 So greetings from WHO in Geneva. My name is Neelam Tingra and I'm the unit head for patient safety flagships at the WHO headquarters in Geneva. And first of all, I would like to acknowledge the leadership of Patient Safety Movement Foundation in organizing the World Patient Safety Science and Technology Summit series. And I welcome all participants who are joining the session and I'll be sharing my thoughts on some strategic global opportunities and WHO initiatives in patient safety which have provided a huge global momentum for patient safety globally in this current decade. My presentation is structured around a couple of key topics which is the burden of harm of unsafe patient care, patient safety at the heart of universal health coverage. What are the gaps in patient safety globally? The Global Ministerial Summit series on patient safety, the World Health Assembly resolution on global action on patient safety, the global patient safety efforts of key organizations and intergovernmental organizations, the global patient safety action plan, 2021 to 2030, the WHO flagship initiative, a decade of patient safety, 2021 to 2030 and where we are with the global patient safety movement the past, the present and the future. We all recognize no one should be harmed in healthcare. However, there's a huge burden of unsafe care globally and we have seen that adverse events are likely to be one of the 10 leading causes of death and disability worldwide. One in every 10 patients is harmed while receiving hospital care in high income countries and in low and middle income countries it is estimated that 134 million adverse events occur each year in hospitals in low and middle income countries alone which contribute to around 2.6 million deaths annually. There's a huge burden of unsafe care globally. We also see that four out of 10 patients are harmed in primary and ambulatory care settings through several estimates. This high cost of treating effects for patient harm and in OECD countries it is estimated that 15% of total hospital expenditures is actually directly to manage the adverse effects of safety failures. Up to 80% of harm to patients in healthcare is avoidable and we also see that unsafe medication practices and errors lead to harm in millions of patients and they cost billions of dollars each year. So it's a huge challenge which we are addressing at global level. Patient safety is at the heart of universal health coverage because they are significant financial cost of unsafe care, health cost of unsafe care and also excess cost of unsafe care. Money is lost in treating safety failures, readmissions and extended stays and surgeries through litigations and legal fees and compensations also huge amount of cost is there of unsafe care to healthcare systems around the world. There's a huge burden of harm which leads to morbidity and mortality due to adverse events and this volume is lost due to loss in faith in healthcare systems so patients don't access the healthcare system and this altered health-seeking behavior actually is counterproductive to the objectives of universal health coverage. There are several gaps in achieving patient safety around the world and it has been seen these gaps could be knowledge gap which is this gap in understanding the extent of problem and causal and contributory factors particularly in low and middle income countries. A policy gap because of inadequate policy environment and fragmented policies related to safety programs and sometimes also lack of political will. Design gap due to inadequate application of science to implementation tools for patient safety and also the management science and practices are not applied at organization and care delivery level leading to a delivery gap. Similarly, the best practices and innovations and coping mechanisms which are followed by countries around the world they're not really correlated and disseminated in a systematic manner which also leads to communication gap around the world. So recognizing these huge gaps in patient safety globally and also there's a huge burden of harm due to unsafe care. Political leaders from around the world have initiated an annual global ministerial summit series on patient safety. Four global ministerial summits on patient safety have been delivered starting from leadership from the UK and German government summit in London in 2016 in Bonn in 2017, in Tokyo in 2018 supported by the Japanese government and in 2019 supported by the Saudi Arabia government in Jeddah. WTO leadership have been very much involved and supportive and leading in the global ministerial summit on patient safety. The next global ministerial summit is planned to be organized in February 23 posted by the Swiss government and to be organized in Monthro next year. The momentum created by the global ministerial summits on patient safety led to a watershed moment for patient safety in 2019 when the 72nd World Health Assembly adopted a landmark resolution on global action on patient safety in May 2019. The assembly also recognized patient safety as a global health priority and established an annual world patient safety day to be observed on 17 September every year. The resolution also urged and a member states to work together with WHO and asked WHO to formulate a global patient safety action plan which is aligned with sustainable development goals. Similarly, at the same time there have been landmark initiatives from other organizations, OECD in particular as initiated a series of publications on economics of patient safety and they have launched one dedicated to economics of patient safety in hospital care which was launched in 2017. In 2018, the economics of patient safety in primary and ambulatory care was released. Economics of patient safety from analysis to action was launched in 2020 and they have been several other publications including economics of patient safety in long-term care as well as safety at the workplace which was launched in September, 2021. The leadership of G20 countries as well recognized patient safety as a standalone agenda item and under the presidency of Saudi Arabia in 2020 and under the presidency of Italian government in 2021 patient safety was included as an agenda item for discussion and asking for commitment of countries of the G20 member states in particular to commit to patient safety and also work with countries around the world to improve patient safety globally. At the same time, the G20 health and developmental partnership working with several influencers and leaders globally released a very important publication the overlooked pandemic which was published in February, 2021 how to transform patient safety and save health care systems. And here, WHO leadership Dr. Ted Ross, WHO director Jeremy also contributed to this extremely important publication the overlooked pandemic. The G7 countries, particularly under the leadership of UK government also have recognized the importance of patient safety and the UK government organized a high-level event on patient safety which was co-sponsored by WHO in November last year to demonstrate the importance of patient safety as a critical global endeavor to facilitate international collaboration and to support strategic initiatives designed to eliminate avoidable harm in healthcare globally. As a response to the global call for action for patient safety, WHO launched a flagship initiative a decade of patient safety 2021 to 2030 to work with member states and partners and prioritize action on patient safety. And a couple of important initiatives under the flagship include the World Patient Safety Day facilitating and catalyzing global action utilizing the pledge form of World Patient Safety Day working with member states to develop a global patient safety action plan and also work with them to implement the action plan. Global patient safety challenge as part of the series of global patient safety challenges the third challenge on medication without harm to focus on addressing medication safety issues globally. Global patient safety collaborative and establishment of networks as well as development of standards and guidelines and tools to support patient safety implementation and patient and family engagement to provide a platform for patients voice for patient safety. After the resolution was adopted in 2019 on global action on patient safety WHO working with several partners and member states started a process of development of global patient safety action plan as a roadmap for patient safety action globally going through several steps of scoping a literature review internal consultations, global expert consultations as well as public consultations and member state consultations. The final draft of the action plan was actually submitted to the World Health Assembly for adoption in May 2021 which was adopted by the World Health Assembly and was formally launched in August 2021. And this was a great event where we had partners around the world coming together, fully engaged and committing to implement the global patient safety action plan which was launched by Dr. Tedros WHO director general on the 4th of August 2021. The action plan provides a vision of the world in which no one is harmed in healthcare and every patient receives safe and respectful care every time everywhere with a mission to drive forward policies and strategies and actions based on science and patient experience and system designs and partnerships as well as a goal to achieve the maximum possible reduction in avoidable harm due to unsafe healthcare globally. It provides a framework of action under seven strategic objectives which relate to policies for zero patient harm high reliability systems and organizations safety of clinical processes patients and family engagement healthcare worker education skills and safety information research and risk assessment leading to improvement and also synergy, partnership and solidarity. World Patient Safety Day has been an important platform for WHO to call for action on priority topics which require attention and which lead to significant harm in healthcare. So far for successful events have been organized since it was adopted and established by the World Health Assembly in 2019. The very first World Patient Safety Day was observed on the 17th September 2019 where a legacy and a visual identity was created for World Patient Safety Day with a logo as well which is a extremely important visual identity for World Patient Safety Day. In addition, this was a year with a theme of patient safety global health priority and gave a slogan to the world on speaker for patient safety. Also asking member states and organizations and partners around the world to lit up iconic monuments and buildings in orange color to paint the world orange to draw the attention on issues of patient safety. In 2020, the World Patient Safety Day was committed and dedicated to health worker safety with a call for action for speaker for health worker safety. In 2021, the theme was on safe, maternal and newborn care and several countries around the world in the legacy of World Patient Safety Day lit up iconic monuments demonstrating global solidarity to observe the day and also take urgent action to address patient safety. World Patients, WHO also launched a WHO global patient safety challenge on medication without harm at the second global ministerial summit on the 29th of March, 2017 in Bonn. And that provided a great platform again to bring member states together to work towards addressing medication-related harm. There is unprecedented and huge burden of medication-related harm globally and recognizing that more than 50% of harm in medical care is due to unsafe medication practices and medication errors. The World Patient Safety Day of this year has been dedicated to the theme of medication safety. Building on to the global challenge on patient safety, which is medication-related harm, under which several important products were developed to work with member states and partners to implement the action on for medication safety under a strategic framework which has actions on patients and the public, healthcare professionals, medicines as products, as well as systems and practices of medication. Several technical reports, tools such as five moments of medication safety, three key action areas have been identified related to higher risk situations and medication safety in higher situations in transitions of care, as well as in polypharmacy. And an important campaign of No Check Ask has also been launched as part of the Global Patient Safety Challenge on medication without harm. This campaign, which signifies through No Check Ask, which is an action to improve interaction of healthcare workers and patients. It is hoped that with the theme of World Patient Safety Day of this year on medication safety, it will really provide a huge impetus for prioritizing medication safety and asking countries and partners to work towards improving medication safety. And we believe that World Patient Safety Day would provide an opportunity and a platform to consolidate the work of the WHO Global Patient Safety Challenge on medication without harm. In addition, WHO has also established Global Patient Safety Network, which brings together member states as well as active members working on patient safety globally. So all important stakeholders as well as partners and member states and WHO country offices, regional offices, all are connected to a network to share experiences and resources in real time. And that is a very vibrant interactive network of sharing of information and also for drawing attention to key areas of concern and looking for solutions collectively. Together with the UK government, WHO has also launched an important initiative, a Global Patient Safety Collaborative, which is focused on actions related to leadership, education and training and research, working with the academic partner Imperial College London. We are developing several technical products, guidelines and tools. And in the phase one of this collaborative are working with four countries, India, Kenya, Mongolia and Pakistan to implement patient safety systems which are sustainable and also improving the patient safety at the bedside in these countries. Several important tools and guidelines have also been issued by WHO to support countries and work with countries to implement patient safety solutions, education and training curriculum guide for multi-professionals, safe childbirth checklist, safer primary care technical series, patience for patient safety initiative, as well as several tools for supporting the establishment of patient safety incident reporting and learning systems such as minimal information model as well as guidelines for establishing patient safety reporting and learning systems. We have worked with several countries to develop national patient safety implementation plans as well India is one of the examples here. And as I mentioned, patient safety incident reporting and learning systems, a technical report and guidance is targeted to support countries in establishing this system which are really important to learn from what has gone wrong in the healthcare system which has caused harm and what are the risks of harm and how to capture them, how do we analyze those and we learn from them and bring about change at policy level and practice level to improve patient safety. So with that, I would like to conclude my presentation just highlighting how we have built the momentum from the past and we are moving to from the present to the future. The foundation for the Global Patient Safety Movement was launched in late 1990s and early 2000 when too early human report was launched that was followed by adoption of World Health Assembly Resolution in 2002 on patient safety. The first global patient safety challenge on clean care and safe care was launched as well as the second challenge was launched around that time during this period of 1999 to 2014. Several activities were initiated across the world and many countries prioritized patient safety during this time. The patient safety movement was rejuvenated with the initiation of the Global Ministerial Summit series which created a foundation for rejuvenation phase from 2015 to 2018. The first summit organized in London the second one in Bonn and also at the Bonn Summit the WHO third global patient safety challenge on medication without harm was launched. The third ministerial summit series was held in Tokyo which led to Tokyo Declaration and also WHO Global Patient Safety Network was launched at this time. 2019 of course was the watershed moment where patient safety was identified as a global health priority. The World Health Assembly Resolution on Global Action on Patient Safety was adopted the World Patient Safety Day was established to be observed on 17 September. The fourth ministerial summit was organized in Jeddah which also led to Jeddah Declaration and patient safety was included for the first time as a G20 agenda under the leadership of Saudi Arabia. The vision of future which is the current decade led to the creation of a vision and a roadmap for Global Patient Safety Action Plan which is a roadmap for the next 10 years and to support the implementation of the Global Patient Safety Action Plan as well as respond to the Global Call for Action WHO established and launched the flagship initiative a decade of patient safety. Continuing from this year the World Patient Safety Day of course provides a great platform every year on 17 September which is dedicated to an annual theme. The fifth ministerial summit continuing in the series is planned to be held in 2023 at Montrose and we hope that the series will keep the momentum and keep engagement of the political leaders as well as provide the high level advocacy for the implementation of action on patient safety in the coming decade. Patient safety in being included on the G20 agenda and high level advocacy through G7 has also provided a huge opportunity for high level advocacy and prioritization of patient safety at global level. Global Patient Safety Collaborative as a mechanism to work with countries and also provide support in implementation of patient safety action is another opportunity and this provides a vision of the coming decade of patient safety. So with that dear colleagues I would like to thank you for your attention and I'm really thankful to Patient Safety Movement Foundation and the organizing committee for giving me this opportunity to share my thoughts with you. Thank you so much indeed.