15 January 2024

Good afternoon from WHO’s Regional Office for the Eastern Mediterranean in Cairo, Egypt.

We are now at the 100-day mark since the hostilities in Israel and the occupied Palestinian territory escalated.

In this short period of time, Gazans – previously waking up every day in their beds to get ready to go to school or work, have family dinners together, and make plans for the future – have lost their closest loved ones, homes and belongings, livelihoods, and most basic human rights.

Almost 85% of the entire population of Gaza -- 1.9 million people – are now displaced and living in overcrowded shelters with extremely limited sanitation services, without food or water, in freezing temperatures, and facing increasing hunger and disease, in addition to risk of injury or death from the bombardments.

The health system is hanging by a thread, desperately trying to maintain functionality amid overwhelming challenges and threats of attack. With only 15 of 36 hospitals functioning – and all of these only partially functioning – many injured patients are being treated on the floors of overcrowded health facilities. Many of those who could be saved are dying due to lack of specialized doctors, fuel and electricity, medicine, food, and clean water.

As a result of restrictions and delays in the delivery of fuel, medicines, and other aid, the unimaginable suffering and risk of death and illness for people in Gaza continues to climb.

For 100 days, we have called for increased flows of humanitarian aid into Gaza and unhindered access to that aid. We have also called on both side to cease the hostilities, which are also triggering a disturbing spillover into Lebanon and Yemen. As of 10 January, Lebanon’s Ministry of Health has reported 138 deaths and 617 injuries in Lebanon as a result of the cross-border armed conflict; the most recent attack on health care on 11 January resulted in two paramedics killed and an ambulance destroyed. We are also closely monitoring the situation in the Red Sea and Yemen.

People in our Region – some of the most vulnerable people in the world -- cannot afford to be further deprived of their most basic right to life, and access to life-saving health care. And health systems – already desperately trying to cling to functionality amid overwhelming challenges – cannot afford to be further tested.

Later this afternoon, WHO is launching its global appeal for health emergencies for 2024, covering emergencies across all WHO regions.

We are launching this appeal at a time when health in the Eastern Mediterranean Region is under threat like never before. In the second half of 2023, our Region was ravaged by six new emergencies, including major a cholera outbreak in Sudan on the back of escalating conflict, floods in Libya, major earthquakes in Morocco and Afghanistan, and the ongoing tragedy unfolding in the occupied Palestinian territory, one of the most challenging humanitarian and public health crises in the Region's modern history.

Today, 140 million people in the Eastern Mediterranean Region are in need of humanitarian assistance – totaling almost 20% of the Region’s population and around 40% of all people in need globally --. In 2024, WHO requires almost US$706 million to respond to major emergencies in the Eastern Mediterranean Region.

Sudan’s health system continues to struggle amidst protracted conflict that now constitutes the largest displacement crisis in the world today. Increasing violence, the spread of diseases such as cholera, impeded access, insecurity and looting of supplies are undermining the efforts of humanitarian partners to save lives. As a result of worsening conflict, aid agencies can now only access 4 out of all 18 states from inside Sudan. Humanitarian agencies have been forced to relocate from Khartoum, Darfur and Al Gezira states. However, we continue to strengthen our operational presence and adjust operations based on rapid changes in context, and the capacity to deliver critical, life-saving services to the most vulnerable.

The humanitarian crisis in Afghanistan remains one of the world’s largest and most severe – with a fragile health system, food deprivation, multiple concurrent disease outbreaks s, ongoing conflict, droughts and other natural disasters now impacting 23.3 million people in need.

In Syria, more than 15 million people need health services amidst a health system plagued by repeated shocks, including disease outbreaks, economic instability, and the devastating earthquake that struck both Syria and Turkiye at the beginning of the year.

Yemen continues to face an acute humanitarian crisis, with almost 18 million people requiring health assistance. The situation remains dire, especially for vulnerable groups like internally displaced people, children, women, the elderly, people with disabilities, and marginalized communities. With only about half of all health facilities fully functional, Yemen also continues to battle infectious disease outbreaks, including measles, polio, dengue, pertussis, and diphtheria.

This year, our regional response, in coordination with health authorities, partners and all three levels of WHO, will also focus on multi-country emergencies, including drought and food insecurity in the Greater Horn of Africa, cholera outbreaks in 9 of the Region’s 22 countries, and dengue fever. Although COVID-19 is no longer a global health emergency, we remain committed to working with countries and communities so that further spread can be prevented while capacities can be built to handle future pandemics.

Dear colleagues,

This is my last press briefing as Regional Director of WHO’s Office for the Eastern Mediterranean as I return to teaching and supervising medical students and residents at Sultan Qaboos University in Muscat, while also overseeing patients at the University's family medicine health centre.

Over my five-year tenure, I have seen over and over the impact of emergencies on the lives of innocent people. I will never forget the dazed look on the face of the little girl who lost her parents in the earthquake that struck Syria; the tears of the elderly woman who lost her grandchild and home in the Beirut port blast; the worry on the face of parents sitting by their weak and malnourished child’s side in Somalia; and the shock at hearing of the death of our colleague Dima Alhaj in Gaza, one of more than 145 UN staff killed since the start of the hostilities, many along with their families.

I leave my post as Regional Director with a heavy heart at the current state of our Region. Fragile gains that have been made are being lost as health becomes entangled in politics, and as the public health impact of climate change grows more severe.

But I have also seen the impact that WHO and its partners make to help save lives and strengthen health systems, so that health care is accessible to all who need it. And I have also seen the solidarity and action by our Member States as they support our vulnerable brothers and sisters in countries facing crisis.

Despite the challenges, we have made a difference in people’s lives and remain committed to doing so, no matter the obstacles facing us. Recently, and most significantly, the situation in Gaza has shown us how fragile the sanctity of health can be. But it has also shown us the determination of health workers and humanitarian actors who are willing go to any lengths – even at the expense of their own safety and wellbeing -- to reach people-in-need with lifesaving care. I am confident that this determination will only continue to grow, raising public health above religious differences, political conflict, and the senseless quests for power and land.

Last week, WHO’s Director General Dr. Tedros noted that 2024 will be a test for humanity; a test of whether we give into division, suspicion and narrow nationalism, or whether we are able to rise above our differences and seek the common good.

I urge us all – and especially the economically and politically stable Gulf countries – to use their resources and their voices in support of our people suffering from some of the worst humanitarian crises anywhere in the world.

Thank you, and I wish you all a blessed 2024. It has been an honor serving this Region and its people. As I step down from my position, I have full confidence in the capable hands of Dr. Hanan Balkhy, who will replace me as Regional Director next month. She brings a wealth of expertise and dedication to the role. I am certain that she will lead with excellence.

To our committed WHO teams at all levels, our dedicated partners, and the brave health workforce across the Region – your tireless efforts have made a significant impact, and I am grateful for your unwavering commitment to public health.

Most importantly, I extend my heartfelt gratitude to the people of the Region. Your resilience and determination to build a better future for your families and countries inspire us all. As we transition, know that WHO stands by you, and will continue to support your journey towards improved health and well-being.

May 2024 bring prosperity, good health, and continued progress to this Region.

Thank you.