Speech by Dr. Luis Gomes Sambo, WHO Regional Director for Africa at the Opening of the Fifty-Eighth Session of the WHO Regional Committee for Africa.Yaounde, Republic of Cameroon, 1–5 September 2008

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Your Excellency Mr Prime Minister, Head of Government, personally representing the Head of State of Cameroon,

Your Excellency the Chairperson of the 57th Session of the Regional Committee,

Distinguished Members of the Government of Cameroon,

Honourable Ministers of Health of Member States of the African Region,

The Commissioner for Social Affairs of the African Union Commission,

The Director-General of WHO,

The United Nations Secretary-General’s Special Envoy for Malaria,

Your Excellencies Ambassadors and Members of the Diplomatic Corps,

Representatives of International Organizations,

Dear Professor Monekosso, Emeritus WHO Regional Director for Africa,

Distinguished Guests,

Ladies and Gentlemen,

It is an honour and a pleasant duty for me to take the floor at the 58th Session of the Regional Committee being hosted for the second time ever by Yaounde, city of seven hills, city abounding with valleys and blossoming flowers, city strewn with many palm trees, a city among the most picturesque in Africa.

I would like to express my profound gratitude to His Excellency Mr Paul Biya, President of the Republic of Cameroon, to the Prime Minister and His Government and to the various authorities for the kind hospitality and all the attention that we have enjoyed since our arrival here in Cameroon.

The past four years have been replete with achievements. The achievements bear testimony to our shared commitment and determination, Member States and partners alike, to strengthen health systems in order to ensure the best possible health status for the peoples of Africa.

WHO’s contribution is based on the five strategic directions guiding WHO action in the African Region during the past four years. The strategic directions are: strengthening support to countries, strengthening and expanding partnerships for health, strengthening health systems and policies, promoting the intensification of essential health interventions and strengthening action on the main health determinants.

As part of strengthening WHO’s presence in countries, a major reprofiling of the staff of WHO country offices was embarked upon with a view to matching the expertise of our staff with the specific health needs of countries.

A special attention was given to the specificities of island States, highly populated countries, countries in crisis and countries in post-crisis situation.

Throughout the region, we continued to develop and implement Country Cooperation Strategies that are more suited to the contexts of countries. Taking into account the MDGs and the ongoing reforms within the United Nations, it became necessary to start updating the Country Cooperation Strategies, and that exercise is in progress.

From the institutional standpoint, I would like to commend the excellent working relations between the WHO Headquarters and the Regional Office. Under the leadership of the Director-General, Dr Margaret Chan, Regional Directors now have a forum for discussion and joint decision making. Furthermore, the Director General’s initiative to organize a special meeting with Directors from the African Region and the East Mediterranean to exclusively discuss problems specific to the African continent has given a new impetus to collaboration between staff of the Regional Office for Africa and staff of Headquarters.

The Regional Office has been reorganized in order to focus its attention on the normative functions of developing policies and strategies and mobilizing resources. Multidisciplinary intercountry teams have been set up and established since the beginning of the year 2007 respectively in Ouagadougou, Harare and Libreville to enhance the quality of technical cooperation with countries. For their part, WHO country offices have been receiving additional support in terms of resources.

There has been appropriate delegation of authority to managers at various levels for enhanced performance of the Regional Office, intercountry teams and country offices.

In the area of management, an efficient system of communication has been established. That has made it possible to link up all levels of the Organization, so we can work better together in real time. In the next coming weeks, a new system of management – the GSM – will go live in the African Region. That will help optimize the execution of transactions and enable enhanced oversight.

Your Excellencies,

Ladies and Gentlemen,

As regards partnership, it is notable that our cooperation with the African Union and regional economic communities has reached unprecedented levels.  We have also strengthened our collaboration with agencies of the United Nations including UNICEF, UNFPA, UNAIDS, UNDP and UNEP and with international financing institutions such as World Bank and African Development Bank.  We have also improved coordination of our respective activities in support to countries.  In addition, we have strengthened our ties of cooperation with bilateral partners including the United States of America, the United Kingdom of Great Britain and France.

This drive is part of the United Nations reform and is consistent with the Paris Declaration on development aid harmonization and effectiveness.

In collaboration with these same partners, the Harmonization for Health in Africa Initiative was launched to assist countries to coordinate the mobilization of foreseeable and sustainable resources to accelerate the achievement of health-related MDGs.

Your Excellencies,

Ladies and Gentlemen,

We continued to contribute to strengthening national health systems based on the primary health care approach and focusing on the local health system which is equivalent to the health district. That was reaffirmed in the Ouagadougou declaration on primary health care and health systems adopted in April 2008.

The crisis of human resources for health remains a concern and the training and retention of qualified personnel require urgent attention. A regional observatory for health personnel has been established at the Regional Office to better identify the progress made by countries and to produce evidence for decision making.

Concerning research, there is still a major gap between knowledge and practices. The Algiers declaration on research for health in Africa adopted in June 2008 will certainly be a milestone in this area.

Significant but varying progress is being made in scaling up priority health interventions for controlling vaccine-preventable diseases, malaria, HIV/AIDS and for integrated management of maternal and child health.

Maternal mortality remains at unacceptable levels and that requires our close attention. There is little progress in this domain and much more investments are needed in this high-priority, yet under-funded, area.

As regards immunization, a significant fact in the African Region remains the reduction of measles mortality by 91% in 2006 compared to the level in 2000. Member states should commit themselves further to keeping up this achievement especially through increased coverage of routine immunization.

Notwithstanding the operational difficulties, substantial progress was made in poliomyelitis eradication which is still technically feasible. However, the existence of endemic foci and the persistence of wild poliovirus circulation in several countries of the Region are a cause for concern.

Concerning malaria, there has been some improvement in access to artemisinin-based combination therapy, insecticide-treated nets, indoor residual spraying and interventions targeted at mother and child who remain a vulnerable group. New financing opportunities are opening up for more effective control of malaria. In this regard, we hail the new Initiative of the United Nations Secretary-General whose Special Envoy for Malaria, Mr Ray Chambers, is in our midst, today, as guest of honour.

In the context of prevention of HIV infection, the year 2007 was declared Year of Acceleration of HIV/AIDS prevention under the auspices of the African Union. Given the current trend of the epidemic, prevention remains the key strategy. As regards access to antiretrovirals, improvement and acceleration has been recorded in the majority of countries.

About a half of countries of the Region reported multidrug resistant tuberculosis in 2007. Tuberculosis-HIV co-infection which is as high as 75% in some countries is a major concern.

WHO regularly supported countries to strengthen their epidemic surveillance and response capacity in accordance with guidelines. Appropriate response was provided for epidemics of Marburg fever, Ebola, cerebrospinal meningitis and cholera which became rife in the Region.

In view of the threats of H5N1 virus avian influenza, the Regional Office prepared a strategic plan and strengthened the intervention capacity of countries in close collaboration with its partners. This preparation helped respond to outbreak of avian influenza epidemics in some countries.

Even so, I should stress that the African Region in general is inadequately prepared to cope with a human pandemic. That is why I am urging Member States to strengthen their level of preparedness.

Your Excellencies,

Ladies and Gentlemen,

Chronic diseases such as diabetes, cancer, hypertension and other cardiovascular diseases are gaining increasing importance as public health problems. Many of them are linked to risk factors such as tobacco use, harmful use of alcohol and lack of exercise, among others.

A Regional Strategy for control of noncommunicable diseases was adopted and other strategies have been submitted to this session for adoption. Surveys on risk factors were carried out in half of the countries of the Region. Now is the time to move into action.

On environment-related risks, I am pleased to commend the success of the First Interministerial Conference of Ministers of Health and Minister of Environment of African countries which ended in Libreville last week. The commitment made by Member States and the guidance contained in the Libreville Declaration adopted by the Conference focus on advocacy, the strengthening of political commitment to sustainable development, the need for investments to improve drinking water supply and sanitation, the establishment of mechanisms for close collaboration between the health sector and the environment sector, and the development of integrated ecosystems policies that take greater account of human health. The need for a more active participation of communities and local councils was highlighted.

Your Excellency Mr Prime Minister, Head of Government,

Your Excellencies,

Ladies and gentlemen,

As you would recall, the history of public health teaches us that substantial improvements in the supply of safe drinking water, public hygiene, access to clean housing, better education and safe and balanced diet and nutrition among others would lead to a significant reduction of communicable diseases and a better quality of life.

We are midway to the 2015 target year and notwithstanding the progress made towards achieving the Millennium Development Goals, we would need to strengthen coordination and partnerships and the mobilization of additional resources for scaling up proven interventions. The active participation of communities and local councils in this effort should be given special attention.

The fact that the performance of African economies has improved and the incidence and magnitude of conflicts have reduced is hope-inspiring. Now more than ever, the conditions for health development seem to be favourable as I personally witnessed during my visits to the majority of countries of the African Region.

In a nutshell, there is reason to be hopeful. I thank you for your kind attention.