Statement by SRSG Mizutori, Build Back Better: building resilient health infrastructure and supply chains. What have we learnt from COVID-19?

United Nations Office for Disaster Risk Reduction
SRSG Mami Mizutori

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Build Back Better: building resilient health infrastructure and supply chains.

What have we learnt from COVID-19?

Statement by Mami Mizutori, Special Representative of the Secretary-General for Disaster Risk Reduction

17th December 2020

Dr P K Mishra, Principal Secretary to the Prime Minister of India,

Dr. Zsuzanna Jakab, WHO Deputy-Director General,

Hon Minister of Health of Sri Lanka, Mrs. Wanniarachchi

Distinguished panelists,

Thank you, Kamal, for that introduction.

We are fortunate to have someone as experienced as yourself to moderate this webinar.

I would also like to extend a warm welcome to the several hundred people who have registered to listen on-line.

This is a very timely discussion to have just as we begin to see some light at the end of the tunnel of this long hard year of death and suffering for millions of people across the globe.

The vaccines are welcome, but we know from the bitter experience of the last twelve months that we cannot simply relapse into a pre-crisis state because we have found an antidote to this coronavirus.

Instead we must confront the reality of the mistakes made and we must apply the lessons learned to reduce the impacts of future disaster events.

It was largely thanks to the experience of UN member States in dealing with disease outbreaks that health figures so prominently in the Sendai Framework for Disaster Risk Reduction, the global plan for reducing disaster losses adopted five years ago.

In fact, one of the Sendai Framework’s seven global targets is focused explicitly on the subject under review here today.

That target calls for a substantial reduction in disaster damage to critical infrastructure and disruption of basic services including health facilities.

At first glance, this would appear to apply to instances where health facilities are themselves in danger of being destroyed by an earthquake, a flood or a storm.

And, as is often said by WHO, the most expensive hospital or clinic is the one that collapses in a disaster.

It can be that the physical structure was not built to a high enough standard or the location was badly chosen.

There are many examples of this.

In December 2004, the Indian Ocean tsunami destroyed 61% of the health facilities in Banda Aceh, Indonesia.

Flood damage in Malawi in 2015 saw patients’ medical records destroyed and the loss of drugs for people living with HIV/AIDS and TB.

So it was a very insightful initiative by the Prime Minister of India to call for the creation and launch this Coalition for Disaster Resilient Infrastructure which is rapidly attracting many other governments to join as they recognise that much of the economic loss attributed to disasters comes from damage to critical infrastructure including health facilities.

In fact, it is a double blow because these facilities are not there when you need them most in the disaster response phase.

Beyond the challenge of maintaining resilient physical infrastructure, COVID-19 and other disease outbreaks in recent years have revealed further gaps in our health systems and supply chains of medication and health related materials that undermine our capacity to save lives and reduce ill-health.

Supply chain disruptions have also affected the availability of non-COVID-19 related medication and materials as well, even in developing countries, such as the EU reporting shortages in commonly used drugs, such as antibiotics.

In the least developed economies, the situation is even more dire as the continued spread of COVID-19 is predicted to highly impact the provision of basic medical services, such as maternal care, immunization and nutrition.

Obviously, there is a serious job of work ahead to identify all the issues which have led to the overburdening of the health infrastructure and supply chain not only of developing countries but also of highly developed ones.

There are deep-rooted vulnerabilities in industry practices, health care policies, infrastructure, logistics, risk assessment and supply chain management which can undermine effective prevention and response.

We have seen how previous disasters have affected the global food supply or disrupted the automobile industry because just-in-time production modality to save costs as much as possible led to shortages of vital parts.

It should not have been a great surprise then that this pandemic which had long been foretold by WHO and others, has resulted in disruptions in the supply of materials and medication globally.

A failure to meet demand for PPE has resulted in competition for resources and ballooning costs. It can also be expected that governments will seek ways to diversify their supplier base, preferably bringing it closer to home.

Extreme weather and the emergence of new pathogens as a result of the climate emergency will add to the burden of health care in the future.

It also must be recognized that little international spending on climate change adaptation attention goes toward public health programmes.

Now, more than ever, the links between climate change, disasters and public health need to be understood so that investments in public health infrastructure and services are risk-informed and resilient to multiple hazards.

UNDRR’s own review this year of existing national strategies for disaster risk reduction has highlighted the lack of focus on biological hazards in many of them and this is now being addressed with our support.

Overall, the COVID-19 crisis is telling us that we must strengthen disaster risk governance and integrate disaster risk management into health care provision at all levels.

We need to learn from current situation and increase investment in prevention.

We need to ensure investment decision are risk-informed; improve reporting and accounting mechanisms; strengthen national regulations that govern design and maintenance of health infrastructure; engage private sector in the development and implementation of disaster risk reduction and resilience strategies; and build the knowledge and capacity of frontline workers and health responders.

I would like to close by congratulating the CDRI Secretariat and my colleagues at UNDRR for organizing this webinar and to recognize in particular the contribution of Dr. PK Mishra Co-Chair of the Governing Council of CDRI who I had the honor of presenting with a Sasakawa Award at the last Global Platform for Disaster Risk Reduction for his work in promoting inclusive disaster risk reduction policies throughout his career.

I am confident that the insights and recommendations that can be gleaned from this webinar and its follow-up will be an essential part of the recovery and preparation for the next pandemic whenever it may happen.

Thank you for your attention.

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