Strategic Alliances in EU-Africa cooperation on access to vaccines, 25 March 2021
Remarks by WHO Regional Director for Africa, Dr Matshidiso Moeti
Honourable Minister of Health of Portugal, Marta Temido,
European Commissioner for Health and Food Safety, Stella Kyriakides,
Chair of the Gavi Board, Mr Durão Barroso,
Permanent Representative of Portugal to the UN, Mr Rui Macieira,
Dear colleagues of partner agencies and distinguished guests,
I see among the participants many past and present colleagues.
Good morning and bom dia!
I’d like to thank Portugal as chair of the European Union for having invited me join you in this important conversation and I am glad to consider with you, the state of health in Africa, including priority actions that are needed to achieve the Sustainable Development Goals, and how the European Union and WHO can build on, and enhance, our cooperation on global health.
Over the past year, the COVID-19 pandemic has dominated the world’s attention, and in Africa there have been more than 4.1 million cases and sadly, 110,000 or so people have lost their lives.
We have seen two epidemic waves, peaking in July last year and in January 2021. And, cases unfortunately are increasing again in some countries, and this may lead to a so-called third wave, particularly with some of the variants that are circulating, population fatigue with the public health measures, and pressure to ease restrictions on economic and other activities.
Overall, the case load and deaths in Africa have been lower than the initial projections. There is, admittedly some underestimation, in part due to challenges countries faced in obtaining test kits and related supplies, partly due to the distortion of the global market including export bans imposed by some producing countries.
Our continent also has a young, mostly rural population, and importantly, most governments acted early and decisively in implementing the social as well as public health measures.
This somewhat drastic action, came admittedly at great cost to economies and livelihoods, and international solidarity will be needed to mitigate the long-term socio-economic impacts as well as those on health.
Now African countries are rapidly rolling out vaccination programmes (and I am very happy to hear our colleague from Gavi state this in detail), after a delayed start due mainly to supply shortages – again in part due to a distorted global market and difficulties in having equitable access at the same time to these supplies.
So, to accelerate equitable access to tests, therapeutics and vaccines, the European Commission joined and played a strong role working with WHO and other partners almost a year ago, in launching the Access to COVID-19 tools (or ACT) Accelerator platform.
The vaccine pillar of this COVAX Facility (to which several speakers have already alluded) has so far delivered more than 16 million doses to African countries, in addition to 11 million shipped through bilateral arrangements and donations. Significantly more doses will be required, and we welcome the pledges from European countries such as Portugal, Norway and France to donate some of their supplies.
Turning then to progress in African countries towards achieving the Sustainable Development Goals – we are seeing improvements in some areas and admittedly challenges in others.
Healthy life expectancy in the WHO African Region for example, increased, from around 50 years in 2005 to an estimate of over 56 years in 2019. This is driven primarily by reductions in deaths among children and from infectious diseases, in which access to childhood vaccination played a critical role. Mr Barroso already alluded to this. But this progress will need to be accelerated to reach the SDG targets.
Deaths related to pregnancy and childbirth are still unacceptably high, with a regional average of 525 maternal deaths per 100,000 live births – this is more than twice as high as the global average of 211. And hypertension and heart-related diseases and cancer, from which African people die at a younger age than people on other continents, urgently require more attention, including more stringent action on tobacco control and promoting healthy diets and lifestyles.
For the SDG target 3.8 on universal health coverage, which is an overarching objective, the Region has improved on the service coverage index from 46 points out of 100 in 2017 to 48 in 2019, compared to the global average which stayed at 66.
On International Health Regulations capacities which are critical for better preparedness and response to the next pandemic, (related to target 3d on risk reduction of the SDGs), the African Region still rates low at 44 out of 100 points, compared to the global average of 63. However, the COVID-19 pandemic has highlighted vulnerabilities across countries globally, including some that score well on some of these indicators.
The comprehensive, multisectoral and people-centred framework of the SDGs emphasizes the interlinkages among the goals, and African countries have been advancing on key targets.
For instance, the Region has experienced some of the highest rates of economic growth, thanks to the expansion of infrastructure and communications technologies. We do know, unfortunately that COVID-19 has disrupted this progress and pushed Africa into a recession for the first time in 25 years, so cooperation with partners, like the European Union, will be essential to getting economies back on track.
Over the years, the EU has contributed to significant health improvements, including kicking wild poliovirus out of Africa, investing in the health of women, strengthening disease surveillance, and containing outbreaks of Ebola and other diseases.
The EU has been a consistent advocate and strong voice for health system strengthening, at a time when most international health financing focused on disease-specific vertical programmes. This includes having provided catalytic funding to WHO to support appropriate national policy development, as well as bilateral support to countries in some of the key cross-cutting system areas like human resources, data and information systems, and decentralized service delivery through well-functioning districts with an emphasis on equity and inclusion.
In addition, the EU is playing a strong role in convening countries and partners to reflect and act on global health. This has helped to make clear the inextricable links between health systems strengthening and health security, as well as the need for more investment, better governance including on countries’ obligations and the need for global solidarity. WHO and the EU have a shared focus on these top priorities in global health.
The EU also has enormous global research and innovation capacities, and has collaborated with Africa, including through the European and Developing Countries Clinical Trial Partnership, or EDCTP, with strong involvement of the private sector. We have been very happy to participate in the EDCTP process and observed some of the capacity-building of African research expertise and products of this research done collaboratively between European and African experts.
This all creates a strong basis from which to build and pick-up on opportunities arising in the context of COVID-19 to enhance cooperation between the EU and WHO for better health in Africa.
In moving forward together, I believe we can improve our cooperation in several key ways:
First, the pandemic has shown that health threats can bring lives and economies to a standstill. Together, we can advocate to turn this experience into increased financing for health at the continental and at the country level – both domestic resources as well as prioritization by countries in their EU collaboration, focusing on rational, integrated investments, less verticality and fragmentation. An emphasis on equity would drive the most progress.
Second, we are seeing in response to COVID-19, and also in the Ebola outbreaks in the DRC and Guinea, the benefits of high-impact, preventive interventions like vaccination, delivered comprehensively, linking epidemic preparedness to health systems strengthening, towards building resilience.
Together, we can influence policy decisions towards the most effective actions and strengthen systems for monitoring, evaluation and accountability.
We can also assist countries to build capacities and adopt innovations and new technologies, with WHO support to drive and fast track their integration into countries’ services and health systems.
And thirdly, we can facilitate multisectoral approaches to address issues that threaten many countries at once. Alliances to mobilize the private sector, civil society, innovators, researchers and investors will be important, to link up across sectors and continents in taking forward key priorities such as boosting manufacturing capacities in African countries, encouraging technology transfer and advancing research and development.
Collaboration at the continental and regional levels, will be needed, working with the African Union and its institutions like the Africa CDC on the EU-Africa Strategy and around the African, Caribbean and Pacific and EU initiative. At the global level, the EU’s strong convening role can be leveraged, ensuring the needs of African countries are taken into account.
In closing, COVID-19 has reaffirmed the importance of investing in health, and our interconnectedness across sectors and national borders, and this is what should be leveraged going forward to achieve sustainable development. As WHO we look forward to continued and stronger cooperation with the EU to realize better health in Africa and all around the world.
And thank you again for having invited me.