"Good morning, good afternoon and good evening. 

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The improvement in child survival over the past two decades is one of the great success stories of global health.  

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In 2000, more than 10 million children died before their fifth birthday. 

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Today, that number has been cut by more than half to 4.9 million deaths in 2024, according to new estimates published today by WHO, UNICEF and other partners. 

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Millions of children are alive today because countries and partners invested in proven solutions: vaccines, skilled care at birth, treatment for severe acute malnutrition, and stronger primary health care.  

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These gains show what is possible when the world commits to protecting the health of its youngest and most vulnerable.  

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Of course, 4.9 million child deaths is still 4.9 million too many. 

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And since 2015, the pace of decline in child mortality has dropped sharply. 

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Sub-Saharan Africa remains the region with the highest under-five mortality in the world, losing around 2.8 million young children in 2024. 

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Every day, about 6300 newborns die. 

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The most common causes are complications of prematurity, labour and delivery. 

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If children survive the first month, malaria, pneumonia and diarrhoea continue to claim many young lives.  

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It’s to be expected that the pace of decline we saw between 2000 and 2015 could not be maintained. 

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Conflict, humanitarian crises and funding pressures are putting essential services at risk in many countries.  

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But we know what works – there are solutions. 

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By strengthening primary health care, expanding immunization, improving maternal and newborn care, and ensuring every child has access to nutrition and lifesaving treatment, we can accelerate progress again.  

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Many countries are showing what’s possible. 

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For example, in 2022 Sierra Leone declared child mortality a national emergency. 

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Since then, almost 1 million children have been screened for malnutrition, and the number of children who have not received any vaccines has been reduced from 15 000 in 2024 to 9000 last year. 

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Likewise, North Macedonia has achieved one of the fastest recent declines globally, cutting neonatal mortality by 87 per cent since 2015 through improvements in emergency obstetric and newborn care. 

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WHO calls on governments, donors and partners to make child survival a political and financial priority; 

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To focus on those at highest risk; 

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To strengthen accountability for commitments; 

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And to invest in primary health care, so that every child has the chance not just to survive, but to thrive.  

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One of the main reasons for the decline in child mortality is immunization. 

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In 1974, only 5% of the world’s children were vaccinated against killer diseases including measles. 

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Today, that number stands at 85%. 

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A large part of that success was due to the establishment more than 50 years ago of the Expanded Programme on Immunization, or EPI. 

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Since 1974, EPI has helped to save more than 150 million lives, from diseases like measles, tetanus, diphtheria and pneumonia. 

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Many countries rely on advice from WHO about which vaccines to include in their routine immunization schedules, who should be vaccinated at what age, with how many doses, and so on. 

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That advice is shaped by the Strategic Advisory Group of Experts on Immunization, or SAGE, a group of independent experts who meet twice a year to review the latest evidence and advise WHO. 

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SAGE concluded its first meeting for the year last week. This time, it issued recommendations on vaccines for COVID-19, typhoid and polio. 

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The biggest change was for typhoid. SAGE has updated its 2018 recommendation to say that countries with a high burden of typhoid disease should consider a booster at around five years of age to maintain protection. 

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On COVID-19, SAGE reviewed more than five years of evidence on the safety and performance of COVID-19 vaccines and concluded they have a very good safety profile. 

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SAGE continues to recommend that countries should consider routine vaccination against COVID-19 for groups at the highest-risk of severe disease, including older people, people in care homes and those who are moderately or severely immunocompromised. 

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SAGE also provided updated recommendations for other risk groups that countries may consider, including pregnant women and children. 

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On polio, SAGE recommended that countries that are using three doses of inactivated vaccine may reduce the use of oral polio vaccine from three doses to two.

 

These recommendations are important for improving the safety and impact of vaccines on the path to polio eradication. 

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I thank SAGE for its recommendations, which I have accepted. 

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Next Tuesday, the 24th of March, marks World TB Day. 

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Tuberculosis, or TB, is another example of a major global health challenge against which the world has made great progress. 

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Since 2000, efforts to fight TB have saved an estimated 83 million lives. 

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But cuts in global health funding and increasing drug resistance are threatening to reverse these gains. 

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Each day, over 3300 people die from TB and more than 29 000 people fall ill with this preventable and curable disease. 

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Millions more are not diagnosed or treated. 

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New diagnostic tests are helping to close this gap, but their uptake has been slow in many countries due, in part, to high costs and the need to transport samples to laboratories. 

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Last week, WHO published new guidelines on TB diagnosis to  expand access and reduce costs. 

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WHO has now expanded our recommendations to support the use of new tests that can be used near the point-of-care, opening up even more options for countries to decentralize services and expand access.   

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For the first time, WHO is also issuing recommendations on the use of tongue swabs for TB testing, and a new sample ‘pooling’ strategy to diagnose people more quickly using fewer tests. 

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These new tools could be truly transformative for TB. Both the new tests and the new ‘pooling’ strategy can cut the cost of testing by 50% or more – all while providing faster results. 

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By bringing fast, accurate diagnosis closer to people, along with access to better treatments and – we hope – a new TB vaccine, these innovations can save lives, reduce transmission and change the future of TB. 

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WHO calls on all countries to scale up access to rapid tests and other tools so every person with TB can be reached and treated promptly. 

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Finally, the conflict in the Middle East continues to impact the health of people across the region. 

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In the Islamic Republic of Iran, more than 1400 civilian deaths have been reported, almost 900 in Lebanon and 20 in Israel. 

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Thousands of people have also been injured in all three countries. 

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Up to 3.2 million people have been displaced in Iran, and over 1 million in Lebanon.

 

Many are living in overcrowded shelters, which have the potential to rapidly increase health risks. 

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Meanwhile, in Iraq, health services are facing increasing pressure, particularly hospitals located near areas affected by conflict and violent demonstrations. 

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And in Syria, more than 100 000 people have recently arrived from Lebanon.  

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Access to health care is becoming more difficult. Some health facilities have closed, and movement restrictions are delaying ambulances, patient referrals, and the delivery of medicines. 

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Injured people, displaced families, patients with chronic diseases, pregnant women and older people must be able to reach life-saving health services. 

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Most concerningly, attacks on health care continue to be reported. 

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In Lebanon, WHO has verified 28 attacks, with 30 deaths and 25 injuries. 

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In Iran, WHO has verified 20 attacks, with nine deaths. 

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And in Israel, WHO has verified two attacks on health care. 

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Attacks on health care are a violation of international law. 

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Air space closures and shipping line congestion have decreased the volume of supplies reaching  WHO’s supplies hub in Dubai. 

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We have activated our contingency plans and are identifying alternative ports of entry to replenish the hub. 

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We are also working with the UAE and partners to consolidate priority cargo movements and explore the possibility of charter flights to deliver supplies to critical emergencies. 

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We expect operations to continue, although there may be more lengthy delivery times. 

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WHO has also released US$ 2 million from the Contingency Fund for Emergencies to support the response in Lebanon, Iraq and Syria. 

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WHO is doing whatever we can to save lives and prevent suffering. 

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But as always, the best medicine is peace. . . "