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Mike Leavitt, Secretary of Health and Human Services


International Red Cross and Red Crescent Museum, Geneva


Tuesday, May 17, 2005

Remarks to the World Medical Association

Good afternoon. Thank you, Dr. Coble, for that wonderful introduction.

I am delighted to be here and grateful for this opportunity to meet so many of my colleagues: Health Ministers from around the globe and senior officials of the World Medical Association.

I want to thank the members of the W.M.A. for your leadership and commitment to advancing better health. We commend your recent call to take action on medical migration. We agree that the lack of health care workers in developing countries is a very serious problem. We all share your goal of healthy people around the world, and the highest international standards for health care. I also want to commend you for your long-standing commitment to the highest ethical standards in medical practice and clinical research.

I would like to call your attention to the disastrous public health impact that an influenza pandemic could have throughout the world. This is one of the most urgent health challenges we face.

Much of our attention is focused, quite appropriately, on the H5N1 virus in Asia. Lessons learned from addressing this challenge can help to prepare us for other potential pandemic influenza viruses that might emerge in the future.

President George W. Bush understands the gravity of our situation. In fact, the United States Government has made significant progress on pandemic influenza since he took office. We have increased spending on influenza ten-fold over the past five years. We have added flu vaccine and flu drugs to the stockpile and made influenza part of our regular public health discussions.

I urge my fellow Ministers and the national medical associations to make pandemic influenza preparedness a top priority for your countries. Preparedness will save lives.

Let me speak for a few moments about an area of special interest: the power of information technology to improve health care.

If we get it right, health information technology can help us address many of the key challenges in health care today. It can lead to fewer medical mistakes, lower health care costs, more convenience, and better health. It can also help us better track epidemics and outbreaks as well as improve our biosurvelliance and emergency preparedness.

In order to get these results from health information technology, we need to resolve a critical question. We can understand that question by studying the railroad industry.

In the 1850s, railroads offered a significant advance in transportation, and several companies in North America competed for business by laying and using rails across the continent. As we know from cell phones and roads, when two or more networks interconnect, they make a big network, which attracts more commerce and is likely to benefit all the owners of the smaller networks.

Unfortunately, the railroad companies were building rails to different standards. The distance between the rails, called the gauge, varied. Some rails were 4 feet 8 � inches apart. Some were 5 feet. Some were 5 feet 3 inches. All three gauges are good, but they�re incompatible. Most trains couldn�t switch from one network to another. The continent had multiple incompatible networks instead of one interoperable network.

Fortunately, in the late nineteenth century, thanks to some extraordinary leadership, the American railroad industry finally settled on a gauge of 4 feet 8 � inches.

My country benefits from a single interoperable rail network to this day.

Our friends in some other countries are not so lucky. Their rail industries have still not settled on a standard.

We face the same challenge with health information technology. In order to talk to each other, health information systems need to speak a common technical language. And in my country, no common language has yet emerged. In fact, in the absence of a single gauge, we are on the verge of creating a health IT system that could be permanently incompatible.

Every country needs a single standard for the exchange of its health data.

There are three ways to reach a single standard. The first is for the government to choose a standard and mandate it. That never works. The second method waits for the market to decide. I call this method the �last vendor standing,� This option is very expensive and slow. The third is collaboration.

Collaboration is messy and hard. But it�s the only thing that works.

Over the course of the next several months, my country must begin a very serious national dialogue and collaboration that includes federal officials as well as private industry leaders. I encourage my colleagues to convene similar national conversations.

And organizations like the World Medical Association and its national medical association members can contribute immensely to the dialogue and the development of clinical guidelines and health information exchange standards.

The W.M.A. is an example of a very potent organization. There are three basic types of organizations: governments, private companies, and voluntary organizations. All of them have a role to play in promoting better health.

Governments excel at monitoring progress, providing incentives, and encouraging innovation. Private companies excel at developing new products and services and marshaling resources to meet consumer demand. And voluntary organizations, including private foundations, from civic organizations to houses of worship excel at marshalling compassion to relieve suffering.

Each type of organization can learn from the others. When they cooperate, they can solve many complex problems. That�s why public-private partnerships must be a foundation for public health in the twenty-first century.

Public-private partnerships have played important roles in some of the largest public health initiatives in recent times. For example, polio eradication efforts would not be possible without collaboration between governments, the W.H.O., and Rotary International.

Another example is the global effort to address iodine deficiency disorders, which is on this year�s Assembly agenda. The salt industry has been a critical partner in every country where iodine progress has been achieved. There are many others examples where the private sector has played a key role � including, for example, infant and young child nutrition, HIV/AIDS, and drug development.

An excellent example of the power of public/private partnership comes from the tremendous global outpouring of generosity in the wake of the devastating Indian Ocean tsunami.

The list could go on and on because collaboration between governments and private entities makes good sense.

When we work together we can accomplish so much more than when we work alone.

It is time to work together. The health of the world�s people depends on it.

Thank you.

Last revised: May 16, 2005


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