Brazzaville, 24 November 2011 -- Disease outbreaks, floods,  droughts, communal tensions, civil strife -- Africa   faces some of the world’s worst natural and man-made disasters which leave thousands dead, and millions injured, displaced and devastated.

And statistics bear this out.  According to the World Health Organization (WHO) Regional Office for Africa, at least 32 of the 46 countries in the Region reported at least one public health emergency in 2009.

Experience in Africa shows that when public health emergencies occur, there is a considerable time gap between the occurrence of these events and the flow of resources – often expected from, or provide by, external sources -- needed to  save lives.

But effective response cannot wait for that long.  This is because in the first few days after an emergency occurs or a disaster strikes,  money is needed to arrange supplies and travel of medical and relief teams; set up and operationalize control rooms with staff and equipment; and   provide direct financial support to affected countries for logistics, communications etc.

This is where the African Public Health Emergency Fund (APHEF) comes in.

In recognition of the inadequate resources available to Member States to respond to  public health emergencies, the WHO Regional Committee for Africa, at its Sixtieth session held in 2010  in Malabo, Equatorial Guinea, approved  a proposal by the Regional Director, Dr Luis Sambo, for the  setting up of the APHEF.

At its just-concluded Sixty-first session held from 29 August to 2 September 2011 in Yamoussoukro, Cote d’Ivoire, the Regional Committee unanimously adopted a resolution which requested Dr Sambo to ac-celerate the operationalization of the Fund.

 The resolution also  set the annual recommended contribution of Member States  to APHEF at a total of $50 million and endorsed the designation of the African Development Bank as the trustee  for  the management of the Fund as well as  the domiciliation of a revolving fund with a limit of US$30 million at the WHO Regional Office for Africa in Brazzaville.

Purpose of APHEF

The purpose of APHEF is to mobilize, manage and disburse in a timely manner additional resources from Member States for responding rapidly and effectively to public health emergencies of national and international concern including epidemic and pandemic-prone diseases, the health impact of natural and man-made disasters and humanitarian crises.

This will ensure significant and sustainable contribution to the reduction of diseases  and deaths, thereby mitigating the socioeconomic impact of epidemic and pandemic-prone diseases in countries in need,   and contributing to poverty reduction. 

As an in-house financing mechanism, the APHEF, will jump-start funding by providing “ready cash” to affected countries for early,  rapid and flexible action. This would save lives and prevent further deaths and spread of diseases during the initial phase of a public health  emergency.

Why APHEF ?

At the Yamoussoukro meeting, Dr Sambo provided   a  solid  and detailed   justification for the establishment of the Fund.  In a report to the ministers, he explained: “The main justification for the establishment of the Fund is the lack of adequate resources to respond to the frequent epidemics and public health emergencies in the African Region.

“Considering the common epidemics in the Region, it costs an average of about US$2.5 million per country to respond to an outbreak of cholera with 30 countries in the Region experiencing an outbreak every year (translating into an estimatedUS$75 million  required per year).

“For 24 countries in the meningitis belt, yearly outbreaks cost an average of US$5 million per country to provide adequate response (US$120 million). In respect to viral haemorrhagic fevers, one outbreak costs as much as US$15 million to provide adequate response. 

It is worth noting that the  estimated total annual cost of responding to at least the three most important disease outbreaks and other public health emergencies in the Region is more than US$500 million – a tall order even for all 54  countries on the African continent  combined !

Furthermore, apart from the lateness in the arrival of external support in the aftermath of  a 

public health emergency,  there is almost always a mismatch between the needs of a country facing an emergency  and available funding.  

For example, according to the financial tracking Office for the Coordination of Humanitarian Action in 2010,  the health sector required US$1.3 billion to respond to emergencies globally. Only  55%  of this amount was funded,  compared to an average of 64% funding for all the sectors combined.  In the same year, the health sectors in the countries in  the WHO African Region appealed for US$ 380 million and received 56% funding.

A delegate commented  during the discussion of the APHEF at  the Yamoussoukro Regional Committee meeting that : “The beauty of the Fund,  when it becomes operational,  is that  funding can be  triggered  off   almost immediately an emergency has been declared,  thus ensuring that  essential priorities are  cov-ered in the first response”. 

Functioning of the APHEF

What will be the modus operandi of the Fund ?  For the functioning of APHEF, the Regional Director will set up a lean secretariat at the Regional Office to manage the Fund’s affairs, screen proposals and issue instructions for financial disbursement to requesting countries.    …/2

The   secretariat  will  also be responsible for executing the decisions of the  Monitoring Committee of the Fund, a body  that will be created and mandated   to  advise  the Regional Director and take decisions regarding the strategic directions of  APHEF.  

The Monitoring Committee will be composed of three sitting ministers of health (one from each WHO sub-regional grouping), and three ministers of finance (one from each WHO sub-regional grouping) or their representatives. 

The secretariat  will also be responsible  for carrying out  the recommendations of the Technical Review Group,  a small body  of WHO experts in epidemic and pandemic-prone diseases, emergencies and  cross-cutting area  such as health systems and health promotion. This group will be based at the Regional Office.  

Conclusion

As  the Regional Director  clearly  pointed out before the unanimous adoption of the resolution  on the APHEF, the Fund will be a solidarity  fund  established and funded by African  countries to meet the  immediate financial needs  and fill critical gaps in fellow African countries in  need.  APHEF is not intended for the use of WHO, nor is it for bulk relief or long-term recovery and therefore does not   replace existing mechanisms such as Flash Appeals or the Consolidated Appeals  Process. The Fund will  explicitly respond  the investigation and response to  public  health emergencies  occurring in the African Region.

Similar financing support mechanisms for public health emergencies have been established and are successfully operating in other regions  of the world, such as South-East Asia.

In Africa, the only option open to  the APHEF is to succeed.

For more information, please contact:

Technical contact:
Dr Benido Impouma; – Tel: +47 241 39773 – E-mail: impoumab [at] afro.who.int 

Media contact:
Samuel Ajibola – Tel : +47 241 39378 – E-mail: ajibolas [at] afro.who.int