• Your Excellency, the Prime Minister of the Republic of Rwanda
• The Honorable Minister of Health of Rwanda
• Honourable Health Ministers from the WHO Africa Region
• Members of the diplomatic corps
• Esteemed partners
• Distinguished guests
• Ladies and gentlemen
• A very warm welcome to this, our first ever Africa Health Forum, focused on “Putting People First: and countries on The Road to Universal Health Coverage, in Africa.
• I am very grateful to His Excellency, President Paul Kagame, and the people of Rwanda for having welcomed our holding this meeting in this beautiful city. The hospitality of the Rwandan people has not stopped since our arrival, proving to us that Kigali was an excellent choice.
• We have other reasons for asking to come here. Excellency Prime Minister, I want to recognize your country’s remarkable leadership – its creativity, tenacity and resolve – which have delivered significant progress in advancing health and development for the benefit of all your people.
• Your achievements in such a short space of time are truly remarkable. President Kagame’s peers, the other leaders of African countries, have recognized this and asked him to lead the reform of the African Union, the continent’s most important political organisation.
• Ladies and Gentlemen, colleagues and friends
• Partnership is the cornerstone of WHO’s work. I committed, on taking office as Regional Director for Africa, to broaden and intensify our strategic partnerships, as part of the Transformation Agenda of WHO in the African Region. This inaugural meeting is an important step in our progress on forging new partnerships, aligning priorities and galvanizing commitment, from national political leaders to civil society, to advancing the health agenda in Africa, and attaining the SDGs.
• It is through our valued, established partners and engaging with new ones, that we will do this.
• Our youth are critical new partners. Africa has an advantage – as the world is getting older, our population is getting younger.
• There is so much potential to harness in young people, their vitality and energy, to create health systems that deliver for all. We want them to not just be beneficiaries of services, but to be with us at the decision-making table.
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• There is a Chinese saying, “May you live in interesting times”. These are, indeed, interesting times. This Forum takes place against the backdrop of a shifting global geo-political landscape, which will have a major impact on international funding for development.
• It takes place as we welcome the appointment of the first African WHO Director-General, Dr Tedros Adhanom Ghebreyesus, who intends to champion increased investment and public-private partnerships.
• At the same time, the reform of the African Union, led by President Kagame, places great emphasis on countries investing more in their own development.
• And the private sector has recognized health as a sector with good returns on investment, and is coming forward to contribute and work with governments towards Universal Health Coverage.
• Burgeoning urbanization in Africa, exponential increases in access to and use of information technology, driven by a youthful population that refuses to be left behind despite low incomes, make for exciting opportunities.
• At the same time, economic inequalities around the world have reached unprecedented levels. According to an Oxfam report, 70% of people in the world live in countries where the gap between rich and poor is greater than it was 3 decades ago. These economic disparities intensify other inequalities such as those related to gender, the rural-urban divide, and access to affordable health care.
• So we have to face up to the reality that equity doesn’t trickle down as wealth in countries grows, due to some force of gravity. It requires targeted policy choices and determined, sustained action.
• We hope through this First Africa Health Forum to drive broader partnerships, placing particular emphasis on working with the private sector and African philanthropists, seize the opportunities, and tackle the challenges, together.
• The transition from the MDGs to the Sustainable Development Goals offer us a great framework for our actions; we’re here to agree on how to collectively get concrete results in improving the health of African people.
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• Over the years, we have seen great progress in Africa’s balance sheet on health: The MDGs helped to decrease under-five and adult mortality, and increase life expectancy.
• We are on the verge of eradicating polio, and for the first time, we have a malaria vaccine offering partial protection of children, who are especially vulnerable to succumbing to this disease.
• Without our partners, including civil society and the private sector, we would not have seen the great strides in reducing Neglected Tropical Diseases, HIV, polio and malaria.
• But improvements have not been at the speed hoped for, and vary across and within countries. And, inequities remain.
• As does the unfinished agenda of Communicable Diseases: Although HIV infections and deaths dropped between 2004 and 2015, Sub-Saharan Africa is still the most affected region in the world, particularly among young women. Treatment coverage in West and Central Africa lags behind the rest of the continent.
• Africa has 16 of the top 30 countries in the world with the highest TB burden, while drug resistant TB is a growing problem, and is very expensive to treat.
• This highlights the fast-emerging problem of anti-microbial resistance, which threatens to set us back decades in being able to manage common infections. Our Region is particularly vulnerable and I hope we can agree here how to work together to tackle it.
• Noncommunicable Diseases are on the rise: Africa has world’s highest hypertension rate, the highest road traffic fatality rate, and the highest pedestrian death rate.
• Much of this morbidity and mortality can be prevented, through legislation, policies, and behavior and lifestyle changes.
Also, strong community health systems and engagement can be a key resource for health security and accelerating progress to UHC, including on NCDs.
• This Forum will address ways to improve health security. Sub-Saharan Africa has more disease outbreaks and public health emergencies than any other region, facing over 100 significant public health events annually.
• I am quite confident that countries in the Region are not where they were before the tragic Ebola outbreak in West Africa. Capacities have improved; emergency operation centres now coordinate action with a clear definition of roles in quite a few countries.
• WHO’s reform, through our re-organised Outbreaks and Emergencies Programme, is also paying dividends. The largest ever yellow fever outbreak was contained when, together with our partners, we supported the governments of Angola and the Democratic Republic of the Congo to vaccinate over 30 million people last year.
• In May, the DRC confirmed a new Ebola outbreak in a remote area, near the border with the Central African Republic. The government’s quick declaration of the outbreak – in line with the International Health Regulations and the Regional Strategy adopted by Ministers of Health last year – enabled WHO to share information, and coordinate closely with partners on actions to stop the outbreak.
• I expect, within the next few days, with the DRC Health Minister, to declare the outbreak over.
Your Excellency, dear partners and colleagues
• We have to make the best use of immunization, one of the most effective public health tools, for the health of children of the African region.
• While national immunization coverage rates are high in many countries, one in five children still does not have access to all the vaccines they need. And inequities persist, with major gaps in coverage between children from the richest and poorest households, and between children whose mothers have different levels of education.
• African Heads of State acknowledged that greater efforts are needed, by endorsing the Addis Declaration on Immunization (ADI) during the African Union Summit in January this year.
• We will be launching a roadmap at this meeting, developed with country governments, WHO, the African Union Commission and immunization partners, to guide the implementation of the ADI.
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• Ladies and gentlemen, stronger health systems are essential to ensuring public health security, as well as assuring access to services for health promotion and prevention, and treatment.
• UHC is about the effective delivery of essential health and related services, with improved coverage and equitable access, and minimal financial barriers.
• Low, middle and upper income countries continue to grapple with equitable access to healthcare; we are seeing this right now even in the wealthiest nations in the world.
• A big concern is the financial barriers that hinder access in the Region, with many individuals and households falling into poverty from seeking health care.
• The first Global Monitoring Report “Tracking Universal Health Coverage”, indicates that in 37 countries globally – eight of which are in Africa – about 15% of poor households are further impoverished by out-of-pocket payments for health care. This is not acceptable.
• For stronger health systems, to ensure health security and bring better access to health services, countries need to strive to reach the minimum $80 per capita expenditure recommended by WHO.
• WHO is actively supporting countries to improve coverage and monitoring of financial protection, especially for the most vulnerable, through strengthening financing strategies, as well as legal and policy instruments for health insurance, that harness and manage domestic revenues for health.
• And, governments also have the opportunity to partner with and leverage the resources of the private sector.
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• This Forum aims to ensure that health interventions are not only focused on the health sector, but that we encourage new partnerships, through effective engagement in stronger intersectoral action towards a common goal: better development and better health for Africa.
• We in the health development community will need to learn new, innovative ways of working, to reap the benefits of sectoral policies that promote health, while reciprocally contributing to other sectors’ outcomes.
• As the head of WHO in the African Region, I am determined to create opportunities for effective engagement. For instance, in December, WHO in the African Region held our first forum on Strengthening Health Systems for UHC and the SDGs.
• This generated a comprehensive Action Framework, providing Member States with a menu of options to tailor their efforts towards attaining UHC and SDG3.
• WHO’s UHC flagship programme – developed to accelerate our efforts in the Region - aims to provide effective support to countries to realize tangible and sustainable improvements of national health systems.
• This includes leveraging information technology for health and UHC as more and more countries adopt eHealth and digital applications as part of public health interventions, to progressively transform health systems and healthcare .
• And so, I am so pleased that eHealth will be discussed in detail at the first Side Event this afternoon with our partner, the International Telecommunications Union.
• I convened this inaugural WHO Africa Health Forum as a further opportunity to gather some of Africa’s best – our key thought leaders, policy makers and bright young people - to spark new thinking, new partnerships and new opportunities for better health action, and outcomes.
• We in WHO will intensify our advocacy, across all our stakeholders, to ensure that the SDGs – and UHC – remain at the top of the political and development agenda, and that adequate domestic and external resources are mobilized.
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• Ladies and gentlemen, I’d like to conclude by leaving you with a story about 2 young girls and equity, which I am passionate about.
• The phrase ‘leaving no one behind’ is central to the SDGs, and must be our constant inspiration.
• The first girl lives in a suburb of a big city – possibly Nairobi, Dakar or Johannesburg. Her family has health insurance, and she can access decent health care. She attends a good school and has the prospects of a future which includes a good job or perhaps starting her own business. She has a Smart Phone and can access information from all over the world – for school and fun.
• The second girl lives in a high density area, or slum. When she is lucky, she has one good meal a day, and stays away from school when she menstruates because she doesn’t have sanitary towels. If she needs to go to a clinic or hospital, the family has to find the money to pay, otherwise she simply has to hope to get better. She has a good chance of falling pregnant before completing her secondary education, or being married off early.
• These differences are the stark reality faced in countries every day.
• However we can, within relevant health policies and targeted actions, work to ensure these girls both have access to good preventive and curative health services, despite their very unequal life circumstances.
• Through UHC, we can contribute to reducing poverty in the countries, so that future generations can have similar chances in life.
• Ladies and gentlemen, this is our common goal for Africa, and my call to action.
• We will get there - with Member States leading and taking stewardship actions at the highest levels, providing the domestic funding to shift health systems towards UHC, and working with the private sector and civil society.
• …With partners and donors maintaining their support and finding innovative ways, despite competing priorities.
• …And especially, with our youth beside us, taking part in policy setting and decision-making.
• I thank you all for having joined us at this inaugural Africa Health Forum. I look forward to lively debates and exciting new partnerships.
• Each and everyone of us here can play a part in ensuring healthy lives; whatever we do best, let’s bring our skills together to make people healthier in the African Region.
• And achieve a prosperous, sustainable future for all.