Address by Dr Luis Gomes Sambo – WHO Regional Director for Africa at the official opening of the 1st Annual Regional Conference on Immunization in Africa, Harare, Zimbabwe, 14th to 17th December 2009

Honourable Minister of Health of Zimbabwe,
Distinguished Senior Officials of the Government of Zimbabwe,
Excellencies, Members of the Diplomatic Corps, and Representatives of Partner Agencies,
Distinguished Representatives of participating countries,
Chairperson of the Task Force on Immunization (TFI) in Africa,
Chairperson of African Regional Interagency Coordination Committee,
The Representative of the WHO country office in Zimbabwe,
Dear Colleagues,
Ladies and Gentlemen,

It is an honour for me to address this distinguished audience on the occasion of the first Annual Regional Conference on Immunization in Africa. This forum has been established to share experiences on the performance of immunization services and update participants on new technologies and evidence to improve further practice in the field of immunization.

I would like, first of all, to express our sincere gratitude to the Government and People of the Republic of Zimbabwe for accepting to host this important event and for the very warm hospitality that has been extended to us all since our arrival here in Harare.

I remember with great appreciation the very warm welcome that the Government and People of Zimbabwe extended to WHO when the Regional Office for Africa was temporarily relocated to Harare between 1997 and 2005.

Through you, Honourable Minister Dr Henry MADZORERA, we would like to express our thankfulness to Zimbabwe for the facilities currently made available for WHO country and inter-country operations.

I wish to welcome you all distinguished participants, in your various capacities, to this meeting. I look forward to your valuable contributions to the deliberations of this meeting that is expected to review the status of immunization in the African Region and propose more efficient ways of utilization of immunization tools and services.

I want to express high appreciation for the technical advice that the WHO Regional Office has been receiving from the members of the Task Force on Immunization in Africa. I welcome the new members of the Task Force and thank them for accepting to serve the Region as technical experts in their various capacities. I am convinced that they will excel in their role of providing advisory services to WHO in support to Member States in the Region.

Honourable Minister,
Ladies and Gentlemen,

Efforts by Member States to reduce child mortality are yielding dividends. Under-five mortality in sub-Saharan Africa declined from 184 per 1000 in 1990 to 144 per 1000 in 2008. Despite this progress, sub-Saharan Africa still accounted for 51% of all under-five deaths globally in 2008. The decline in child deaths in sub-Saharan Africa is still inadequate to achieve the MDG4 target by 2015. Increasing access to EPI vaccines as well as to new vaccines is essential in accelerating progress towards MDG4.

Honourable Minister,
Ladies and Gentlemen,

We must further explore the potential benefits of available vaccination technology and combine these with other child health interventions. This would facilitate the implementation of the Regional Child Health Strategy and accelerate progress towards the reduction of under-five morbidity and mortality. We have a recent example of such success with the 92% reduction in measles mortality. However, we are currently facing difficulties in sustaining this important gain because of lack of adequate funding.

Routine immunization coverage in the Region increased during the last ten years from 40% to 74% as of December 2008. However, the overall increase in routine immunization coverage masks disparities between and within countries. For example, about 5 million children missed DTP3 vaccination in 2008 and 75% of them are concentrated in 10 countries. I would like to point out that in most of these countries the poliovirus is still circulating for this very reason.

Ongoing operational research on the issue of unvaccinated children will certainly enlighten us and provide recommendations for further action. I am informed that the preliminary findings in this very important area will be shared during this meeting.

Honourable Minister,
Ladies and Gentlemen,

More and more people in sub-Saharan Africa have access to new vaccines. Currently, 45 countries are providing Hepatitis B Vaccine, 40 countries are providing Haemophilus Influenza Type B Vaccine and two are providing Pneumoccocal Conjugate Vaccine as part of their routine immunization services.

Preparations for the introduction of Conjugate Meningococcal A Vaccine in countries in the meningitis belt are at an advanced stage. We are also in discussions with partners regarding the introduction of Rotavirus Vaccine and Human Papillomavirus Vaccine.

I wish to acknowledge the leadership of governments in the Region in addressing the key issues of logistics, staff training, communication and financial sustainability that are crucial for the introduction of new vaccines.

We also acknowledge the significant funding support from GAVI for new vaccine introduction in countries of the African Region.

Nonetheless, immunization coverage with new vaccines is still very low and, in our view, Member States should step up their funding efforts for routine immunization and new vaccine introduction.

Honourable Minister,
Ladies and Gentlemen,

The efforts of Member States to rid the African Region of the poliovirus continue. I wish to congratulate the Federal Government of Nigeria for the significant progress that the country has made in addressing the resurgence of wild poliovirus transmission in 2008 and early 2009. As a result of this, transmission of wild poliovirus in Nigeria is at its lowest level ever. There is a 50% reduction in all wild poliovirus transmission and 90% reduction in Wild Poliovirus Type 1 (WPV1) transmission in 2009 compared to 2008. It is critical that this progress should be consolidated and sustained. It is gratifying to learn that the national authorities in Nigeria intend to use the experience in improving the quality and coverage of polio eradication activities and to strengthen routine immunization and primary health care delivery in the medium and long term.

Several polio-free countries in our Region have suffered setbacks in polio eradication. The number of countries with polio outbreaks following wild poliovirus importations increased from 13 in 2008 to 19 in 2009. We commend countries for the efforts they have made to mount effective responses to poliovirus importation.

To address this issue further, I will have consultations this week with Ministers of Health from the polio priority countries to discuss the steps that should be taken to overcome the remaining barriers to interrupting wild poliovirus transmission.

It is my hope that the African Region will stop the transmission of poliovirus, move towards certification and concentrate on other public health priorities.

Honourable Minister,
Ladies and Gentlemen,

I wish to appreciate the support that immunization services in the African Region continue to receive from international development partners. I would like to salute the dedicated efforts of the chairman and members of the African Regional Interagency Coordination Committee (ARICC) and, in this regard; single out the special support provided, during this year, by Rotary International and Bill and Melinda Gates Foundation.

I would like to seize this opportunity to assure you all that the World Health Organization will continue to work with governments, partners and other key stakeholders to further strengthen immunization services in Africa.

Let us put our efforts together to reach every child with immunization and other child survival interventions.

Their future is our hope.

I thank you for your attention.