Speech by Dr Luis Gomes Sambo, WHO Regional Director for Africa, at the Sixtieth session of the WHO Regional Committee for Africa

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Your Excellency Mr Teodoro Obiang Nguema Mbasogo, President of the Republic of Equatorial Guinea,
Your Excellency, Professor Alpha Omar Konaré, Former President of the Republic of Mali,
Distinguished Members of Government of Equatorial Guinea,
Your Excellency, The Chairman of the Fifty-ninth session of the WHO Regional Committee and Minister of Health of Rwanda,
Honourable Ministers of Health of Member States of the WHO African Region,
Director-General of WHO,
Distinguished Members of the Diplomatic Corps and Heads of Mission,
Dear Colleagues, Directors, representatives and officials of United Nations system agencies,
Distinguished Guests,
Members of the press,
Ladies and Gentlemen,

It is an honour and a pleasant duty for me to address this august assembly on the occasion of the Sixtieth session of the WHO Regional Committee for Africa.

I would like especially to express my profound gratitude to you, Mr President, for having invited the Regional Committee for Africa to Equatorial Guinea and authorized its holding in this magnificent building. I would also like to thank you for the generous hospitality accorded us in this picturesque and beautiful city of Malabo. Your Excellency, Mr President of the Republic, we wish you all the success in your efforts to ensure the socioeconomic and health development of Equatorial Guinea.

Allow me to take this opportunity to express a warm welcome to Dr Margaret Chan, Director-General of the World Health Organization. I hail the presence of honourable ministers of health and representatives of Member States of the WHO African Region who have made it a duty to travel to Malabo. I would also like, ladies and gentlemen, to extend a special word of welcome to our guest of honour this year, His Excellency Professor Alpha Omar Konaré, former President of Mali and former Chairperson of the African Union Commission. I would like to state how much his leadership style has amazed and inspired us and how much we appreciate his contribution to health and to the development of our continent.

Excellencies,
Ladies and Gentlemen,

With the support of development partners, the governments of African countries have made progress in the area of public health. However, at the present pace, that progress is not enough to attain the Millennium Development Goals (MDGs) by 2015. The health situation is worsened by the poverty of the people, limited access to drinking water, deficient sanitation and food insecurity affecting a good proportion of the population. Under these conditions, health policies in Africa should always include health care equity and quality objectives for poor and disadvantaged people.

Excellencies,
Ladies and Gentlemen,

The context created by the global financial crisis may lead to a health system crisis in Africa. In fact, the reduction in health budgets and spending could jeopardize the ideals of universal access and health care quality.

We have knowledge, good policies and strategies and most of the tools that we need are available, but what will make the difference between hope and the present reality of millions of Africans is the implementation of these policies backed by judicious mobilization of domestic and external resources.

Honourable ministers,

In the present situation, I am calling on you to share and scale up best practices in public health in Africa.

Five years to the deadline for the attainment of the Millennium Development Goals we need to do better. In this note of hope, we will have to update national health policies by using the most recent evidence and emphasize the implementation of priority actions clearly identified in National Health Development Plans. The plans should serve as a guide and incorporate the actions of all stakeholders including development partners.

In this connection, I am pleased that many Member States of our Region are already introducing reforms in this direction. Nevertheless, I would like to recall the need to strengthen intersectoral collaboration, broaden policy dialogue with local authorities to capitalize on synergies and make State structures and the health action of local communities more efficient.

Excellencies,
Distinguished Guests,
Ladies and Gentlemen,

In my humble opinion, health spending is not merely costs that must be borne by States but more so a vital investment towards sustainable socioeconomic development of countries.

Although there has been a general increase in health spending since 2001, only five countries have reached the Abuja target of allocating 15% of the total State budget to health.

This figure shows us the remaining gap to be filled in order to ensure optimal financing of health services. It is in the light of this situation that I would like to urge Member States to increase their budgetary allocations to the health sector and establish sustainable mechanisms for social protection.

In the same vein, permit me to inform you that the WHO African Region is facing a significant budget deficit which is affecting priority programmes such as HIV/AIDS, tuberculosis and malaria control, and maternal and child health.

With the current budgetary trends, the Organization will be obliged to send away a good number of experts, which will reduce our capacity to meet the demands of Member States.

However, to better address disasters and epidemics, I have proposed the creation of an African Public Health Emergency Fund in accordance with the recommendations of ministers of health.

To this end, I have called on all Heads of State of the Region and the African Union to promote and establish the Fund with the assistance of the African Development Bank.

Excellencies,
Distinguished Guests,
Ladies and Gentlemen,

The African Region bears a disproportionate burden of maternal and child deaths and we are far from reaching the global target in maternal mortality reduction. Current trends reveal that only five countries in our Region are likely to attain MDG 4 relating to child health. Nevertheless, some significant progress has been made in child immunization.

May I therefore hail the immense efforts made by some countries in the implementation of corrective strategies aimed at eradicating poliomyelitis. Indeed, at the end of July 2010, the number of poliomyelitis cases dropped by 86% compared to the number of cases recorded in 2009.

It is in this context that I would like to congratulate in particular the Governments of Nigeria and Chad on the very significant progress their countries have made recently and call on them to sustain such success.

Still concerning child health, it is noted that despite the remarkable progress that led to 92% reduction in measles deaths between 2000 and 2008, this disease is re-emerging.

Such re-emergence noted in 27 countries is due to the slackening of both routine and supplementary immunization as well as a decline in the political and financial support of Member States and partners.

I also have good news for you: WHO has just prequalified a new conjugate vaccine against meningococcal meningitis A epidemic. This vaccine is the fruit of public-private partnership between WHO and the NGO known as Programme for Appropriate Technology in Health (PATH). The vaccine will help wipe out meningitis epidemics which have for long plunged thousands of families into mourning. The introduction of the new vaccine will be officially launched in December 2010.

Excellencies,
Distinguished Guests,
Ladies and Gentlemen,

With the support of development partners, countries of the African Region have made significant strides in the intensification of malaria and HIV/AIDS prevention, diagnosis and treatment.

Recent trends show a stabilization of HIV prevalence in the Region and even a decline in some countries. However, we must be vigilant and continue to prioritize prevention and allocate adequate resources to control these diseases whose burden is still very heavy.

The United Nations General Assembly declared the period 2001–2010 the "Roll back malaria" Decade. During the period, African countries have so far reported a drop in the burden of malaria following the implementation of a comprehensive package of proven interventions. It is more than ever necessary to strengthen malaria prevention and treatment programmes and increase political and financial mobilization that is very vital for large-scale outcomes.

Regarding tuberculosis, the regular spread of resistant strains is an alert signal which requires urgent and sustained attention. The efficient management of the directly-observed treatment short-course (DOTS) services as well as staff training in DOTS are crucial in reversing current trends in the African Region and preventing new outbreaks with serious consequences for public health. We acknowledge the decisive role of the Global Fund to Fight AIDS, Tuberculosis and Malaria in the successes recorded.

There is significant progress in onchocerciasis control and I would like to especially mention and express satisfaction at Equatorial Guinea's success in the elimination of the onchocerciasis vector in the Island of Bioko. This success has freed the people of the related hazards and also enabled the resumption of agricultural and economic activities by the local communities.

The countries of our Region are confronted with the resurgence of chronic diseases. Risk factors such as excessive alcohol consumption, tobacco abuse, sedentary lifestyles and poor feeding habits are associated with the increase in some of these diseases such as diabetes, cancers and cardiovascular diseases.

Ladies and Gentlemen,

Allow me to mention here the problem of counterfeit medicines and products which is persisting, with a tendency to increase. The use of counterfeit medicines is often the cause of treatment failure, intoxication and drug resistance.

Consequently, counterfeiting requires more vigorous vigilance and regulation mechanisms in our Region.

Excellency, Mr President of the Republic,
Hounourable Ministers and Heads of Delegation,
Distinguished Representatives of Development Partners,
Ladies and Gentlemen,

I would also like to express my profound gratitude to you for the support you are giving to me and the confidence you have reposed in me by giving me a second term as Regional Director.

Inspired by the Eleventh WHO General Programme of Work and strategies of cooperation with the 46 countries and in consultation with the Director-General, I proposed to you the new Strategic Directions for the period 2010–2015 which place emphasis on WHO's key roles and responsibility in accordance with its mandate, namely health systems strengthening; maternal and child health; disease control; and promoting and addressing health determinants.

Before ending my speech, may I thank my colleagues, regional directors of agencies of the United Nations system for responding to my invitation and above all for their collaboration in the harmonization of cooperation programmes in the area of health.

My thanks also go to the African Union for its leadership and especially for the recent Heads of State's declaration on maternal and child health during their recent summit in Kampala.

May this year, when we take stock of the Millennium Development Goals, also be an opportunity for innovating reflections and initiatives for Africa's development.

I Thank you for your kind attention.