Message of the WHO Regional Director for Africa, Dr Luis Gomes Sambo, on the Occasion of the Regional Meeting on Pandemic Influenza, Opening Remarks

Distinguished delegates
Representatives of Food and Agriculture Organization, UNICEF, African Union 
Partners in Health Development in Africa
Dear participants
Members of staff
Ladies and gentlemen

First of all I would like to welcome you all to the WHO Regional Office for Africa here in Brazzaville, particularly those of you who have traveled long distances to join us at this important regional meeting on pandemic influenza. I wish you all a happy new year, 2006.

The current risk of a pandemic of avian influenza occurring in the near future and spreading to humans is high. In the recent past, evidence has emerged of a zoonotic transmission of avian influenza virus in some Asian and European countries. Most of you have heard of the pandemic spread in Turkey in the last few days. Available data suggests that the H5N1 virus is now endemic in parts of Asia, having established an ecological niche in poultry. The risk of human cases due to the avian influenza will persist, as will opportunities for both human and avian pandemics.

The 56th World Health Assembly, in Resolution WHA56.19 in May 2003 urged Member States of WHO to strengthen their capacity to prevent, detect and diagnose influenza virus infections and to be prepared for a possible pandemic.

In the WHO African Region, little is known about the burden of avian influenza since few countries have laboratory capacity for virus isolation. No documented H5N1 infection has been reported in the region. However, an outbreak of H5N2 influenza was reported among ostriches in South Africa in 2004 and in December 2005 in Zimbabwe. In order to address the threat of a pandemic of influenza, WHO has established a response that includes improvement of laboratory capacities for influenza diagnosis within the framework of Integrated Disease Surveillance and Response (IDSR) strategy adopted by Member States in 1998.

During the 55th Session of the WHO Regional Committee for Africa held in Maputo in August 2005, Ministers of health discussed pandemic influenza as an additional agenda item. Delegates expressed their concern on the potential impact of a pandemic in the region. Following these discussions, I decided to set up an Ad hoc advisory panel on pandemic influenza made up of experts from the region, including virologists, laboratory experts, clinicians and veterinarians with a wealth of experience to advice on preparedness measures to be adopted by countries in the African region.

The expert advisory panel met on 12th and 13th October 2005 in Harare, Zimbabwe and a report of the meeting is in your folders. I am glad many of the panel members are also present at this meeting here today.

Ladies and gentlemen

There is increasing concern that Africa is at great risk of pandemic influenza. Firstly, as winter sets in Northern hemisphere, migratory birds can bring the deadly virus to Africa. Secondly, with increasing global travel there is a high risk of dissemination of the H5N1 virus. And thirdly, the poor health infrastructure in Africa and the non-availability of vaccines or drugs throughout the duration of a possible pandemic means that millions of people would be at high risk if a pandemic influenza emerges of contract human influenza.

To minimize the occurrence of a pandemic and its spread, we must put in place clear strategies and action plans at regional and country level. The partnership with all sectors including animal health, world wildlife, agriculture and public health should be reinforced. Mutli-sectoral task forces should be set up at country level to ensure appropriate coordination.

The occurrence of human cases would create enormous new challenges for health systems. Laboratory confirmation and management of human H5N1 viral infections is technically challenging, expensive, and demanding on human and financial resources. 
During this meeting, we would like to focus on the following thematic areas: 
• Surveillance, laboratory and data management, 
• Preparedness and response coordination and logistics operations
• Training, communication and information
• Health system strengthening and operation research

From WHO global experiences, I sent guidelines to all Ministers of Health outlining the recommended strategic actions for responding to the threat of pandemic influenza. Guidelines on strategic actions and step by step planning for pandemic influenza were disseminated to enable all Member States in the African Region to develop their national preparedness and response plans.

Technical support has been provided to Member States upon request. As at the end of November 2005, planning process had started in Benin, Cameroon, Ethiopia, Ghana, Mali, Guinea, Uganda, South Africa, Seychelles, Kenya, Malawi, Senegal, Tanzania, Togo, Zambia and Zimbabwe. Many other countries have already established their multi-sectoral Task Forces and are at different levels of preparedness.

A network of laboratories which are flu net members have a great role to play in this phase of the pandemic alert. They should be on the front line supporting the surveillance to be able to identify the first cases which could occur.

Surveillance is critical in this pandemic alert period. Through information, communication and health education, the public must be sensitized about the risk of bird flu and how this can be minimized. Health and veterinary officials need technical update with which to plan their joint response. I called this meeting together with FAO and OIE and other partners, senior scientists to provide insights on this issue. WHO is providing accurate information about the nature of the disease and the way it spreads in order to make appropriate decisions about the size and allocation of human and financial resources needed to combat the disease.

At the end of this meeting, I would like to have the advice and recommendations to finalize the regional as well as guidance on finalization of country plans, the African Region showed be fully prepared for the forthcoming donor meeting in Beijing and the WHO Executive Board.

It is my sincere hope that by the end of the two days, we will be able to achieve the expected outcomes. Thank you once again to all of you for accepting to come at very short notice and I wish you all a very pleasant stay in Brazzaville.

I also wish you all fruitful deliberations and it is my pleasure to declare this meeting officially open.

Thank you for your attention.