UNITED NATIONS - / MaximsNews
Network
/ 01 May 2010 -
Geneva - Dr. Margaret Chan, Director-General of the World Health Organization,
held a press briefing at WHO headquarters this week to discuss the details of
her visit to the Democratic People's Republic of Korea; the following is the
Full-Text of her remarks about the DRP Korea's public health achievements
including immunization coverage, effective implementation of maternal, newborn
and child health interventions, excellent DOTS coverage for tuberculosis and
successfully reducing the malaria cases.
Listen
to the Director-General's press conference [mp3, 15Mb] and follow the
full-text of the press briefing:
"Good
afternoon. We welcome you to this virtual press conference today, April 30th,
2010.
My
name is Christy Feig, and with us is Dr Margaret Chan, Director-General of the
World Health Organization.
Dr
Chan will be discussing her trip to the Democratic People's Republic of Korea
from which she has just returned.
After
some brief comments, Dr Chan will accept questions about the trip. Reporters
who would like to ask a question, please dial 01 on the keypad to get into the
queue. Now I will hand over to Dr Chan.
Dr
Chan: Thanks
Christy. Good day to friends of the media. As you know I have just returned
from a country visit to the Democratic People's Republic of Korea, DPRK. In
fact this was my third visit to a developing country this year. Earlier in the
year, I had the pleasure of visiting the Maldives and Bangladesh.
Since
taking on this job, I've been invited to visit a number of developing
countries and, of course, all countries wanted to put on their best face when
they welcome a guest. But I am also invited because countries want to show me
the challenges they face and hear my views about potential support from WHO
and other agencies.
My
visit to DPRK was very brief and focused on some specific health problems and
health needs. You may have some questions that I may not be able to answer.
Let
me take a minute to give you my initial impressions and thoughts of my visit
to DPRK.
I
was impressed with some of the notable public health achievements such as:
•
Good immunization coverage. Childhood immunization coverage averages 90% and
above.
•
Effective implementation of maternal, newborn and child health interventions,
very good DOTS coverage for tuberculosis and success in controlling a recent
resurgence of malaria. WHO is currently providing substantial financial and
commodity support to improve maternal and child health and to maintain malaria
control.
•
The opening of a telemedicine facility established in 2008-2009 is very
important in using information and communication technology to extend access
to health care and improve its quality, especially in remote areas. As you
well know, 80% 2 of
the country's land is quite mountainous. It also opens possibilities for
better training of health staff and better disease surveillance.
•
Finally, the provision of primary health care has a very prominent place in
the health system. I noted the large number of family doctors, and in DPRK
they call them household doctors, offering services at facilities and also
through reaching out to families.
Despite
these successes, there are challenges.
•
The health system requires further strengthening in order to sustain the
governments policy of universal coverage, and of course to improve the quality
of services.
•
More investments are required to upgrade infrastructure and equipment, to
ensure adequate supply of medicines and other commodities, and to ensure the
correct skill mix of the health workforce.
•
Greater emphasis is needed on nutrition and lifestyle related disease like
cancers, heart diseases and stroke, along with more efforts in tobacco
control.
Increased
flexibility of the government in engaging with international health partners,
such as the Global Fund and the Global Alliance for vaccines and immunization
that we call GAVI has resulted in recent programme funding from these
initiatives.
The
emphasis on transparency, good quality data and accountability are important
because to do that we will be able to bring in more international support in
terms of resources.
The
last point I wish to make is the "Improving Women and Children's Health
Project" which is a partnership between the DPRK, WHO, and the Republic
of Korea. This is helping to build a bridge for dialogue and trust between
DPRK and the Republic of Korea.
And
WHO was happy to be able to assist in this effort.
Thank
you.
Christy
Feig: Dr
Chan, thank you very much. Again to ask a question, please type 01 on your
keypad to get into the queue. Before we go over to questions, may I remind you
that an audio file of Dr Chan's briefing will be available immediately
afterwards in the media centre section of the WHO website. And a transcript
will be available a few hours later.
If
you have a question that you want to ask Dr Chan about her trip, please type
01 on your keypad to get into the queue. Do we have any
questions?
Again
a transcript will be available in about an hour after this press conference
and it will be on the website at www.who.int.
And if you click on the media section it will lead you to where the
transcripts are. You can find it there. And if you have any questions you can
always call the media line.
Our
first question is from Jonathan Lin with Reuters.
Jonathan:
Hello Dr Chan. Thank you for talking to us today. Did you discuss how North
Korea is dealing with the H1N1 pandemic and has WHO already delivered vaccines
to North Korea?
Dr
Chan: Jonathan,
thank you for that question. Yes we indeed we also touched upon the issue of
how the country dealt with H1N1. In fact, the work in DPRK in terms of control
of communicable diseases is pretty robust.
I'm
reflecting on the experiences both in controlling H5N1, earlier, and of
course, currently in dealing with H1N1. So they have in place a good system to
deal with that.
On
the vaccines, we are now actually on the way to delivering them to the country
so they can deploy it as and when they have received the vaccines from us.
Jonathan:
Could you say how many vaccines you will be supplying to North Korea?
Dr
Chan: Normally,
we say that we would provide about 10% of the country's population. DPRK has
about 24 million people so we will be delivering about 2 million doses or
there about.
Jonathan:
Just
on the timing of the delivery of vaccines to North Korea?
Christy:
I'm
going to direct you to the Flu media department here at WHO, and that is
Gregory Hartl's number.
Christy:
Next
question is from E J Cho of the Voice of America EJ: Dr Chan,
how to rate the nutritional level of ordinary North Koreans and how is this
linked to their susceptibility to illnesses?
Dr
Chan: Thank
you E.J. for that question. As I have indicated earlier on, I spent about two
and a half days in Pyongyang but based on what I saw, the population in the
capital, in terms of their height and weight, they are pretty similar to Asian
people who I have seen in other countries.
I
don't have direct data yet on the nutritional status but I could tell you that
based on the evidence available to WHO and also during my visit to the
hospitals, I could see that nutrition is an area that the government has to
pay attention, and especially for pregnant women and also for young children.
We
know how important nutritional status is in the nine months during the
pregnancy and the plus 24 months, meaning
the first two years of a child's life.
I
did see anaemia in children in the country and I did see some low birth-weight
babies.
Again
the situation has improved over the years, but there are still some areas that
the government needs to work on. 4
Christy:
Thank
you EJ. Again if you would like to get into the queue to ask a question,
please type 01 on your keypad.
Any
other questions on the Director General's trip to the DPRK, please type 01 on
your keypad.
Lisa
Schlein from
Voice of America: Dr Chan, first of all just a technical question. How
long were you in the country, you said it was very quick. I was wondering who
were you meeting with. And you talked about the challenges, but what sort of
things did the country or officials actually ask you for direct help
Dr
Chan: I
arrived in Pyongyang on Sunday and I came back here last night, so I am still
a bit confused with the time. But I was there solidly for about two and a half
days.
During
that time, I met with government officials such as the President of the
Presidium? of the Supreme People's Assembly, I met with the Minister of
Foreign Affairs, and the Minister of Public Health, and his team. Of course, I
also met with senior officials of the United Nations who are accredited in the
DPRK.
During
one of the receptions I had the opportunity to meet with ambassadors from
countries which have embassies in the country, meaning DPRK.
I
also had the pleasure to talk to very important members of civil society
groups, such as Red Cross and Red Crescent Societies.
Of
course during those two and a half days, I also visited a central hospital,
and a maternity hospital in Pyongyang, and then I also visited a rural
hospital located about an hour's drive from the city.
I
also visited the telecommunication centres where I was able to make
connections by video conferencing with three provincial hospitals and talked
to the directors in charge of those hospitals.
I
wanted to understand how telemedicine has improved the quality of care and how
it helps them in terms of their professional training.
Those
were all the things I did in two and a half days.
And
your question about some of the direct issues for which the government was
requesting help.
I've
outlined some of the challenges for the country, including a couple of very
obvious things. They are keen to sustain the gains in MDGs 4, 5, 6, that is
maternal, child mortality improvement, as well as their work in TB and
malaria. Now as perhaps I need to explain, they have received two Global Fund
grants.
One
for malaria and one for TB and this is very important for them.
Number
one, there is now significant resources to help them to do more work on
tuberculosis as well as malaria.
Also
they were requesting support from WHO, UNICEF and other agencies to help them
to implement this project as they did not have experience in
implementing a Global Fund project.
As
we all know, Global Fund agreements and projects are quite onerous in terms of
requiring result-based financing; they require very good reporting; and they
also require unrestricted access of authorized representatives of Global Fund
to the country and to the programme sites in order to check the programme
method and documentation.
It
is important to recognize that for DPRK and more specifically, for the
Ministry of Public Health to accept these conditions. This is a big
improvement and the government has demonstrated flexibility and a willingness
to work with partners in global health and to improve the health of their
people.
Lisa:
If
I may follow-up, I understand you have to be invited by a country and can't
just impose yourself upon the country. From what you said now, does it appear
to you that the government of North Korea is perhaps becoming more open and
more willing to be more open and to engage more with other countries, not just
on health but on other issues as well.
Dr
Chan: I
would not be able to comment on other issues, but basically during my two and
a half days' meetings and discussion with them, I think this is a very useful
visit for myself and to understand the country and to see how WHO can help
them in global health.
Also,
according to the feedback from the country, they are very pleased with the
visit because we were very professional, we discussed technical areas for
which the country needs international support.
The
impression I'm getting is I can confirm, at least in the area of health, that
the government is receptive to engagement with international partners and they
are receptive to the request for increased transparency, to have better
quality data, and to being held accountable for the resources flowing into the
country to improve health.
To
me this is a very good sign, as it signals for the international community who
wish to engage a government in terms of health, we need to encourage them. We
need to be able to be a global actor.
The
next question from Jules in Kyoto News.
First
question, your predecessor in 2001, Dr Brundtland said that the DPRK's health
system was in near collapse, and I quote. Now you say you are impressed with
some improvements. But how would you rate the country's overall health system?
The
second question I have concerns this ranking…to what extent does WHO rely on
DPRK figures, does WHO consider these figures to be reliable and so why?
Dr
Chan:
Thank you for those two very important questions. I would not be able to
assess the situation as to what it was like in 2001, but in my discussion with
the government, it was very clear to me that in 2001 or there about, was a
very difficult period for the country because they had successive natural
disasters.
Now
based on what 6 I have seen I can tell you they have something which most
other developing countries would envy.
For
example, DPRK has no lack of doctors and nurses, as we have seen in other
developing countries where most of their doctors have migrated to other
places.
But
DPRK has enough doctors and nurses, they have a very elaborate health
infrastructure, starting from the central to the provincial to the district
level.
One
very important element they have is what they call "household
doctor".
One
doctor takes care of 130 families and about 500-550 people depending on the
size of the family. So the doctors there work in the clinic to provide family
health care services.
Of
course they use both traditional and western medicine. In afternoons they will
do home visits, and they keep good medical records. I personally reviewed
those medical records at the clinical level.
But
the only point I need to mention is the records are not computerized but
manual.
So
that is something we need to address when we say they need to improve the
quality of data in order to use modern technology to properly collect those
data and do analysis. It is very difficult to work on manual records.
My
sense is that the data needs improving. And in order to improve the confidence
of partners, there is a good infrastructure that may be the entry of many
people.
Another
important element is that as a government policy the health of every citizen
in the country is covered, so there is universal coverage. People in the
country do not have to worry about a lack of financial resources to access
care.
But
the country has another challenge, and that is distance.
I
found travelling in the mountain area to be quite difficult and of course,
there is a lack of fuel; that too is a challenge.
That
is why in this country the use of telemedicine would be important to improve
the health service and to help the professionals so that the doctors and
nurses can get access to centres of excellence in the capital, and not working
in isolation.
So
what struck me was what they have managed to do under very difficult
conditions.
Question
from Shabtai Gold at DPA:
Shabtai:
Can
I clarify something earlier, you said the height and weight in DPRK is similar
to that of other Asian countries, did I hear you right?
Dr
Chan: I
said what I saw in Pangung might not be representative for the entire country,
but that is what I saw in the capital. Of course, one thing I recognized is
that walking is quite well observed in that country, and I suggest that is why
I didn't see many obese people.
And
if you look at me I am also an Asian, I am pretty short but Asian standards,
so when I compare to most of the people I saw on the street, I can only make a
very broad comparison.
But
mind you, as I said, now in Asian countries, because of affluence and intake
of food we are seeing obesity which I don't see in DPRK.
The
study from South Korea a few years ago said that North Korean males were 5.9
centimetres shorter than their Southern contemporaries, and for women there
was also a similar gap.
And
there are obviously nutritional problems in DPRK, so is the obesity and size
issue connected to a serious nutrition problem in the country and a serious
lack of good food for the people.
Dr
Chan: Of
course there is no denying that, as I said, I have not looked at the study you
refer to but the government does accept that they have gone through some very
difficult years with flooding and drought and natural disaster, so
malnutrition is a problem but
things have improved in recent years.
It
is also important to mention that the national support through World Food
Program and also like UNICEF and other agencies like Red Cross and Red
Crescent needs to be sustained.
Christy:
That's all
we have time for today. I apologize to the journalists who were not able to
get their questions through. This has been the virtual press briefing from
World Health Organization headquarters with Dr Margaret Chan, Director-General
of the World Health Organization.
I
would like to remind you that there will be an audio file posted on our
website shortly and later today a transcript of the briefing.
The
web site is www.who.int/.
If you need to
reach us please call our media line at +41.22.xxx.xxxx if you have a question
about pandemic influenza please call +41.22.xxx.xxxx. Thank you again for
joining us and have a good day.
|
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(MaximsNews Network)
•••
BILL
& MELINDA GATES: URGE GLOBAL LEADERS TO KEEP UP INVESTMENTS IN
GLOBAL HEALTH, TROPICAL DISEASES AND CHILD VACCINES:
(MaximsNews Network)
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