Address By Dr Luis Gomes Sambo, WHO Regional Director for Africa, at the Opening of the Sixty-First Session of the WHO Regional Committee for Africa

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Excellency Mr Daniel Kablan Duncan, Minister of State, Minister of Foreign Affairs of the Republic of Côte d'Ivoire,

Honourable Members of the Government of Côte d'Ivoire,

Honourable Vice-Chairman of the 60th session of the WHO Regional Committee for Africa,

Honourable Ministers of Health,

Honourable Ministers of Finance,

The WHO Director-General, Dr Margaret Chan,

Excellencies, Members of the Diplomatic Corps and Heads of International Cooperation Agencies,

Distinguished Directors of Agencies of the United Nations System and other Multilateral Cooperation Agencies,

Venerable Traditional Chiefs and Religious Leaders,

Distinguished Guests,

Ladies and Gentlemen.

It is my great pleasure and honour to welcome you to the Sixty-first session of the WHO Regional Committee for Africa, which is being held in this wonderful building of the Fondation Houphouët-Boigny pour la Recherche de la Paix in Yamoussokro. I would first of all like to express to H.E. Mr Alassane Ouattara, President of the Republic, and to the People of Côte d'Ivoire, our profound gratitude for the kind hospitality shown to us since our arrival in Côte d'Ivoire. We are extremely grateful for all the arrangements made for the holding of this meeting.

I would like to acknowledge the presence at this gathering of the Ministers of Health, and the Ministers of Finance of Member States as well as their delegations that have travelled all the way to Yamoussoukro. Also present at this Regional Committee meeting are the Directors of UNICEF, UNAIDS, USAID, World Bank, African Development Bank, Bill and Melinda Gates Foundation, GAVI, and the Executive Director of the Global Fund to fight AIDS, Tuberculosis and Malaria, among other important health development partners in Africa, who accepted my invitation to attend this Regional Committee, which is a forum for reflection on public health issues in our Region. I wish to welcome all of you.

Honourable Minister of State,

Distinguished Guests,

Ladies and Gentlemen,

Our first few days in Côte d'Ivoire were marked by the tragic event that occurred in Abuja. It is with the deepest emotion that we learnt about the bomb explosion at the UN building in Nigeria. This explosion killed and seriously injured several UN officials, including those of WHO, while they were carrying out their mission for the benefit of humankind. I express my deepest condolences to the bereaved families. May I request that we observe a minute's silence in memory of the victims of this violence.

Excellencies,

Ladies and Gentlemen,

I would now like to examine with you some specific issues regarding health in our Region. Although, we have made some progress lately in the area of health, there are still other very important challenges to meet.

Concerning epidemics, cholera is first on the list, with 108 000 cases and 3350 deaths recorded in 2010. Limited access to safe drinking water and basic sanitation facilities and inadequate hygiene remain the main causes of cholera epidemics in our Region. It is, therefore, a multisectoral issue that should be treated as such.

Cerebrospinal meningitis continued to wreak havoc, with 31 000 cases and 3300 deaths notified in 2010 by countries within the meningitis belt. The introduction, in December 2010, of the new conjugate vaccine A brought us hope for reducing the importance of meningitis as a public health problem. This considerable progress became possible thanks to the partnership between PATH, Bill and Melinda Gates Foundation, Serum Institute of India, WHO and GAVI.

Haemorrhagic fevers remain a threat. In the year 2010, 206 cases of yellow fever, 279 cases of Rift Valley fever and 370 cases of Lassa fever were recorded. Fortunately, we have not received notification of cases of Ebola or Marburg virus fever.

Disasters occurred in several countries. Significant among them were the drought in Niger, Ethiopia, Kenya, affecting the entire Horn of Africa. More than 12 million people are affected. Massive displacement of populations, shortage of water, poor sanitation, loss of cattle and harvests are at the origin of the famine and the many cases of malnutrition. These conditions are increasing the risk of diseases and, as a result, the health services are often overstretched. The WHO Regional Offices for Africa and Eastern Mediterranean are collaborating with countries in the Horn of Africa to provide response to public health emergencies.

Floods and landslides also affected 15 countries in the Region in 2010. These phenomena affected about 1 000 000 people in West Africa, and 368 000 people in Southern Africa. These droughts and floods occur in the general context of climate change which is a reality in our Region today. That is why I am proposing for the consideration of this Regional Committee a Framework document for public health adaptation to climate change so that the health systems can effectively address this threat.

The capacity to investigate and respond to epidemics and public health emergencies remains weak in our Region. It is in this context that you decided to create the African Public Health Emergency Fund, through Resolution AFR/RC60/R5. The documents on the funding modalities of the Fund as well as the annual contributions of each Member State are submitted to this session for a decision so as to make the Fund operational and, thereby, help reduce the number of human lives lost during public health emergencies.

Honourable Minister of State,

Honourable Ministers,

Distinguished Guests,

Ladies and Gentlemen,

During our deliberations, we shall have the opportunity to make a detailed analysis of the implementation of the health-related Millennium Development Goals. I would, however, like to draw your attention to the following points:

  • Concerning under-five mortality, the most recent figures show a declining trend, but although 34 out of the 46 countries in our Region are making some progress, only seven countries are really on track to achieve MDG4 by the 2015 deadline.
  • On improvement of maternal health, records show that maternal mortality remains high and that the progress being made by 34 out of the 46 countries in our Region is inadequate for achieving MDG5. Contraceptive prevalence rate in Africa is among the lowest in the world. This challenges us to ensure the promotion of contraceptive methods as a way of preventing maternal mortality.
  • In the case of HIV/AIDS, a 25% decline in incidence is noted in 22 countries. Besides, according to the new case management criteria, 37% of patients in need of treatment have access to ARVs. According to the 2010 WHO/UNAIDS/UNICEF Report on universal access, AIDS-related deaths have declined significantly in 16 countries. These reductions range from 11% in Congo to 72% in Rwanda.

In addition to these encouraging results, I would like to stress the need to intensify the implementation of the package of measures of prevention of HIV infection, which should include primary prevention, prevention of mother-to-child transmission as well as other proven and innovative preventive methods including male circumcision which is already being implemented in some countries of the African Region.

In malaria control, 23 countries are supplying insecticide-treated bednets free-of-charge to all persons at risk. A total of 289 million insecticide-treated bednets were distributed in 2010, representing about 35% coverage of under-five children.

Another significant progress worth mentioning is the 50% reduction in malaria cases and related deaths in health facilities of 12 countries in the African Region. By rallying top African leaders to the cause of malaria control and making a decisive contribution to advocacy for access of the vulnerable population groups to the means of preventing malaria, the African Leaders Malaria Alliance (ALMA) has become a reliable partner today.

Concerning the Global Polio Eradication Initiative, the objective set for the current year is to interrupt transmission of wild poliovirus. In 2010, the supplementary immunization campaigns covered more than 114 million under-five children. However, wild poliovirus is still circulating in the African Region. This calls for intensification of efforts in order to halt transmission in the Region by the end of December 2011, particularly in Angola, Chad, Democratic Republic of Congo and Nigeria. To that end, the four countries mentioned above have developed, with the support of WHO and UNICEF, emergency plans for the period July - December 2011. For its part, the Regional Office has put in place a plan for accelerating the implementation of the emergency plans of the above-mentioned target countries. The budget for this acceleration plan is estimated at US$ 55 million which Bill and Melinda Gates Foundation, Rotary Club, USAID and Canadian International Cooperation Agency have pledged to finance. Let me take this opportunity to express our profound gratitude to the partners I just mentioned. It is important to recall that to achieve the polio eradication objective, the responsibility of Member States of the African Region is being put to the test. We commend the commitment of Heads of State and communities, including traditional chiefs and religious leaders, and call on them to pursue their efforts towards achieving the eradication goal.

Honourable Minister of State,

Honourable Ministers,

Distinguished Guests,

Ladies and Gentlemen,

Noncommunicable diseases (NCDs) are acknowledged as a major health problem of our times. Cardiovascular diseases, cancers, chronic respiratory diseases, diabetes, diseases caused by genetic disorders such as sickle-cell anemia, mental diseases, injury and violence are on the increase. The common risk factors, smoking and abusive use of alcohol, lack of exercise and poor dietary habits are identified and should be addressed by health promotion programmes.

These problems prompted you, Ladies and Gentlemen, to adopt the Brazzaville Declaration calling for urgent and concerted action under the slogan "United against noncommunicable diseases: the time to act is now". I hope that the high-level Summit, to be held shortly in New York, will be an opportunity for inspiration and promotion of the control of chronic diseases in Africa.

Honourable Minister of State,

Excellencies,

Ladies and Gentlemen,

The 2008 global financial crisis is seriously affecting health institutions in the world and the World Health Organization has not been spared. The consequences of this crisis have severely affected the WHO Regional Office for Africa which has a funding gap of US$ 350 million in the current biennial period. The crisis has compelled us to sever with a sizable part of our staff, and that is affecting our technical cooperation with Member States. Unfortunately, programmes most affected by the reduction in the budget, staff and cooperation activities are priority programmes such as the control of HIV/AIDS, Tuberculosis and Malaria, programmes on maternal health and programmes on health system strengthening.

Honourable Minister of State,

Honourable Members of Delegations of Member States,

The World Health Organization, which is more than 60 years old today, is about to undertake an unprecedented reform. The WHO Director-General will certainly talk about that.

We are expecting an active contribution from Member States of the African Region to the debate on the WHO reform.

Honourable Minister of State,

Honourable Members of Delegations of Member States,

Before I conclude, I would like to announce the launch, during this session of the Regional Committee, of the African Federation of Public Health Associations. After it has been established in our Region, it will certainly contribute to the dialogue on public health issues and formulation of health policies.

With the determination of governments, partners and communities, we are sure to overcome the major challenges and achieve our health and human development objectives in Africa.

I thank you for your kind attention and wish you every success in your deliberations.