French Health Secretary sets out plans to tackle international public health risks
Ministry of Social Affairs, Health and Women’s Rights – Speech by Marisol Touraine Minister for Social Affairs and Health, Conference on International Health Regulations (IHRs)
Wednesday 23 March 2016
Directors of international agencies,
Ladies and gentlemen,
In 2005, the world provided itself with an international legal instrument with an essential and even vital mission: to protect individuals in the face of spreading risks to public health. In ten years, we have been able to measure the strength of those risks as well as the growing need for reinforced international co-operation. That is because climate disruption, the globalisation of exchanges, and the growth in mobility amongst people, animal species, and foodstuffs, do not acknowledge any borders. Yes, health crises represent a growing challenge for the international community. Each one has its specificity, but they all surprise us, destabilise us, call upon us to build health systems and an international architecture that are capable of facing up to the unexpected.
Ten years after the adoption of the International Health Regulations (IHRs), we find ourselves once again in the city that is home to the office set up to support their implementation. Lyon, an innovative metropolis, a place of reference for research with over 500 laboratories and academic centres. Lyon, where the P4 Jean Mérieux Laboratory (of which I should like to salute the teams) played an essential role in dealing with the Ebola virus. Lyon, where SANOFI Pasteur produces the first vaccine against dengue fever, and where over a hundred SMEs and start-ups have been established to create a world-class competitiveness cluster.
Your work started yesterday. At a time when we approach the central question of international steering, I should like to go back over France’s experience in managing the health crises that have hit us over the last few years. I feel that there are three essential lessons to be learnt: anticipation, public mobilisation, and international co-operation.
Firstly, anticipation means building an effective system of supervision. We know the extent to which unattended alerts can lead to crises. If contamination is suspected, swift detection is essential. The Ebola crisis showed the crucial role played by isolating patients whilst awaiting confirmation that contamination is present or absent. That is as much to protect the population from possible contagion as it is to provide reassurance.
Anticipation also means preparing healthcare professionals. A few weeks ago, I was in the French départements in the Americas that are affected by the Zika epidemic. Once again, I was able to measure the extent to which infrastructures alone are not sufficient, and the extent to which training, mobilisation, and putting together medical teams are important. In addition, I saw how our health system manages to progress in each crisis. Our experience of the chikungunya epidemic in 2014 enables us today to be better armed against Zika. Training programmes for healthcare professionals must be developed at international level, so that the community of States can rely on the experience acquired.
Anticipation also means giving research the means required. It is through research that we have been able to identify the links between the Zika virus and fœtal malformations. We must support and boost research and international collaboration between researchers and caregivers, especially non-governmental organisations, which are in the vanguard.
Finally, anticipation means preparing ourselves to “strike while the iron is hot” when a situation arises that has an unknown component. Building health-response systems is the best guarantee of limiting the extent of a crisis. Also on that point, we must advance by supporting those States with health systems that are still weak, for example by also arming them with vector-control facilities. Reacting appropriately means knowing how to adapt, because each crisis has its specificities. The Ebola crisis required a massive response, the setting up of high-quality laboratory services, and the organisation of risk-free burials. The Zika epidemic calls for other types of intervention, with specific monitoring and action for pregnant women.
That challenge was perfectly illustrated during the Ebola epidemic in West Africa. Public mistrust in health assistance contributed to difficulties in containing the epidemic.
That is why communication is a major factor in crisis management. It is a matter of providing the population with exact and precise information, at a time when knowledge is likely to change. During the Ebola crisis, we provided information about the dangers without causing psychosis in our countries. Similarly, as soon as the first case of illness caused by the Zika virus appeared on French territory, I made the general public aware of individual protection measures, in particular by using radio and television commercials broadcast over local media.
So that the official discourse is adhered to in all circumstances, the population must be called upon to play its part as early as possible. That may be done via social networks, especially for sensitive subjects like vaccination. The challenge here involves transparency and empowerment.
Health security must remain a priority item on the world political agenda. The International Health Regulations (IHRs) form our common legal framework, a guide that, if it is respected by each State, guarantees the protection of the entire planet.
In order for the International Health Regulations (IHRs) to be implemented universally and effectively, we must advance on two fronts. Firstly, we must carry out a lucid and independent assessment of the application of the International Health Regulations (IHRs) in each State. Next, we must boost financial, technical, and human assistance to help States in meeting their commitments. On those two points, the role of the WHO is a central one. We must all stand with it, member countries as well as international backers.
The next World Health Assembly meeting will be the opportunity to take the decisions needed to enable the WHO to fulfil those two missions. The outcome document that will be adopted at the end of the work done at that conference will enable us to take that important step.
Ladies and gentlemen,
Health security is a right for our populations, for whom we must guarantee optimum protection. Our duty as political leaders is to build national and international health systems that are capable of facing up to large-scale epidemics. Anticipation, responsiveness, health democracy, international solidarity – those are the keys to success for world health safety.