Responding to future pandemics – 81st Session of the UN General Assembly

Happy to introduce the next panel. And Mr. Tedros, if you want to take the stage, we can start the session. And I'm going to hand it over to Samira Hussein from BBC News. Thank you so much.

Good morning. I am delighted to welcome Dr. Tedros to the stage, and it is an exceptionally timely discussion, given the current Ebola outbreak happening in the Democratic Republic of Congo. And before, rather than a lengthy introduction, I just want to get right into it, because I think Ebola has been such an issue globally, but perhaps hasn't been getting as much attention. I'm wondering how would you characterize the response so far to the outbreak?

Yeah, thank you. This Ebola outbreak, as you know, is a result of a Bundibugyo type. And the Bundibugyo actually was discovered in 2007. So the first outbreak was in Uganda in a village called Bundibugyo. That's why the name comes also from that. And then the second outbreak was in 2012 in Isiro province in DRC. So this is basically the. So after 2012, 14 years later, we have another one in Ituri province in DRC. So because of that, test kits not optimized, vaccine treatments not available, of course, now under trial. and the virus also got a head start because it was not detected for some time, so I think it circulated for some months. And as I said earlier, because of the head start, unprecedented speed actually was showing and still, and we're still playing a catch-up. And it's a very serious one, still concern, but the concern not only comes from a head start and so on, but this outbreak is happening in the middle of, you know, an armed conflict, active armed conflict. And there is also because of the armed conflict, mobility, stabilization, and due to the armed conflict, there are other challenges. So that makes it a bit complicated and affects the response. But the positive side is, since we declared it as fake, it's already four months now, it's contained within the DRC. So that's positive within Eastern DRC. Of course, few cases cross to Uganda, but swiftly controlled. That's a plus. And then the number of cases is also on the decline now. especially in Ituri, the epicenter, although there is an increase in North Kivu. But the overall is some modest decline. That's also positive. Number of recoveries is on the increase. The contact tracing is improving. So the response is growing from strength to strength. But we are not out of the woods yet. But the key problem still to make more gains and progress is addressing the serious community mistrust that we have. And we're trying to do that because the government leadership is important and community ownership is even more important because the partners role like WHO is support. Otherwise, the two are critical, the government leadership and community ownership. Even in terms of community trust, we see improvements now, but it still continues to be a serious problem.

I'm wondering what we can take from the international response to Ebola thus far, and what does that mean in terms of global preparedness for any kind of pandemics?

So on any kind of pandemics, the preparedness, of course, I have the same question in many platforms. I say the preparedness is a no and yes. Maybe I put the no first because still, you know, more often no than a yes. The no is because As you know, the world is not prepared and its priorities also shifted since COVID. We have what you call this cycle of panic and neglect. During COVID, the whole world was panicking, so there was a lot of investment, but as soon as COVID was declared over, the priorities shifted and the investment decreased. Of course, you wouldn't expect that level of investment to continue, but it reduced significantly. So the investment that's happening now is not really good enough to prepare the world for the next pandemic. And next pandemic is a matter of when, not if. So we need to continue to invest. But the alarming part in terms of especially investment is not only it shifted, but it's shifting to investments in defense. I attended the Munich Security Conference last year, and many countries from developed world were announcing an increase in funding from military expenditure, of course, from 2% to 4%, from 3% to 5% or over. That's a lot of money. And as you know, the military expenditure in 2005 was around 2.7 trillion US dollars, while what we are investing in health security is actually very, very, very, very small. And at that time, I asked the foreign ministers and defense ministers, you know, what's happening? And said, "Oh, we have concerns, so we have to invest." Of course, I can understand that. But the health security part is very important because a virus that could affect all of us can emerge anytime and have even more consequences than a conventional war. So what I suggested to them is, I cannot say, you know, you don't have concerns, but I can ask you to keep a balance because we are still vulnerable. and a respiratory infection could emerge and wreak havoc. And unless we invest and strike a balance, you know, we could regret it. So still, I don't see increased investment, and that's why I say, in terms of preparedness, it's a no. But the yes part is, based on COVID lessons, there are some progresses we have made, a very modest one. For instance, one of the critical things in emergency preparedness is the capacity at national level, because we are as strong as the weakest link. So the capacity in each country is really crucial. And that's why, together with the Global Fund, we have established the Pandemic Fund to support countries based on a peer review mechanism to fill the gaps they identify. So that's very critical. And then of course there are other COVID lessons like increasing the improving surveillance because there were surveillance weaknesses and the pandemic intelligence hub is established to fix that. And there was a problem in sharing samples and we have the bio hub in order to share samples as soon as possible. Equity was a problem because sharing, you know, diagnostic treatment or vaccines was considered as charity, but it's not. So we have established the mRNA technology transfer hub in Cape Town and the biomanufacturing in Korea to, you know, improve local production. So the equity issue could be addressed. But more importantly is the pandemic agreement, which was negotiated and agreed in May 2025. Now there is the Paris Annex of the pandemic agreement is being negotiated. That will help us in preparing and responding in a very coordinated way, and it will improve the governance. But still the improvement is modest, and countries will hopefully show more commitment.

I'm wondering if the investment changes that you talked about had a direct impact in terms of the response to Ebola.

Of course, on Ebola, can you rephrase it, maybe?

Well, you were just mentioning about the decreases in investments in the post-COVID era, that there was a lot of attention that was paid to the pandemic at that time. Once it was declared over, there was less attention being paid to this kind of preparedness. Did that lessening of investments have an impact in terms of the response to Ebola.

Yeah, it has, because we're responding to the Ebola outbreak after it happened. But before that, especially if you see in early 2025, there was a significant funding cut. And ODA declined by more than 40%. And that affected many countries, including the DRC. Whether it's having it had an impact or not is not even a debatable. It's true. So that's also what we're saying. You know, to make the world safer, we have to invest today during peacetime. It's not when it happens. That's why I said when something hits, there is panic, we tend to react instead of preparing in advance. But when there is a period where we can prepare, there is actually reducing the investment in health in general or health security. So that should stop. But that's what we have seen just even from 2025. And it has affected Ebola and it will continue to affect other health issues as well.

Forgive me, this is a little bit of housekeeping. I see that the timer is saying zero, but I do believe I might have 10 more minutes. Okay, great. I do want to, you know, when we're talking about investment, there has been a significant change in terms of investment from the United States, and it has withdrawn from the World Health Organization. And overall, we've seen a lot of funding cuts. by different countries when it comes to international aid. I'm wondering about the finances of the WHO and how prepared the organization is going forward.

Yeah, so on the US and WHO, of course, you know, the decision for the US to withdraw from WHO is unfortunate, and that decision is a lose-lose. the US lose and the rest of the world lose because in health and health security, especially solidarity is important, cooperation is important. And that's what we're missing now. So I hope the US will reconsider. But when I say US hopefully will reconsider, it's not about the money. I'll come later to this, but the money issue is already addressed. It's about solidarity, it's about cooperation, it's about the US leadership because US has excellent institutions. So that's the most important. So it's not about money because some people say, oh, you don't have money. So that's why you're asking. No. In terms of money, what we have done is we designed a new, we reduced our budget, designed a new structure. We implemented that. We have taken measures. Of course, we had to say bye to some colleagues. But compared to other institutions from which US hasn't withdrawn, the number of people that were separate from our organization is actually less. Because we started a finance reform without even, you know, this issue, the US issue. And the finance reform was based on the risk that we identified some years ago. that reliance on few traditional donors is a major risk for WHO and of course other organizations. So we decided to diversify our revenue base and the assessed contribution or membership fees, the best equalizer or that really broadens the donor base. And our member states, based on our request, agreed to double their membership fee. and to make it 50 to 60% of the core budget of the organization. That's significant. It prevents shocks like now, and also it ensures independence of the organization because we can use this flexible money that comes from all countries to use it based on country priorities, based on our priorities. So because of that, we had some resources that minimized the impact of the US withdrawal. So if you see our budget now, when I started in 2017, it was 3.4 billion for a biennium. Now it's around 4.2 billion. It's an increase, actually. And then the 2026-2027 biennium budget, 95% of it is already secured. And then I can go on and on. So in terms of financial stability, we are stable. And the measures we have taken stabilize the organization further. And we are moving forward.

Dr. Tedros, we're running out of time, but ever so briefly, I do want to ask you, since we're talking about the United States, currently there are outbreaks of measles in this country. The World Health Organization has worked over more than two decades and has brought measles down to 88%. How concerned are you about these current outbreaks here in the United States?

Yeah, I'm concerned. Not only the US, by the way. Measles is raging in other countries as well. Not only I'm concerned, but I'm disappointed as well, because maybe I can share with you my own story. My younger brother died around the age of between two to three. And from what my mother tells me, the symptoms are very close to measles. At that time, even the advent of vaccine was not there. This is in 1960s. So kids could die then because there was no technology. But now, when there is vaccine, when there is technology, effective and safe, kids dying, it's unacceptable. So I think countries should do everything to protect their kids. And it makes me sad. I'm even sad about my brother's death at that time. But now there is no reason for children to die.

Dr. Tedros, we've run out of time. A fascinating discussion. Thank you very much for joining us.

Thank you. Thank you for having me. Thank you.