Good morning and good afternoon to our colleagues who have joined us today.
I am very pleased to be joined today by the Honourable Minister of Health of Cameroon, Dr Manaouda Malachie, bienvenue Monsieur le Ministre, and Dr Naeem Dalal who is a Psychiatrist Register at the University Teaching Hospital in Lusaka and co-founder of the COVID-19 Zambia Wellbeing and Mental Health Alliance, to have a conversation in the lead up to World Mental Health Day on 10 October. I also have online my colleague Dr Ngoy Nsenga, who is the Incident Manager for our response to the COVID-19 pandemic.
We all have friends or family members who have been affected, at some point in their lives, by mental disorders. The COVID-19 pandemic has brought out clearly, how mental health is integral to overall well-being. Deaths of loved ones, job losses, restrictions on movement and gathering, and fears of infection, have led to depression, anxiety and fear. There are also reports of upsurges in intimate partner violence and suicides.
African countries account for 15 of the top 30 countries globally for suicide per 100,000 people. So, the need for mental health care is really significant, and although many countries have developed national mental health policies, the availability of services is often limited to specialized institutions in capital cities, so access is a real challenge. We know that mental health rates among the health problems that need most progress to be made in our Region.
Government expenditure per capita on mental health is low globally at $2.50 per person. In the African Region this drops to less than 10 cents per capita. Most mental health services are paid for directly by patients and their carers, and this can cause financial hardship, particularly for low-income households and other vulnerable groups. Countries are including mental health care in emerging national health insurance schemes and now work is underway to define the costing of essential mental health care packages and services at different levels of care.
A recent report by Human Rights Watch has also highlighted the harmful practice of shackling people with psychosocial disabilities, and the stigma many people with mental health issues do face. WHO’s quality rights initiative, which Ghana and Kenya are implementing in our Region, focuses on addressing these issues by improving the quality of community-based care and task sharing with nurses, psychiatric nurses and technicians.
Community-led initiatives are also very important, such as the Friendship Bench, which started in Zimbabwe and has been replicated internationally. This programme provides training to older women to talk to and support people in need with problem solving therapy on park benches, so public spaces where people can come and have a conversation with an older, supportive, trained community member.
At WHO we are working with governments to review mental health legislation and related policies, and to build capacities among primary health care workers as well as providing psychosocial skills training for first responders on the COVID-19.
In a global survey led by WHO, 27 of the 28 African countries that responded, indicated mental health and psychosocial support was included in the national COVID-19 response plan, but only 17 had funding, either from the government and partners, for the planned activities. This reaffirms the importance of increasing investments in mental health and building the realization of its importance, and its place in priorities in decision-making in health.
There are key steps we can all take to improve our mental health: getting plenty of sleep, eating healthy food, avoiding alcohol, exercising, and being in close touch with friends and family, and developing strategies to manage stress and anxiety. Together we need to find ways to leverage the community spirit that’s been so richly generated by COVID-19 even in the context of separation.
Finally, as students prepare to go back to school and borders are opening-up, we all need to remain vigilant, and play our part, in preventing the spread of COVID-19 by keeping a distance, wearing masks, and frequently washing our hands. In the Region so far, we have had over 1.2 million cases and 26,000 people have lost their lives, although we are seeing a levelling of cases.
In closing, I would like to address the recent horrific reports of sexual exploitation and abuse by people who said that they were working for WHO and other organizations during the Ebola response in Beni City in the Democratic Republic of the Congo. The Director-General of WHO and I are working to start an investigation of these allegations and are speaking in fact to some potential leaders of the panel that we are going to put in place. We are determined that those who are found wanting, those who are found to have perpetrated these abuses, will be held accountable. We are also strengthening our platforms to protect whistle-blowers and communities, in line with enforcing WHO’s policy of zero tolerance of sexual exploitation and abuse in our work places and in our operations.
I look forward very much to our discussion today on mental health and its link to the COVID-19 pandemic and again thank you so much for having joined us today.