Governing the Future with the Sustainable Development Goals
How is WHO and WHO/Africa in particular approaching the Intersectoral approach to the SDGs? Will WHO work differently?
Honourable ministers, distinguished guests, ladies and gentlemen
Allow me to extend my appreciation to the organizers of this year’s World Health Summit, and commend you for this session that will encourage reflection on achieving the ambitious goals of the 2030 agenda for sustainable development, while leaving no one behind.
WHO in the African Region is pursuing a deliberate strategy on multisectoral engagement to deliver on the strategic priorities in the Region. This includes tackling the social and economic determinants of health; improving health security; and promoting universal health coverage through health systems strengthening.
We are making concerted effort to build capacity for countries in tackling social and economic determinants of health (SDH) to address the causes of disease, disabilities and premature deaths that exist outside the health sector. To date, five Small Island Developing Countries have built country capacity for integrating Health in All Policies (HiAP) through conducting intersectoral workshop for policy-makers representing ministries of health, development planning, social affairs, local government and academic institutions. Seychelles has since undertaken health equity analysis to address gender disparities across programmes and sectors. Carbo Verde also has developed healthy cities operational plan to tackle urban health and climate change using intersectoral action across all sectors of government including private sector and civil society.
Currently, illicit drugs and substance abuse is one of the pressing public health challenges in five Small Island Developing States (Cabo Verde, Comoros, Mauritius, Seychelles, Sao Tome & Principe). With technical support from WHO on the prevention and control of illicit drugs, these countries have developed policies, legislation and regulations, treatment programmes as well as training and involvement of the private sector, civil society groups and NGOs through intersectoral action.
Countries like Botswana, Namibia, Rwanda, Senegal and Zambia have now developed coordination mechanisms to monitor progress and document intersectoral health actions across programmes and sectors. The coordination is done at the top level of government structures, such as the President’s Office, to ensure integration of health into all government plans and policies, and accountability in addressing social determinants of health. For instance, Namibia’s National Strategy for Health in All Policies is coordinated by the Prime Minister’s Office, with strong links to the National Planning Commission to ensure policy coherence for health and wellbeing.
We continue to build Members States’ capacity for policy makers and practitioners to embrace the concept of climate resilient water safety planning to manage drinking-water supplies through multi-stakeholder structured incremental actions.
At least 20 countries have been supported to date with a range of activities e.g. training on how to prepare and implement climate-resilient water safety plans (WSP) and technical support to implement WSP pilot projects; awareness raising on WSP for different stakeholders; and establishment of partnership with UNICEF and the International Water Association at global, regional and national levels to support planning and implementation of WSPs. Multi-sectoral interventions are supported to develop strategic plans for WASH, WASH-NTDs, emergency response to outbreaks and humanitarian crisis.
WHO AFRO has established a Climate Change and Health Network for Africa (Clim-HEALTH Africa), a network of Pan-African technical institutes and international partners across relevant disciplines including Health, Meteorology, Environment, Water and Agriculture.
The Network serves shares expertise for integrating climate and health related challenges into policy, socio-economics, planning and programming, in order to strengthen the public health resilience of Member States and communities. Clim-HEALTH Africa also provides scientific leadership, capacity building, research, and policy support for the health sector across Africa.
Member States are supported to assess Vulnerability and Adaptation for protecting health from climate change. Based on the priority of specific countries, assessments involve key sectors such as health, environment, water resources, and agriculture including the vulnerability of climate-sensitive diseases such as vector-borne, nutrition and food-borne, water-borne, air-borne and respiratory diseases programs to climate anomalies.
By February this year, ten Member States[1] had completed comprehensive risk assessments to identify and plan for the health impacts of climate change, while 11 Member States[2] developed national health and climate country profiles as a proactive measure to mitigate these impacts, in accordance with the Paris Agreement on Climate Change in collaboration with UN Framework Convention on Climate Change, UNEP & UNDP.
Vector borne diseases account for about 17% of the global burden of communicable diseases. WHO in collaboration with UNEP and DFID is strengthening capacity for evidence-based, more integrated, multisectoral and environmentally sound approach for the control of these diseases such as Malaria, Zika Chikungunya, Congo-Crimean haemorrhagic fever, dengue, dracunculiasis, human African trypanosomiasis etc.,
Based on information gathered from 40 countries in 2014, the risk of chemical poisoning is high in the region, from pesticides used in agriculture, mercury from artisanal gold mining to lead in paint, which is largely uncontrolled and unmonitored. National legislation and global Conventions on the management of these chemicals, are by in large, not implemented. WHO/AFRO and UNEP are implementing an African Chemical Observatory project to develop a prototype of national integrated health and environment observatories to predict, prevent and reduce chemicals risks to human health and environment. From experiences and lessons of the project, WHO will develop regional strategic framework on how to address the wide spread problem chemical poisoning using intersectoral approach within the context of the Libreville declaration.
We also plan to create a network of the relevant sectors and partners, similar to Clim-Health Africa, to support Member States in capacity building, planning and implementation of inter-sectoral actions for sound management of chemicals.
To address public health emergencies holistically, countries in Africa need to strengthen and sustain their capacities to prevent, rapidly detect and respond to any events of public health importance. We are at the centre, coordinating and supporting joint external evaluations (JEE) of IHR core capacities for countries. The JEE Alliance is a platform for facilitating multisectoral collaboration on health security capacity building and International Health Regulations (IHR 2005) implementation. To date, 25 countries out of the 47 Member States have completed these evaluations
We are also committed to ‘One Health’, another intersectoral platform aimed at enhancing collaboration between environmental, animal (wildlife and domestic) and human health. The platform recommends interventions to be undertaken by government institutions and other partners to enhance existing structures and pool additional resources to prevent and control zoonotic diseases and other events of public health importance.
WHO, UNFAO and USAID organized a ‘One Health’ meeting in November 2016 in Dakar, Senegal, attended by Ministers in 18 countries in charge of Health, Agriculture, and Wildlife. National authorities renewed their commitment to implement existing frameworks (e.g. Inter-national Health Regulations (2005), the Integrated Disease Surveillance and Response (IDSR) strategy, and the Performance of Veterinary Services (PVS) process), in line with the One Health approach. Agreement was reached on a framework for implementation of the One Health approach at all levels, with emphasis on strengthening the technical and community capacities of staff. We are now at the forefront, advocating for governments to mobilize domestic resources for health security based on their commitment to sustain the One Health approach.
The pursuit of UHC is one of the key health targets in the SDGs and has featured highly on health policy agendas. UHC is about the effective delivery of essential health and related services, with improved coverage and equitable access, and minimal financial barrier. In December last year, WHO in the African Region held its first Forum on Strengthening Health Systems with the aim of making context-specific plans and investments to assist our Member States to build sustainable health systems for Universal Health Coverage and the SDGs.
We have intensified our advocacy across governments, the private sector, philanthropic foundations and our partners 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.
WHO in the African Region, has introduced extensive changes to the way we are working for better health results through our Transformation Agenda – a bold, relevant and timely strategy which is turning the Regional Office for Africa into an organization focused on results, is transparent, accountable and equipped to deliver on our mandate of improving the health of Africa’s people.
Forging strategic partnership and multisectoral engagement is at the centre of our delivery strategy. We recently relaunched a regional mechanism called ‘Harmonization for Health in Africa’ to help coordinate partners’ support to countries and enhance synergies in the health sector.
In June this year, we held the first ever Africa Health Forum, themed ‘Putting People First: the Road to Universal Health Coverage in Africa’ in Kigali, Rwanda. This meeting convened a unique mix of stakeholders, including government ministers, health activists, the private sector and youth, who vigorously debated public health challenges and opportunities in the Region.
WHO has a unique leadership position in health, and we are adapting and transforming to be at the forefront of improving health.
As a catalyst for the SDGs, WHO shall continue to use its convening powers, as the technical agency and custodian of public health in the Region, to gather some of Africa’s best - our key thought leaders, policy makers, advocacy groups and bright young people - to discuss health issues that affect our Region.
Through intersectoral engagement, and creating and optimizing opportunities, we want to spark new thinking, ignite new partnerships and embrace opportunities for better health outcomes.
We are committed to working with countries and partners to attain the highest possible level of health the continent, leaving no one behind in our pursuit of a more prosperous, productive and healthy Africa.
The next step is to develop a comprehensive, inclusive, multisector strategy to guide our intersectoral work to improve the health and wellbeing of all people and all communities, everywhere in sub-Saharan Africa.
[1] Benin, Burkina Faso, Ethiopia, Ghana, Guinea, Madagascar, Malawi, Mali, United Republic of Tanzania and Zambia
[2] Algeria, Botswana, Ethiopia, Ghana, Kenya, Madagascar, Malawi, Nigeria, South Africa, United Republic of Tanzania and Uganda