Divisional Directors,
Distinguished Members of the Scientific Committee,
UNICEF Deputy Director for Western and Central Africa,
Dear Participants,
Dear Colleagues,
Ladies and Gentlemen,
It is with real pleasure that I address this gathering on behalf of the WHO Regional Director for Africa at the opening of the Consultative Meeting on Primary Health Care and Health Systems.
The WHO Regional Office for Africa has decided to organize a conference on Primary Health Care and Health Systems, in Ouagadougou, Burkina Faso, from 28 to 30 April 2008. In the year 2008, we will celebrate the 30th Anniversary of the Alma Ata Declaration on PHC and the 60th Anniversary of the establishment of WHO. For these occasions, WHO has launched a global drive to revive Primary Health Care as an appropriate approach to health system strengthening.
For the African Region, the 2008 conference will provide an opportunity to undertake advocacy at the highest level to draw attention to the major challenges facing Primary Health Care implementation.
Participants in the conference will include decision makers, political leaders, health systems managers, primary health care professionals, representatives of NGO, representatives of training institutions, associations of health professionals, representatives of communities, ministries active in the area of health, international bodies, bilateral and multilateral partners, the media and members of the Primary Health Care expert panel.
The holding of this consultative meeting, which a follow-up to the PHC internal meeting held from 11 to 13 September 2007, is part of the preparations for the Ouagadougou conference in order to ensure its full success.
We commend the presence, in our midst, of distinguished members of the scientific committee and other personalities who have accepted to honour our invitation. We say, “thank you”.
Given your rich experience and your commitment to improving the health status of African populations, we are convinced that, by the end of the deliberations, we would have;
- clearly identified the themes of the Ouagadougou conference;
- reached a consensus on the content of the basic document on PHC and health systems;
- drawn up a draft programme for the conference;
- prepared a Declaration for renewing the commitment of Member States to strengthening health systems through PHC.
Since 1978, the year of adoption of the Alma Ata Declaration, countries of the African Region have recognized the potential benefit of Primary Health Care to improving the health status of the people and have embarked upon its implementation. All the countries have made substantial progress, but challenges and disparities as regard access to quality health care remain among and within countries.
The review of the implementation of the PHC carried out in 2003 on the occasion of the commemoration of 25 years of the Alma Ata Declaration showed that national health policies in most of the countries are well-articulated with PHC even though the scope of some of the constituents elements of PHC such as equity, community participation, health financing and intersectoral collaboration was not given all the attention it deserves.
In addition, some countries made quite significant progress which, unfortunately, diminished as time went on. The pace of improvement has been slow as evidenced by the high infant and child mortality rate, high maternal mortality and low life-expectancy at birth in some countries. Factors contributing to that situation include high-level of poverty among the populations of the Region, huge debt burden, decline in production and worsening terms of trade, decrease in financial resource allocation to health to the detriment of PHC and deteriorating social fabric, causing a growing number of conflicts with attendant population displacement, and so on and so forth.
Over and above the under-investment in training and the difficulty in retention of health personnel especially in remote areas, there are other constraints including dilapidation of infrastructures, lack of essential medicines and equipment, increasing prevalence of noncommunicable diseases and emergence of new diseases.
Under the circumstances, WHO continued to carry out advocacy among Member States for the integration of PHC principles in national health policies and organization, financing and management of national health systems so that, in concert with other development sectors, it can contribute to achieving the health-related Millennium Development Goals.
Against this background, many sessions of the WHO Regional Committee for Africa examined and adopted major documents on health system strengthening using the PHC approach, on delivery of integrated quality, accessible and affordable services and on specific issues such human resources for health, health financing, essential medicines, health technologies, health information and hospitals.
The principles underpinning the Alma Ata Declaration are still valid. However, WHO and its development partners should ensure that the central ideas contained in the Declaration are integrated in national health systems to help meet the new challenges that the countries are facing.
In this regard, we feel that WHO should continue its efforts among Member States and development partners:
- to establish structural frameworks for renewing commitment to PHC and its integration in health systems;
- to strengthen participation in the local health systems by individuals, families and communities;
- to develop intersectoral work in both public and private sectors that operate in areas related to health determinants;
- to direct health care towards quality integrated services including health promotion actions;
- to strengthen human resources for health in order to increase their contribution to PHC in a decisive manner;
- to mobilize increasing financial resources especially for the poor;
- to invest in infrastructures, medicines and appropriate technologies;
- to strengthen partnerships and networks of international cooperation in order to ensure greater harmonization for PHC promotion.
We remain convinced that from these three days of deliberations, we will achieve results that will help stimulate rich and varied debates during the Ouagadougou Conference on PHC and health systems.
On this note, we wish you fruitful deliberations and, on behalf of the WHO Regional Director, declare open this consultative meeting on Primary Health Care and Health Systems.
We thank you for your kind attention.