Report of the Regional Director on the Work of WHO in the African Region
Mr Gilbert Mokoki, Minister of Health and Population of the Republic of Congo and RC74 Chair,
Congratulations again, Monsieur le Ministre, on your election; we look forward to working closely with you.
Excellencies, Ministers, Heads of Delegation, dear colleagues and friends,
I am pleased to present the work that my colleagues in 47 countries and the Regional Office have done between July 2023 and June 2024.
During this reporting period, we focused on supporting our Member States in the region to recover from the COVID-19 pandemic and accelerate progress towards the SDG health targets.
My presentation is structured in six parts:
First, consolidating our Transformation Agenda;
Second, progress towards the Universal Health Coverage;
Third, protecting people from health emergencies;
Fourth, protecting and promoting health and wellbeing;
Fifth, integrated action for better health; and
Sixth, improved capacity in Country Offices.
I will end with the conclusion and way forward.
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The Transformation Agenda strengthened our commitment to WHO values and ethical standards, as demonstrated by our actions.
It strengthened leadership, teamwork, and partnership and contributed to the successful implementation of health program priorities described in my report.
It integrated diversity, equity, and inclusion with prevention and response to abuse, harassment, and sexual exploitation.
During the reporting period, we made significant progress in enhancing accountability and financial management.
I’m very proud, in presenting my last annual report to this Governing Body, to share with you that the number of overdue reports decreased by 98%, from 1,861 in March 2016 to just 36 by April 2024. It shows how much we’ve demonstrated discipline in managing the funds entrusted to us.
Our efforts in financial stewardship have increased resource allocation for our Country Offices, rising from 67% of our budget in the 2018–2019 biennium to 75% in 2022–2023.
My colleagues and I appreciate the recognition by the Independent Expert Oversight Advisory Committee; they confirmed our progress in enhancing risk management capacity and accountability during their visit to the region in November 2023.
The Committee highlighted this progress in their report to the Executive Board in January 2024.
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On progress towards Universal Health Coverage—
We supported our Member States in translating commitments they made at UN High-level Meetings into concrete actions during this reporting period.
The commitment to primary health care and UHC has never stood a better chance of realization: Close to 90% of our Member States have now put primary health care and UHC at the center of their national health policies, strategies, and plans.
Poor people in our region often suffer impoverishing expenditures to attain essential health services. It is key that health financing systems ensure that the most vulnerable can get the services they need without financial hardship. By the end of June 2024, we had supported 32 of our 47 countries to formulate and implement evidence-based health financing strategies to protect people from out-of-pocket spending.
Building on the renewed commitment to accelerate progress to end preventable maternal and childhood mortality and scale up access to quality high-impact interventions, we supported twenty (20) countries to update their strategic plans for reproductive, maternal, newborn, child, and adolescent health.
Our region has not yet attained the health worker density required for achieving UHC. This situation is being made worse by the “dramatic surge” in the recruitment of health workers from many countries in our region by wealthy nations.
Together with our partners, we developed the Africa Health Workforce Investment Charter and launched it in Windhoek in May. Over ten countries are already implementing it to enhance recruitment and retention of health workers.
Ensuring access to medicines, vaccines, and other medical products was an important lesson from the COVID-19 pandemic. We’ve supported countries in improving access to health products through global market shaping and building national capacity to monitor and ensure efficient and transparent procurement and supply systems.
For instance, we helped create a pooled procurement mechanism for Africa’s Small Islands Developing States (SIDS), initially serving as its secretariat. It is the first of its kind in Africa.
Mauritius has since signed long-term agreements with identified suppliers. It is buying medicines for 50% less than it used to pay.
Seychelles and Comoros have also signed long-term agreements. Like Mauritius, they can buy medicines at substantially reduced costs.
The lessons we have learned in supporting the SIDS countries in establishing a pooled procurement will be valuable for the African Medicines Agency (AMA) – concerning the role it is expected to play on the continent.
Strong national regulatory authorities are critical in ensuring access to quality, safety, and efficacious medical products imported or manufactured locally, including medicines and vaccines. We provided technical assistance to countries to enhance the capacities of national regulatory authorities.
In June, Zimbabwe became the fifth country in our region to attain maturity level 3, joining Ghana, Nigeria, South Africa, and the United Republic of Tanzania.
The African region registered significant strides in disease control, elimination, and eradication during the reporting period.
In 2020, we celebrated the certification of wild poliovirus eradication in our region—a feat that once seemed insurmountable. Only to have a reversal when the region experienced imported wild poliovirus into southern Africa in 2021.
The good news is that, in May 2024, the transmission of the imported wild poliovirus in southern Africa was confirmed interrupted. It resulted from a coordinated sub-regional outbreak response effort across five counties: Malawi, Mozambique, Tanzania, Zambia, and Zimbabwe.
The region also continues to progress in stopping outbreaks due to vaccine-derived polioviruses. There was a 54% reduction in the number of confirmed circulating vaccine derived polioviruses during the reporting period compared to the preceding 12 months.
In January 2024, Cabo Verde was certified for malaria elimination, becoming the third country in our region to do so. The country’s certification gives us hope to dream of a malaria-free Africa with existing and new tools.
One such new tool is the malaria vaccine. Introducing the malaria vaccines into national immunization programmes in our Member States with high malaria burden was a historic achievement; and will be a game-changer.
Besides malaria, our region has continued its progress in controlling neglected tropical diseases.
In April, Chad became the 8th country in our region to be validated for eliminating Human African Trypanosomiasis (or sleeping sickness) as a public health problem.
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Regarding protecting people from health emergencies—
We supported the participation of our Member States in global negotiation processes for health emergency prevention, preparedness, response, and resilience.
These processes included the work of the Intergovernmental Negotiating Body (or INB) to draft a pandemic treaty.
Our Member States also participated actively in the Working Group on Amendments to the International Health Regulations (2005). We all rejoiced in the package of amendments approved by the 77th World Health Assembly on the 1st of June.
The high number of public health events on the continent underlines the importance of surveillance systems. Our Transforming African Surveillance Systems (TASS) flagship programme continues strengthening capacity and improving our Member States’ performance.
The proportion of countries with the capacity to analyse and link data from surveillance systems at national and intermediate levels has increased from 68% in 2022 to 98% in 2023.
In the past 12 months, we received reports of 146 public health events, comprising 126 outbreaks and 20 humanitarian crises. Among these, 25 required significant operational support from us.
Chiefly, the region witnessed an upsurge in cholera outbreaks, especially in southern Africa, with countries such as Malawi, Zambia, and Zimbabwe experiencing unprecedented events. Our teams were on the ground, providing day-to-day support to communities.
The commitments by the SADC Heads of State in February 2024 provided an excellent opportunity to accelerate multisectoral national efforts to control cholera.
The region is also witnessing an increasing number and intensity of climate-related crises (droughts, floods, and cyclones) and zoonotic transmission-related outbreaks.
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Concerning protecting and promoting health and well-being—
Time and again, we’ve seen the importance of community engagement. We developed the Regional Strategy for Community Engagement 2023–2030. The implementation plan is underway.
Working with our health ministers, we built a common African position on climate and health. Twenty-nine (29) African Member States signed the historic COP28 UAE Declaration on Climate and Health. We shall not cease sounding the alarm on the severe health implications of climate change.
Tobacco use in our region continues to decline. The African region is one of only two WHO regions on track to meet the Global NCDs action plan goal of a 30% reduction in tobacco use prevalence by 2025. In late 2023, Malawi ratified the WHO Framework Convention on Tobacco Control.
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And now to integrated action for better health—
The African region continues to experience a high burden of antimicrobial resistance and associated mortality. During the reporting period, working closely with partners, we supported our Member States’ capacities in AMR governance, surveillance, and optimal antimicrobial use.
To maximise the benefits of health research, we worked with the European and Developing Countries Clinical Trial Partnership (EDCTP) to strengthen research capacity, regulatory activities, and the clinical trial ecosystem in the region.
We equally supported our Member States to strengthen and increase access to primary health care through normative guidance, digital health leadership and impact, and scaling up innovations.
As to the improved capacity of our Country Offices—
By the end of 2023, 556 new staff, including 94 international professionals and 42 UN Volunteers, were recruited to perform newly identified functions in countries.
This shift is already producing increased performance in Country Offices: they’re building more partnerships, coordinating resources, and providing more evidence in support to our Member States.
Finally, the conclusion and way forward—
As you have seen, Honorable Ministers, we’re doing everything possible to implement priority actions to regain momentum towards achieving the SDG health targets.
We’re only six years away.
Lessons from the COVID-19 pandemic and other emergencies and events that the region frequently experiences highlight the critical importance of strong, resilient health systems, founded on primary health care.
The adoption of the 14th General Programme of Work (GPW14) by the 77th session of the World Health Assembly provides an excellent opportunity for harmonized actions by our Member States, with global health endeavours.
Excellencies,
We’ve lived up to our mandate in a very challenging time, protecting the people’s health in the region.
I’ve highlighted some key results, but there’s far more to say. In this vein, I recommend the full report to you.
Thanks again for being so supportive, which has made all these results possible at the country level and the Secretariat.
Thank you to all our partners for sharing the collaborative journey with us during this reporting period.
My colleagues and I remain committed to serving you as best we can, as we work together for a healthier, safer, and fairer region.
Thank you all so much.