Yaoundé, Cameroon, 14th December 2012
- Your Excellency, the Minister of Public Health
- Your Excellency, the Minister of Family and Women’s Affairs,
- The Representative of the Minister of Higher Education
- The Representative of the Rector of the University of Yaounde 1
- Excellencies, Heads of Diplomatic Missions and Representatives of International Organizations
- Dear Professor Monekosso, Regional Director Emeritus of the WHO African Region
- Professors, Associate Professors, Lecturers, Assistant Lecturers
- The WHO Resident Representative to Cameroon,
- Dear Colleagues,
- Dear Students,
- Ladies and Gentlemen,
My first words turn to greet everybody with respect and happiness and to say how much we have been overwhelmed since our arrival in Cameroon by the warmth of the welcome and the kindness shown to us. You surely know how to welcome your guests!
I thank especially the President of Cameroun, His Excellency Mr Paul Biya for his personal sponsorship of the celebration of the 50 years of cooperation between the government of Cameroon and the World Health Organization. I equally thank the Minister of Public Health for inviting me to take part in these celebrations as well as the Minister of Higher Education and the Rector of the Yaoundé 1 University for providing the facilities for this conference. Your presence here today, dear audience, is most gratefully appreciated.
I am honoured to be invited to give a keynote speech at this 50th Anniversary of the collaboration between the World Health Organization (WHO) and the Government of Cameroon and I am intellectually inspired to address, for the second time, the University of Yaoundé 1, one of the leading universities in Africa whose main missions are training, research, and supporting the human development.
WHO is proud to have been associated with the birth of the University Centre of Health Sciences (CUSS) of the University of Yaoundé in 1969 and its subsequent exponential growth over the ensuing years. You may recall that the University Centre of Health Sciences subsequently became the Faculty of Medicine and Biomedical Sciences.
In my talk, I will pay tribute to some Cameroonians who have made significant contributions to WHO’s work both regionally and globally; I will then address important areas in which WHO has contributed to Cameroon’s health programmes, spending some time on immunisation. Following that I will address some important global health issues of significance to our region and I will end by highlighting some of the challenges that we still face as we move forwards in the collaboration between the Republic of Cameroon and WHO.
Excellencies
Ladies and Gentlemen,
Some eminent sons and daughters of this great nation of Cameroon have made outstanding contributions to the work of WHO in the African Region. I will mention just a few of them here while being fully cognizant that many others have also made and continue to make valuable contributions.
I will begin with Professor Gottlieb Lobe Monekosso, the renowned son of Cameroon, who has made internationally acclaimed contributions to the promotion of health in Africa. This great thinker, scholar and public health leader has made invaluable contributions to health systems management, training and research. He is indeed a living testimony of the spirit and stated mission of the University of Yaoundé.
Prof GL Monekosso was the Regional Director of WHO in Africa from 1985 to 1995. I had the privilege of meeting him for the first time in 1984 and of eventually becoming one of his close collaborators since 1989. I pay tribute to him for introducing me to the importance of operational research for creative problem solving in health systems management.
After his first election, he said in one of the speeches, and I quote:
"…Africa needs a Marshall Plan that will lead to self-reliance and self-sufficiency[in human resources for health]. We propose to follow the primary health care path until it becomes an increasing wider road --even a boulevard. We believe that WHO should be a close partner of ministries of health and assist in developing policies, strategies and action plans, and implementing these; with the support of other African countries, and with the technical assistance of bilateral agencies and non-governmental organizations."
It therefore did not come as a surprise to the public health scholars and practitioners, when The Royal Society for Public Health (RSPH) declared Professor Monekosso the 2012 winner of the Queen Elizabeth II Gold Medal. As you earlier heard, this prestigious award was in recognition of his contributions to public health. I take this opportunity to publicly congratulate Professor Monekosso for this award.
The Republic of Cameroon has been of great benefit to WHO through its other sons and daughters who have and continue to make significant contributions to WHO’s work in the region. They include Professor Peter Ndumbe, Professor Emmanuel Eben Moussi, Dr Matthieu Kamwa, Dr Solange Kouo Epa, Dr Lucien Manga, and Dr Jean Baptiste Tapko and many others.
Excellencies,
Ladies and Gentlemen
I am pleased to inform you that during the last 50 years WHO provided support to Cameroon in strategic areas such as those mentioned below:
- Health Systems: Creation of the University Centre for Health Sciences, CUSS; institution of the Primary Health Care approach; organization of health services into district (operational), regional (technical) and central (policy) support; adoption of the essential medicines list;
- Disease Prevention and Control: Institution of the Expanded Programme on Immunization (EPI); Control of onchocerciasis; setting up of programmes for HIV/AIDS, TB, malaria, neglected tropical diseases, and addressing the risk factors associated with non-communicable diseases;
- Technical and normative support have also been provided in the areas of Child, Adolescent and Maternal Health, and Ageing.
Details of these and other areas are available in the 50th anniversary documents and the WHO African Region website.
Excellencies
Ladies and gentlemen,
I will now spend some time to discuss the area of vaccination in which WHO has made significant contributions to Cameroon and other African countries.
Vaccination is one of the most cost-effective public health interventions and it prevents 2-3 million deaths every year. Its benefits are the reduction of the incidence of disease and prevention of deaths associated with target diseases.
Significant events related to vaccination globally include the following:
- The start of an immunization programme against smallpox in 1966 based on a thermostable vaccine;
- The expansion of this programme in 1974 ( the Expanded Programme on Immunization) to cover six diseases: diphtheria, whooping cough, tetanus, poliomyelitis, tuberculosis and measles;
- The adoption in 1977 of the goal of Universal Childhood Immunization (UCI) by 1990: the aim being the achievement of 80% global coverage for the six basic EPI vaccines. At the end of 1990 the region reported an increase of DPT3 coverage from 5% in 1980 to 57%;
- The global poliomyelitis eradication initiative (GPEI) launched in 1988 which resulted in 99% reduction of polio cases globally from an estimated 350 000 cases in more than 125 endemic countries, to 650 reported cases in 2011. Polio is still endemic in Afghanistan and Nigeria;
- The creation of the Global Alliance for Vaccines and Immunization in the year 2000, mobilizing additional funds to increase the number of antigens provided in the EPI to 14 in some countries;
- implementation of measles control activities through the Measles Partnership efforts which started in 2001 with the goal of reducing measles deaths by 90% by 2009 as compared to the year 2000 estimates. In the African Region, there was a 91% mortality reduction by the end of 2006 as compared to 2000 estimates;
- In 2002, WHO and its partners developed the Reaching Every District (RED) approach to increase and sustain high levels of routine immunisation. By the end of 2011, 71% of children in the Africa region have received the 3rd dose of DTP vaccine (DTP3);
- The conjugate meningococcal meningitis A vaccine (MenAfriVacTM), developed for countries in the African meningitis belt through a partnership between WHO and the Program for Appropriate Technology in Health (PATH). The new vaccine was prequalified by WHO in early 2010 and has been successfully introduced in hyper endemic countries in the meningitis belt. About 100 million people have so far been vaccinated with the new vaccine. This has resulted in a considerable reduction of meningitis epidemics with an absence of meningitis A among the vaccinated persons;
- The observance of the 1st and 2nd editions of the African Vaccination Week in April 2011 and 2012 resulted in the vaccination of more than 95 million children against polio and other diseases in 32 out of 46 Member States in the African Region.
Excellencies,
Ladies and Gentlemen
The fact that many children were not reached by these efforts highlights two issues: the need for increased funding to cover additional outreach activities and the weak capacity of health systems to deliver vaccinations.
In May 2012, the WHA adopted the Global Vaccine Action Plan (GVAP) as part of the Decade of Vaccines (DoV). This plan includes a strong focus on strengthening systems and creating synergies with other public health programmes at the operational level.
Health systems issues were addressed at the 2008 Ouagadougou Conference on Primary Health Care (PHC) in Africa at which all Member States were called upon to "use priority health interventions, including immunisation, as entry points to strengthen national health systems."
The Infant Mortality Rate (IMR) in Sub-Saharan Africa has decreased from 105 to 76 deaths per 1000 live births between 1990 and 2010 and this is expected to reduce further with the introduction and increase of coverage of newer vaccines against pneumonia and rotavirus diarrhoea.
Excellencies
Ladies and Gentlemen
The current immunization’s evolving environment requires renewed emphasis in strengthening immunization systems. More antigens are expected to be delivered which will target a broader range of populations.
It is therefore important that:
- the political will in our countries be translated in the mobilization of national resources including innovative ways of financing health activities;
- international solidarity be strengthened to ensure that priority programmes are funded in the countries of the region;
- health information systems and data management activities be modernized and used for the generation of evidence to permit an accurate monitoring and evaluation of our investments in health;
- It is also important that:
- We increase people’s demand for vaccination and other health promotion and prevention activities, through social awareness, and community mobilization.
WHO is committed to intensify its support to countries in vaccine use, control, research and development as appropriate.
Excellencies,
Ladies and gentlemen:
Over the last 30 years life expectancy has increased globally. According to the most recent WHO estimates it has reached an average of 68 years ranging from 54 years in the African Region to 76 years in the Americas. Communicable diseases represent 63% of total deaths in the African Region most of it related to HIV/AIDS, diarrhoeal diseases, malaria, tuberculosis and childhood diseases.
According to the WHO Commission for Macroeconomics and Health most of those deaths can be prevented because effective health interventions already exist to either prevent or cure the priority diseases. These interventions do not reach a significant proportion of those in need.
Following a situation analysis of health systems and the burden of disease in the African Region, the Regional Committee for Africa adopted policies and several strategies to guide the work of countries in the region.
These are:
- the provision of normative and policy guidance and the WHO role in strengthening international partnerships and harmonization;
- the strengthening of health systems based on the primary health care approach;
- prioritizing the health of mothers and children;
- accelerated actions on HIV/AIDS, malaria and tuberculosis;
- intensifying the prevention and control of communicable and non-communicable diseases; and
- accelerating the response to the determinants of health.
The Minister of Health,
The Minister of Higher Education,
Excellencies
Ladies and Gentlemen
I would like to end my talk by re-iterating my gratitude to the Cameroon government and people for their cooperation and friendship with the World Health Organization during the last 50 years. This collaboration has resulted in tangible results for both parties.
We are pleased to note and thank the Cameroon government for providing a new building for the WHO country office. This will improve the working conditions of staff as well the scope and quality of our cooperation. The health of our populations remains our main concern and we advocate for increased partnership between the governments, partners, and communities as well as public and private partnerships.
The latest Cameroon Demographic and Health Survey conducted in 2011 and published in December 2012 indicates considerable progress in many areas including the reduction of the infant mortality rate. However some challenges still exist. They include:
- Increased maternal mortality
- The slow regression of the HIV/AIDS pandemic and
- The need to intensify the fight against non-communicable diseases.
Quoting HE Mama Fouda, Minister of Health of Cameroon, and I paraphrase:
"If you have a tooth problem and you hide it, it will not be too long before you are unable to eat and maybe die from starvation"
The fact that Cameroon has identified and published these challenges means that the government is ready to find solutions to them. Although there are known strategies for addressing these issues, their implementation is contextual and we should adapt them to the local environment.
The WHO Regional Office, with its partners are ready to work with you to address these issues as we move into the next 50 years of our collaboration.>
The Minister of Public Health,
The Minister of Higher Education,
Excellencies,
Ladies and Gentlemen,
Permit me to end by requesting that you convey my most grateful wishes to the Head of State, His Excellency Mr Paul Biya for his kind patronage of these fiftieth anniversary celebrations and to the great people of Cameroon for their generosity, warmth and kindness.
Long live the cooperation between the Republic of Cameroon and the World Health Organization.
I thank you all for your kind attention.