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Opening remarks by Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean at the Regional Health Alliance meeting on Strengthening public health action on substance use

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01 June 2025

Distinguished Regional Directors,

Colleagues, and partners,

Substance use is one of the most urgent, yet often neglected, public health challenges in the Eastern Mediterranean Region today.

It threatens not only individual health but the security, safety, and economic well-being of our societies.

The human and economic toll is staggering. Substance use contributes to the burden of mental health disorders, hepatitis, tuberculosis, and HIV. It accounts for as much as 2 per cent of GDP in some countries due to health costs, crime, and lost productivity.

In 2022, an estimated 292 million people globally—5.6 per cent of the population aged 15–64—used drugs.

In our Region, 6.7 per cent of the population has used drugs—higher than the global average. The burden is especially heavy on young people, with 4.9 per cent of young men in the Region having used cannabis in the past year.

Unfortunately, treatment coverage remains alarmingly low. In 2022, in the Eastern Mediterranean Region, only 1 in 13 people with a substance use disorder received treatment.

This is further exacerbated by stigma, disparities in access to essential medications, and an overreliance on punitive measures.

To bridge these gaps, we have launched the Regional Flagship Initiative for Accelerating Public Health Action on Substance Use, endorsed at the 71st session of the WHO Regional Committee in 2024.

This initiative marks a strategic shift towards a public health approach—centred on prevention, care, and dignity—through action across three key domains:

  1. Promotion and Prevention, to stop initiation and create supportive environments free from stigma.
  2. Health System Interventions, integrating treatment for substance use disorders into Universal Health Coverage benefit packages.
  3. Policy and Regulatory Interventions, supporting countries to adopt evidence-based, health-centred responses.

In February 2025, we convened over 100 stakeholders in Abu Dhabi for a high-level policy dialogue.

We have since established a Strategic and Technical Advisory Group and are launching a Regional Coalition of Civil Society Organizations to support implementation and amplify the voices of people with lived experience.

But success depends on collaboration. Substance use is not a challenge that any one sector—or agency—can solve alone.

This is where the Regional Health Alliance (RHA) becomes a game-changer.

As a collaborative platform of 18 UN agencies, the RHA provides a vital mechanism for aligning strategies, coordinating technical support, and maximizing our collective impact.

In a context of shrinking resources and growing needs, doing more with less requires unified, strategic action.

Today, I have three key asks:

Partner with us to localize the initiative through national policy dialogues and coordinated UN country missions—ensuring alignment with national priorities and translating regional goals into concrete action.

Collaborate on joint, resourced country support workplans (2025–2028) and a Joint Resource Mobilization Plan to secure the financial and human resources needed for sustainable implementation, including integration of substance use interventions into UHC benefit packages.

Support national capacity-building efforts by strengthening the health workforce and establishing robust monitoring and accountability frameworks.

Together, we can transform how substance use is addressed in this Region—from punishment to prevention, from isolation to integration, and from fragmentation to coordinated, impactful action.