Johannesburg, 1 September -- The World Health Organization (WHO) and its Member States in the African Region have made definite progress towards polio eradication, with the Region attaining certification level surveillance for the first time in 2002, and the number of polio-endemic countries reduced by 67%, from six in 2001 to two in 2002, WHO says in a report released on Monday. 
The report, on the work of WHO in the African Region in 2002, was presented by the WHO Regional Director for Africa, Dr Ebrahim Samba, to the 53rd session of the WHO Regional Committee for Africa meeting from 1 to 5 September in Johannesburg, South Africa.

Dr Samba attributes the reduction in the number of polio-endemic countries in the Region to repeated quality National Immunization Days (NIDs) conducted in 16 West African and six Central African countries during the period under review, and the continuing political commitment to polio eradication in all countries in the Region.

The section of the report dealing with communicable disease prevention and control also indicates that there was increased commitment to the Roll Back Malaria (RBM) Initiative in all countries in the Region, with the Regional Office prioritizing support to Member States to improve RBM coverage intervention.

Highlights of other achievements include programmatic interventions which focused on the health sector response to HIV/AIDS. Building on the Regional Strategy for HIV/AIDS prevention and control, and the need to clarify the health sector response to the epidemic, the Regional Office supported Member States to scale up the implementation of health sector programmes that deliver an essential package of effective public health interventions against the disease.

With regard to tuberculosis (TB), WHO supported countries to implement multi-year plans to accelerate the expansion of the Directly Observed Treatment, Short Course (DOTS) strategy; develop operational plans, and community TB care and TB/HIV collaborative activities, and obtain drug grants. In addition, the first annual Regional TB surveillance report was published. Implementation of the Regional Integrated Disease Surveillance and Response activities has contributed to improvement in the early detection of, and timely response to, epidemics in the African Region.

WHO also provided support to countries to stem the tide of vaccine-preventable and other communicable diseases such as meningococal meningitis, cholera, Ebola, yellow fever, guinea worm, leprosy, lymphatic filariasis, schistosomiasis, leishmaniasis, trypanosomiasis, intestinal parasitosis, buruli ulcer, and neonatal tetanus.

Prevention and Control of non-communicable diseases (NCDs)

For NCDs, now increasingly becoming major public health challenges, the Regional Office worked with countries to map the emerging epidemics in this area; devise tools for intersectoral collaboration; promote good practices and evidence-based methods and strategies for promotive and preventive interventions; develop or update national action plans, establish surveillance systems; and build capacities for programme development and implementation.

A Regional Strategy for Health Promotion and various related guides were produced and disseminated to countries, which also benefited from workshops on disability and injury prevention and rehabilitation, and mental health disorders. Almost all countries participated in the intergovernmental negotiation sessions for the Framework Convention for Tobacco Control. As at June 2003, the Convention had been signed by 41 countries worldwide, 10 of these in the African Region.

Family and Reproductive Health

During the period under review, the Child and Adolescent area of work addressed the problem of high perinatal and newborn mortality and morbidity, the negative consequences of child abuse and neglect, and the reduction of the vulnerability of adolescents to morbidity associated with early sexual activity and other risky behaviour.

Advocacy material developed by the Regional Office during the year under review included a brochure Africa's newborns: the forgotten children which focuses on common causes of newborn deaths and the capacity of health facilities to provide care for mothers and their newborns. Other tools developed for advocacy and strengthening adolescent health in countries include the Framework for Implementation of the Regional Adolescent Health Strategy and The Adolescent Health and Development: Briefing Kit.

The Regional office conducted a study on the inclusion of Integrated Management of Childhood Illness (IMCI) into pre-service training, the results of which were used to support 10 countries to develop plans for its inclusion in their health training institutions.

Other achievement were: the establishment of the Regional Reproductive Health Task Force; the development of a regional reproductive health database for monitoring trends in reproductive health indicators; support to national and sub-regional medical associations for promoting reproductive health research and interventions; the development of a framework to guide countries to determine priorities, define effective and affordable interventions, and implement appropriate programmes; assistance to countries for maternal death audits; support to professional associations in introducing Integrated Management of Pregnancy and Childbirth (IMPAC) tools into pre-service institutions; and support to countries to incorporate Women's Health and Development into national policies and programmes.

Also undertaken by the Regional Office were the establishment of networks involved in reproductive health research, and networks for the Integration of Prevention and Control of Malaria in Pregnancy; support to countries to integrate activities for the prevention and control of malaria in pregnancy in reproductive health programmes; support to countries to develop community ambulance systems for transporting pregnant women to health facilities during emergencies; the mapping of obstetric care services based on defined minimum packages of care, and technical assistance to countries for the elimination of female genital mutilation and other forms of harmful traditional practices.

Healthy Environments and Sustainable Development

Key achievements in this area included support to countries to improve their preparedness for, and response to, emergencies; the management and prevention of sexual abuse; capacity strengthening through awareness raising, and training workshops.

The Regional office also conducted a survey on food safety, which analyzed the health risks associated with food handling; initiated or continued the 'Healthy Cities' project in many countries in the Region, and supported countries to strengthen environmental health programmes.

In addition to conducting a survey on occupational health in the Region, the Regional Office initiated discussions with the International Labour Organization (ILO) on the possibility of establishing a WHO/ILO Joint Effort in Occupational Health. It also initiated a process that would enable the Universities of Cape Town and Benin to serve as WHO Collaborating Centres for occupational health.

During the period under review, the Regional Committee adopted two regional strategies in this area of work: one on environment and health, and the other on health and poverty reduction. Nationals of six Francophone countries were also trained in long-term health planning.

Health Systems and Services Development

In line with WHO's priority of strengthening health systems to deliver quality health services, the Regional Office produced various documents, tools, and guidelines on health system development including human resources development.

Support was provided to countries in support of their health sector reforms to review their national health policies and plans, strengthen district health systems, address the problem of brain drain and weak motivation of workers, review and update their strategies to improve access to affordable, quality and safe medicines, improve quality of care through appropriate and affordable technologies, and set up mechanisms to provide adequate and safe blood to those in need.

Guidelines for documenting African traditional medicine were developed and technical assistance provide to countries for either the evaluation of traditional medicines or the development of traditional medicine programmes.

Administration and finance

Successes recorded in this area included the successful relocation of 200 personnel and 300 tones of office equipment and personal effects from Harare to Brazzaville, improvement of information and communication infrastructure, the development of accounting software for managing imprests, and the extension of decentralization of financial management services to Divisions at the Regional Office and Country Offices.

General Programme Development and Management

General programme Development and Management ensured smooth overall coordination of the work of WHO in the Region. Some organizational changes effected in 2002 included the transfer of the Emergency and Humanitarian Action area of work to the Division of Healthy Environments and Sustainable Development in order to provide an institutional anchor for the considerable work accomplished in environmental risk assessment and long-term health development. The Inter-Agency Resource Management and Governing Bodies units were merged to form the External Relations and Governing Bodies Area of Work.

Other achievements recorded during the period were included: capacity strengthening for the formulation and implementation of country cooperation strategies; improving the leadership and managerial capacities of WHO Representatives; the strengthening of collaboration and coordination between the three levels of WHO, and the finalization of 10 project agreements valued at $48.7 million to support programme implementation.

To make information about WHO more readily available in countries, the WHO country offices were supported to implement the Information, Education and Communication (IEC) component of their workplans. Health reporting was improved in 14 countries through technical support for workshops for media practitioners, and for the strengthening of health desks in national media institutions. The development of the Regional Office website has helped to increase the flow of information to the media and the general public. This, in turn, has helped to sustain a positive public image and professional credibility with media partners and other publishers in the Region.

Enabling and constraining factors

According to the report, the work of WHO in the African Region during the period under review was facilitated by global political and government commitment to addressing health problems, close collaboration among various stakeholders and WHO at national, regional and global levels, and excellent collaboration between WHO Headquarters, Regional and country offices.

Among the constraining factors were security problems, complex emergencies and national disasters in the African Region resulting in an increase in the number of unimplemented activities; frequent delayed responses, and limitations in human and financial resources.

Conclusion

Overall, says the Report, "The year 2002 was marked by unprecedented commitment to health-related issues on the part of Member States and international agencies, and there was a greater understanding of the management process by the WHO programme."

For further information, please contact

Samuel T. Ajibola
Public Information and Communication Unit 
World Health Organization - Regional Office for Africa 
P.O. Box 6, Brazzaville, Congo. 
E-mail: ajibolas [at] afro.who.int 
Tel:+ 47 241 39378; Fax: + 47 241 39513; 
in Johannesburg: +27-72-722-5680