the same pharmacy that dispenses medicines for one disease can dispense them for others.
In fact, if implemented, this plan will deliver health benefits beyond the 12 diseases.
And it will deliver dividends beyond health, in poverty reduction, social equality and economic prosperity.
In other words, this plan is a plan for a healthier Brazil, but also for a fairer Brazil.
Before I close, I would like to recognize Brazil's role globally. I don't how many of you know, but Brazil has contributed to the formation of UNITAID. We have the CEO of UNITAID in the room, Philippe Duneton.
In addition to that, I wanted to recognize one person who has been involved in the first phase of the negotiation, from Brazil, Ambassador Celso Amorim.
And I wanted to recognize not only that you have made progress locally, and you want to do even more, and you have contributed globally.
Thank you for your support to WHO and Gavi. It comes from your commitment to multilateral organizations. Not only in supporting them, but in creating them, like UNITAID.
Once again, I congratulate Brazil for its vision and commitment to health at home, and to its leadership regionally and globally, as G20 President this year and BRICS President in 2025. We even expect more from Brazil.
And all the best of success to Brazil.
You can count on WHO’s total support.
Obrigado. I thank you.
[END]
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[1] Url:
https://www.who.int/director-general/speeches/detail/national-plan-for-the-elimination-of-socially-determined-diseases-7-february-2024
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