Tedros warned that important work at the assembly to address a long list of global health emergencies and challenges, including the Covid-19 crisis, could not succeed “in a divided world”.

“We face a formidable convergence of disease, drought, famine and war, fuelled by climate change, inequity and geopolitical rivalry,” he warned.

The former Ethiopian health minister said he was viewing the ravages in Ukraine through a personal lens: “I am a child of war”. In Ukraine and elsewhere, he said, it is clear peace “is a prerequisite for health”, adding: “We must choose health for peace, and peace, peace, peace.”

WHO chief says China’s zero-Covid policy not ‘sustainable’

But it was war that dominated the high-level speeches on the first day of the assembly.

“The consequences of this war are devastating, to health, to populations, to health facilities and to health personnel,” French President Emmanuel Macron said in a video address.

He called on all member states to support a resolution to be presented by Ukraine and discussed by the assembly on Tuesday, which harshly condemns Russia’s invasion, especially its more than 200 attacks on healthcare, including hospitals and ambulances, in Ukraine.

The resolution will also voice alarm at the “health emergency in Ukraine”, and highlight the dire impacts beyond its borders, including how disrupted grain exports are deepening a global food security crisis.

But while Russia has been shunned and pushed out of other international bodies over its invasion, no such sanctions are foreseen at the World Health Assembly.

“There’s not a call to kick them out,” a Western diplomat said, acknowledging the sanctions permitted under WHO rules are “very weak”.

The Ukraine conflict is far from the only health emergency up for discussion this week, with decisions expected on a range of important issues, including on reforms towards strengthening pandemic preparedness.

“This meeting is a historic opportunity to strengthen universal architecture for security and health,” Dominican Republic President Luis Abinader Corona told the assembly.

Among the decisions expected at the assembly is Tedros’s reappointment to a second five-year term. His first term was turbulent, as he helped steer the global response to the pandemic and grappled with other crises, including a sexual abuse scandal involving WHO staff in the Democratic Republic of Congo.

While he has faced his share of criticism, he has received broad backing and is running unopposed, guaranteeing him a second term.

There will be no shortage of challenges going forward, with the Covid-19 pandemic still raging and demands for dramatic reforms of the entire global health system to help avert similar threats going forward.

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What is monkeypox and should we be worried that it’s spreading?

What is monkeypox and should we be worried that it’s spreading?

And new health menaces already loom, including hepatitis of mysterious origin that has made children in many countries ill, and swelling numbers of monkeypox cases far from Central and West Africa where the disease is normally concentrated.

One of the major reforms up for discussion involves the WHO budget, with countries expected to approve a plan to boost secure and flexible funding to ensure the organisation can respond quickly to global health threats.

The WHO’s two-year budget for 2020-21 ticked in at US$5.8 billion, but only 16 per cent of that came from regular membership fees.

The idea is to gradually raise the membership fee portion to 50 per cent over nearly a decade, while WHO will be expected to implement reforms, including towards more transparency on its financing and hiring.

The remainder is to come from voluntary contributions that are heavily earmarked by countries for particular projects. “There is no greater return on investment than health,” UN chief Antonio Guterres told the assembly in a video address.

The Covid pandemic laid bare major deficiencies in the global health system, and countries last year agreed numerous changes were needed to better prepare the world to face future pandemic threats.

Amendments are being considered to the International Health Regulations – a set of legally binding international laws governing how countries respond to acute public health risks. And negotiations are underway towards a new “legal instrument” – possibly a treaty – aimed at streamlining the global approach to pandemic preparedness and response.

But experts warn the reform process is moving too slowly. Former New Zealand prime minister Helen Clark, who co-chaired an expert panel on pandemic preparedness, warned reporters last week little had yet changed. “At its current pace, an effective system is still years away, when a pandemic threat could occur at any time.”